Mixed-effects Model Analysis Research Articles

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

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

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

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

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

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

Sleep quality and cognitive functioning among Chinese older adults living in the US: a mixed-effects model analysis

BackgroundRacial and ethnic disparities in sleep quality and cognitive health are increasingly recognized, yet little is understood about their associations among Chinese older adults living in the United States. This study aims to examine the relationships between sleep health and cognitive functioning in this population, utilizing data from the Population Study of Chinese Elderly in Chicago (PINE).MethodsThis observational study utilized a two-wave panel design as part of the PINE, including 2,228 participants aged 65 years or older who self-identified as Chinese. Participants completed interviews at two time points. Cognitive functioning was assessed using a battery of tests, including the Chinese Mini-Mental State Examination (C_MMSE), the immediate and delayed recall of the East Boston Memory Test, the Digit Span Backwards assessment, and the Symbol Digit Modalities Test. Sleep quality was assessed using items from the Pittsburgh Sleep Quality Index (PSQI), covering four aspects: subjective sleep quality, sleep latency, sleep efficiency, and sleep duration. Insomnia was assessed using four items from the Women’s Health Initiative Insomnia Rating Scale. Mixed-effects regression models were used to assess the effects of sleep parameters on baseline cognitive functioning and cognitive change over time.ResultsParticipants had an average age of 77.42 years (± 7.57) at baseline, with about 39% reporting fairly bad or very bad sleep quality. Poorer overall sleep quality (B = -0.01, SE = 0.01, p < .01), and more insomnia symptoms (B = -0.01, SE = 0.00, p < .001) were associated with lower baseline global cognition. However, these associations diminished over time (sleep quality: B = 0.01, SE = 0.00, p < .05; insomnia: B = 0.00, SE = 0.00, p < .05). Among sleep quality subdomains, all except sleep efficiency had significantly negative relationships with baseline global cognition. The associations between sleep parameters and the four cognitive domains were less consistent.ConclusionsThe findings highlight cross-sectional negative relationships between self-reported sleep parameters and cognition, showing distinct associations between various aspects of sleep quality and cognitive domains. Targeted interventions to improve sleep quality may have the potential to enhance cognitive health outcomes.

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

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

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

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

Moisture Loss from Cheese During Baking: Influence of Cheese Type, Cheese Mass, and Temperature.

This study examined how temperature, cheese mass and moisture content impact moisture loss rate in various cheeses during baking. Understanding these factors is essential for determining the browning properties of cheese during baking. Eight cheese types, differing in moisture content, were baked at 100-200 °C in a halogen moisture analyzer, and moisture loss over time was recorded. A mixed-effects model analysis showed that temperature had the most significant impact on moisture loss rate (F = 2008.54; p < 0.00001), followed by cheese mass (F = 1973.28; p < 0.00001) and time (F = 278.49; p < 0.00001). Higher temperatures and larger cheese mass accelerated moisture evaporation rate. The moisture content of cheese explained 21.8% of model variation, suggesting that other factors, such as cheese structure, also play a significant role. The cheese baking process involving moisture removal followed by distinct drying stages. Initially, the drying rate increased as the cheese reached the wet bulb temperature; this was followed by a steady rate, and finally, a reduction in dehydration rate as the moisture decreased, limiting further evaporation. Browning, assessed through changes in lightness (L*), was more noticeable at higher temperatures, particularly in Mozzarella and processed Cheddar, after approx. 30% moisture loss in all cheeses.

Rethinking the tunnel effect: income comparison and the dynamics of happiness in a changing economic landscape (2005–2018)

The tunnel effect explains how higher income of a reference group signals potential future income growth for individuals, fostering tolerance of inequality in a changing macroeconomic environment. This paper examines the interplay between economic growth, income comparison, and individual subjective well-being, providing empirical tests for the tunnel effect from the perspectives of reference groups, effect heterogeneity, and contextual moderators. Using data from 10 waves of CGSS spanning from 2005 to 2018, the mixed-effects model analysis reveals: (1) the tunnel effect exists, with reference group income positively impacting individual’s happiness after controlling for personal income; (2) the tunnel effect is stronger among younger people, lower income group and rural residents; (3) economic growth, rather than economic uncertainty or inequality growth, enhances the tunnel effect—provinces with faster growth show a more pronounced effect. These findings bridge the individual well-being with macroeconomic environment, illustrating group heterogeneity and identifying macroeconomic conditions sustaining this psychological dividend.

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

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

Positive Correlation of Social Rank and Hair Cortisol Concentration in Group-Housed Pregnant Cows

In intensive beef production systems, social dominance relationships among cattle and human-cattle relationships constantly affect cattle welfare. However, these factors have not been investigated to assess their long-term effects on cattle welfare. In this study, the relations of hair cortisol concentrations of group-housed pregnant cows with their social rank and avoidance distance when approached by humans were analysed. Thirty-two Japanese black cows were used in this study. Examinations were conducted six times throughout two years, and each cow was subjected to one–three examinations. Hair sampling was conducted on each examination day. The hair cortisol concentrations were measured using a cortisol enzyme immunoassay kit. Social behaviour recordings were made about 6 h on each examination day. The numbers of occurrences of butt, threat, chase, and avoidance behaviours of each animal were recorded using continuous recording methods, and the social rank score for each animal was calculated from the data. Avoidance distances from humans approaching were measured for 23 test cows during the first three examination days. Measurements were taken 5–10 min after the start of morning feeding. The relations between the hair cortisol concentration and social rank score or avoidance distance were analysed using a mixed-effects model or correlation analysis. Significant positive correlation was found between the social rank score and hair cortisol concentration (F1, 48 = 4.54, p = 0.038). No significant correlation was found between the cows’ responsiveness to humans and their hair cortisol concentration (r = −0.004, p = 0.99, n = 23). The findings suggest that low-ranking cows had lower cortisol levels.

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

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

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

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

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

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

Atypical pupil-linked arousal induced by low-risk probabilistic choices, and intolerance of uncertainty in adults with ASD.

Adults with autism spectrum disorder (ASD) experience stress when operating in a probabilistic environment, even if it is familiar, but the underlying mechanisms remain unclear. Their decision-making may be affected by the uncertainty aversion implicated in ASD and associated with increased autonomic arousal. Previous studies have shown that in neurotypical (NT) people, decisions with predictably better outcomes are less stressful and elicit smaller pupil-linked arousal than those involving exploration. Here, in a sample of 46 high-functioning ASD and NT participants, using mixed-effects model analysis, we explored pupil-linked arousal and behavioral performance in a probabilistic reward learning task with a stable advantage of one choice option over the other. We found that subjects with ASD learned and preferred advantageous probabilistic choices at the same rate and to the same extent as NT participants, both in terms of choice ratio and response time. Although both groups exhibited similar predictive behaviors, learning to favor advantageous choices led to increased pupillary arousal for these choices in the ASD group, while it caused a decrease in pupillary arousal in the NT group. Moreover, greater pupil-linked arousal during decisionswithhigherexpected value correlated with greater degree of self-reported intolerance of uncertainty in everyday life. Our results suggest that in a nonvolatile probabilistic environment, objectively good predictive abilities in people with ASD are coupled with elevated physiological stress and subjective uncertainty regarding the decisions with the best possible but still uncertain outcome that contributes to their intolerance of uncertainty.

Investigating heart rate responses of children to active travel: a mixed effects modeling analysis

BackgroundThe active travel concept has gained recognition as an effective method to enhance physical activity in children’s everyday mobility. Yet, there is a notable gap of quantitative evidence on its direct impacts, especially regarding physiological outcomes that can concretely demonstrate its influences on physical intensity and overall health of children.MethodsThis study investigates the effects of active travel on children, focusing on trip-level physiological responses, specifically heart rate. Through a mixed survey design, we obtained a repeated-measures dataset from a cohort of 73 children (average age 13) across three Austrian secondary schools, each observed for 7 days. By applying mixed effects modelling approach, both fixed and random effects to children’s heart rates were explored.ResultsAccording to results from developed mixed linear models (maximum R2 = 0.22), it revealed a significant positive association between active travel mode(s) engagement and heightened physiological responses (Low, Medium and High active level of trip compare to None: β = 1.81, 5.01 and 8.34, t-value = 4.70, 10.29 and 21.34), indicating that increased usage of active travel modes led to elevated heart rate values. Additionally, subjective perceptions also played an important role in influencing children’s physiological responses. Feelings of exhausted, anxiety, and stress contributing to a higher heart rate (β = 14.79, 16.69 and 1.99, t-value = 20.42, 5.67 and 3.0), while unhappiness was associated with a lower heart rate (β = -5.96, t-value = -14.62). Effects of social interactions were also found during the trip. The presence of adults was associated with a calming effect (β = -1.92, t-value = -5.72), whereas solo travel resulted in lower heart rate compared to travel with peers (β = -1.95, t-value = -6.59).ConclusionOur article innovatively employs mixed survey methods and heart rate data to quantitatively demonstrate the positive association between engagement in active travel modes and heightened physiological responses in children, elucidating the intricate interplay of subjective perceptions and social interactions during trips, thus offering valuable insights into the health implications of active travel at a trip level. Future research will keep on leveraging survey and experimental methods.

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

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

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

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

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

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

Effects of HIV Self-Testing on Testing Promotion and Risk Behavior Reduction Among Transgender Women in China: Randomized Controlled Trial.

To date, no randomized controlled trials have specifically addressed behavior changes after HIV self-testing (HIVST) among transgender women. This study aims to evaluate the effects of HIVST on changes in HIV testing behavior, frequency of condomless sex, and partner numbers among transgender women in China. Participants were recruited from 2 Chinese cities using both online and offline methods. Transgender women were randomly assigned to receive an HIVST intervention. Data from the previous 3 months were collected at baseline, 3 months, and 6 months. The primary outcome was the mean change in the number of HIV tests among transgender women during the 6-month follow-up. An intention-to-treat analysis was conducted. The statistical analysis used analysis of covariance and linear mixed-effects models. From February to June 2021, and 255 transgender women were recruited, of which only 36.5% (93/255) had a steady job, and 27.1% (69/255) earned less than US $414.9 of income per month. They were randomly assigned to the intervention (n=127) and control (n=128) groups. At 6 months, the mean number of HIV tests was 2.14 (95% CI 1.80-2.48) in the intervention group and 1.19 (95% CI 0.99-1.40) in the control group (P<.001), with increases of 0.84 (95% CI 0.54-1.14) and 0.11 (95% CI -0.19-0.41) over 6 months, respectively. The net increase was 0.73 (95% CI 0.31-1.15; P<.001), with a similar adjusted result. No significant differences in the frequency of condomless sex or partner numbers were observed between the 2 groups. HIVST is an effective strategy for enhancing regular HIV testing behavior among transgender women in China. This strategy should be combined with measures to address the financial vulnerability of the transgender women community to reduce subsequent risk behaviors, including condomless sex. Chinese Clinical Trial Registry ChiCTR2000039766; https://www.chictr.org.cn/showproj.html?proj=61402.

Cisternal Blood Clearance Attenuates Systemic Inflammatory Response After Subarachnoid Hemorrhage

Abstract Background Aneurysmal subarachnoid hemorrhage (SAH) frequently triggers systemic inflammatory response syndrome (SIRS). SIRS has been associated with inferior outcomes and, specifically, delayed cerebral infarction after aneurysmal SAH. Here, we assess the impact of intracranial blood clearance through stereotactic catheter ventriculocisternostomy on SIRS in patients with aneurysmal SAH. Methods We assessed daily SIRS criteria (heart rate &gt; 90 beats/min, respiratory rate &gt; 20 breaths/min or abnormal respiratory coefficient, temperature &gt; 38 °C or &lt; 36 °C, white blood cell count &lt; 4000 or &gt; 12,000 cells/mm3) between admission and day 21 in 80 consecutive patients who underwent cisternal lavage through stereotactic catheter ventriculocisternostomy from 2015 to 2022. These patients were compared with 80 matched controls who received treatment at our institution between 2010 and 2015. We conducted a mixed effects model analysis using restricted maximum likelihood estimation to assess the effects of treatment groups on the SIRS rate while accounting for repeated measures. Additionally, Bonferroni’s correction was employed to examine specific differences between groups at different time points. Results The mean percentages of patients meeting SIRS criteria during the first 21 days after aneurysmal SAH were 23% in the matched cohort group and 14% in patients who underwent cisternal lavage (p &lt; 0.001). Additionally, significant differences were observed in the mean leukocyte count (p = 0.047), mean heart rate (p = 0.019), and mean respiratory rate (p = 0.0018) between the two groups. However, there was no significant difference in mean body temperature (p = 0.36). Conclusions Intracranial blood clearance and cisternal lavage after aneurysmal SAH is associated with a decline in SIRS prevalence and severity.