Marginal Significance Research Articles

Probabilistic coverage of the frontal aslant tract in young adults: Insights into individual variability, lateralization, and language functions.

The frontal aslant tract (FAT) is a crucial neural pathway of language and speech, but little is known about its connectivity and segmentation differences across populations. In this study, we investigate the probabilistic coverage of the FAT in a large sample of 1065 young adults. Our primary goal was to reveal individual variability and lateralization of FAT and its structure-function correlations in language processing. The study utilized diffusion MRI data from 1065 subjects obtained from the Human Connectome Project. Automated tractography using DSI Studio software was employed to map white matter bundles, and the results were examined to study the population variation of the FAT. Additionally, anatomical dissections were performed to validate the fiber tracking results. The tract-to-region connectome, based on Human Connectome Project-MMP parcellations, was utilized to provide population probability of the tract-to-region connections. Our results showed that the left anterior FAT exhibited the most substantial individual differences, particularly in the superior and middle frontal gyrus, with greater variability in the superior than the inferior region. Furthermore, we found left lateralization in FAT, with a greater difference in coverage in the inferior and posterior portions. Additionally, our analysis revealed a significant positive correlation between the left FAT inferior coverage area and the performance on the oral reading recognition (p = .016) and picture vocabulary (p = .0026) tests. In comparison, fractional anisotropy of the right FAT exhibited marginal significance in its correlation (p = .056) with Picture Vocabulary Test. Our findings, combined with the connectivity patterns of the FAT, allowed us to segment its structure into anterior and posterior segments. We found significant variability in FAT coverage among individuals, with left lateralization observed in both macroscopic shape measures and microscopic diffusion metrics. Our findings also suggested a potential link between the size of the left FAT's inferior coverage area and language function tests. These results enhance our understanding of the FAT's role in brain connectivity and its potential implications for language and executive functions.

P379 PD-1-positive cells contribute to the diagnosis of Inflammatory Bowel Disease and can aid in predicting response to vedolizumab

Abstract Background Differentiating inflammatory bowel disease (IBD) from other inflammatory diseases is often challenging. Programmed cell death protein-1 (PD-1) is expressed in T cells and is an indicator of their exhaustion. The role of PD-1 expression in diagnosing IBD and predicting the response of biologic agents remains inconclusive. Methods In this study, endoscopic biopsy samples of 19 patients diagnosed with IBD and other inflammatory diseases were analysed using multiplexed immunohistochemistry . Other inflammatory diseases comprised five patients with intestinal tuberculosis, and five with intestinal Behçet’s disease. Additionally, a separate prospectively maintained "vedolizumab (VDZ) cohort", established in 12 ulcerative colitis(UC) patients who underwent endoscopic biopsy before VDZ administration was analysed to predict response to VDZ. Results In the immunohistochemistry analysis, the cell density of T cell subsets, including helper T cell (Th), cytotoxic T cell (Tc), regulatory T cell (Treg), PD-1+ cell, PD-1+ Th, PD-1+ Tc, and PD-1+ Treg was investigated and compared between IBD and other inflammatory disease. Cell densities of PD-1+ cells (p=0.028), PD-1+ Th (p=0.008), and PD-1+ Treg (p=0.024) were higher in IBD compared with other inflammatory disease.(Figure 1) In addition, the proportion of PD-1+ cells in Th and Treg was higher in the IBD group than in the other inflammatory disease group (median 7% vs. 3%, p=0.008; median 6% vs. 2%, p=0.004, respectively). Comparing within IBD, the cell density of Treg was higher in Crohn’s disease(CD) than in UC (p=0.042), whilst the cell density of Tc was higher in CD than in UC with marginal statistical significance (p=0.066). In the VDZ cohort, patients with a 14-week steroid-free clinical response had higher levels of PD-1+ cells (p=0.026), PD-1+ Th (p=0.026), and PD-1+ Treg (p=0.041) than the no response group.(Table 1) Conclusion We explored the relationship between PD-1 expression and IBD using multiplexed immunohistochemistry. We compared IBD and other inflammatory disease in their expression of various immune cells including PD-1+ cells, and found IBD had higher PD-1 expression, as well as higher PD-1+ Th and PD-1+ Treg compared with other inflammatory diseases. In addition, VDZ-responsive patients had higher PD-1 expression. Our study confirmed the difference in PD-1 expression in IBD and other inflammatory diseases and revealed that PD-1 expression could be a predictive marker for VDZ responsiveness.

Cysteine thiol sulfinic acid in plant stress signaling.

Cysteine thiols are susceptible to various oxidative posttranslational modifications (PTMs) due to their high chemical reactivity. Thiol-based PTMs play a crucial role in regulating protein functions and are key contributors to cellular redox signaling. Although reversible thiol-based PTMs, such as disulfide bond formation, S-nitrosylation, and S-glutathionylation, have been extensively studied for their roles in redox regulation, thiol sulfinic acid (-SO2H) modification is often perceived as irreversible and of marginal significance in redox signaling. Here, we revisit this narrow perspective and shed light on the redox regulatory roles of -SO2H in plant stress signaling. We provide an overview of protein sulfinylation in plants, delving into the roles of hydrogen peroxide-mediated and plant cysteine oxidase-catalyzed formation of -SO2H, highlighting the involvement of -SO2H in specific regulatory signaling pathways. Additionally, we compile the existing knowledge of the -SO2H reducing enzyme, sulfiredoxin, offering insights into its molecular mechanisms and biological relevance. We further summarize current proteomic techniques for detecting -SO2H and furnish a list of experimentally validated cysteine -SO2H sites across various species, discussing their functional consequences. This review aims to spark new insights and discussions that lead to further investigations into the functional significance of protein -SO2H-based redox signaling in plants.

Kidney Transplantation Contraindications: Variation in Nephrologist Practice and Training Vintage

IntroHealth system leaders aim to increase access to kidney transplantation in part by encouraging nephrologists to refer more patients for transplant evaluation. Little is known about nephrologists’ referral decisions and whether nephrologists with older training vintage weigh patient criteria differently (e.g., more restrictively). MethodsUsing a novel, iteratively validated survey of U.S.-based nephrologists, we examined how nephrologists assess adult patients’ suitability for transplant, focusing on established, important criteria: seven clinical (e.g., overweight) and seven psychosocial (e.g., insurance). We quantified variation in nephrologist restrictiveness—proportion of criteria interpreted as absolute or partial contraindications versus minor or negligible concerns—and tested associations between restrictiveness and nephrologist age (proxy for training vintage) in logistic regression models, controlling for nephrologist- and practice-level factors. ResultsOf nephrologists invited (n=144), 42 survey respondents (29% response rate) were 85% male and 54% non-Hispanic white, with mean age 52 years, and 67% spent ≥1 day/week in outpatient dialysis facilities. Nephrologists interpreted patient criteria inconsistently; consistency was lower for psychosocial criteria (intraclass correlation coefficient [ICC] 0.28) than for clinical criteria (ICC 0.43; p<0.01). With each additional 10 years of age, nephrologists’ odds of interpreting criteria restrictively (top tertile) doubled (adjusted odds ratio [aOR] 1.96, 95% CI 0.95-4.07), with marginal statistical significance. This relationship was significant when interpreting psychosocial criteria (aOR 3.18, 95% CI 1.16-8.71) but not when interpreting clinical criteria (aOR 1.12, 95% CI 0.52-2.38). ConclusionNephrologists interpret evaluation criteria variably when assessing patient suitability for transplant. Guideline-based educational interventions could influence nephrologists’ referral decision-making differentially by age.

Sweat Rate, Sweat Sodium Losses, and Body Composition in Professional Male Soccer Players in Southwest Colombia.

Background and Objective: Dehydration and hyperhydration impact athletes' performance. Exploring the fluid balance concerning body composition might help estimate individual hydration requirements. This area of research, particularly regarding sodium losses, has been relatively understudied. We evaluated the sweat rate (SR), sweat sodium losses, and their relationship with body composition in professional soccer players in Cali, Colombia. Materials and Methods: Thirty-two male players, aged 24.3 (±5.2) years, from the Colombian main soccer league, underwent high-intensity training at 32 °C (with a relative humidity of 79%). The outcome variables included SR, calculated using weight loss and fluid intake; forearm sweat sodium concentration (FSCC), measured through the direct ion-selective electrode method; and estimated the predicted whole sweat sodium loss (PWSSL) in mmol. Predictor variables (body mass, fat, and muscle masses) were estimated using the Deborah Kerr anthropometry method. The association between predictors and outcomes was assessed using linear regression. Results: The mean FSCC, PWSSL, and SR were 26.7 ± 11.3 mmol/L, 43 ± 15.9 mmol/L, and 1.7 ± 0.5 L/h, respectively. Body mass positively predicted FSCC in unadjusted and age/fat-mass-adjusted models [Beta 1.28, 95% confidence interval (CI) 0.39-2.18, p = 0.006], and continued related to FSCC after adjustment for muscle mass with marginal significance [Beta 0.85, 95% CI -0.02 to 1.73, p = 0.056]. Muscle mass was associated with the PWSSL in unadjusted and age/fat-mass-adjusted models [Beta 2.42, 95% CI 0.58-4.26, p = 0.012] and sustained an association with marginal statistical significance after adjustment for body mass [Beta 1.86, 95% CI -0.35 to 4.09, p = 0.097]. Conclusions: Under hot tropical weather conditions, FSCC was relatively low among the players. Body mass was better associated with the FSSC, and muscle mass better related to the PWSSL. Body and muscle masses could be regarded as potential factors to be explored in the estimation of individual sodium needs. However, further studies are required to validate and contrast our findings.

High-expressed ACAT2 predicted the poor prognosis of platinum-resistant epithelial ovarian cancer

BackgroundAcetyl-CoA acetyltransferase 2 (ACAT2) is a lipid metabolism enzyme and rarely was researched in epithelial ovarian cancer (EOC).MethodsACAT2 expressions were confirmed in two pairs of cell lines (A2780 and A2780/DDP, OVCAR8 and OVCAR8/DDP) from Gene Expression Omnibus database by bioinformatics analysis, and in A2780 and A2780/DDP cell lines by quantitative real-time polymerase chain reaction and western blotting. Tissue samples were stained by immunohistochemistry and scored for ACAT2 expression. The relationships between ACAT2 expression and clinicopathological characteristics were analyzed by χ2 test. The prognosis of ACAT2 was analyzed by the log-rank tests and Cox regression models.ResultsACAT2 was remarkably upregulated in the above drug-resistant cell lines by mRNA (all P < 0.05) and protein expression (P = 0.026) than those in sensitive ones. Patients were classified as ACAT2-high (n = 51) and ACAT2-low (n = 26) according to immunohistochemical score. ACAT2 expression had a significantly inverse correlation with FIGO stage (P = 0.030) and chemo-response (P = 0.041). A marginal statistical significance existed in ACAT2 expression and ascites volume (P = 0.092). Univariate analysis suggested that high-expressed ACAT2 was associated with decreased platinum-free interval (PFI) (8.57 vs. 14.13 months, P = 0.044), progression-free survival (PFS) (14.12 vs. 19.79 months, P = 0.039) and overall survival (OS) (36.89 vs. 52.40 months, P = 0.044). Multivariate analysis demonstrated that ACAT2 expression (hazard ratio = 2.18, 95% confidence interval: 1.15–4.11, P = 0.017) affected OS independently, rather than PFI and PFS.ConclusionThe expression of ACAT2 in A2780/DDP and OVCAR8/DDP was higher than the corresponding A2780 and OVCAR8. High-expressed ACAT2 was associated with advanced FIGO stage, chemo-resistance, and decreased PFI, PFS and OS. It was an independent prognostic factor of OS in EOC.

The association between COVID-19 vaccination and confirmed patients with hospitalization in Omicron era: A retrospective study

With the emergence of Omicron variant of severe acute respiratory syndrome coronavirus 2, Taiwan has encountered the greatest coronavirus disease 2019 (COVID-19) pandemic since 2022 spring. We analyzed the characteristics, vaccinations, and outcomes of hospitalized COVID-19 patients quarantined in a dedicated ward. This retrospective study enrolled hospitalized COVID-19 patients in the dedicated wards of a district hospital in southern Taiwan from May 2022 to July 2022. We assessed in-hospital mortality, hospital length of stay (LOS), and dedicated ward LOS. Among 209 COVID-19 patients, the in-hospital mortality rates were 20.7% and 29.7% (P = .145) in patients with and without vaccination. A shorter dedicated ward LOS was noted in the vaccination group, with marginal statistical significance. Age, Charlson Comorbidity Index, and quick Sequential Organ Failure Assessment score were recognized as strong prognostic indicators for mortality in multivariable analysis. Vaccination demonstrated significant lower odds of death among relatively young populations in subgroup analysis. COVID-19 vaccination had significant efficacy in hospitalized COVID-19 patients in the relatively young group, and the effect may decline among individuals with advanced age and multiple comorbidities.

A new EEG neurofeedback training approach in sports: the effects function-specific instruction of Mu rhythm and visuomotor skill performance.

Achieving optimal visuomotor performance in precision sports relies on maintaining an optimal psychological state during motor preparation. To uncover the optimal psychological state, extensive EEG studies have established a link between the Mu rhythm (8-13 Hz at Cz) and cognitive resource allocation during visuomotor tasks (i.e., golf or shooting). In addition, the new approach in EEG neurofeedback training (NFT), called the function-specific instruction (FSI) approach, for sports involves providing function-directed verbal instructions to assist individuals to control specific EEG parameters and align them with targeted brain activity features. While this approach was initially hypothesized to aid individuals in attaining a particular mental state during NFT, the impact of EEG-NFT involving Mu rhythm on visuomotor performance, especially when contrasting the traditional instruction (TI) approach with the FSI approach, underscores the necessity for additional exploration. Hence, the objective of this study is to investigate the impact of the FSI approach on modulating Mu rhythm through EEG-NFT in the context of visuomotor performance. Thirty novice participants were recruited and divided into three groups: function-specific instruction (FSI, four females, six males; mean age = 27.00 ± 7.13), traditional instruction (TI, five females, five males; mean age = 27.00 ± 3.88), and sham control (SC, five females, five males; mean age = 27.80 ± 5.34). These groups engaged in a single-session EEG-NFT and performed golf putting tasks both before and after the EEG-NFT. The results showed that within the FSI group, single-session NFT with augmented Mu power led to a significant decrease in putting performance (p = 0.013). Furthermore, we noted a marginal significance indicating a slight increase in Mu power and a reduction in the subjective sensation of action control following EEG-NFT (p = 0.119). While there was a positive correlation between Mu power and mean radial error in golf putting performance (p = 0.043), it is important to interpret this relationship cautiously in the context of reduced accuracy in golf putting. The findings emphasize the necessity for extended investigation to attain a more profound comprehension of the nuanced significance of Mu power in visuomotor performance. The study highlights the potential effectiveness of the FSI approach in EEG-NFT and in enhancing visuomotor performance, but it also emphasizes the potential impact of skill level and attentional control, particularly in complex visuomotor tasks.

The moderating effects of mobile applications on the use of urban green space and mental health of older people: A mixed-method investigation in Hong Kong

Existing literature on the relationship between urban green space (UGS) use and mental health of older people was mainly conducted before the widespread adoption of digital technologies in daily life. In particular, the COVID-19 pandemic outbreak has fostered the use of mobile applications (apps) at a time city dwellers, including older people, were required to stay home. Drawing upon the insights from emerging literature on the changing relationship between UGS use and mental health of older people in the digital era in urban and gerontological studies, this paper offers a vivid mixed-method to investigate whether mobile app use has supplemented or substituted UGS visits and activities that further influence on the mental health of older people. This is achieved by conducting 360 questionnaire surveys in elderly community centers amid the pandemic and 23 semi-structured interviews in local neighbourhood parks after the pandemic by the authors. Results demonstrates mobile app use frequency may moderate the proximity-mental health relationship, but only among the older people with lower mental health levels. Among this sub-group, digital consumption app use frequency weakens the proximity-mental health relationship on marginal significance, which illustrates digital consumption apps may substitute the role of urban parks on improving older people’s mental health. Furthermore, digital communication and recreation mobile app use frequency strengthens the proximity-mental health relationship on marginal significance, which suggests these mobile apps may supplement the role of urban parks on improving older people’s mental health, particularly during the pandemic. The research pleas for more research on how digitalization of everyday activities is transforming the use of UGS such as neighbourhood parks and subsequent impact on the mental health of older people in the widespread adoption of digital technologies.

Sleep and rest-activity rhythms for women at different menopausal statuses: the role of mental health.

To examine how mental health interplays with menopausal status in relation to sleep patterns and rest-activity rhythms (RARs) among middle-aged women. This cross-sectional study recruited 87 women aged 45 to 60 years from community and a gynecology clinic in Taiwan. Participants wore actigraphy devices for 7 days and were also assessed with self-reported questionnaires. Hierarchical regression was used to examine the effects of menopausal status and mental health on sleep and RARs. Perimenopausal and postmenopausal women had higher relative amplitude and interdaily stability of RARs than premenopausal women. There were no differences in actigraphy-based sleep parameters across menopausal statuses. There was no difference in depressive symptoms or loneliness across menopausal statuses. Higher levels of depressive symptoms were significantly associated with longer sleep latency ( β = 0.26, P = 0.022) and wake after sleep onset ( β = 0.28, P = 0.012), and lower sleep efficiency ( β = -0.30, P = 0.008) after adjusting for menopausal status and age. In addition, there was marginal significance of the positive association between loneliness and interdaily stability ( β = 0.18, P = 0.079). A moderating effect ( βmenopausal status*loneliness = -0.40, P = 0.025) showed that lonelier premenopausal women exhibited greater relative amplitude (RA) of rest-activity rhythms, but lonelier menopausal women had lower RA of RAR. Mental health plays an important role for middle-aged women with different menopausal statuses in relation to sleep patterns and RARs.

Did COVID-19 or COVID-19 Vaccines Influence the Patterns of Dengue in 2021? An Exploratory Analysis of Two Observational Studies from North India.

Dengue experienced a rise in disease burden in 2021 in specific regions of India. We aimed to explore the risk factors of dengue occurrence and severity in the post-COVID-19 and post-COVID-19 vaccination era and performed an exploratory analysis involving participants from two prior observational studies conducted from February 2021 to April 2022 in a tertiary hospital in North India. Health care workers constituted the majority of the study participants. Individuals were stratified into five groups based on COVID-19 infection and timing of vaccination: COVID-No Vaccine, Vaccine-No COVID (VNC), COVID After Vaccine (CAV), Vaccine After COVID (VAC), and No Vaccine-No COVID (NVNC) groups. The occurrence of laboratory-confirmed dengue and severe forms of dengue were the main outcomes of interest. A total of 1,701 participants (1,520 vaccinated, 181 unvaccinated) were included. Of these, symptomatic dengue occurred in 133 (7.8%) and was "severe" in 42 (31.6%) cases. Individuals with a history of COVID-19 in 2020 had a 2-times-higher odds of developing symptomatic dengue (P = 0.002). The VAC group had 3.6 (P = 0.019)-, 2 (P = 0.002)-, and 1.9 (P = 0.01)-times-higher odds of developing symptomatic dengue than the NVNC, VNC, and CAV groups, respectively. The severity of dengue was not affected by COVID-19 vaccination but with marginal statistical significance, a 2-times-higher risk of severe dengue was observed with any COVID-19 of the past (P = 0.08). We conclude that COVID-19 may enhance the risk of developing symptomatic dengue. Future research should explore the predisposition of COVID-19-recovered patients toward other viral illnesses. Individuals receiving COVID-19 vaccines after recovering from COVID-19 particularly seem to be at greater risk of symptomatic dengue and need long-term watchfulness. Possible mechanisms, such as antibody-dependent enhancement or T-cell dysfunction, should be investigated in COVID-19-recovered and vaccinated individuals.

Biological Factors Associated with Treatment-Free Remission in Clinical Practice: Data from the Canarian Registry of CML

Introduction: The probability of maintaining treatment-free remission (TFR) after the discontinuation of tyrosine kinase inhibitors (TKI) is affected by clinical factors such as length of TKI treatment and the depth of molecular response. However, some individuals with similar treatment duration and response remain in TFR while others relapse. Thus, patient-specific factors must also play a role. Biological factors suggested to influence TFR include BCR::ABL1 transcript type, blasts at diagnosis, halving time (HT, first 3 months), BCR::ABL1 positivity at stop, and presence of somatic mutations. The aim of this study was to evaluate the biological factors associated with TFR in the clinical practice, using data from the Canarian CML Registry. Methods: The OMOP-standardized data of adult patients with chronic phase CML who discontinued TKI treatment included in the Canarian CML Registry (https://rclmc.es/rclmc/) were reviewed. Criteria to discontinue included TKI treatment ≥5 years and MR4.5 or better ≥3 years. TFR was defined as major molecular response (MMR), or deeper after stop. Molecular relapse was defined as loss of MMR in two consecutive tests. NGS was performed with the 30-gene panel Myeloid Solution (SOPHiA) on the MiSeq (Illumina) platform using 200 ng genomic DNA extracted from peripheral blood at diagnosis. Results: A total of 109 patients were included, with an average age of 50.5 years; 54 were male (49.5%). Median follow-up was 3.3 years. 86 patients discontinued from first-line, 21 from second- and 2 from third-line. 51% of patients (n=56) discontinued from imatinib, 31% from nilotinib (n=34), 16% from dasatinib (n=17), and 1% from bosutinib and ponatinib (1 patient each). The median TFR was 101 months ( Figure 1A; range 1.02-148.4 months). Thirty-two patients had molecular relapse and re-started TKI treatment: 36.7% with imatinib or dasatinib, 26.7% with nilotinib. Median time to regain MMR was 101 days (range 25-276). No difference was observed in the time to regain MMR for imatinib vs. 2G-TKI (106 vs. 144, p=0.419). No patients progressed to an accelerated phase. Differences were observed in duration of MR4 and MR4.5 prior to stop comparing the TFR vs. relapse groups (88.3 vs. 69.9 months, p=0.044; 74.2 vs. 58.6 months, p=0.079), but not total time on TKI (172.6 vs. 102.1, p=0.310), respectively. In terms of biological factors at diagnosis, 44 patients had blasts, 66.7% had a low Sokal risk. 23.9% expressed transcript e13a2 and 76.1% had e14a2. No differences in TFR were observed when blasts, Sokal or transcript were considered in chi-squared analyses. A long HT (&amp;gt;21.9 days, Shanmuganathan et al. Blood 2021;137) was of marginal significance for molecular relapse (p=0.076, OR 3.2) but no difference was found for short HT (&amp;lt;9.4 days). By Kaplan-Meier analysis, an MR3, 4, or 4.5 at stop was predictive of molecular relapse (n=42; Figure 1B) vs. an MR5 or undetectable (limit of detection 0.0001%). In multivariable analysis, only an MR5 or deeper at stop and withdrawal syndrome were predictive for TFR (p=0.003, HR 4.3; p=0.049, HR 0.20, respectively). NGS data was available for 47 patients. Myeloid mutations were detected in 21 patients (44.7%) at diagnosis, of these 11 had an epigenetic mutation (23.9%; in ASXL1, DNMT3A, TET2 or EZH2). 11 patients (23.9%) had a variant that was potentially germline (VAF 40-60%). By chi-squared and Kaplan-Meier analysis, no differences were observed between the median TFR for patients with or without a pathogenic somatic, epigenetic, ASXL1 or germline mutation. However, a greater separation of the curves was observed when considering TFR at 36 months for somatic (p=0.101) but not germline mutation. Conclusions: We confirmed previous observations that the biological factors BCR::ABL1 positivity at stop and longer HT were associated with molecular relapse although no difference was found for short HT. The impact of clinical factors on TFR, including duration of MR4 and MR4.5 prior to stop, were also confirmed in our real-life series with a long follow-up, while total TKI duration was not prognostic. Adnan Awad et al. associated the presence of epigenetic mutations at diagnosis with shorter TFR and higher relapse probability (Blood Cancer J. 2022;12). Here, a significant difference in TFR was not observed for epigenetic mutation at diagnosis; however, a tendency was observed between a pathogenic somatic but not a germline myeloid mutation and TFR at 36 months.

Temporal Variability in Soil Greenhouse Gas Fluxes and Influencing Factors of a Primary Forest on the Eastern Qinghai-Tibetan Plateau

Soil greenhouse gas (GHG) fluxes relate to soil carbon and nitrogen budgets and have a significant impact on climate change. Nevertheless, the temporal variation and magnitude of the fluxes of all three major GHGs (CO2, CH4 and N2O) and their influencing factors have not been elucidated clearly in primary forests on the eastern Qinghai-Tibetan Plateau. Herein, field chamber GHG fluxes from May to November, soil microbial community and enzyme activity were analyzed in a fir-dominated (Abies fargesii var. faxoniana) primary forest. The emission rates of CO2 and N2O ranged between 64.69–243.22 mg CO2 m−2 h−1 and 1.69–5.46 ug N2O m−2 h−1, exhibiting a temporally unimodal pattern with a peak in July. The soil acted as a CH4 sink, and the uptake rate varied between 52.96 and 84.67 μg CH4 m−2 h−1 with the higher uptake rates in June and November. The temporal variation in the CO2 flux was significantly correlated with the geometric mean of enzyme activities, suggesting that the soil CO2 flux was determined by microbial activity rather than soil microbial biomass. The soil N2O flux was positively related to nitrate concentration with marginal significance, probably because N2O was a byproduct of nitrification and denitrification processes. The soil CH4 uptake was closely associated with methanotrophic biomass (18:1ω7c). The results highlight divergent temporal dynamics of GHG fluxes owing to different driving mechanisms and an important CH4 sink in the primary forest soil, helping to evaluate the carbon and nitrogen budgets of primary forests on the eastern Qinghai-Tibetan Plateau.

Associations of frailty with symptoms, and HRQOL in older cancer survivors after cancer treatments: a systematic review and meta-analyses.

Frailty in older adult cancer survivors after cancer treatments is associated with various health outcomes. However, there is less agreement on how frailty affects symptoms and health-related quality of life (HRQOL). This systematic review and meta-analysis aimed to evaluate the current literature on frailty, symptoms, and HRQOL, as well as the associations of frailty with these factors in older adult cancer survivors with chemotherapy. A review was conducted on peer-reviewed publications from 2008 to 2023, using seven electronic databases. Meta-analyses were performed using random effects models to determine pooled effect estimates for frailty prevalence, symptom severity, and HRQOL scores. A total of 26 studies involving older cancer survivors were included in the analysis. Most of these studies were conducted in Western countries and focused on White survivors, particularly those with breast cancer. The mean pooled prevalence of frailty was 43.5%. Among frail survivors, the most common symptoms reported after cancer treatments were pain (36.4%), neuropathy (34.1%), and fatigue (21.3%). Frailty was associated with higher pooled mean symptom severity (B = 1.23, p = 0.046) and lower functional HRQOL (B = -0.31, p = 0.051, with marginal significance) after cancer treatments. Frail older cancer survivors are at high risk of adverse symptoms and poor HRQOL after cancer treatment. Further research on screening for frailty is needed to prevent older adults from developing worse symptoms burden and maintain HRQOL. It is also essential to understand the mechanisms of the associations between frailty, symptoms and HRQOL in this population.

Life-course adiposity and severe liver disease: a Mendelian randomization analysis.

There is little evidence on the genetic associations between life-course adiposity (including birth weight, childhood BMI, and adulthood BMI) and severe liver disease (SLD; including cirrhosis and liver cancer). The current study aimed to examine and contrast these associations. Genetic variants were obtained from genome-wide association studies. Two-sample Mendelian randomization (MR) analyses were performed to assess the genetic associations of life-course adiposity with SLD and liver biomarkers. Cox regression was used to estimate adjusted hazard ratios for SLD associated with genetic risk scores of life-course adiposity and adulthood weight change in the China Kadoorie Biobank. In observational analyses, genetic predispositions to childhood adiposity and adulthood adiposity were each associated with SLD. There was a U-shaped association between adulthood weight change and risk of SLD. In meta-analyses of MR results, genetically predicted 1-standard deviation increase in birth weight was inversely associated with SLD at a marginal significance (odds ratio: 0.81 [95% CI: 0.65-1.00]), whereas genetically predicted 1-standard deviation higher childhood BMI and adulthood BMI were positively associated with SLD (odds ratio: 1.27 [95% CI: 1.05-1.55] and 1.79 [95% CI: 1.59-2.01], respectively). The results of liver biomarkers mirrored those of SLD. The current study provided genetic evidence on the associations between life-course adiposity and SLD.

Competence of Health Care Providers on Clinical Management of Myocardial Infarction in Selected Hospitals with Intensive Care Unit Western Kenya

Background: The capacity of healthcare providers to execute an accurate initial assessment is crucial for recognizing the urgency and treatment needs of patients and for creating baseline data from which any changes in patient status may be monitored. In Western Kenya, there is little evidence of studies carried out on the competence of healthcare providers in the clinical management of myocardial infractions thus this study's main aim was to investigate the competence of healthcare providers in the clinical management of myocardial infractions.&#x0D; Material and Methods: A cross-sectional analytical study design was used. The study population comprised a total sample of 114 healthcare providers. A structured questionnaire and observation checklist were used. Participants will be picked using a systematic sampling method for those who meet the inclusion criteria. The sample size was determined using Fisher's Method. The data collected was compiled using SPSS software version 22. The data was analyzed through the application of descriptive statistical analysis.&#x0D; Findings: Variables that positively influenced the competency are specialization (AOR: 15.1; 95% CI: 2.6 – 87.3; p = 0.002), knowledge (AOR: 5.4; 95% CI: 1.1 – 26.5; p = 0.04) and having a protocol in patient's file (AOR: 10.2; 95% CI: 0.9 – 112.6.5; p = 0.06), although the latter was marginally statistically significant. Healthcare provider's qualification (KRCHN) (AOR: 0.04; 95% CI: 0.008 – 0.219; p = 0.002), filling of the protocol (AOR: 0.03; 95% CI: 0.001 – 0.585; p = 0.02) and use of high dose heparin as opposed to the use of other thrombolytic like Metalase (AOR: 0.1; 95% CI: 0.01 – 0.63; p = 0.02) were all negatively associated with healthcare providers competency.&#x0D; Recommendation/Conclusion: The study recommends the need of specialized training and knowledge advancement for health care providers on critical care nursing. This study found marginal statistical significance between the factors that influence competence among healthcare providers on clinical management of myocardial infraction.

FRI641 Assessing Insulin Prescription Adequacy At Hospital Discharge And Its Association With Characteristics Of Diabetic Patients

Abstract Disclosure: T. Akcan: None. S. Sharma: None. J. Liu: None. A. Jayarangaiah: None. M. Gilani: None. A. Surendran: None. N. Imamudeen: None. R. Gabor: None. R.D. Pathak: None. Diabetes is becoming increasingly prevalent, and appropriate insulin therapy during the post-discharge period is essential to improve glycemic control and reduce readmissions. Despite extensive research on insulin use during hospitalization, little is known about insulin dosing at discharge and patient factors that affect post-discharge needs. Therefore, this retrospective study aimed to evaluate the adequacy of insulin dosing at hospital discharge for diabetic patients and identify patient characteristics impacting post-discharge insulin requirements. Using a retrospective study design, we identified 350 patients meeting the inclusion criteria. The results showed that 19.1% of patients required a decrease in insulin total daily dose (TDD) at follow-up, 50.9% experienced no change, and 30.0% necessitated an increase. Factors found to impact insulin dose adjustments post-discharge include BMI, CKD, discharge TDD, and HbA1c levels. The multivariate analysis revealed that CKD was associated with a decrease in insulin TDD at follow-up (95% CI: -9.65- -0.47, p=0.031). Additionally, insulin TDD at discharge was negatively associated with follow-up dose, with a 0.37 unit decrease (95% CI: -0.44- -0.30, p&amp;lt;0.001) in insulin TDD for each additional unit prescribed. Finally, there was a marginal significance observed in the discharge regimen. Patients on a premixed regimen had a decrease in insulin TDD at follow-up compared to those on a basal-bolus regimen (95% CI: -21.85- 0.27, p=0.057). Our study findings suggest the need for improved estimation of insulin doses at discharge and emphasize the importance of short-term follow-up for insulin titration post-discharge. Patient factors such as body weight, kidney disease, insulin dose at discharge, and HbA1c levels influence these changes. These findings have significant implications for optimizing patient outcomes and reducing hospital readmissions, underscoring the importance of carefully evaluating these factors when tailoring individualized insulin regimens. Presentation: Friday, June 16, 2023

Female students’ personality and stress response to an academic examination

ABSTRACT Background Women are vulnerable to stress-related disorders. Examinations are a source of stress, triggering emotional, cognitive, and hormonal responses. We examined women’s psychological and hormonal stress responses and academic performance according to personality during a real-life examination. Methods Female students (N = 66) were divided into two groups based on hierarchical cluster analysis: one cluster characterized by high neuroticism and moderate extraversion (HN-ME; n = 42) and the other by low neuroticism and high extraversion (LN-HE; n = 24). Academic performance, perceived stress, and emotional dysregulation were analyzed. State anxiety, affect, and cortisol release were measured before and on the examination day. Results The HN-ME cluster was high in perceived stress, emotional dysregulation, and negative affect. This cluster also had higher state anxiety levels two days before and shortly after the examination compared to the LN-HE cluster. Students’ cortisol levels were higher on the examination day, and there was a marginal significance of the Cluster factor in the cortisol release regardless of the day of measurement. Conclusions Women with high neuroticism and moderate extraversion may be more vulnerable to psychological stress in academic settings but similar to other women in their cortisol response.

Dietary Patterns and Association with Anemia in Children Aged 9-16 Years in Guangzhou, China: A Cross-Sectional Study.

Anemia affects 1.8 billion people worldwide, and diet is one of the key modifiable factors for treating anemia in children. The dietary pattern has changed rapidly in recent decades, but its effect on childhood anemia has not been reported. This study aimed to identify dietary patterns among children in rural areas of Guangzhou, China, and explore their association with anemia. A total of 1476 children aged 9-16 years old were included in this study. Demographics, lifestyle, and anthropometric and dietary information were collected. Factor analysis was used to identify dietary patterns, and anemia was diagnosed based on hemoglobin levels. Robust Poisson regression and subgroup analysis were used to analyze the association between dietary patterns and anemia. The prevalence of anemia in children was 10.4%, with 6.1% in boys and 15.4% in girls. Four dietary patterns were identified, including a fast food pattern, a vegetarian pattern, a meat and egg pattern, and a rice and wheat pattern. A high score in the fast food pattern was positively associated with risk of anemia in children entering puberty (PR = 1.767, 95% CI: 1.026~3.043, p = 0.039), especially in girls after menarche, with marginal significance (PR = 1.740, 95% CI: 0.977~3.097, p = 0.059). A high score in the meat and egg pattern was negatively associated with risk of anemia in children entering puberty (PR = 0.498, 95% CI: 0.286~0.866, p = 0.013), especially in boys after spermatorrhea (PR = 0.237, 95% CI: 0.031~0.590, p = 0.007). The fast food pattern was a risk factor for anemia in children, and the meat and egg pattern was a protective factor for anemia in children entering puberty. The findings of this study could be used to guide the strategies of evidence-based preventive nutrition interventions to curb anemia in children.

SOX11 and Epithelial-Mesenchymal Transition in Metastatic Serous Ovarian Cancer.

Ovarian cancer is the leading cause of death from gynecological malignancies, with serous carcinoma being the most common histopathologic subtype. Epithelial-mesenchymal transition (EMT) correlates with increased metastatic potential, whereas the transcription factor SRY-box transcription factor 11 (SOX11) is overexpressed in diverse malignancies. In the present study, we aimed to evaluate the potential role of the immunohistochemical expression of SOX11 in 30 serous ovarian carcinomas in association with E-cadherin and vimentin expression as well as with patients' clinicopathological data. Most of the examined cases showed concurrent expression of E-cadherin and vimentin, whereas SOX11 was expressed in a minority of the cases (26.7%). Interestingly, the positive cases more frequently had a metastatic disease at the time of diagnosis compared with the negative cases (p = 0.09), an association, however, of marginal significance. Moreover, there was a negative correlation between E-cadherin and SOX11 expression (p = 0.0077) and a positive correlation between vimentin and SOX11 expression (p = 0.0130). The present work, for the first time, provides preliminary evidence of a possible implication of SOX11 overexpression in the promotion of EMT in metastatic serous ovarian cancer, thereby endorsing tumor metastasis.