Multivariate Linear Regression Analysis Research Articles

Association of systemic immunity-inflammation index with type 2 diabetes and insulin resistance in NHANES 2005–2018

Although the interplay between inflammation and diabetes is increasingly recognized, it is unclear whether the systemic immunity-inflammation index (SII), as a biomarker of systemic inflammatory response, is associated with type 2 diabetes (T2D) and insulin resistance (IR). This cross-sectional study was performed in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2018, and finally enrolled 17,017 participants. To explore the relationship between SII and T2D and IR, a series of statistical analyses were conducted including weighted multivariate linear regression, logistic regression, and subgroup analysis. The fully adjusted multivariate linear regression revealed a positive correlation between SII and fasting plasma glucose (β = 0.13, 95% CI: 0.01, 0.24), fasting serum insulin (β = 12.90, 95% CI: 6.77, 19.04), and homeostasis model assessment of insulin resistance (β = 0.68, 95% CI: 0.25, 1.10). A per-SD increase in SII was found to be associated with a 4% increase in the odds of T2D, and a 5% increase in the odds of IR. The trend was significant across all SII quartile groups. Subgroup analysis revealed a stronger positive association existed between SII and T2D and IR in female, younger, and obese populations. SII was positively associated with the risk of T2D and IR, indicating that reducing SII levels may help prevent these conditions in the general population.

Supportive care needs and associated factors among caregivers of elderly patients with gastrointestinal cancer: an exploratory study

BackgroundGastrointestinal cancers, including gastric and colorectal cancers, are major contributors to cancer-related morbidity and mortality worldwide, placing significant burdens on patients and their informal caregivers. This study aims to evaluate the level of supportive needs among informal caregivers of patients with gastrointestinal cancer and to identify key factors influencing these needs.MethodsWe conducted a descriptive survey involving 335 informal caregivers of patients with gastrointestinal cancer at a large hospital in Shanghai, China, from September 2023 to April 2024. Multivariate linear regression analysis was employed to examine potential factors affecting supportive needs, including demographic information, caregiver burden, and self-efficacy.ResultsThe average supportive needs score among the 335 caregivers was 113.59 ± 52.97. This score was positively correlated with caregiver burden (r = 0.363, P < 0.001), self-efficacy (r = 0.224, P < 0.001), and patients’ Karnofsky Performance Status (KPS) score (r = 0.119, P < 0.05). Multivariate regression analysis revealed that the care experience, duration of caregiving, relationship (sibling), self-efficacy, caregiver burden, KPS score of patients, treatment duration of patients, and cancer type of patients were significant factors influencing the supportive care needs of caregivers for elderly gastrointestinal cancer patients (P < 0.05).ConclusionInformal caregivers of elderly patients with gastrointestinal cancer often have increased levels of supportive needs. Clinical practice should include comprehensive assessments of these needs and the development of targeted interventions to improve caregiving skills and reduce caregiver burden, thereby enhancing the quality of life for both caregivers and patients.

CineECG Repolarization Gradients Predict Acute Hemodynamic Response in CRT Patients.

A variable proportion of non-responders to cardiac resynchronization therapy (CRT) warrants the search for new approaches to optimize the position of the left ventricular (LV) lead and the CRT device programming. CineECG is a novel ECG modality proposed for the spatial visualization and quantification of myocardial depolarization and repolarization sequences. The present study aimed to evaluate CineECG-derived parameters in different pacing modes and to test their associations with acute hemodynamic responses in CRT patients. CineECG was used to construct the average electrical path within the cardiac anatomy from the 12-lead ECG. CineECG and LV dP/dt max were tested in 15 patients with nonischemic dilated cardiomyopathy and left bundle branch block (QRS: 170 ± 17 ms; LVEF: 26 ± 5.5%) under pacing protocols with different LV lead localizations. The CineECG-derived path directions were computed for the QRS and ST-T intervals for the anteroposterior (Xh), interventricular (Yh), and apicobasal (Zh) axes. In a multivariate linear regression analysis with adjustment for the pacing protocol type, the ST-T path direction Yh was independently associated with the increase in dP/dt max during CRT, [regression coefficient 639.4 (95% confidence interval: 187.9-1090.9), p = 0.006]. In ROC curve analysis, the ST-T path direction Yh was associated with the achievement of a 10% increase in dP/dt max (AUC: 0.779, p = 0.002) with the optimal cut-off > 0.084 (left-to-right direction) with sensitivity 0.67 and specificity 0.92. The acute hemodynamic response in CRT patients was associated with specific CineECG repolarization sequence parameters, warranting their further testing as potential predictors of clinical outcomes.

Epidemiology of Rome IV Fecal Incontinence in Japan: An Internet Survey of 9995 Individuals.

Fecal incontinence (FI) is a debilitating condition defined as recurrent uncontrolled passage of fecal material according to Rome IV. Although FI greatly impacts patients' health-related quality of life (HRQOL), there have been few studies about the prevalence of FI in the Japanese general population. The aim of this study was to investigate the epidemiology of FI using Rome IV criteria in Japan. This was a cross-sectional internet survey for Japanese individuals aged 18 to 79 years using a questionnaire about demographics, comorbidities, lifestyle, abdominal symptoms, bowel habits, HRQOL, and disorders of gut-brain interaction according to Rome IV diagnostic criteria. Multivariate linear regression analysis identified factors associated with FI fulfilling Rome IV criteria (Rome IV FI). Overall, 9995 subjects were analyzed. Of which, 9.5% of the participants had at least one episode of FI in the last 3 months, and the prevalence of Rome IV FI was 1.2%. HRQOL was significantly impaired in patients with Rome IV FI compared to continent individuals. Major functional bowel disorders overlapped with 39.5% of Rome IV FI where functional diarrhea (25.8%) was the most predominant. The overlap further impaired HRQOL in Rome IV FI patients. Alcohol consumption (odds ratio 1.82, 95% CI 1.24-2.66, p = 0.002) was independently related to Rome IV FI apart from gastroesophageal reflux disease, irritable bowel syndrome, functional abdominal bloating/distension, and functional diarrhea. The prevalence of Rome IV FI was 1.2% in Japan. Further study is warranted to investigate the effect of lifestyle modification on the management of FI.

Access to Care and Health-Related Quality of Life in Multiple Sclerosis.

Despite their high health care use, it is unclear whether the health care needs of people with MS are being met and what their priorities are. We assessed priorities for access to, and affordability of care, by people living with MS in the United States. We also tested the association between perceived inadequate access to care and health-related quality of life (HRQoL). In Fall 2022, we conducted a cross-sectional survey of participants in the North American Research Committee on Multiple Sclerosis Registry about access to care and HRQoL (Health Utilities Index Mark III). We used multivariable polytomous logistic regression to test sociodemographic and clinical factors associated with access to care. We used multivariable linear regression analysis to test the association between access to care and HRQoL. We included 4,914 respondents in the analysis, of whom 3,974 (80.9%) were women, with a mean (SD) age 64.4 (9.9) years. The providers who were most reported as needed but inaccessible were complementary providers (35.5%), followed by allied health providers (24.2%), occupational therapists (22.7%), and mental health providers (20.7%). Over 80% of participants reported that it was important or very important to be able to get an appointment with their primary MS health care provider when needed, to have sufficient time in their appointments to explain their concerns, to see their neurologist if their status changed, and that their health care providers communicated to coordinate their care. Participants who reported needing to see the provider but not having access or seeing the provider but would like to see them more often had lower HRQOL (ranging from -0.059 to -0.176) than participants who saw the provider as much as needed. Gaps in access to care persist for people with MS in the United States and substantially affect HRQoL. Improving access to care for people with MS should be a health system priority.

Comparison of nasal microbiota between preterm and full-term infants in early life.

The respiratory microbiota influences infant immune system maturation. Little is known about how perinatal, physiological, and environmental exposures impact the nasal microbiota in preterm infants after discharge, or nasal microbiota differences between preterm and healthy full-term infants. Nasal swabs (from 136 preterm and 299 full-term infants at mean postmenstrual age of 45 weeks from the prospective Basel-Bern Infant Lung Development cohort) were analyzed by 16S-rRNA gene amplification and sequencing (Illumina MiSeq). Associations were tested with multivariable linear regression and principal coordinate analysis. Presence of older siblings in preterm infants was associated with β-diversity (PERMANOVA p = 0.001) and an increased abundance of Moraxella and Haemophilus. The nasal microbiota of preterm infants exhibited a distinct composition compared to that of full-term infants (PERMANOVA, R2 = 0.014, p = 0.001), characterized by a reduced abundance of the Moraxella and Dolosigranulum genera (ANCOM-BC, p < 0.05). Our results indicate that, despite both infant groups having similar nasal microbiota patterns, there are some disparities which suggest that prematurity influences the initial microbiota colonization. In preterm infants the presence of older siblings had an effect on the nasal microbiota, whereas perinatal and early postnatal factors did not show significant effects. Presence of older siblings affected the nasal microbiota of preterm infants. This study demonstrated that microbiota composition differs between full-term and preterm infants, with a lower abundance of Moraxella and Dolosigranulum in preterm infants. Examining the differences in nasal microbiota between preterm and full-term infants may contribute to understanding the trajectory of the bacterial component of the nasal microbiota of preterm infants.

Enhancing aquifer protective capacity prediction over Ibeator and environ, Southeastern Nigeria using artificial neural networks and multivariate linear regression analysis

Aquifer protection is essential for securing a sustainable supply of clean water. This study integrates an artificial neural network (ANN) model, identifying non-linear connections, with multivariate linear regression (MLR) analysis to improve predictions of aquifer protective capacity and assess vulnerability. Twelve vertical electrical soundings (VES) were conducted with a maximum electrode spacing of 250 m. Aquifer parameters derived from the VES dataset were analyzed using ANN to capture complex patterns. The ANN model, trained on historical data, learned the relationship between input variables and protective capacity. MLR analysis identified influential factors affecting vulnerability. Results reveal varying aquifer depths, with Umudime being the deepest and western parts having the shallowest depths. The resistivity map shows high values around Okorobi and Uhuala and low values in eastern to northeastern parts. Hydraulic conductivity and 3D subsurface models exhibit an inverse relationship with resistivity. Transmissivity and storativity maps exhibit similar patterns. MLR outperforms ANN in predicting resistivity, transmissivity, and storability, indicating high forecasting accuracy for aquifer protective capacity. Input parameters' contribution levels follow a specific order for different aquifer properties. R2 Value 0.0869, indicating a weak correlation between the predicted and actual values in ANN model while R2 Value 0.9775 in MLR model shows a strong correlation and much better performance than the ANN model. The results of the modeling suggest that both the ANN and MLR models have shown promising effectiveness and accuracy in predicting aquifer parameters, aiding decision-makers in implementing targeted protection measures, predicting aquifer parameters, providing insights for effective management strategies.

Problematic Substance Use in Depressed Youth: Associations with Suicidal Ideation and Suicide Attempt History

Objective: Depressed youth exhibit higher rates of suicidal behavior compared to healthy controls, with problematic substance use potentially intensifying this risk. Accordingly, this study aimed to examine the impact of comorbid depression and problematic substance use and its association with suicidality in youth populations. Methods: We examined differences in clinical features and demographic characteristics between 797 depressed youth ages 8–20 years with and without problematic substance use from the Texas Youth Depression and Suicide Research Network (TX-YDSRN). Additionally, to assess whether the effect of depression severity on suicidal ideation and suicide attempt history were influenced by problematic substance use, multivariable linear and logistic regression analyses were conducted. Results: Depressed youth with problematic substance use (versus those without) were significantly older, more likely to exhibit suicidal ideation and a history of suicide attempts and had significantly worse school functioning after controlling for age, sex, race, and ethnicity. Problematic substance use did not moderate the effect of depression severity on suicidal ideation or suicide attempt history. Conclusions: Findings shed light on the impact of problematic substance use in depressed youth which may allow for earlier and more specified intervention efforts aimed at identifying and targeting youth suicidality.

Hidden blood loss of minimally invasive transforaminal lumbar interbody fusion of lumbar degenerative diseases in patients with osteoporosis: a retrospective study.

To compare hidden blood loss (HBL) of minimally invasive transforaminal lumbar interbody fusion (Mis-TLIF) of lumbar degenerative diseases in patients with or without osteoporosis (OP) and identify the risk factors for HBL with OP. The data from 156 patients with lumbar degenerative diseases, who underwent Mis-TLIF between January 2018 and December 2021, were retrospectively analyzed. The patients were divided into the Osteoporosis and Non-osteoporosis groups. We recorded demographic characteristics and blood-related parameters in each group. Blood loss was measured by quantifying visible blood loss and calculating HBL using preoperative hematocrit (Hctpre) and postoperative hematocrit (Hctpost). Pearson or Spearman correlation analysis was used to investigate the association between OP patient's characteristics and HBL. Multivariate linear regression analysis was used to confirm independent risk factors of HBL in patients with OP. The mean HBL of the Osteoporosis and Non-osteoporosis groups was 608.27 ± 175.23 and 173.04 ± 67.55ml, respectively. There were significant differences in age, BMI, subcutaneous fat thickness, muscle thickness, Hctpost, average hematocrit of preoperative and postoperative (Hctave), visible blood loss, HBL and volume of allogeneic blood transfusions between the two groups (P < 0.05). Multivariate linear regression analysis showed that Hctpost, T-score, use of tranexamic acid (TXA) and preoperative regular anti-osteoporosis treatment were independent risk factors for HBL in patients with OP. There was significant perioperative HBL in patients with OP. Hctpost, T-score, use of TXA and preoperative regular anti-osteoporosis treatment were independent risk factors for HBL in patients with OP. More attention should be paid to the perioperative period to ensure the safety of patients with OP.

Advanced liver fibrosis, but not MASLD, is associated with accelerated biological aging: a population-based study

BackgroundThe process of biological aging in patients diagnosed with chronic liver disease remains unclear.AimThe current study aims to investigate if there is an accelerated biological aging process in participants with advanced fibrosis (AF) and metabolic dysfunction-associated steatotic liver disease (MASLD).MethodsData from the 2017–2018 NHANES cycle were analyzed. AF was determined based on the values of liver stiffness measurement (LSM) and MASLD was defined according to new consensus nomenclature. Klemera-Doubal method biological age (KDM bioage) and Phenotypic age (Phenoage) were adopted to quantify biological age. Phenoage advancement (Phenoage_advance) and KDM advancement (KDM_advance) were generated as the difference between the calculated biological age and chronological age, and a positive residual was regarded as an indicator of accelerated biological aging.ResultsA total of 3974 participants was enrolled. The weight mean KDM_advance and phenoage_advance in AF group was 4.22 years (95%CI: 2.96–5.49 years) and 2.61 years (95%CI: 1.80–3.41 years), while in MASLD group was 0.37 years (95%CI: -0.28–1.03 years) and 0.04 years (95%CI: -0.64–0.72 years), respectively. Multivariate linear regression analysis showed that participants with AF had older KDM_advance and phenoage_advance compared with those without AF (1.50 years (95%CI: 0.23–2.77 years), P = 0.02; 1.00 years (95%CI: 0.18–1.82 years), P = 0.02; respectively), in models adjusting demographic characteristics, socioeconomic status, lifestyle factors, and comorbidities. No significant association was found between MASLD and KDM_advance and phenoage_advance.ConclusionsAF, not MASLD, was independently associated with accelerated biological aging in adults from a US representative sample.

Association between thoracic epidural anesthesia and driving pressure in adult patients undergoing elective major upper abdominal surgery: a randomized controlled trial

BackgroundThoracic epidural anesthesia (TEA) is associated with a knowledge gap regarding its mechanisms in lung protection and reduction of postoperative pulmonary complications (PPCs). Driving pressure (ΔP), an alternative indicator of alveolar strain, is closely linked to reduced PPCs with lower ΔP values. We aim to investigate whether TEA contributes to lung protection by lowering ΔP during mechanical ventilation.MethodsIn this prospective, randomized, patient and evaluator-blinded parallel study, adult patients scheduled for elective major upper abdominal surgery were assigned to either the TEA group with combined thoracic epidural anesthesia and general anesthesia (TEA-GA) (n = 30) or the control group with only general anesthesia (GA) (n = 30).MeasurementsThe primary outcome was the minimum ΔP determined based on positive end-expiratory pressure (PEEP) after intubation. Secondary outcomes included the incidence of PPCs within seven days, the minimum ΔP at various time points, blood gas analysis, intensive care unit (ICU) admission rates, length of hospital stay, and 30-day mortality rate.ResultsThe TEA group had a significantly lower minimum ΔP titrated based on PEEP compared to the control group (11.23 ± 2.19 cmH2O vs. 12.67 ± 2.70 cmH2O; P = 0.028). Multivariate linear regression analysis showed that intraoperative TEA application (compared with its absence; unstandardized beta coefficient (B) = -1.289; P = 0.008) significantly correlated with ΔP. The incidence of PPCs did not differ significantly between the two groups (8 of 30 [26.7%] vs. 12 of 30 [40%]; P = 0.273), but the incidence of atelectasis in the TEA group was significantly lower than in the control group (5 of 30 [16.7%] vs. 12 of 30 [40.7%]; P = 0.012). Multivariate logistic regression analysis indicated that ΔP was the only variable significantly associated with PPCs (Adjusted Odds Ratio [OR] = 2.190; 95% Confidence Interval [CI]: 1.300 to 3.689; P = 0.003).ConclusionCompared to GA, TEA-GA can reduce intraoperative ΔP in patients undergoing major upper abdominal surgery, especially those undergoing laparoscopic surgery. However, compared to GA combined with ΔP-guided ventilation, TEA-GA combined with ΔP-guided ventilation does not reduce the risk of PPCs. There was no significant difference in the total use of various vasoactive drugs between the two groups.Trial registrationThis study was registered in the Chinese Clinical Trial Registry (registration number ChiCTR2300068778 date of registration February 28, 2023).

Prevalence and risk factors of osteoporosis in lupus nephritis patients in China: a cross-sectional study

BackgroundOsteoporosis is a significant concern among individuals with lupus nephritis (LN), with reported prevalence rates exhibiting considerable variation. This study investigates the prevalence and identifies risk factors contributing to osteoporosis in premenopausal and postmenopausal LN patients, addressing the paucity of data specific to the Chinese population.MethodsThis cross-sectional study enrolled patients with renal biopsy-proven LN, who underwent bone mineral density (BMD) measurements using dual X-ray absorptiometry at the lumbar spine, total hip, and femoral neck. The study was conducted at Tongji hospital from May 2011 to June 2018.ResultsA total of 130 patients were evaluated, with a mean age of 46.2 ± 12.9 years, including 2 males and 128 females. A significant majority, 52.3% (n = 67) of the female patients, were identified as postmenopausal. BMD measurements revealed that 40.0% of patients had osteoporosis in at least one site. The spearman rank correlation of BMD with clinical characteristics indicated that age at menopause, weight, height, and body mass index were positively correlated with BMD, while age, age at diagnosis of LN, and menopause duration were negatively correlated with BMD in lumbar spine, total hip, and/or femoral neck. Multivariable linear regression analysis demonstrated that body mass index was positively associated with BMD, whereas disease duration and menopause duration were negatively associated with BMD in all and postmenopausal patients. Postmenopausal patients consistently had a higher prevalence of osteoporosis across all measured sites. Factors such as older age, lower weight, and the absence of bisphosphonates therapy were independently associated with an increased risk of osteoporosis in LN patients.ConclusionOur findings underscore a substantial prevalence of osteoporosis in LN patients, especially among postmenopausal individuals. The study identifies older age, lower weight, and absence of bisphosphonates treatment as risk factors for osteoporosis in this patient population.

Associations between metabolic score for visceral fat and adult lung functions from NHANES 2007–2012

BackgroundObesity is a significant part of the factors affecting lung function, and the assessment of obesity using the Metabolic Score for Visceral Fat (METS-VF) is more precise than other indicators like waist circumference and body mass index. This study investigated the relationship between lung function and METS-VF in The National Health and Nutrition Examination Survey (NHANES) database from 2007 to 2012.MethodThe data utilized in this study was obtained from National Health and Nutrition Examination Survey spanning the years 2007 to 2012. A multivariate linear regression analysis was employed to investigate the association between METS-VF and lung function, followed by subgroup analysis to identify populations that may exhibit heightened sensitivity. Nonlinear correlations were assessed by fitting a restricted cubic spline, with validation of results conducted via threshold effect analysis.ResultIn a study involving 4,356 participants, a weighted multiple linear regression model revealed a significant negative association between the METS-VF and forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, and forced expiratory flow between 25 and 75% of FVC (FEF25-75%). However, no association was observed with peak expiratory flow rate (PEF). When dividing the METS-VF into thirds, participants in the highest third exhibited significantly decreased levels of FEV1 (β: −342, 95%CI: −440, −245, p &amp;lt; 0.001), FVC (β: −312, 95%CI: −431, −192, p &amp;lt; 0.001), FEV1/FVC (β: −0.020, 95%CI: −0.030, −0.010, p &amp;lt; 0.001), and FEF25-75% (β: −424, 95%CI: −562, −285, p &amp;lt; 0.001). However, there was no significant relationship with PEF (β: −89, 95%CI: −325, 147, p = 0.446). RCS curve indicated a nonlinear negative correlation between METS-VF and FEV1, FVC, and FEV1/FVC. For FEV1, a significant negative correlation was found when the METS-VF &amp;lt; 6.426 (β = −158.595, 95%CI: −228.183, −89.007). This negative association became more pronounced when the METS-VF &amp;gt; 6.426 (β = −314.548, 95%CI: −387.326, −241.770). For FVC, a negative association was observed when the METS-VF &amp;lt; 6.401, (β = −5.477, 95%CI: −91.655, 80.702), but it did not reach statistical significance. However, METS-VF &amp;gt; 6.401, METS VF and lung function show a significant negative correlation (β = −399.288, 95%CI: −486.187, −312.388). FEV1/FVC showed a negative correlation only before the inflection point (METS-VF &amp;lt; 6.263) (β = −0.040, 95%CI: −0.047, −0.032), after the inflection point (METS-VF &amp;gt; 6.263), no correlation was found, but there was no statistical significance (β = 0.000; 95%CI: −0.006, 0.007), and METS-VF had a linear negative correlation with FEF25-75%. Subgroup analysis showed that the association was consistent across a variety of demographic factors, including age, sex, race, hypertension, and coronary heart disease. In addition, we found a stronger association between men under 40 and lung function.ConclusionMETS-VF showed a linear negative correlation with FEF25-75%, and a nonlinear negative correlation with FEV1, FVC, FEV1/FVC, and FEF25-75%, but was not associated with PEF, particularly among males under the age of 40. These findings offer valuable insights into managing lung function by controlling visceral fat.

Association of Self-Reported Sleep Characteristics With Neuroimaging Markers of Brain Aging Years Later in Middle-Aged Adults.

To determine the association between early midlife sleep and advanced brain aging patterns in late midlife. Using the CARDIA study, we analyzed sleep data at baseline and 5 years later, focusing on short sleep duration, bad sleep quality (SQ), difficulty initiating and maintaining sleep (DIS and DMS), early morning awakening (EMA), and daytime sleepiness. These were categorized into 0-1, 2-3, and >3 poor sleep characteristics (PSC). Brain MRIs obtained 15 years later were used to determine brain age through a machine learning approach based on age-related atrophy. This cohort study included 589 participants (mean age 40.4 ± 3.4 years, 53% women). At baseline, around 70% reported 0-1 PSC, 22% reported 2%-3%, and 8% reported >3 PSC. In multivariable linear regression analyses, participants with 2-3 or >3 PSC had 1.6-year (β = 1.61, 95% CI 0.28-2.93) and 2.6-year (β = 2.64, 95% CI 0.59-4.69) older brain age, respectively, compared with those with 0-1 PSC. Of the individual characteristics, bad SQ, DIS, DMS, and EMA were associated with greater brain age, especially when persistent over the 5-year follow-up. Poor sleep was associated with advanced brain age in midlife, highlighting the importance of investigating early sleep interventions for preserving brain health.

Reporting of Search Strategy Among Systematic Reviews in Leading Dental Specialty Journals: A Research-On-Research Study.

Literature searching is one of the main determinants of a systematic review (SR)'s reliability. Thus, adequate reporting of search strategy is essential for the critical appraisal of SRs and evidence-based practice. To assess the reporting quality of search strategy among SRs in leading dental specialty journals, and to identify factors associated with quality of reporting. Six leading dental journals with the highest 5-year impact factors in their respective specialty were included. A hand search was undertaken to identify SRs published between 2017 and 2022. Full texts were reviewed by two authors to identify eligible SRs. Reporting quality was assessed and scored using a modified 15-item checklist based on Preferred Reporting Items for Systematic reviews and Meta-Analyses literature search extension (PRISMA-S). Univariable and multivariable linear regression analyses were then performed. A total of 152 reviews were included and assessed. As for information sources, only 'citation searching' was adequately reported in most reviews 110 (72.4%). Only 23 (15.1%) of the included reviews clearly reported search strategies. Information about peer review was provided in only 10 reviews (6.6%). Only 91 (59.9%) of the included reviews documented the total records clearly. According to multivariable regression analysis, industrial funding (p = 0.012), registration (p = 0.013) and librarian involvement (p = 0.004) were significantly associated with higher reporting quality. The reporting quality of search strategy among SRs in leading dental specialty journals is suboptimal. Researchers, librarians, reviewers and journal editors in dentistry need to be familiar with the PRISMA-S checklist, and make concerted efforts to improve the reporting of search strategy in SRs.

The ZJU index is associated with the risk of sarcopenia in American adults aged 20–59: a cross-sectional study

BackgroundThe ZJU index is an innovative computational method which integrates BMI, FBG, TG, and ALT to AST ratio. It strongly correlates with measures of lipid metabolism and glucose intolerance. No researches have yet explored the relationship between the ZJU index and sarcopenia.MethodsWe analyzed NHANES data from 2011 to 2018, dividing the ZJU index into quartiles. The association was investigated by adjusting for confounders using multivariable linear and logistic regression analysis. Results were visualized through RCS regression and threshold effect analyses. We conducted various subgroup and sensitivity analyses and plotted ROC curves to assess prediction efficacy, with the AUC as the measure of accuracy.ResultsAs the ZJU index increases, the prevalence of sarcopenia also rises. Following the control of potential confounders via logistic regression analysis, our research identified a distinct relationship between the ZJU index and sarcopenia, which was statistically significant (P < 0.001), with higher ZJU index values associated with increased risk (OR = 12.40, 95% CI: 8.46–18.17). Interaction analysis suggests that the relationship between the ZJU index and the risk of developing sarcopenia varies significantly between males and females across different ZJU index levels. ROC analysis for the ZJU index shows an AUC of 0.749. Conclusions: The ZJU index significantly correlates with a heightened risk of sarcopenia in Americans, suggesting its potential as a predictive marker for sarcopenia.

Up versus down: Does cuff spine orientation affect early adherence to upper airway stimulation?

Upper airway stimulation (UAS) is a treatment option for moderate-to-severe OSA, in which electrical stimulation is applied to the hypoglossal nerve via an electrode cuff. In this study, we assess the effect of electrode cuff positioning on UAS outcomes, in particular device adherence. Patients at a single academic institution who met the Food and Drug Administration criteria for UAS between 2016 and 2021 were included. The electrode position was documented as superior (cuff spine up) or inferior (cuff spine down) to the hypoglossal nerve based on postoperative lateral neck X-ray. Patients underwent titration polysomnography 2-6months following surgery. The most recent postoperative variables from sleep studies following titration polysomnogram were used for statistical analysis.Adherence data was downloaded from the UAS device. 327 patients met inclusion criteria. The average age of patients was 60.9 ± 11.1years, with 105 (32.1%) females. Cuff spine up position was present in 169 (51.7%) patients as compared to 158 (48.3%) with cuff spine down. UAS adherence was significantly higher among cuff spine down patients (45.4 vs. 41.0h device use/week, p = 0.015). Cuff position was not significantly associated with therapeutic amplitude, change in apnea hypopnea index, or change in symptoms as measured by the Epworth Sleepiness Scale. On multivariable linear regression analysis, cuff spine down position (β = 3.7, CI [1.3, 7.4], p = 0.038) and increased age (β = 0.22, CI [0.07, 0.38], p = 0.005) were associated with increased adherence. UAS cuff spine down position is associated with increased device adherence. Further investigation into cuff positioning is warranted.

Peripapillary and Macular OCTA Predictors of Visual Improvement in Patients Treated with Vitrectomy for Idiopathic Epiretinal Membrane

Introduction: We investigated the changes of peripapillary and macular microvasculature in idiopathic macular epiretinal membrane (iERM) eyes before and after pars plana vitrectomy (PPV), aiming to identify potential optical coherence tomography angiography (OCTA) predictors of visual acuity improvement. Methods: Fifty-seven eyes diagnosed with iERM were enrolled and underwent PPV with ERM and Internal limiting membrane (ILM) peeling. Data were collected before surgery and during the twelve-month postoperative period. OCTA analysis focused on radial peripapillary capillary (RPC) vessel density (VD), superficial and deep capillary plexus (SCP and DCP, respectively). Functional, and OCT structural outcomes, including best-corrected visual acuity (BCVA) and macular thickness, were also recorded. Results: Multivariate linear regression analysis revealed that higher preoperative RPC VD, lower SCP VD, and lower BCVA were predictors of postoperative BCVA improvement (p&lt;0.001, p=0.047, and p&lt;0.001, respectively). Throughout the follow-up period, there was an observed increase in intradisc RPC VD, whole-disc VD, and parafoveal DCP VD (all p&lt;0.001). BCVA and central macular thickness (CMT) demonstrated significant improvement (p&lt;0.001) within the first month following vitrectomy, which then stabilized from the third month onwards. Conclusions: Preoperative microvascular measurements in iERM patients can forecast postoperative BCVA. OCTA findings reveal that both increased RPC density and reduced SCP density at baseline could serve as predictors of better visual outcomes after surgery. Enhanced RPC density may reflect a healthier optic nerve with greater potential for visual recovery, while a less dense SCP could indicate less iERM contraction, both contributing to more favorable postoperative visual results.

Pushing the boundaries of endoscopic surgery: the extended transodontoid approach for craniovertebral junction pathologies. Comprehensive technique description and comparative result.

The craniovertebral junction (CVJ) is susceptible to diverse pathologies. While the transoral-transpharyngeal approach has been the primary method for addressing anterior CVJ conditions, it carries significant morbidity. Endoscopic endonasal approach (EEA), has emerged as a Minimally invasive option. However, EEA has potential limitations in providing adequate caudal exposure. This study aims to evaluate the feasibility of enhancing caudal exposure to the endoscopic transodontoid (TO) approach by drilling the posterior part of the central hard palate, thus achieving an extended endoscopic approach to odontoid (ETO) and to compare the accuracy of predictive lines, (Nasopalatine line (NPL), Nasoaxial line (NAxL), and Rhinopalatine line (RPL)) in predicting the caudal limit of the approach. Eight cadaveric specimens underwent pre and post-endoscopic dissection measurements. The distance resected (DR), and inferior exposure of C2 posterior wall (PW) were measured and compared between TO and ETO. Furthermore, multivariable logistic regression was utilized to assess the predictive line values for DR. Implementation of the ETO resulted in a significant increase in mean DR (8.6mm, 52% improvement, p-value 0.03381), and the inferior exposure of the PW increased by 5.31mm (p-value 6.063e-05, 37% greater exposure). The linear multivariable regression analysis indicated significant positive associations between NAxL, RPL and DR after TO. However, these associations were not seen for ETO. The ETO proved superior to the traditional approach, providing improved caudal exposure and distance resected. While NPL and NAxL demonstrated predictive value for the TO, their utility was somewhat limited in the ETO.

Association of Apical Periodontitis with Glycated Hemoglobin Levels and Systemic Inflammatory Markers in Patients with Type 2 Diabetes: A Cross-Sectional Study

IntroductionThis cross-sectional study, as a preliminary part of an ongoing project, aimed to investigate the effect of apical peridontitis (AP) on glycated hemoglobin (HbA1c) and systemic inflammatory markers in diabetic individuals. MethodsA total of 280 individuals (140 with type 2 diabetes mellitus [T2DM] and 140 healthy) with and without AP were enrolled. Sixty-four age-, gender-, and body mass index–matched participants each in T2DM with AP group (DAP), T2DM without apical periodontitis (D), systemically healthy controls with apical periodontitis (CAP), and without apical periodontitis (C) groups were evaluated. Radiologic and clinical oral examination was performed for confirming the diagnosis of AP and periapical index scoring (PAI). Blood analyses were carried out for interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, high-sensitivity C-reactive protein (hsCRP), and HbA1c assessment. ResultsSignificantly higher levels of IL-1β, TNF-α, and hsCRP were observed in patients with AP in both diabetes and control groups (P < .05). In the diabetes group, AP contributed to significantly raised levels of HbA1c compared with T2DM group patients without AP. After controlling for possible confounders, partial corelation coefficients revealed positive corelation of presence of AP as well as size of the periapical lesion with HbA1c and serum levels of inflammatory markers in both diabetic and healthy individuals. Multivariate linear regression analysis revealed both presence of AP (P < .05) as well as the size of lesion (P < .001) were found to significantly predict the HbA1c levels as well as the levels of IL-1β, IL-6, TNF-α, and hsCRP in both diabetic and non-diabetic individuals. ConclusionsThese findings suggest that both presence of AP and size of periapical lesion was associated with glycemic control and systemic inflammatory burden in patients with T2DM.