Mean Levels Research Articles

The Effect of the Holy Quran Recitation on Inflammatory Markers in Hemodialysis Patients in Iran: A Randomized Clinical Trial.

Increased inflammation is a common complication in chronic hemodialysis (HD) patients. Addressing the psychological symptoms of patients may help reduce inflammation and its negative impact on the body. Considering the calming effects of listening to the Holy Quran, this may help reduce mental, psychological, and physical problems in Muslim patients. The present study sought to examine the effects of listening to Holy Quran recitation on the level of inflammatory markers in HD patients. This was a randomized controlled trial involving 50 HD patients at Kowsar Hospital in Semnan, Iran, in 2019-2020. The participants were divided into experimental and control groups using simple randomization by sealed envelopes. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and interleukin-6 (IL-6) levels in blood were measured before the intervention. The participants in the experimental group listened by headphones to the Holy Quran being recited three times a week, 20 min each time, for one month. For those in the control group, headphones were placed but on silent mode. At the end of the intervention one month later, inflammatory markers were measured again for participants in both groups. Data were analyzed in SPSS-16 using descriptive and inferential statistics (t test, Wilcoxon, and Mann-Whitney U). Mean IL-6 level decreased by 20.2pg/ml, mean ESR level by 16.8mm/hr, and mean CRP level by 19.9mg/dl in the experimental group, while these values increased in the control group. The between-group differences in the intervention and control groups at follow-up were significant for all three inflammatory markers (p < 0.05). Listening to the Holy Quran being recited is recommended as a complementary therapy for reducing systemic inflammation (as indicated by inflammatory markers) in Muslim HD patients.Trial registration: Iranian Registry of Clinical Trials, Trial No: IRCT20120109008665N9. Registered 4 Nov 2019.

The Throughfall, Stemflow, and Canopy Interception Loss in Corn and Soybean Fields in Northeast China

Information about throughfall, stemflow, and canopy interception loss is essential for the water use efficiency of crops and the dynamic processes of water erosion. A two-year field experiment was conducted under natural rainfall conditions to observe the characteristics and factors that affect throughfall, stemflow, and canopy interception loss in corn (Zea mays L.) and soybean (Glycine max L.) fields in northeast China from 2019 to 2020. Nine measurement sites (A, B, C, D, E, F, G, H, and I) were distributed horizontally between two planting rows under the crop canopy. The mean value of the throughfall volume (TF) in measurement locations B, C, and G under the corn canopy and measurement locations B and C could represent the mean level of TF of corn and soybean fields, respectively. The volume of TF, stemflow (SF), and canopy interception loss (CI) of two growing seasons from 2019 to 2020 accounted for approximately 58.5%, 30.1%, and 11.4% of the gross rainfall (GR) of two growing seasons in corn fields, and 78.0%, 7.5%, and 14.5% of the GR in the soybean field, respectively. The TF and TFR of each rainfall event in the corn and soybean fields could be predicted by linear regression models with a normalized root mean square error (NRMSE) lower than 25.0%. These results and prediction models will be used in water management and soil erosion control in northeast China.

Pengaruh Edukasi Media Booklet Terhadap Kepatuhan Diet Pada Penderita Diabetes Melitus Tipe 2 Di Wilayah Kerja Puskesmas Ranomuut

Diabetes Mellitus is a group of metabolic diseases characterized by hyperglycemia due to impaired insulin production, insulin action. Management of the 4 pillars of diabetes mellitus includes education on eating arrangements. The purpose of this study was to determine the effect of booklet media education on dietary compliance in patients with type 2 diabetes mellitus in the ranomuut health center work area.The research design used is a pre-experiment with a one group pre and posttest design approach. The sample in this study were 23 respondents using purposive sampling technique. the research instrument used was a questionnaire sheet. Then the data that has been collected is processed using the SPSS 16.0 program to be analyzed using the Mc.Nemar statistical test with a level of meaningfulness (α) = 0.05. Based on the results of the study when given education for the pre-test, the highest percentage was non-compliant 21 respondents (91.3%) and the post-test the highest percentage was compliant 22 respondents (95.7%). From the results of the Mc.Nemar statistical test, the P value = 0.000 with a significance of &lt;0.05, which means Ha is accepted and Ho is rejected. The conclusion of this study is that there is an effect of booklet media education on dietary compliance in patients with type 2 diabetes mellitus in the ranomuut health center work area. This study is expected to increase knowledge in implementing dietary compliance so that it can control the problem of diabetes mellitus.

Foodborne Viruses and Somatic Coliphages Occurrence in Fresh Produce at Retail from Northern Mexico.

Foodborne disease outbreaks linked to consumption of vegetables have been often attributed to human enteric viruses, such as Norovirus (NoV), Hepatitis A virus (HAV), and Rotavirus (RoV). Information about the occurrence of these viruses is scarce in many fresh-producing countries. Viral contamination detection of indicators, such as somatic coliphages, could indirectly reflect the presence of viral pathogens, being a valuable tool for better viral risk assessment in food industry. This study aimed to establish the occurrence and correlation of foodborne viruses and somatic coliphages in leafy greens in northern Mexico. A total of 320 vegetable samples were collected, resulting in 80 composite rinses, 40 of lettuce and 40 of parsley. Somatic coliphages were determined using the EPA 1602 method, while foodborne viruses (HAV, RoV, NoV GI, and GII) were determined by qPCR. The occurrence of RoV was 22.5% (9/40, mean 2.11 log gc/g) in lettuce and 20% (8/40, mean 1.91 log gc/g) in parsley. NoV and HAV were not detected in any samples. Somatic coliphages were present in all lettuce and parsley samples, with mean levels of 1.85 log PFU/100ml and 2.28 log PFU/100ml, respectively. Spearman analysis established the correlation of somatic coliphages and genomic copies of RoV, resulting in an r2 value of -0.026 in lettuce and 0.349 in parsley. Although NoV or HAV were undetected in the samples, the presence of RoV is a matter of concern as leafy greens are usually eaten raw, which poses a potential risk of infection.

Association of Hypocalcemia with In-Hospital Outcomes in Patients with Heart Failure

Objective: To determine the association of hypocalcemia with in-hospital outcomes in terms of in-hospital mortality in patients with heart failure. Methodology: This descriptive Study was done at department of Cardiology, LUMHS, Jamshoro, from March 2022 to March 2023. Patients aged 18 to 80 years old both genders, patients who were present with heart failure were included. Baseline investigations, including serum calcium levels, were performed, with hypocalcemia defined as serum calcium levels &lt;8.7mg/dL. Patients were then categorized based on the presence or absence of hypocalcemia and assessed for in-hospital mortality. Data analysis was conducted using SPSS version 24.0. Results: The mean age of the patients was 63.84 years with a standard deviation of 15.55 years and mean serum calcium level was 8.80 mg/dL. Among the patients, 69.4% were male and 30.6% were female. Among patients of heart failure, the in-Hospital mortality was 18.3%. The overall frequency of hypocalcemia in patients with heart failure was 19.40%. Among patients how died during hospital stay, 2.6% had hypocalcemia, while 16.8% were died without hypocalcemia, the p-value 0.316 indicated that the association of hypocalcemia was statistically insignificant (p-0.316). The P-values for gender and diabetes mellitus were significant (&lt;0.05), indicating a correlation between these factors and hypocalcemia, while age and hypertension showed insignificant associations with hypocalcemia (&gt;0.05).

In-vehicle ultrafine and fine particulate matter exposures during commuting in a South Asian megacity: Dhaka, Bangladesh

We measured ultrafine particle number concentration (PNC) and fine particulate matter mass concentration (PM2.5) levels in public buses and private cars under three conditions: windows open, windows closed with air recirculation off, and windows closed with air recirculation on in Dhaka, Bangladesh—an extremely polluted megacity in South Asia. We collected measurements on ∼10 repeated round trips on unique days for each selected transportation mode, covering various routes that spanned multiple arterial roads over several months (January to March 2020 and November to December 2020) and different times of the day to account for the variability in traffic and meteorological conditions. We used a condensation particle counter (CPC) to measure PNC and a PurpleAir sensor to measure PM2.5 mass concentrations. We applied corrections to the raw data and analyzed quality-assured data to investigate exposure differences across modes, pollutants, locations, and times. Public buses and private cars with open windows had mean PNC levels of 112,000 # cm−3 and 117,000 # cm−3, approximately 5–6 times higher than the mean urban background level of around 20,000 # cm−3. PM2.5 levels in these vehicles were approximately ∼100 μg m−3, about 20% higher than the urban background PM2.5 level of 85 μg m−3. With closed windows and air recirculation off, concentrations were 15% lower for PNC and 10% lower for PM2.5. Under closing windows and keeping air recirculation on, mean PNC and PM2.5 levels were 60,000 # cm−3 and 70 μg m−3, respectively, representing a 50% reduction for PNC and a 30% reduction for PM2.5 compared to open windows. Our findings suggest that commuters in public buses and private cars with open windows have higher and similar exposure levels, whereas those commute in private cars with closed windows and air recirculation on have lower exposure levels.

Breast Cancer Risk Assessment among Rural Women in Turkey

Background: Breast cancer is the most prevalent cancer type in women both Turkey and worldwide. In order to construct screening programs correctly, to identify breast cancer at the early stage and to reduce the burden of disease after diagnosis; first, women’s risk levels should be determined. Aim: The aim of this study is to identify women’s breast cancer risk levels, the frequency of BSE, and affecting factors in rural women in Turkey. Method and Material: This cross-sectional study was included 280 adult women. As data collection tools were used “The Sociodemographic Characteristics Questionnaire” and “Breast Cancer Risk Assessment Tool”. Results: Women’s mean breast cancer risk level was found as 137.69±67.56. 91.1 % of women were found to be in a low-risk group. When women’s mean scores related to Breast Cancer Risk Assessment Tool and sociodemographic variables were compared and a statistically significant difference was detected between vocational status, education level and smoking status. The vast majority of women take place in the low-risk group in terms of breast cancer. Conclusions: The effects of community-based and opportunistic national breast cancer screenings on mortality rates and their cost-effectiveness must be assessed. Primarily, individual breast cancer risk evaluations must be done instead of community-based screenings, useful tools must be selected for risk evaluation, screening programs must be performed according to the risk and women should be invited to health organizations for screenings.

Investigating How Immersion Semester High Schools Promote Meaningful Experiences

Background: Practitioners want to create meaningful experiences for youth because they provide positive benefits. Immersion semester high schools are likely to provide meaningful experiences. Purpose: This study sought to identify what types of activities are most meaningful to youth, whether activities are more meaningful in immersion semester high schools, and to determine which aspects of immersion semester high schools predict meaningfulness and whether this varies by emotional valence. Methods: Youth ( N = 261) provided 11,498 surveys (6,062 at program/5,435 at home) when they participated in an immersion semester high schools and when they were at home. They reported on the meaningfulness of experiences twice daily for 3 weeks in each context. Findings: The results showed that hanging out with peers was the most meaningful activity, that experiences in immersion semester high schools were more meaningful than at home, and that whereas higher levels of emotion predicted higher levels of meaningfulness regardless of how positive or negative the experience was, behavioral engagement was more predictive for positive experiences, whereas psychological engagement was more predictive for negative experiences. Implications: Immersion semester high schools can create more meaningful experiences than at home, especially those that are emotionally engaging.

The Military Health History: An Educational Initiative to Improve Veteran Healthcare.

As a result of the nature of military service, veterans are a unique patient population with many special health considerations. For various reasons, measures are often not taken by clinicians to address such special considerations. This results in a healthcare disparity for veterans first described by Dr. Jeffrey Brown in 2012. To address this disparity, we introduced "the military health history" to third-year medical students at a large medical school in the southeastern United States. Our objective was to assess the effectiveness of this educational intervention and determine its potential role in creating a future in which veteran healthcare is of the highest quality. This study was approved as a quality assurance/quality improvement project by both Louisiana State University Health Science Center and Southeast Louisiana Veteran Healthcare System IRB offices. A short lecture outlining the components of the military health history was presented to 186 third-year medical students. The students were given the opportunity to answer five survey questions before and after the lecture. These questions assessed the students' current confidence performing a military health history, perceived importance of doing so, and likelihood of future implementation. To determine useful retention of the lecture material, the post-lecture survey was readministered to the same population sample 6 months after the lecture. A series of repeated measures analyses of variance were conducted to examine changes in mean levels of confidence, importance, and likelihood of ascertaining military history during a patient encounter at pre- and post-presentation as well as at the 6 month follow-up. Results revealed a significant effect of time on importance, Wilks' Lambda = 0.74, F (2, 87) = 15.41, P < 0.001; confidence, Wilks' Lambda = 0.61, F (2, 87) = 27.58, P < 0.001; and likelihood of ascertaining a military history during a future patient encounter, Wilks' Lambda = 0.46, F (2, 88) = 50.58, P < 0.001. Results are demonstrated in detail in Table I of the manuscript. The lecture resulted in a statistically significant increase over 6 months in both the likelihood and confidence parameters. The team believes that this result indicates that the students demonstrated useful retention of the lecture material. Our hope is that these students continue to employ the military health history throughout their years of clinical work. In the future, we plan to survey veterans immediately following Veterans Health Administration clinic visits with members of our study population to assess the patient's perceived benefit of the military health history. The team will continue to investigate ways in which military health curricula can be implemented in undergraduate medical education.

Cord Blood Cortisol Level - A Possible Predictor for Respiratory Distress Syndrome in Preterm Neonates.

Respiratory Distress Syndrome (RDS) is a leading cause of death in premature infants. There are different clinical/ biochemical markers associated with the RDS. One of the potential biochemical markers is cortisol in cord blood. This study aims to correlate cortisol levels in preterm neonates with RDS and to establish whether cord blood cortisol is a reliable predictor for RDS. This prospective analytical study was conducted in a tertiary care hospital over nine months among fifty preterm neonates. Data were collected using proforma, and cord blood was collected at the time of delivery. Cortisol levels were compared and correlated to the development of RDS. The mean ± SD cord blood cortisol level among preterm neonates was 5.97 ± 2.74 (SD) μg/dl. The levels were higher in neonates whose mothers received antenatal steroids and were significantly lower (2.86 ± 1.66 μg/dl) in those who developed RDS. Association between cord blood cortisol level and RDS was found with an odds ratio of 57.4, which was statistically significant. The percentage of babies developing RDS in mothers not covered with antenatal steroids was significantly higher than those covered (p-value is 0.000). The mean cord blood cortisol levels were exceptionally low (1.89 μg/dl) in neonates who expired compared to those who survived (7.02 μg/dl). There is an association between cord blood cortisol levels and RDS. Hence, Cord blood cortisol levels may be used to predict RDS and help initiate early treatment, thus preventing mortality and morbidity.

The promotive and protective effects of parents' perceived changes during the COVID-19 pandemic on emotional well-being among U.S. households with young children: an investigation of family resilience processes.

The COVID-19 pandemic may constitute a traumatic event for families with young children due to its acute onset, the unpredictable and ubiquitous nature, and the highly distressing disruptions it caused in family lives. Despite the prevalent challenges such as material hardships, child care disruptions, and social isolation, some families evinced remarkable resilience in the face of this potentially traumatic event. This study examined domains of changes perceived by parents of young children that were consistent with the post-traumatic growth (PTG) model as factors that facilitate family resilience processes. This study drew data from the RAPID project, a large ongoing national study that used frequent online surveys to examine the pandemic impact on U.S. households with young children. A subsample of 669 families was leveraged for the current investigation, including 8.07% Black, 9.57% Latino(a), 74.44% non-Latino(a) White families, and 7.92% households of other racial/ethnic backgrounds. In this subsample, 26.36% were below 200% federal poverty level. Approximately half of the parents reported moderate-to-large degrees of changes during the pandemic, and the most prevalent domain of change was appreciation of life, followed by personal strengths, new possibilities, improved relationships, and spiritual growth. Black and Latino(a) parents reported more changes in all five domains than White parents and more spiritual growth than parents of the other racial/ethnic groups. Moreover, parent-reported improved relationships were found to indirectly reduce young children's overall fussiness/defiance and fear/anxiety symptoms through reducing parents' emotional distress. Perceived changes in the new possibilities, personal strengths, and appreciation of life domains were found to serve as protective factors that buffered the indirect impacts of material hardship mean levels on child behavioral symptoms via mitigating parents' emotional distress. These findings shed light on resilience processes of a family system in a large-scale, disruptive, and stressful socio-historical event such as the COVID-19 pandemic. The five PTG domains could inform therapeutic and intervention practices in the face of future similar events. Importantly, these findings and the evinced family resilience should not negate the urgent needs of policy and program efforts to address material hardships, financial instabilities, and race/ethnicity-based structural inequalities for families of young children.

The interest of inflammatory biomarkers in the diagnostic approach in an internal medicine department: A cross-sectional study

Background The role of inflammatory biomarkers in etiological orientation is increasingly under study, and their potential significance is recognized. Given the diversity of diseases managed in internal medicine and the delayed results of microbiological tests, clinicians often face challenges in the diagnostic approach. This study aimed to describe the biomarkers’ role in distinguishing between infectious and noninfectious diseases and define their thresholds for infections. Methods Procalcitonin (PCT), neutrophil-to-lymphocyte-ratio (NLR), C-reactive-protein (CRP), fibrinogen, ferritinemia and lactate were measured on admission in all patients admitted to the Internal Medicine Department of Sahloul Hospital, over a 7-month period. The optimal cut-off values for the sensitivities and specificities to the infectious diseases were determined using receiver operating characteristic (ROC) curve analysis and Youden’s index. The diagnostic accuracy of biomarkers for predicting infectious etiologies was calculated by area under the curve (AUC). Results Overall, 164 patients were included of whom 32.3% had infectious diseases. The high mean levels of leukocytes (12,047 cells/mm3), NLR (9.7), CRP (152.5 mg/L), PCT (3.28 ng/ml) and fibrinogen (5.37g/L) were significantly linked to infectious etiologies. We identified cut-offs of NLR (6.1), CRP (123mg/L), PCT (0.24ng/mL) and fibrinogen (4.9g/L) to discriminate infectious etiologies in our population. For diagnosing infectious diseases, the CRP showed higher AUC (Sp:89.7%, Se:64.3%, AUC=0.9, 95% CI: 0.83, 0.96; p&lt;10-3) than PCT (Sp:86.1%, Se:62.3%, AUC=0,87, 95% CI: 0.80, 0.93; p&lt;10-3), NLR (Sp:87.1%, Se:61%, AUC=0.81, 95% CI: 0.731, 0.902; p&lt;10-3) and fibrinogen (Sp:84.7%, Se:68.3%, AUC=0.77, 95% CI: 0.65, 0.98; p&lt;10-3). The combination of CRP and NLR levels improved the diagnostic accuracy (AUC=0.93, 95% CI: 0.84, 0.96; p&lt;10-3) for distinguishing between infectious and non-infectious diseases. Conclusions Our study showed the usefulness of inflammatory biomarkers, particularly the NLR and its combination with CRP, which are low cost and easy to assess, in promoting the diagnostic accuracy to distinguish infections among other diagnoses.

The effects of multicultural family support services on the longitudinal changes of acculturative stress, peer relations, and school adjustment.

This study investigated the long-term trends of acculturative stress, peer relationship, and school adjustment among adolescents from multicultural families in South Korea, and examined the concurrent and lagged effects of multicultural family support services (MFSS) on the longitudinal changes in the variables of interest. Concurrent and lagged models as well as developmental trajectories via latent growth modeling (LGM) were employed on a sample of 1,443 middle school students (706 boys, 737 girls) from the Multicultural Youth Panel Survey (MAPS). The results revealed that peer relationships and school adjustment perceived by adolescents demonstrated consistent, gradual declines across 3-year time points while there was a lack of significant change in acculturative stress during the same period. The absence of significant change in acculturative stress could be attributed to floor effects, stemming from its initial low mean level. Nevertheless, the LGM modeling also exhibited significant concurrent and lagged effects of MFSS at the first and third time points of investigation. The intermittent significant effects of MFSS and the direction of its improvement were discussed. More educational interventions guiding students from multicultural families would be needed as they navigate the complexities of adolescence.

Medication adherence in kidney transplant recipients: A cross-sectional study from a nursing clinical practice perspective

Medication non-adherence is implicated as one of the major causes of early and late kidney transplant rejection. The present study aimed to evaluate medication adherence in kidney transplant recipients. The study design was cross-sectional and descriptive. The sample was 144 kidney transplant patients, and sampling was by convenience. The researchers collected data using a three-part questionnaire, including demographic characteristics, clinical features, and simplified medication adherence questionnaire (SMAQ). Findings suggest that medication adherence in participants was at the desired level (94.4%; 95% CI: 89.8-97.3; P&lt;0.001) and the number of hospitalizations was a predictor of medication adherence in kidney transplant recipients (95% CI: 0.236-1.009; OR:0.488; P=0.053). The mean serum levels of Tacrolimus, Sirolimus, Cyclosporine, and Everolimus in kidney transplant recipients were 8.22 (SD=4.75), 59.66 (SD=82.71), 138.25 (SD=74.99), and 5.7, respectively. Glomerular filtration rate and serum levels of Tacrolimus and Cyclosporine were higher in patients with appropriate medication adherence than those with poor medication adherence (P&gt;0.05). With the increasing number of hospitalizations, medication adherence in these patients decreased. Overall, the medication adherence in kidney transplant recipients at the Kidney Transplantation Referral Center was at the desired level. Therefore, medicating related training programs are a promising approach to improve the quality of life in kidney transplant recipients and potentially reduce the incidence of transplant rejections among kidney transplant patients.

Eliminating the need for preoperative intravenous hyperhydration: Sodium thiosulfate as nephrotoxicity prevention in HIPEC-treated patients – A retrospective analysis

BackgroundCytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) is an effective treatment for peritoneal metastases. However, HIPEC with cisplatin is associated with renal toxicity. Sodium thiosulfate (ST) has been shown to prevent cisplatin-induced toxicity. MethodsA retrospective, single-center analysis of patients treated curatively for peritoneal surface malignancy, who underwent cytoreductive surgery with cisplatin-based HIPEC between 2015 and 2020. Patients were categorized into three groups based on the management of cisplatin-induced renal toxicity: preoperative hyperhydration alone (PHH), preoperative hyperhydration with ST (PHH + ST), and ST alone. Renal function and complications, in terms of Acute (AKI) and chronic kidney injury (CKI), were monitored and analyzed during 3 postoperative months. ResultsThis study included 220 consecutive patients. Mean serum creatinine levels were 95, 57 and 61 mmol/L, for PHH, PHH + ST and ST groups, respectively (p < 0.001). Glomerular Filtration Rate (GFR) were 96, 94 and 78 ml/min/1.73 m2, respectively (p < 0.001). AKI and CKI are respectively for PHH, PHH + ST and ST groups were 21 % (n = 46), 1 % (n = 2) and 0 % vs 19 % (n = 42), 0 % and 0 % (p < 0.001), for pairwise analysis did not show any difference between PHH + ST and ST alone combination, regarding nephrological outcomes. All patients were followed 3 months postoperatively. ConclusionThere is no need for preoperative hyperhydration when sodium-thiosulfate is used to prevent cisplatin-induced nephrotoxicity in patients undergoing cytoreductive surgery with HIPEC. These findings have implications for improving and simplifying the management of patients with peritoneal metastases undergoing HIPEC with cisplatin.

Impact of Upadacitinib on Laboratory Parameters and Related Adverse Events in Patients with RA: Integrated Data Up to 6.5 Years.

Upadacitinib (UPA) is a Janus kinase inhibitor that has demonstrated efficacy in moderate-to-severe rheumatoid arthritis (RA) with an acceptable safety profile. We investigated laboratory parameter changes in UPA RA clinical trials. Pooled data from six randomized trials in the SELECT phase 3 program were included. Key laboratory parameters and safety data were measured for UPA 15 and 30mg once daily (QD), adalimumab (ADA) 40mg every other week + methotrexate (MTX), and MTX monotherapy. Exposure-adjusted event rates (EAERs) of adverse events were calculated. A total of 3209 patients receiving UPA 15 mg QD (10 782.7 patient-years [PY]), 1204 patients receiving UPA 30mg QD (3162.5 PY), 579 patients receiving ADA + MTX (1573.2 PY), and 314 patients receiving MTX monotherapy (865.1 PY) were included, representing up to 6.5years of total exposure. Decreases in mean levels of hemoglobin, neutrophils, and lymphocytes, and increases in mean levels of liver enzymes and creatinine phosphokinase were observed with UPA, with grade 3 or 4 changes observed in some patients. Mean low- and high-density lipoprotein cholesterol ratios remained stable for patients receiving UPA 15 mg QD. EAERs of anemia and neutropenia occurred at generally consistent rates between UPA and active comparators (3.1-4.3 and 1.7-5.0 events [E]/100 PY across treatment groups, respectively). Rates of hepatic disorder were higher with MTX monotherapy, UPA 15mg and UPA 30mg (10.8, 9.7, and 11.0 E/100 PY, respectively) versus ADA + MTX (6.4 E/100 PY). Rates of lymphopenia were highest with MTX monotherapy (3.2 E/100 PY). Treatment discontinuations due to laboratory-related events were rare, occurring in 1.1% and 2.2% of patients treated with UPA 15 and 30mg QD, respectively. The results of this integrated long-term analysis of laboratory parameters continue to support an acceptable safety profile of UPA 15 mg QD for moderate-to-severe RA.

Study of serum calprotectin level in rheumatoid arthritis: unexpected low level and possible explanations

BackgroundAssessment of disease activity in rheumatoid arthritis (RA) is crucial to optimize the response to treatment and prevent radiographic progression. DAS28 is the most commonly used disease activity index, which incorporates either erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP). Several studies showed that using ESR and/or CRP in assessing disease activity falls short of detecting a significant portion of patients with active disease. Calprotectin (CLP) is an interesting protein that was found to be a promising biomarker of disease activity in RA patients’ sera when CRP is normal. This study aimed to measure serum CLP level in 50 RA patients with different grades of disease activity and compare its level with age- and sex-matched control.ResultsIn this case–control study, the mean serum CLP level was significantly lower in RA patients (25.94 ± 25.87 ng/ml) compared to the control group values (53.02 ± 77.93 ng/ml), p < 0.001. The measured serum CLP in RA patients was lower than its level in other published studies. No significant difference was found between patients with different disease activity grades in the serum CLP level (H = 4.28, p = 0.23). Serum samples were collected and stored from RA patients over 4 months and from the control subjects over 1.5 months and were stored at –80 °C until analysis was performed according to the manufacturer’s instruction.ConclusionThe low level of serum CLP among RA patients is most probably due to proteolysis related to storage conditions. Pre-analytic factors like the type of blood sample, whether the sample is fresh or frozen, and duration of storage exert an effect on serum CLP level when measured by enzyme-linked immunosorbent assay.

Predicting Completion of Ecological Momentary Assessments Among Substance-Using Women Experiencing Intimate Partner Violence.

Noncompletion of ecological momentary assessment (EMA) surveys is a common issue and may yield bias in results if not properly handled. Using data observed at scheduled times as well as data retrieved later to fill missing responses, this study aims to investigate predictors of EMA completion, including demographic characteristics, time-related factors, and momentary experiences/behaviors. Data were from a 30-day EMA study including 145 women currently experiencing intimate partner violence (IPV) and using substances. The average rate of EMA completion was initially 51.4% at the scheduled times and increased to 72.6% after incorporating data from later-retrieved surveys. Participants who were younger, had more children, or had lower mean levels of negative affect dysregulation showed lower completion rates. At the momentary survey level, more days into the study and afternoon/evening reports (vs. morning reports) were associated with lower completion; lower levels of negative affect dysregulation, less smoking or alcohol use, and experiencing IPV were linked to lower momentary completion. Implications of the results for handling missing data in EMA are discussed and have important ramifications for future research, practice, and theory.

Could admission level of uric acid predict total diuretic dose in acute heart failure?

BackgroundRecent studies have shown that increases in serum UA levels are associated with adverse clinical outcomes in patients with chronic heart failure (CHF); the aim of this study was to determine the relationship between serum uric acid and total diuretic dose received during hospitalization in hospitalized patients with acute exacerbation of heart failure. The main purpose of this study is to determine the role of uric acid as a biomarker that can be a substitute for pro-BNP in clinical evaluation and the need for diuretics in hospitalized patients with acute heart failure.MethodsAfter approving the plan in the Research Council of the Heart Department and obtaining an ethical code from the Regional Committee on Research Ethics (Human Subjects Studies), the researcher referred to the archives of our center, the case of 100 patients diagnosed with acute heart failure. Cardiac patients were selected, and the information required for the study was collected using a pre-prepared data collection form, and the information was entered into SPSS software after categorization and appropriate analysis and statistical tests were performed on it. Were performed and in all statistical tests the statistical significance level was considered 0.05:Results100 patients with acute heart failure were included in this study with a mean age of 63.43 ± 14.78 years. 66% of them were men. The mean dose of furosemide in these patients was 680.92 ± 377.47 mg and the mean serum uric acid level in these patients was 8.55 ± 2.50 mg / dL. In the study of the relationship between the variables, there was a significant relationship between the dose of furosemide received with the serum level of serum uric acid (P = 0.017, r = 0.248 and P = 0.009, r = -0.267, respectively). There is also a significant relationship between serum uric acid level and patient mortality (P = 0.013, r = 0.247). However this relationship lost its significance after multivariate analysis.ConclusionThere is a significant relationship between serum uric acid level and diuretic use. However, in-hospital mortality is not related to uric acid levels at admission.

Canonical Correlation for the Analysis of Lifestyle Behaviors versus Cardiovascular Risk Factors and the Prediction of Cardiovascular Mortality: A Population Study

Objectives: To assess the overall association of lifestyle behaviors with multiple cardiovascular risk factors and mortality. Material and Methods: In the Italian Rural Areas of the Seven Countries Study, involving 1712 middle-aged men (40–59 years) enrolled in 1960, smoking habits, physical activity, dietary habits, marital status, and socioeconomic status (SES) were studied as possible determinants of 15 measurable risk factors (body mass index, tricipital and subscapular skinfold, arm circumference, systolic and diastolic blood pressure, heart rate, double product (systolic blood pressure × heart rate), vital capacity, forced expiratory volume, serum cholesterol, urine protein, urine glucose, corneal arcus and xanthelasma) using canonical correlation (CC). Results: The first CC had a value of 0.54 (R2 0.29, p &lt; 0.0001). The role of marital status was marginal; that of a high SES was contrary to expectations. The strongest behaviors based on standardized CC coefficients were dietary habits and physical activity. The risk factors mostly associated with overall lifestyle behaviors were some anthropometric and cardiovascular measurements. The mean levels of risk factors distributed in tertile classes of the CC variate score of lifestyle behaviors were largely associated in a coherent and graded way with the expected relationship of behaviors versus risk factors. In a large series of Cox models, the CC variate scores were significantly associated with 50-year coronary heart disease (CHD) mortality and much less with stroke and other heart diseases of uncertain etiology. Conclusions: Lifestyle behaviors correlate well with cardiovascular risk factors associated with CHD mortality, and CC is a useful method of analysis to detect long-term impacting characteristics.