Markers Of Status Research Articles

Association of neutrophil/lymphocyte and platelet/lymphocyte ratios with inflammation and survival in Mexican patients on chronic hemodialysis.

Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are markers of systemic inflammatory status. The relationship between NLR, PLR, and mortality is controversial among hemodialysis (HD) patients. Evaluate NLR and PLR in the prediction of mortality in chronic HD patients. We analyzed 130 patients with a follow-up for 66 months. Four groups were established according to NLR-PLR values. Kaplan-Meier curves and Cox proportional hazards analysis were used. NLR-PLR correlated positively with C-reactive protein. Cox regression analysis for overall mortality among the four groups included age (HR 1.027, 95% CI 1.003-1.053) and albumin (HR 0.25, 95% CI 0.073-0.85). For cardiovascular (CV) mortality only pulse pressure differential (PPD) was included (HR 1.033; 95% CI 1.014-1.052). Low NLRs and high PLRs were associated with CV mortality (Log Rank test, p = 0.033). Low NLRs and high PLRs predict the risk of CV mortality among HD patients.

Cardiohemodynamic responses and heart rate variability following an active orthostatic test among male residents of the North with different NOS3 (rs2070744) genotypes

AIM: This study explored associations between the -786TC (rs2070744) genetic polymorphism of the NOS3 gene and the main indices of systemic hemodynamics and heart rate variability following an active orthostatic test in men living in the North. MATERIAL AND METHODS: Eighty-three healthy men aged 33.5±1.5 yеаrs on average, who were permanent residents of the Magadan Region, comprised the sample. The participants underwent both resting and active orthostatic testing modes. Cardiovascular system variables were recorded using an automatic tonometer. Hemodynamic indices were then calculated. Short-term heart rate variability in frequency and spectral areas was simultaneously measured using the Varikard hardsoft complex unit. Genotyping was conducted using polymerase chain reaction. The sample was then divided into two groups: Group 1 consisted of homozygotes with the TT genotype (n=34), while Group 2 comprised carriers of the NOS3*C allele variant (genotypes TC+CC) associated with reduced nitric oxide production (n=49). RESULTS: By examining the complex vasomotor, chrono- and inotropic reactions of hemodynamic and heart rate variables during the active orthostatic test, we were able to discern unique patterns in the response of the two groups under study. Men in Group 1 demonstrated an elevated cardiac output response during orthostatic changes, while maintaining consistent vascular resistance values. This was accompanied by a shift towards sympathetic autonomic activity and an increase in the very low-frequency component of heart rate variability. In Group 2, individuals with sympathetic insufficiency and increased vascular resistance during the orthostatic test showed a 35% increase in the low-frequency component of the cardiac rhythm reflecting the importance of this indicator as a stimulator of blood pressure rhythm fluctuations mediated by baroreflex mechanisms. CONCLUSION: Our findings suggest that men lacking the NOS3*С allele variant in their genotype demonstrate more favorable responses to the active orthostatic test. This may reflect higher level of cardiovascular functional reserves. The 786TC (rs2070744) polymorphism of the NOS3 gene can be considered as a marker of cardiohemodynamic status and autonomic regulations during functional exercise, such as an active orthostatic test.

The Effect of Propolis Irrigation as an Adjunctive to Scaling and Root Surface Debridement on Periodontal Health Status, Glycemic Control and Biochemical Markers in Subjects with Type 2 Diabetes Mellitus and Chronic Periodontitis: A Randomized Clinical Trial.

The Effect of Propolis Irrigation as an Adjunctive to Scaling and Root Surface Debridement on Periodontal Health Status, Glycemic Control and Biochemical Markers in Subjects with Type 2 Diabetes Mellitus and Chronic Periodontitis: A Randomized Clinical Trial.

Sodium-Glucose Cotransporter 2 Inhibitor Combined with Conventional Diuretics Ameliorate Body Fluid Retention without Excessive Plasma Volume Reduction.

We previously reported that sodium-glucose cotransporter 2 (SGLT2) inhibitors exert sustained fluid homeostatic actions through compensatory increases in osmotic diuresis-induced vasopressin secretion and fluid intake. However, SGLT2 inhibitors alone do not produce durable amelioration of fluid retention. In this study, we examined the comparative effects of the SGLT2 inhibitor dapagliflozin (SGLT2i group, n = 53) and the combined use of dapagliflozin and conventional diuretics, including loop diuretics and/or thiazides (SGLT2i + diuretic group, n = 23), on serum copeptin, a stable, sensitive, and simple surrogate marker of vasopressin release and body fluid status. After six months of treatment, the change in copeptin was significantly lower in the SGLT2i + diuretic group than in the SGLT2i group (-1.4 ± 31.5% vs. 31.5 ± 56.3%, p = 0.0153). The change in the estimated plasma volume calculated using the Strauss formula was not significantly different between the two groups. Contrastingly, changes in interstitial fluid, extracellular water, intracellular water, and total body water were significantly lower in the SGLT2i + diuretic group than in the SGLT2i group. Changes in renin, aldosterone, and absolute epinephrine levels were not significantly different between the two groups. In conclusion, the combined use of the SGLT2 inhibitor dapagliflozin and conventional diuretics inhibited the increase in copeptin levels and remarkably ameliorated fluid retention without excessively reducing plasma volume and activating the renin-angiotensin-aldosterone and sympathetic nervous systems.

Oxidative status: A general but overlooked indicator of welfare across animal species?

Because of their ubiquity, plasticity, and direct effects on the nervous system, markers of oxidative status may be of great value to assess animal welfare across species and conditions in the wild. However, welfare biologists have not yet seized this opportunity, possibly because the validity of these markers as welfare indicators remains questionable. A validation process was, therefore, performed here using a meta-analytical approach considering three conditions assumed to impair the welfare of animals. With very few exceptions, two of the four considered markers consistently varied across these negatively-valenced conditions. By highlighting the current underrepresentation of markers of oxidative status in animal welfare studies, and by concretely illustrating that some of these markers can consistently reflect negative affective states, this article aims to encourage biologists to include these physiological markers in their toolbox to better measure, monitor, and perhaps also improve the welfare of animals in their natural habitat.

Iron status is associated with tibial structure and vitamin D metabolites in healthy young men

The influence of iron on collagen synthesis and vitamin D metabolism has implications for bone health. This cross-sectional observational study investigated associations between markers of iron status and tibial structure, vitamin D metabolites, and circulating biochemical markers of bone metabolism in young healthy men. A total of 343 male British Army recruits participated (age 22 ± 3 y, height 1.77 ± 0.06 m, body mass 75.5 ± 10.1 kg). Circulating biochemical markers of iron status, vitamin D metabolites, and bone metabolism, and tibial structure and density by high-resolution peripheral quantitative computed tomography scans (HRpQCT) were measured in participants during week 1 of basic military training. Associations between markers of iron status and HRpQCT outcomes, bone metabolism, and vitamin D metabolites were tested, controlling for age, height, lean body mass, and childhood exercise volume. Higher ferritin was associated with higher total, trabecular, and cortical volumetric bone mineral density, trabecular volume, cortical area and thickness, stiffness, and failure load (all p ≤ 0.037). Higher soluble transferrin receptor (sTfR) was associated with lower trabecular number, and higher trabecular thickness and separation, cortical thickness, and cortical pore diameter (all p ≤ 0.033). Higher haemoglobin was associated with higher cortical thickness (p = 0.043). Higher ferritin was associated with lower βCTX, PINP, total 25(OH)D, and total 24,25(OH)2D, and higher 1,25(OH)2D:24,25(OH)2D ratio (all p ≤ 0.029). Higher sTfR was associated with higher PINP, total 25(OH)D, and total 24,25(OH)2D (all p ≤ 0.025). The greater density, size, and strength of the tibia, and lower circulating concentrations of markers of bone resorption and formation with better iron stores (higher ferritin) are likely as a result of the direct role of iron in collagen synthesis.

Anaerobic glycolysis and oxidative stress interrelation in erythrocytes under administration of Cornus mas L. fruit extracts to rats with streptozotocin-induced diabetes mellitus

Background. In diabetes mellitus (DM), analysis of changes in the biochemical profile of erythrocytes is the important stage of complex scientific research to clarify the mechanism of action of medicinal products based on plant raw materials. The fruits of Cornus mas L. are widely known. The biologically active compounds of these fruits show multiple biological effects. However, the effect of the fruit extracts of cornelian cherry on the functional state of erythrocytes in diabetes has not been sufficiently studied. The high glucose concentration in erythrocytes induces various structural and functional changes, which lead to numerous disturbances in their metabolism. Glucose transported into erythrocytes by facilitated diffusion via GLUT2 undergoes catabolic breakdown in anaerobic glycolysis (90 % of all glucose) and pentose phosphate pathway (the rest 10 %). ATP and reduced coenzymes of NADH + H+ and NADPH + H+ formed due to metabolism participate in maintaining the structure of hemoglobin. Enzymes of the antioxidant defense system, which prevent hemoglobin oxidation into methemoglobin, are especially important. Hyperglycemia and the development of oxidative stress in diabetes are the cause of a decrease in the activity of antioxidant enzymes and the accumulation of ligand forms of hemoglobin (HbCO2, MetHb, HbA1c). Therefore, the work aimed to investigate the effect of extracts of red and yellow fruits of Cornus mas L. on the content of end products of the glycolytic breakdown of glucose in erythrocytes and biochemical markers of the antioxidant status of these blood cells in rats with streptozotocin-induced diabetes. Materials and Methods. DM 1 type in animals was induced by intraperitoneal injection of streptozotocin. Experiments were performed on male Wistar rats, who, from the 10th day after diabetes induction, were administered per os extracts of red and yellow fruits of the cornelian cherry and loganic acid obtained from yellow fruits at a dose of 20 mg/kg of body weight for 14 days. On the 24th day of the experiment, the rats were decapitated under ether anesthesia, and blood was taken. The content of pyruvate and lactate (as the end products of anaerobic glycolysis) and L-lactate dehydrogenase activity were determined in plasma and erythrocytes, as well as biochemical markers of the antioxidant status of erythrocytes (activity of superoxide dismutase, catalase and glutathione peroxidase, level of reduced glutathione, TBA-reactive substances, concentration of oxidative modifications of proteins and advanced oxidation protein products). Results. The activity of catalase, superoxide dismutase, glutathione peroxidase and the concentration of reduced glutathione significantly increased against the decrease in the content of oxidative modifications of proteins, advanced oxidation protein products, TBA-reactive substances, pyruvate, L-lactate, and lactate dehydrogenase in rats with DM after administration of the fruit extracts of the cornelian cherry. Noteworthy, these biochemical indicators made it possible to assess the intensity of anaerobic glycolysis and the antioxidant status of blood erythrocytes in streptozotocin diabetes. Conclusions. Extracts of Cornus mas L. fruits might be potential natural drugs for the treatment of metabolic disorders in diabetes, as they have a corrective effect on the catabolic breakdown of glucose and the antioxidant defense system of erythrocytes, preventing the development of oxidative stress. It should be pointed out that the extract of red fruits of cornelian cherry showed the best effect among the studied extracts in normalizing these indicators.

MRI-based vertebral bone quality score as a novel bone status marker of patients with adolescent idiopathic scoliosis

To investigate the application of MRI-based vertebral bone quality (VBQ) score in assessing bone mineral density (BMD) for patients with adolescent idiopathic scoliosis (AIS). We reviewed the data of AIS patients between January 2021 and October 2023 with MRI, whole-spine plain radiographs, quantitative computed tomography (QCT) and general information. VBQ score was calculated using T1-weighted MRI. Univariate analysis was applied to present the differences between variables of patients with normal BMD group (QCT Z-score > − 2.0) and low BMD group (QCT Z-score ≤ − 2.0). The correlation between VBQ score and QCT Z-score was analyzed with Pearson correlation test. A multivariate logistic regression model was used to determine the independent factors related to low BMD. Receiver operating characteristic curve (ROC) was drawn to analyze the diagnostic performance of VBQ score in distinguishing low BMD. A total of 136 AIS patients (mean age was 14.84 ± 2.10 years) were included, of which 41 had low BMD. The low BMD group had a significantly higher VBQ score than that in normal group (3.48 ± 0.85 vs. 2.62 ± 0.62, P < 0.001). The VBQ score was significantly negative correlated with QCT Z score (r = − 0.454, P < 0.001). On multivariate analysis, VBQ score was independently associated with low BMD (OR: 4.134, 95% CI 2.136–8.000, P < 0.001). The area under the ROC curve indicated that the diagnostic accuracy of the VBQ score for predicting low BMD was 81%. A sensitivity of 65.9% with a specificity of 88.4% could be achieved for distinguishing low BMD by setting the VBQ score cutoff as 3.18. The novel VBQ score was a promising tool in distinguishing low BMD in patients with AIS and could be useful as opportunistic assessment for screening and complementary evaluation to QCT before surgery.

Monitoring the Immune System in Critically Ill Patients (Review)

Most patients with critical illness, regardless of the cause, develop activation of innate and adaptive immunity. This is often a critical process leading to organ dysfunction.The aim of the review is to systematize information on monitoring the immune system in critical illness for physicians of different specialties (anesthesiology and intensive care, surgery, general practice, obstetrics and gynecology).The review includes information from 83 recent national and international publications (mostly from 2023), available in the public domain and found by keyword search.We have summarized the current understanding of the relationship between infections and the human immune system, as well as the clinical application of traditional markers of immune status. We provided data on novel promising markers for the assessment of immunity in patients with various diseases.Limitations of the studies reviewed include the need for additional large-scale clinical trials of even the most promising markers, as well as a synthesis of the evidence for their performance. In addition, immune monitoring is likely to increase the cost of patient care, necessitating the development of more affordable research methods.Conclusion. Almost all disorders in critically ill patients are associated with changes in the immune system. Management of patients based on their immune profile requires determination of a personalized strategy for immune modulation, treatment, and prevention of infection. Advanced monitoring of immune system functions will contribute to the personalization of medicine, and the continuous development of biological technologies will allow to improve its methods.

Deterrence icons as status symbols: American forces in NATO’s eastern flank

How can a signal of extended deterrence, such as prepositioning of foreign military forces, signify status for the beneficiaries of the allied deterrence/reassurance chain? This article explores how the manifestation and communication of allied deterrence can concurrently constitute an affectively charged status symbol for the protégé states of this international security practice. It does so on the example of the Baltic states and Poland, probing the presence and functionality of the American forces as a status marker in North Atlantic Treaty Organization (NATO)’s eastern flank states after 2014. Engaging discourse analysis and expert interviews, the article shows (1) how the intersubjectively determined success of deterrence is dependent on historically potent symbols which have become emblematic of extended deterrence and (2) how deterrence icons can simultaneously serve as multifarious status symbols in intra-alliance politics. The self-identification of protégé states as worthy stakes to deter over emerges as an ambivalent status position defined by the shortage of attributes, rather than a function of their tally. The article contributes to the understanding of the symbolic form of (allied) deterrence and the multivocal status value ascribed to the American ‘boots on the ground’.

#2774 Association of serum CA-125 and lung ultrasound with other markers of volumen status in peritoneal dialysis patients

Abstract Background and Aims Volume overload (VO) represents the main risk factor for cardiovascular death in peritoneal dialysis (PD) patients. The lack of objective methods and validated markers constitutes the basis for the high prevalence, which is one of the main causes of technique failure. The use of lung ultrasound, VExUS score and serum CA-125 (SeCA-135), has emerged to assess volume in heart failure patients. In this pilot study, we explored the association of these novel approaches with classical markers of VO Method A cross-sectional cohort study was conducted on fourteen PD outpatients, in which volume status was simultaneously assessed through SeCA-125 levels along with standardized 28-site lung ultrasound, VExUS Score (excluding renal Doppler), NT-proBNP levels, and bioimpedance spectroscopy (BIS). Clinical and physical examination parameters were collected simultaneously, and echocardiographic measures were collected from the clinical history in the previous 6 months. The inclusion criteria were: patients over 18 years old, in a PD program for at least 6 months, with good adherence to the technique. The exclusion criteria were: cardiovascular event in the three months prior to the study initiation, active uncontrolled neoplastic disease, or active infection or intercurrent illness in the 2 months prior to evaluation. Because NT-ProBNP does not follow the normal distribution, we used the Ig transformation (LgNT-proBNP) in the statistical process. Results The mean age was 68.9 ± 14.9 years, with an average of 29.9 ± 19.61 months on dialysis, a mean residual diuresis of 1.22 ± 0.88 liters, and the mean weekly KT/V was 2.10 ± 0.63. 28.6% of the patients have Congestive Heart Failure, 57.1% have Diabetes Mellitus and 100% have hypertension. The patients had a mean Charlson Index of 5.7 ± 2.1 and were using an average of 2.4 ± 1.1 antihypertensive drugs. 28.6% of the patients presented dyspnea, 14.3% had pulmonary crackles, and 35.7% had peripheral edema. Mean ECW/TBW was 0.48 ± 0.02, and overhydration by BIS was 1.18 ± 1.46 L. The mean number of B-lines was 8.79 ± 6.43, Se-CA-125 was 20.42 ± 8.66 IU/mL, and NT-proBNP was 3950 (172-35,000) ng/L. SeCA125 was positively associated with left atrial volume (r = 0.823, p = 0.01), estimated PASP (r = 0.787, p = 0.03), LogNT-proBNP (r = 0.614, p = 0.02) and negatively correlated with TAPSE (r = −0.77, p = 0.05). Likewise, LogNT-proBNP was positively associated with CRP (r = 0.54, p = 0.05), and ECW/TBW ratio (r = 0.57, p = 0.03) and negatively correlated with albumin (r = −0.66, p = 0.01). There was no correlation between the number of B-lines and Se-CA-125 with the diameter or collapsibility of the IVC, pulsatility portal vein, or analysis of Doppler hepatic vein, VExUs grade, ECW/TBW ratio, NT-proBNP levels, renal residual function or the presence of edema or pulmonary crackles. Patients with overhydration by BIS (&amp;gt;7.5% OH/TBW) showed more B-lines (13 ± 6.32 vs. 5.57 ± 5.028 p = 0.04). Patients diagnosed as overloaded by B-lines (&amp;gt;5 lines) did not show a higher level of SeCA-125 (22.2 ± 9.50 vs 16 ± 4.16; p &amp;gt; 0.05), VCI diameter (1.6 ± 9.43 vs 2 ± 0.27; p &amp;gt; 0.05), OH/TBW ratio (8.4 ± 8.55 vs 2.55 ± 4.13; p &amp;gt; 0.05) or Log NT-proBNP (0.91 ± 0.76 vs 3.19 ± 0.91; p &amp;gt; 0.05). Conclusion The number of B-lines in lung ultrasound can detect patients with VO earlier compared to BIS. SeCA-125 levels are sensitive to changes in the echocardiogram. The use of both methods can help us detect early signs of volume overload in peritoneal dialysis patients.

Whole dried black soldier fly (Hermetia illucens) larvae are acceptable, palatable, and do not negatively affect health when fed to healthy, adult horses at low inclusion rates

Black soldier fly larvae (BSFL) have the potential to be incorporated into equine feed as a sustainable and nutritionally dense insect-derived source of protein and fat. The purpose of this study was to investigate the suitability of whole dried BSFL as a novel protein source in equine diets based on acceptability, palatability, and various health parameters. Seventeen horses (15.2 ± 7.0 years; 596 ± 122 kg body weight (BW) (mean±SD)) and three ponies (19.7 ± 0.6 years; 364 ± 53 kg) were separately fed a BSFL-based supplement (TRT) and a roasted soybean-based supplement (CON) (0.75 g crude protein per kg BW0.75) for 28-days using a cross-over study design. Feed intake was recorded throughout the feeding periods to assess the acceptability of the novel ingredient. Body weight, body condition score (BCS), plasma biochemistry, and complete blood counts were assessed at the beginning and end of each treatment period as markers of health status. After the cross-over study, two-bowl tests were used to assess the palatability of the BSFL supplement, with or without the presence of other concentrates. Minimal differences were observed between treatment groups for biochemical analytes and complete blood counts, and BW and BCS did not change throughout the study period. Both supplements were willingly consumed by the horses over the 28-day feeding periods, though feed intake was 8% greater in the CON compared to the TRT group (P<0.01). For the palatability tests, horses first approached (P=0.03) and first consumed (P=0.03) the CON more frequently than the TRT supplement when the supplements were supplied with other concentrates. When the supplements were offered in the absence of other concentrates, there was no difference in which bucket was approached first, but horses tended to first consume the CON rather than the TRT supplement. Overall, these data indicate that dietary consumption of BSFL for 28 days at a low-inclusion rate results in no negative health outcomes in horses; however, longer-term studies are warranted to further examine physiological effects of consuming BSFL and at higher inclusion rates. Though horses did favour the CON supplement based on palatability parameters, horses willingly consumed the BSFL supplement, indicating that BSFL at low inclusion rates may be considered a palatable ingredient in equine diets.

#2085 Testosterone and markers of nutritional status correlate with leptin in chronic kidney disease

Abstract Background and Aims Leptin, the anorexic hormone, also appears to have a proatherogenic effect, contributing to the development of cardiovascular morbidity and mortality. Current data on factors related to serum leptin levels in different stages of chronic kidney disease (CKD) are inconsistent. The aim of this study was to evaluate the determinants of leptin level in pre-dialysis stage of CKD. Method We performed a cross-sectional study, including 73 patients, mean age 67 (60-78) years, 38% diabetic, with GFR 31 ± 20.85 ml/min per 1.73 m(2). We followed the correlations of leptin with inflammatory, nutritional, lipid markers, testosterone and others by univariate analysis and subsequently determined the strongest predictor for leptin level by multivariate analysis. Results Table. Correlation between the parameters and leptin in CKD pre-dialysis group. In the CKD pre-dialysis patients the best predictors for leptin level were body mass index, adipose tissue mass, lean tissue mass (for each p &amp;lt; 0.001) and testosterone (p &amp;lt; 0.001). Blood glucose (p = 0.013) was also a significant determinant of leptin level in pre-dialysis CKD patients. Conclusion In pre-dialysis CKD patients, testosterone levels together with nutritional markers are the best predictive markers for leptin levels. The management of these determinants can influence the level of leptin in CKD pre-dialysis patients and future research will determine if it can influence the atherosclerotic process.

Gut microbiota associations with chronic kidney disease: insights into nutritional and inflammatory parameters.

The gut barrier, comprising gut microbiota, plays a pivotal role in chronic kidney disease (CKD) progression and nutritional status. This study aimed to explore gut barrier alterations in hemodialyzed (HD) patients, non-HD (NHD) CKD patients, and healthy volunteers. Our cross-sectional study enrolled 22 HD patients, 11 NHD patients, and 11 healthy volunteers. We evaluated fecal microbiota composition (assessed via bacterial 16S rRNA gene sequencing), fecal IgA levels, surrogate markers of gut permeability, serum cytokines, appetite mediators, nutritional status, physical activity, and quality of life. HD patients exhibited significant alterations in fecal microbiota composition compared to healthy volunteers, with observed shifts in taxa known to be associated with dietary patterns or producing metabolites acting on human host. In comparison to healthy volunteers, individuals with HD patients exhibited elevated levels of inflammatory markers (CRP, IL-6 and TNF-α), glucagon-like peptide-2, and potential anorexigenic markers (including leptin and peptide YY). NHD patients had increased levels of CRP and peptide YY. Overall fecal microbiota composition was associated with height, soft lean mass, resting energy expenditure, handgrip strength, bone mineral content and plasma albumin and TNF-α. Compared to healthy volunteers, HD patients have an altered fecal microbiota composition, a higher systemic inflammation, and a modification in plasma levels of appetite mediators. While some differences align with previous findings, heterogeneity exists likely due to various factors including lifestyle and comorbidities. Despite limitations such as sample size, our study underscores the multifaceted interplay between gut microbiota, physiological markers, and kidney function, warranting further investigation in larger cohorts.

Do sex, age, and comorbidities modify the association of socioeconomic status and opioid use after total hip arthroplasty?: a population-based study from the Danish Hip Arthroplasty Register.

We aimed to examine the association between socioeconomic status (SES) markers and opioid use after primary total hip arthroplasty (THA) due to osteoarthritis, and whether sex, age, or comorbidities modify any association. Using Danish databases, we included 80,038 patients undergoing primary THA (2001-2018). We calculated prevalences and prevalence ratios (PRs with 95% confidence intervals [CIs]) of immediate post-THA opioid use (≥ 1 prescription within 1 month) and continued opioid use (≥ 1 prescription in 1-12 months) among immediate opioid users. Exposures were individual-based education, cohabitation, and wealth. The prevalence of immediate opioid use was ~45% in preoperative non-users and ~60% in preoperative users (≥ 1 opioid 0-6 months before THA). Among non-users, the prevalences and PRs of continued opioid use were: 28% for low vs. 21% for high education (PR 1.28, CI 1.20-1.37), 27% for living alone vs. 23% for cohabiting (PR 1.09, CI 1.04-1.15), and 30% for low vs. 20% for high wealth (PR 1.43, CI 1.35-1.51). Among users, prevalences were 67% for low vs. 55% for high education (1.22, CI 1.17-1.27), 68% for living alone vs. 60% for cohabiting (PR 1.10, CI 1.07-1.12), and 73% for low wealth vs. 54% for high wealth (PR 1.32, CI 1.28-1.36). Based on testing for interaction, sex, age, and comorbidity did not statistically significant modify the associations. Nevertheless, associations were stronger in younger patients for all SES markers (mainly for non-users). Markers of low SES were associated with a higher prevalence of continued post-THA opioid use. Age modified the magnitude of the associations, but it was not statistically significant.

Nutritional Challenges in Nursing Homes: Pilot Study on Macronutrient Intake and Status of Vitamins D and B12.

Older adults living in nursing homes (NH) are considered a population group that could be at risk in terms of nutrition, even more so than their community-dwelling peers. Evidence on the nutritional status of NH residents is scarce, as they are commonly excluded from population-based dietary studies. This is also the case in Slovenia. In the presented pilot study, we assessed the intake of macronutrients as well as the intake and status of vitamin D and vitamin B12 on a sample of NH and NH daycare center users to explore the need for a larger representative study. The pilot study included 37 participants from three Slovenian NH (20 participants) and their daycare centers (17 participants). Daycare centers offer daytime care services for older adults, where users are also provided with major meals during their stay. Intakes of energy and nutrients were estimated by three 24 h dietary records. Fasting blood samples were collected for the assessment of vitamin D and vitamin B12 status. Over 90% of the participants had daily energy and protein intakes below recommendations (reference values: energy intake: males 2100 kcal and females 1700 kcal; protein intake > 1 g/kg body mass). The males' median daily intakes of vitamin D were 1.7 µg (1.5 µg females), and 2.3 µg for vitamin B12 (2.0 µg females). None of the participants had adequate vitamin D intake (>20 µg), and 92.3% males and 87.5% females had inadequate vitamin B12 intake (<4 µg). The prevalence of vitamin D deficiency (serum 25-OH-D conc. < 30 nmol/L) was 100% among NH residents and 53% among NH daycare center users. The prevalence of vitamin B12 deficiency was found in 20% of NH residents. The study results highlighted that certain nutrients might be critical in this population, especially among NH residents; however, a more thorough investigation with the inclusion of other important markers of nutritional status should be performed on a larger, representative sample to support the development and implementation of appropriate public health interventions.

The Los Angeles motor scale (LAMS) is independently associated with CT perfusion collateral status markers

Background and aimThe Los Angeles Motor Scale (LAMS) is an objective tool that has been used to rapidly assess and predict the presence of large vessel occlusion (LVO) in the pre-hospital setting successfully in several studies. However, studies assessing the relationship between LAMS score and CT perfusion collateral status (CS) markers such as cerebral blood volume (CBV) index, and hypoperfusion intensity ratio (HIR) are sparse. Our study therefore aims to assess the association of admission LAMS score with established CTP CS markers CBV Index and HIR in AIS-LVO cases. Materials and MethodsIn this prospectively collected, retrospectively reviewed analysis, inclusion criteria were as follows: a) CT angiography (CTA) confirmed anterior circulation LVO from 9/1/2017 to 10/01/2023, and b) diagnostic CT perfusion (CTP). Logistic regression analysis was performed to assess the relationship between admission LAMS with CTP CS markers HIR and CBV Index. p ≤ 0.05 was considered significant. ResultsIn total, 285 consecutive patients (median age = 69 years; 56 % female) met our inclusion criteria. Multivariable logistic regression analysis adjusting for sex, age, ASPECTS, tPA, premorbid mRS, admission NIH stroke scale, prior history of TIA, stroke, atrial fibrillation, diabetes mellitus, hyperlipidemia, coronary artery disease and hypertension, admission LAMS was found to be independently associated with CBV Index (adjusted OR:0.82, p < 0.01), and HIR (adjusted OR:0.59, p < 0.05). ConclusionLAMS is independently associated with CTP CS markers, CBV index and HIR. This finding suggests that LAMS may also provide an indirect estimate of CS.

Comparison of physical activity and physical fitness in children and adolescents of Chinese Han and Tibet ethnicity.

Physical activity (PA) and physical fitness (PF) are important markers of health status in children and adolescents in different ethnicities. In this study, we aimed to compare the PA and PF indicators between Tibetan and Han children and adolescents. Children and adolescents of 4-9 grades were recruited in Shigatse (n = 963) and Shanghai (n = 2,525) respectively. The information related to demographic, PA, and PF was collected via a self-reported questionnaire. PA was assessed through the participation of moderate to vigorous PA (MVPA), muscle-strengthening exercise (MSE) and organized sport participation (OSP). PF was estimated using the International Fitness Scale containing components of overall fitness, cardiorespiratory fitness, speed and agility, muscular strength and flexibility. Han (mean age = 13.45 ± 3.3 years; 49.7% girls) and Tibet (mean age = 13.8 ± 2.5 years; 48.3% girls) children and adolescents from Shanghai and Shigatse completed the questionnaire survey. It was revealed that Tibetan students had higher MVPA, MSE and OSP than children and adolescents of Han ethnicity (p < 0.01, small to medium effect size). A relatively higher percentage of student in Shanghai did not participate in any form of PA. On the other hand, less Tibetan students thought their PF indicators including overall fitness, cardiorespiratory fitness, speed and agility, muscular strength and flexibility were poor or very poor than their counterparts of Han ethnicity (p < 0.01, small to medium effect size). Tibetan children and adolescents have higher levels of PA and PF in comparison to their Han counterparts. More children and adolescents of Han ethnicity engage in no PA and think their PF indicators were poor.

Time‑dependent ROC curve analysis to determine the predictive capacity of seven clinical scales for mortality in patients with COVID‑19: Study of a hospital cohort with very high mortality.

Clinical data from hospital admissions are typically utilized to determine the prognostic capacity of Coronavirus disease 2019 (COVID-19) indices. However, as disease status and severity markers evolve over time, time-dependent receiver operating characteristic (ROC) curve analysis becomes more appropriate. The present analysis assessed predictive power for death at various time points throughout patient hospitalization. In a cohort study involving 515 hospitalized patients (General Hospital Number 1 of Mexican Social Security Institute, Colima, Mexico from February 2021 to December 2022) with COVID-19, seven severity indices [Pneumonia Severity Index (PSI) PaO2/FiO2 arterial oxygen pressure/fraction of inspired oxygen (Kirby index), the Critical Illness Risk Score (COVID-GRAM), the National Early Warning Score 2 (NEWS-2), the quick Sequential Organ Failure Assessment score (qSOFA), the Fibrosis-4 index (FIB-4) and the Viral Pneumonia Mortality Score (MuLBSTA were evaluated using time-dependent ROC curves. Clinical data were collected at admission and at 2, 4, 6 and 8 days into hospitalization. The study calculated the area under the curve (AUC), sensitivity, specificity, and predictive values for each index at these time points. Mortality was 43.9%. Throughout all time points, NEWS-2 demonstrated the highest predictive power for mortality, as indicated by its AUC values. PSI and COVID-GRAM followed, with predictive power increasing as hospitalization duration progressed. Additionally, NEWS-2 exhibited the highest sensitivity (>96% in all periods) but showed low specificity, which increased from 22.9% at admission to 58.1% by day 8. PSI displayed good predictive capacity from admission to day 6 and excellent predictive power at day 8 and its sensitivity remained >80% throughout all periods, with moderate specificity (70.6-77.3%). COVID-GRAM demonstrated good predictive capacity across all periods, with high sensitivity (84.2-87.3%) but low-to-moderate specificity (61.5-67.6%). The qSOFA index initially had poor predictive power upon admission but improved after 4 days. FIB-4 had a statistically significant predictive capacity in all periods (P=0.001), but with limited clinical value (AUC, 0.639-0.698), and with low sensitivity and specificity. MuLBSTA and IKIRBY exhibited low predictive power at admission and no power after 6 days. In conclusion, in COVID-19 patients with high mortality rates, NEWS-2 and PSI consistently exhibited predictive power for death during hospital stay, with PSI demonstrating the best balance between sensitivity and specificity.

Bioavailability of Lutein from Marigold Flowers (Free vs. Ester Forms): A Randomised Cross-Over Study to Assess Serum Response and Visual Contrast Threshold in Adults.

Lutein (Lut) and zeaxanthin (Zeax) are found in the blood and are deposited in the retina (macular pigment). Both are found in the diet in free form and esterified with fatty acids. A high intake and/or status is associated with a lower risk of chronic diseases, especially eye diseases. There is a large global demand for Lut in the dietary supplement market, with marigold flowers being the main source, mainly as lutein esters. As the bioavailability of Lut from free or ester forms is controversial, our aim was to assess the bioavailability of Lut (free vs. ester) and visual contrast threshold (CT). Twenty-four healthy subjects (twelve women, twelve men), aged 20-35 and 50-65 years, were enrolled in a cross-sectional study to consume 6 mg lutein/day from marigold extract (free vs. ester) for two months. Blood samples were taken at baseline and after 15, 40, and 60 days in each period. Serum Lut and Zeax were analysed using HPLC, and dietary intake was determined with a 7-day food record at the beginning of each period. CT, with and without glare, was at 0 and 60 days at three levels of visual angle. Lut + Zeax intake at baseline was 1.9 mg/day, and serum lutein was 0.36 µmol/L. Serum lutein increased 2.4-fold on day 15 (up to 0.81 and 0.90 µmol/L with free and ester lutein, respectively) and was maintained until the end of the study. Serum Zeax increased 1.7-fold. There were no differences in serum Lut responses to free or ester lutein at any time point. CT responses to lutein supplementation (free vs. ester) were not different at any time point. CT correlated with Lut under glare conditions, and better correlations were obtained at low frequencies in the whole group due to the older group. The highest correlations occurred between CT at high frequency and with glare with serum Lut and Lut + Zeax. Only in the older group were inverse correlations found at baseline at a high frequency with L + Z and with Lut/cholesterol and at a low frequency with Lut/cholesterol. In conclusion, daily supplementation with Lut for 15 days significantly increases serum Lut in normolipemic adults to levels associated with a reduced risk of age-related eye disease regardless of the chemical form of lutein supplied. Longer supplementation, up to two months, does not significantly alter the concentration achieved but may contribute to an increase in macular pigment (a long-term marker of lutein status) and thus improve the effect on visual outcomes.