Low Level Research Articles

Recurrent Hospitalizations for Fluid Overload in Diabetes with Kidney Failure Treated with Dialysis

Background & Aims Diabetes Mellitus is the most common cause of end-stage kidney disease (ESKD) in Singapore. ESKD patients have high disease burden and are at increased risk of recurrent hospitalizations, including fluid overload. This study aimed to characterize the risk factors associated with readmissions for fluid overload that will identify high-risk hospitalizations for interventions to reduce readmissions. Methods Retrospective cohort study of all hospitalizations for fluid overload in adults with diabetes and ESKD on dialysis in SingHealth hospitals between 2018 and 2021. Fluid overload was defined by discharge codes for fluid overload, heart failure, pulmonary edema, and generalized edema until 30th December 2022. Multivariable Cox regression analysis using the Prentice, Williams and Peterson Total Time (PWP-TT) model was performed for the outcomes of readmissions for fluid overload within 30 days and 90 days of discharge. Results Among 3234 hospitalizations for fluid overload, readmission for fluid overload within 30-day and 90-day occurred in 585 (18.1%) and 967 (29.9%) hospitalizations, respectively. Ischemic heart disease, peripheral vascular disease and lower hemoglobin level were independently associated with readmissions for fluid overload within 30 and 90 days. Additionally, heart failure, hemodialysis (compared to peritoneal dialysis) and lack of statin at discharge were associated with increased 90-day readmission risk. Conclusion Modifiable (hemoglobin level, statin use) and non-modifiable factors (ischemic heart disease, peripheral vascular disease and heart failure) influenced the risk of readmission for fluid overload. These results may guide risk stratification and inform targeted interventions to reduce avoidable, unplanned readmissions for recurrent fluid overload among individuals with diabetes and ESKD.

A longitudinal analysis of psychological, physiological, and rehabilitation outcomes in basketball players following acute sports injuries

This cross-sectional study examines psychological behavior, biological factors, and rehabilitation treatment concerning acute sports injuries involving basketball players. Psychological trauma is also prevalent whereby athletes develop anxiety, depression and or fear that slow down their healing process and inability. The present study is a naturalistic cohort design where 50 basketball players with an injury completing self-report measures such as DASS-21 (Depression, Anxiety and Stress Scale) and biological markers, cortisol level at monthly intervals for 12 months. Qualitative data in the form of interviews conducted after treatment, or quantitative data from neuropsychological examinations, are employed to determine therapeutic impacts of CBT and/or specified individual rehabilitation plans in changing psychological effects, regain biological functions, and the speed of physical rehabilitation. Current data analyzed evidence lower level of stress, cortisol, beneficial shifts in cardiovascular, respiratory patterns, and aspects of rehabilitation outcomes in the player receiving both psychological and physical-motor interventions in comparison to the group receiving only physical-motor treatment. Based on the developed arguments it can be seen that the mental health and the biological issues also matter thus boosting the believably of better rehabilitation for athletes.

Features of Providing Air Temperature and Humidity Parameters in the Engine Room Working Area at Sewage Pumping Stations

Statement of the problem. There is an important task for engineers to improve the working conditions of workers in industrial facilities. The waste water system includes a large number of structures with different temperature and humidity microclimate characteristics. The possibility has been discussed to improve these characteristics by redistributing air flows in the engine room of a city sewage pumping station with PLI panel. Results. There are the results of the temperature and humidity microclimate parameters research in the working area of the engine room at a high-voltage sewage pumping station which is located in Moscow. The author has proved the possibility of use the cooled air from the machine room lower level in a high-voltage pumping station at the machine room main working area. It has been described the calculation features of the heat transfer coefficients in the proposed model for local ventilation at the main technological working area. It has been described the results of temperature and humidity parameters instrumental study in the main working area and the lower level. Conclusion. Thelocal ventilation systems could be used for the working area, where an employee performs repair work of the main technical equipment in a sewage pumping station. The balanced mathematical thermal model includes PLI panel’s potential location.

Utilization of Artificial Intelligence in the Creation of Patient Information on Laryngology Topics.

To evaluate and compare the readability and quality of patient information generated by Chat-Generative Pre-Trained Transformer-3.5 (ChatGPT) and the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) using validated instruments including Flesch-Kincaid Grade Level (FKGL), Flesch Reading Ease, DISCERN, and Patient Education Materials Assessment Tool for Printable Materials (PEMAT-P). ENTHealth.org and ChatGPT-3.5 were queried for patient information on laryngology topics. ChatGPT-3.5 was queried twice for a given topic to evaluate for reliability. This generated three de-identified text documents for each topic: one from AAO-HNS and two from ChatGPT (ChatGPT Output 1, ChatGPT Output 2). Grade level and reading ease were compared between the three sources using a one-way analysis of variance and Tukey's post hoc test. Independent t-tests were used to compare DISCERN and PEMAT understandability and actionability scores between AAO-HNS and ChatGPT Output 1. Material generated from ChatGPT Output 1 and ChatGPT Output 2 were at least two reading grade levels higher than that of material from AAO-HNS (p < 0.001). Regarding reading ease, ChatGPT Output 1 and ChatGPT Output 2 documents had significantly lower mean scores compared to AAO-HNS (p < 0.001). Moreover, ChatGPT Output 1 material on vocal cord paralysis had a lower PEMAT-P understandability compared to that of AAO-HNS material (p > 0.05). Patient information on the ENTHealth.org website for select laryngology topics was, on average, of a lower grade level and higher reading ease compared to that produced by ChatGPT, but interestingly with largely no difference in the quality of information provided. NA Laryngoscope, 2024.

Efficacy of compound sodium acetate Ringer's solution in early fluid resuscitation for children with septic shock: a preliminary retrospective cohort study.

The effectiveness of acetated Ringer's solution in pediatric shock has received little attention. This study aimed to assess the clinical outcomes of using compound sodium acetate Ringer's solution (AR) for fluid resuscitation in children with septic shock. We retrospectively analyzed the clinical data of children with septic shock admitted to the pediatric intensive care unit of the Affiliated Hospital of Southwest Medical University from December 2019 to January 2023. Based on the resuscitation fluid administered, the participants were categorized into the compound AR and normal saline (NS) groups. We compared blood circulation conditions, internal environment parameters (arterial blood pH, lactic acid, serum sodium, chloride, calcium, magnesium, potassium, and blood glucose), and 28-day clinical outcomes between the two groups. This study included 40 children, with 13 and 27 in the compound AR and NS groups, respectively. The two groups showed no significant differences in sex, age, body weight, body mass index, primary inflammation level, or Pediatric Sequential Organ Failure Assessment on admission. Similarly, no significant difference was observed in resuscitation fluid volume administered during the first hour (compound AR group: 250.00 mL [100.00, 390.00]; NS group: 250.00 mL [100.00, 500.00]). The total amount of crystalloid and colloid fluids administered within 24h, vasoactive drug use, and blood pressure recovery post-resuscitation did not significantly differ between the groups. However, at 6h post-resuscitation, the compound AR had considerably lower lactate level than the NS group (1.12 vs. 2.20 mmol/L). There were no significant differences in arterial blood pH, serum sodium, chloride, calcium, magnesium, potassium, and blood glucose levels between the groups. After treatment, in the compound AR group, 3 patients died, 2 improved, and 8 were cured. In the NS group, 7 patients died, 8 improved, and 12 were cured. The 28-day treatment outcomes (mortality rate, improvement rate, cure rate, or side effects) showed no significant differences between the groups. Compound AR was as effective as NS as a resuscitation fluid in pediatric septic shock, demonstrating similar intravascular volume restoration and hemodynamic stability maintenance. However, it caused a faster decline in arterial lactate levels without obvious side effects.

Psychometric properties of the German version of the Traumatic Grief Inventory-Self Report Plus (TGI-SR+)

ABSTRACT Background: Prolonged Grief Disorder (PGD) has been recognized as a mental health disorder and was added to the ICD-11 and DSM-5-TR. Despite the same name, both versions of PGD differ in symptom count, content, and diagnostic algorithm. A single instrument to screen for both PGD diagnoses is critical for bereavement research and care. The study aimed to evaluate the psychometric properties of the German version of the Traumatic Grief Inventory Self-Report Plus (TGI-SR+), a self-report measure to assess PGDICD-11 and PGDDSM-5-TR symptoms. Methods: Out of a representative sample of the German general population (N = 2509), 1062 reported a significant loss and completed questions about sociodemographic and loss-related variables, the TGI-SR+, and a measure of health-related quality of life. Results: Item analyses demonstrated good item characteristics. Confirmatory factor analyses showed a good fit for two-factor models for PGDICD-11 and PGDDSM-5-TR. Omega values demonstrated good internal consistency. In support of concurrent validity, symptoms of PGDICD-11 and PGDDSM-5-TR were associated with worse health-related quality of life. In support of known-groups validity, symptoms of PGDICD-11 and PGDDSM-5-TR were significantly higher among women, people with a lower educational level, more recently bereaved, those who lost a spouse or child (vs. other person), and those who lost someone due to unnatural causes (vs. natural causes). ROC analyses showed optimal cut-off scores of ≥60 and ≥65 to screen for probable caseness for PGDICD-11 and PGDDSM-5-TR, respectively. Limitations: The analyses were based on a cross-sectional design, and data on retest-reliability and predictive validity is missing. Conclusion: Results support the reliability and validity of the German TGI-SR+ as a screening instrument for PGD in research.

Relationships between personality factors and DC/TMD Axis II scores of psychosocial impairment among patients with pain related temporomandibular disorders

This cross-sectional analytical study aimed to assess the relationship between personality factors and the DC/TMD Axis II scores of psychosocial impairment among patients with pain related temporomandibular disorders (TMD). 120 participants (60 females and 60 males) who were diagnosed with pain related TMD according to the Axis I DC/TMD protocol were recruited. The participants were requested to complete four tests including the NEO Five Factor Inventory (NEO-FFI) to assess personality factors and three Axis II DC/TMD tools; the Graded Chronic Pain Scale (GCPS) Version 2.0 to assess TMD pain intensity and pain-related disability, Patient Health Questionnaire-4 (PHQ-4) to assess psychological distress due to TMD pain, and Generalized Anxiety Disorder-7 (GAD-7) to assess patients’ stress reactivity. Results showed that 49.2% of the participants experienced high intensity of characteristic pain, 14.2% reported pain related disability more than 30 days (grade 3 disability days) and had disability scores of 70 or above (grade 3 disability scores), 16.7% demonstrated severe distress, and 18.3% reported severe anxiety due to TMD pain. Females scored higher on all these variables than males (P < .05). Multiple regression analyses indicated that higher extraversion scores, higher agreeableness scores and being a female were associated with higher intensity of characteristic pain (p < .05). Also, higher neuroticism and agreeableness scores were associated with more disability days (p < .05). In addition, higher agreeableness scores were associated with higher disability scores and disability point values (p < .05). Furthermore, lower neuroticism scores and being a female were associated with higher PHQ total scores, while being a female and having a lower level of education were associated with higher GAD total scores (p < .05). In conclusion, personality profiles and gender significantly impact the DC/TMD Axis II scores of psychosocial impairment among patients with pain related TMD.

Duration of insomnia and success expectancy predict treatment outcome of iCBT for insomnia

IntroductionIdentifying prognostic factors of treatment outcome may assist in customizing an intervention to a patient's needs. Hence, we conducted a secondary analysis of data from a randomized controlled trial to investigate the effectiveness of an internet-based cognitive behavioral therapy for insomnia (iCBT-I) to find patient characteristics that may predict the change of insomnia severity after treatment.Materials and methodsIn this exploratory analysis involving 94 chronic insomnia patients, we examined the predictive value of several self-reported measures, medical history, and sociodemographic variables to psychological distress with separate linear regression models. The main outcome was the Insomnia Severity Index score improvement from pre- to post-treatmentResultsThe study found that duration of insomnia, b (SE) = −0.02 (0.01), p = 0.01, and attitudes about the expected treatment success, b (SE) = 0.80 (0.27), p = 0.004, were predictors of a better outcome. Moreover, a better outcome was associated with a lower level of the following traits: attention seeking, b (SE) = −1.06 (0.51), p = 0.04; grandiosity, b (SE) = −1.50 (0.57), p = 0.01; distractibility, b (SE) = −1.57 (0.75), p = 0.04; and rigid perfectionism, b (SE) = −1.32 (0.65), p = 0.05.ConclusionOur results suggest that iCBT-I might be particularly beneficial for patients with higher expectations from the therapy and those who have a shorter duration of insomnia. Some pronounced personality traits, such as attention seeking, grandiosity, distractibility, and rigid perfectionism, may predict worse outcomes. However, because this was a post-hoc analysis, our results must be considered exploratory and verified in further studies.Clinical trial registrationhttps://clinicaltrials.gov/study/NCT04300218?cond=NCT04300218&amp;amp;rank=1, Identifier NCT04300218.

Empowering Investors: Reducing Herd Bias through Financial Literacy and Self-reflective Thinking

Herd behavior, where investors mimic the trades of others rather than relying on their own information or analysis, is a widespread phenomenon that can lead to suboptimal investment decisions and market inefficiencies. Hence, understanding how to reduce this behavior is crucial for improving individual investment outcomes and sustainable market performance. Though the literature suggests that self-reflection and financial literacy have potential to mitigate herd bias, it is unclear as to how these two perspectives interact to minimize this irrational behavior. By drawing on insights from the adaptive market hypothesis, transformative learning theory, concept of bounded rationality and dual process theory, this study attempts to enhance the understanding of this phenomenon by introducing a conditional mediation model that promotes self-directed learning. It predicts that investors can reduce their herd bias through self-reflection on their past stock trading experiences, which they can practice by engaging intuitive logical thinking and strengthen further through their financial literacy. Since herding is generally predicted to be more prevalent in frontier stock markets, the study was conducted in a frontier market - the Colombo Stock Exchange. The data was obtained through a self-administered questionnaire from 253 active individual investors, and analyzed by applying the PROCESS procedure. The findings reveal the significance of self-reflection as a mediating variable across its antecedents, which provides strong evidence for its central role in reducing herd bias. Notably, the findings indicate that self-reflection has a stronger effect on reducing herd bias of investors with lower level of financial literacy. It implies that investors with low financial literacy are more susceptible to herd bias, and self-reflection facilitates them to recognize and minimize their herd bias. Accordingly, the study concludes that promoting self-reflection can empower individual investors to become more financially literate and thereby mitigate their herd bias.

The Mechanisms Underlying Religious Coping and Hopelessness: Role of Meaning in Life and Affectivity

AbstractReligion can fulfill both positive and negative functions in coping with stress. There is a lack of research regarding the mechanism underlying the link between religious coping and mental health. The purpose of this study was to verify how religious coping is related to mental health. Two indirect mechanisms were tested for finding meaning in life and emotional regulation. The study was conducted with 115 students from Poland. According to the results, both positive and negative religious coping were indirectly related to hopelessness through finding meaning in life and affectivity. More frequent use of negative religious coping was positively related to the intensity of negative affect and problems with finding meaning in life, which, in turn, led to a higher level of hopelessness. Meanwhile, more frequent use of positive religious coping was correlated with a greater intensity of positive effect and supported individuals in finding meaning in life. Finding meaning in life was related to a lower level of hopelessness, but positive affect was not correlated with hopelessness. The research confirmed the role played by finding meaning in life and affectivity within the mechanism underlying the link between religious coping and hopelessness. In conclusion, theoretical and practical implications are presented.

Functional difficulty among children in Malaysia – findings from the National Health and Morbidity Survey (NHMS) 2019

IntroductionData on child functioning and disability are important for public policy development which aimed at reducing child disability prevalence and strengthening the provision of appropriate and timely health care services. This study reports the prevalence of functional difficulty in Malaysian children aged 2–17 years and its associated sociodemographic factors and epilepsy.MethodsData on children aged 2–17 years (n = 4576) were generated from the National Health and Morbidity Survey (NHMS) 2019, a population-based cross-sectional survey. Functional difficulty in children was assessed using the United Nations Children’s Fund (UNICEF)/Washington Group on Disability Statistics (WG) Child Functioning Module (CFM). The questionnaires were administered to the parents or guardians of the children via face-to-face interviews. Functional difficulty, defined as having difficulty in at least one domain, was examined for its prevalence and associations with sociodemographic variables and the epilepsy variable in children using descriptive analysis and multiple logistic regression.ResultsThe overall prevalence of functional difficulty among children aged 2–17 years was 4.7%. Multiple logistic regression analysis revealed that older children, children from households whose heads of household had a lower education level and children who have epilepsy were significantly more likely to experience functional difficulty (p < 0.05). Children of Chinese ethnicity were less likely to experience functional difficulty compared to children of Malay ethnicity.ConclusionsThis study provides baseline findings on the prevalence of functional difficulty among children in Malaysia using nationally representative data. Although the prevalence was relatively low, the information is important for the planning of strategies to improve the development and well-being of children in Malaysia and for achieving the Sustainable Development Goals (SDGs).

On penalized goal-reaching probability minimization under borrowing and short-selling constraints

Abstract We consider a robust optimal investment–reinsurance problem to minimize the goal-reaching probability that the value of the wealth process reaches a low barrier before a high goal for an ambiguity-averse insurer. The insurer invests its surplus in a constrained financial market, where the proportion of borrowed amount to the current wealth level is no more than a given constant, and short-selling is prohibited. We assume that the insurer purchases per-claim reinsurance to transfer its risk exposure to a reinsurer whose premium is computed according to the mean–variance premium principle. Using the stochastic control approach based on the Hamilton–Jacobi–Bellman equation, we derive robust optimal investment–reinsurance strategies and the corresponding value functions. We conclude that the behavior of borrowing typically occurs with a lower wealth level. Finally, numerical examples are given to illustrate our results.

Hemoglobin level and common mental disorder among school adolescent girls in Central Ethiopia: Structural Equation Model.

The prevalence of common mental disorder (CMD) and anemia is observed to be on the rise over time, adversely affecting the health and overall quality of life among adolescents. Extensive literature corroborates the significant impact of anemia on cognitive development, intelligence and developmental milestones. Nevertheless, the linkage between hemoglobin level and CMD emerging during adolescence remains relatively unexplored. Thus, the objective of this study was to investigate the association between hemoglobin level and CMD as well as the mediating factor among school adolescent girls residing in Central Ethiopia. A cross-sectional study design was conducted among adolescent girls attending schools in Silti Woreda, Central Ethiopia, comprising a total sample size of 516 individuals during the period from October 2-20, 2023. Hemoglobin level was adjusted for altitude, while CMD was evaluated utilising the summation score of a 20-item Self-Reporting Questionnaire. Data were analysed through fitting Structural Equation Model and the maximum likelihood estimation method. Goodness of fit was assessed using the χ2The -test statistic, Comparative Fit Index, Root Mean Square Error of Approximation, Standardised Root Mean Square Residual, Non-Normed Fit Index, Pclose and coefficient of determination (R2). The prevalence of CMD was 22.3% (95% CI: 18.6%-25.8%). Hemoglobin level (UTE = -0.73, CI: -0.93, -0.53) and experience of morbidity symptoms (UTE = 1.05; CI: 0.74, 1.38) were significantly associated with CMD. Furthermore, hemoglobin level is significantly influenced by morbidity frequency symptoms (UDE = -0.63, CI = -0.77, -0.49) and animal source food (ASF) (UDE = 0.09, CI = 0.01, 0.17). Hemoglobin level has been identified as a significant mediator of the experience of morbidity symptoms and ASF on CMD. However, household food insecurity and wealth index had no significant association with CMD. A significant proportion of adolescent girls face CMD, often linked to a lower hemoglobin level. Having a significant association with CMD, the hemoglobin level is found to mediate a significant effect of morbidity symptom experience and ASF on CMD. Hence, addressing early infection prevention, promoting ASF and treating anemia are promptly needed.

Consistent Egalitarianism or Heterogeneous Belief Patterns? Gender Ideologies in Contemporary East and West Germany

Abstract Studying gender ideologies is crucial for understanding the work and family related behaviors of women and men. This paper analyzes the gender ideologies of respondents living in East and West Germany, and whether these belief patterns differ by socio-demographic characteristics. To this end, latent class analysis is applied to eight gender role items from the FReDA 2021 survey. The results show the presence of a consistent and widespread egalitarian gender ideology in both regions, as well as a less prevalent traditional one in the West. Additionally, heterogeneous gender ideologies are to be found with egalitarian essentialism present in both regions, and intensive parenting only in the West. Respondents with a lower level of education and males have higher chances of holding non-egalitarian ideologies. The findings align with the literature on persisting East-West differences in gender ideology, and with research on the diversification of gender ideology.

Empowering and Influencing Factors of Intellectual and Spiritual Capital in Improving Organizational Performance at Tourism Institutions

This research aims to measure factors that influence intellectual and spiritual capital in increasing organizational performance at tourism institutions in Banda Aceh City through the variable organization. The methodology used is quantitative. Data was collected from respondents using a structured questionnaire with a Likert scale. Seventy-five questionnaires were distributed in all to the Banda Aceh City Tourism Institution. Sample selection utilized a disproportionate technique of stratified random sampling. The research data underwent descriptive, and structural equation modeling analysis using SPSS and SEM AMOS software. The analysis that was produced was: Research has demonstrated that intellectual capital has a substantial and favorable impact on the functioning of organizations, that is 0.000 &lt; 0.05 as the significant value; spiritual capital has a -0.070 direct effect on organizational performance; the coefficient of the indirect effect is 0.273, the mediation process has a substantial impact, and the effect of mediation has been proved to be significant, the coefficient for the indirect effect is 0.458, at the lower level for intellectual capital boot of 0.227, and the upper level for intellectual capital of 0.676, with a 95% confidence interval.

Systematic multiomics analysis and in vitro experiments suggest that ITGA5 could serve as a promising therapeutic target for ccRCC

BackgroundIntegrin alpha 5 (ITGA5) was previously confirmed to be related to prognosis in several cancer types; however, its function in clear cell renal cell carcinoma (ccRCC) and how this molecule regulates tumor progression and the tumor microenvironment (TME) remain to be elucidated.MethodsWe investigated the prognostic implications of ITGA5 with a machine learning model and evaluated biological behaviors of different levels of ITGA5 expression in vitro. Bioinformatic analysis was performed to explain the comprehensive effect of ITGA5 on the TME and drug sensitivity.ResultsWe constructed a machine learning model to elaborate the prognostic implication of ITGA5. As tumorigenesis of ccRCC was tightly relevant with several mutant genes, we investigated the correlation between ITGA5 expression and frequent mutations and found ITGA5 upregulation in VHL mutant ccRCC (P = 0.016). Through overexpressing, silencing, and blocking ITGA5, we verified the role of ITGA5 in promoting ccRCC adverse biological activities; and the potential functions of ITGA5 in ccRCC were bioinformatically demonstrated, summarizing as cell proliferation, migration, and angiogenesis. The localization of ITGA5 primarily in endothelia and macrophages further verified its magnitude in angiogenesis and aroused our excavation in ITGA5 regulation of immune infiltration landscape. Generally, ITGA5-high ccRCC presented an immunosuppressive TME by inducing a lower level of CD8 + T cell infiltration. For the last part we predicted drug sensitivity relevant to ITGA5 and concluded that a joint medication of ITGA5 inhibitors and VEGFR-target drugs (including sunitinib, axitinib, pazopanib, and motesanib) might be a promising therapeutic strategy.ConclusionOur findings clarified the adverse outcome induced by high expression of ITGA5 in ccRCC patients. In vitro experiments and bioinformatical analysis identified ITGA5 function as predominantly cell proliferation, migration, angiogenesis, and macrophage recruitment. Further, we predicted immune infiltration and medication sensitivity regulation by ITGA5 and proposed a joint use of ITGA5 inhibitors and anti-angiogenetic drugs as a potential potent therapeutic strategy.

BMI trajectories from birth to young adulthood associate with distinct cardiometabolic profiles.

Numerous studies have investigated links between body mass index (BMI) trajectories and cardiovascular risk, yet discrepancies in BMI measurement duration and timing of the cardiovascular-related outcome evaluation have led to inconsistent findings. We included participants from the Swedish birth cohort (BAMSE) and applied latent class mixture modeling to identify BMI trajectories using data of multiple BMI measures (≥ 4 times) from birth until 24-year follow-up (n = 3204). Subsequently, we analyzed the associations of BMI trajectories with lipids (n = 1974), blood pressure (n = 2022), HbA1c (n = 941), and blood leukocytes (n = 1973) using linear regression. We also investigated the circulating levels of 92 inflammation-related proteins (n = 1866) across BMI trajectories. Six distinct BMI groups were identified, denoted as increasing-persistent high (n = 74; 2.3%), high-accelerated increasing (n = 209; 6.5%), increasing-accelerated resolving (n = 142; 4.4%), normal-above normal (n = 721; 22.5%), stable normal (n = 1608; 50.2%), and decreasing-persistent low (n = 450; 14.1%) BMI groups. The increasing-persistent high and high-accelerated increasing BMI groups had higher levels of total cholesterol [mean difference (95% confidence intervals): 0.30 (0.04-0.56) and 0.16 (0.02-0.31) mmol/L], triglyceride, low-density lipoprotein, hemoglobin A1C [3.61 (2.17-5.54) and 1.18 (0.40-1.98) mmol/mol], and low-density lipoprotein/high-density lipoprotein ratios, but a lower level of high-density lipoprotein than the stable normal BMI group. These two groups also had higher leukocyte cell counts and higher circulating levels of 28 inflammation-related proteins. No increased cardiometabolic markers were observed in the increasing-accelerated resolving BMI group. Participants with persistently high or accelerated increasing BMI trajectories from birth to young adulthood have elevated levels of cardiometabolic risk markers at young adulthood than those with stable normal BMI. However, a raised BMI in childhood may not be inherently harmful to cardiometabolic health, provided it does not persist into adulthood.

Utility of First-Morning-Voided Urinary Total Luteinizing Hormone in Detecting the Onset of Central Puberty.

Early morning basal serum luteinizing hormone (S-LH) ≥0.3 IU/L is a specific marker for the onset of central puberty. In this study, we aimed to investigate the sensitivity and specificity of the first-morning-voided (FMV) total urinary LH (U-LH) to replace this marker. We re-analyzed our previously published data set of 297 children (145 boys and 152 girls, aged 5-15 years, across Tanner stages 1 through 5) using receiver operating characteristic (ROC) analysis and determined cutoff values for FMV total U-LH in predicting early morning S-LH concentration at or above 0.3 IU/L. We also determined S-LH and serum follicle-stimulating hormone (S-FSH) concentrations in girls at different stages of sexual maturation. ROC analysis showed that FMV total U-LH levels of 0.60 and 0.63 IU/L in girls and boys, respectively, predicted early morning S-LH levels of 0.3 IU/L or higher with 97.4% sensitivity and 90.6% specificity. Higher cutoff levels for U-LH (0.78 IU/L for boys and 0.79 IU/L for girls) yielded 94.7% specificity at the expense of a relatively lower level of sensitivity (94.1%). The areas under the curve were 0.98 in boys and 0.99 in girls, respectively. Additionally, the increase in FMV total U-LH (or S-LH) levels identified the activation of central pubertal development at the mean age of 10.3 (10.3) in boys and 10.5 (10.6) in girls. The S-FSH concentrations of the six biochemically prepubertal girls with thelarche, ranging between 2.3 and 2.7 IU/L, were significantly higher than those measured in biochemically and clinically prepubertal girls of the same 10-12-year-old age group and significantly lower than those measured in both biochemically and clinically pubertal girls (p = 0.039 and p = 0.018, respectively). A FMV total U-LH concentration of 0.6 IU/L or above reliably reflects pubertal morning S-LH levels and is effective in detecting the onset of central puberty, which occurs at similar ages in both sexes. Concurrent S-FSH or noninvasive FMV U-FSH determinations may be useful in the differential diagnosis of isolated thelarche.

Rapid Zooplankton Assessment: Evaluating a Tool for Ecosystem‐Based Fisheries Management in the Large Marine Ecosystems of Alaska

ABSTRACTEcosystem‐based fisheries management (EBFM) remains an aspirational goal for management throughout the world. One of the primary limitations of EBFM is the incorporation of basic lower trophic level information, particularly for zooplankton, despite the importance of zooplankton to fish. The generation of zooplankton abundance estimates requires significant time and expertise to generate. The rapid zooplankton assessment (RZA) is introduced as a tool whereby nontaxonomic experts may produce rapid zooplankton counts shipboard that can be applied to management in near real time. Zooplankton are rapidly counted shipboard and placed into three broad groups of zooplankton relevant to higher trophic levels: large copepods (&gt; 2 mm), small copepods (&lt; 2 mm), and euphausiids. A Bayesian, hierarchical linear regression modeling approach was used to validate the relationship between RZA abundances and laboratory‐processed abundances to ensure the rapid method is a reliable indicator. Additional factors likely to impact the accuracy of the RZA abundance predictions were added to the initial regression model: RZA sorter, survey, season, and large marine ecosystem (Bering Sea, Chukchi/Beaufort Sea, and Gulf of Alaska). We tested models that included the random effect of sorter nested within survey, which improved fits for both large copepods (Bayes R2 = 0.80) and euphausiids (Bayes R2 = 0.84). These factors also improved the fit for small copepods when the fixed effect of season was also included (Bayes R2 = 0.65). Additional RZA data were used to predict laboratory‐processed abundances for each zooplankton category and the results were consistent with model training data: large copepods (Bayes R2 = 0.80), small copepods (Bayes R2 = 0.64), and euphausiids (Bayes R2 = 0.88). The Bayesian models were therefore able to predict laboratory‐processed abundances with an associated error when accounting for these fixed and random effects. To demonstrate the utility of zooplankton data in management, zooplankton time series from the Bering Sea shelf were shown to vary in relation to warm and cold conditions. This variability impacted commercially important fish, notably Walleye Pollock (Gadus chalcogrammus), and these time series were used by managers using a risk table approach. The RZA method provides a rapid zooplankton population estimation in near real time that can be applied to the management process quickly, thus helping to fill a gap in EBFM.

Correlates of Socio Demographic Factors with Utilization of ICT Gadgets by Rural Students

Aims: This study investigates the utilization of ICT gadgets by rural students, focusing on usage patterns and their correlation with socio-demographic factors. As the demand and usage of ICT is increased, it is necessary to identify the ICT gadgets used by rural students and their extent of utilization so they may not be lag behind as urban population increasing the digital divide. Study Design: The research design was descriptive correlational research in nature. Research targeted two government senior secondary schools, one each from the villages of Niyana and Bhiwani Rohilla. A total of 100 students from grades 9 to 12 participated in the study who were willing and interested to participate. Place and Duration of the Study: The study was conducted in the Hisar district of Haryana state. The collection of data was done through the self-constructed questionnaire in the month of May, 2022 by the researcher itself. Duration of the study was 6 months. Methodology: Utilization was the usage of the ICT gadgets to reveal which types of ICT gadgets were being utilized by the respondents and which were not utilized. The developed questionnaire was used to discover the most utilized ICT gadgets by the respondents. For calculating, Level of Utilization of ICT gadgets, an excel sheet was made with the responses of the students given on the self-developed questionnaire on the usage of number of gadgets (0-15). For Comparison of School-I and School-II, Significance of the Difference was used. Correlation between Socio-Demographic profile of the respondents and utilization of ICT gadgets by School-I and School-II was also analyzed with P=.05. Results: It was revealed that all students in School-I utilized smartphones and televisions, with most displaying a medium level of usage. In contrast, students in School-II exhibited a lower level of ICT gadget utilization, despite similar access to smartphones and televisions. The t-score analysis revealed a significant difference in usage levels between the two schools. Smartphones were the most utilized devices for a variety of purposes, including academics, entertainment, and online transactions, while laptops were the least used gadgets. The study also found a positive correlation between education level and ICT gadget usage, suggesting that students with higher education engage more with ICT tools. A negative correlation was observed between distance from urban centers and ICT usage, indicating that students farther from cities face greater challenges in accessing technology. The results of the research will be beneficial for government and policymakers to formulate programs to enhance the utilization of ICT gadgets by rural students of India to overcome digital gap. Conclusion: These findings emphasize the influence of socio-demographic factors on ICT usage and highlight the need for targeted interventions to enhance technology access and utilization in rural education.