Multivariate Linear Regression Research Articles

Serum levels of free light chains and syndecan-1 in patients with rheumatoid arthritis and systemic lupus erythematosus

Abstract Objectives Systemic autoimmune rheumatic diseases (SARDs) are characterized by chronic inflammation. Reliable biomarkers are crucial for diagnosis, monitoring disease progression and therapeutic responses. This study explores serum Syndecan-1 (SDC-1) as a biomarker for these conditions and its relationship with free light chain (FLC) levels. Methods A retrospective analysis was performed on sera from 60 patients with rheumatoid arthritis (RA) and from 60 with systemic lupus erythematosus (SLE), alongside 50 healthy donors (HD). Κ- and λ- FLCs were determined by turbidimetric assay, while SDC-1 levels by ELISA. Kruskal-Wallis test, Wilcoxon-Mann–Whitney U test, multivariable linear regression and Spearman’s correlation were employed to compare biomarker levels across groups and to explore correlations. Results SDC-1, κ-FLC, and λ-FLC were significantly increased in RA and SLE patients compared with HD (p< 0.001), while no significant differences in the κ/λ ratio were observed among the groups (p= 0.4). A significant difference in subject age was also identified. However, multivariate regression analysis indicated that RA and SLE are significantly associated with the levels of these markers, with minimal confounding by age. A significant correlation was observed separately in all groups between the FLC markers. Conversely, no correlation was detected between SDC-1 and FLCs, nor between these markers and age or disease activity indices. Conclusion Elevated serum levels of FLCs and SDC-1 in RA and SLE patients compared with HD underscore their potential as biomarkers for SARDs. The findings also suggest sustained plasma cell activation, supporting the multifaceted role of SDC-1 in the pathogenesis of SARDs.

Caloric requirement targets for nutritional support in adult autoimmune encephalitis: a retrospective cohort study.

Autoimmune encephalitis (AE) is a severe neurological disease often accompanied by consciousness disturbances, severe swallowing difficulties, and gastrointestinal dysfunction, increasing the risk of malnutrition. However, the optimal caloric intake target during the acute phase of AE remains unclear. This study aims to evaluate the impact of caloric intake on short-term clinical outcomes in AE patients, specifically focusing on the improvement in Clinical Assessment Scale for Autoimmune Encephalitis (CASE) scores, to provide recommendations for nutritional support during the acute phase. A retrospective study analyzed clinical data from 128 adult AE patients requiring nutritional support, admitted to West China Hospital, Sichuan University, from January 2020 to January 2024. Patients were categorized into low-calorie intake (below 70% of requirements), standard-calorie intake (70-100% of requirements), and high-calorie intake (above 100% of requirements) groups. Multivariate linear and logistic regression models were used to quantify the associations. Higher caloric intake was significantly associated with improved CASE scores (β = 8.58, SE = 3.75, 95% CI = 1.14 to 16.03, p = 0.02). Low caloric intake negatively impacted the improvement of CASE scores (p = 0.049), particularly in seizures and speech problems. The low-calorie intake group had significantly longer hospital stays and nutrition therapy durations (45.79 ± 30.98 days, p < 0.01; 40.39 ± 31.92 days, p = 0.02). Adequate caloric intake has a significant positive impact on the short-term clinical outcomes of AE patients, suggesting that meeting or exceeding caloric requirements may promote neurological recovery in AE patients. Future prospective studies are needed to validate these findings and further optimize nutritional support strategies.

Diffusion-derived intravoxel-incoherent motion anisotropy relates to CSF and blood flow.

Multi-b-value diffusion MRI was acquired in 32 gradient directions for 11 healthy volunteers, and in six directions for 29 patients with cSVD and 14 controls at 3 T. A physics-informed neural network was used to estimate intravoxel incoherent motion (IVIM)-DTI model parameters, including the parenchymal slow diffusion (D-)tensor and the pseudo-diffusion (D*)-tensor, from which the fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were derived. Comparisons of D*-tensor metrics were made between lateral, third, and fourth ventricles and between the middle cerebral arteries and superior sagittal sinus. Group differences in D*-tensor metrics in normal-appearing white matter were analyzed using multivariable linear regression, correcting for age and sex. D*-anisotropy aligned well with CSF flow and arterial blood flow. FA(D*), MD(D*), AD(D*), and RD(D*) were highest in the third, moderate in the fourth, and lowest in the lateral ventricles. The arteries showed higher MD(D*), AD(D*), and RD(D*) than the sagittal sinus. Higher FA(D*) in the normal-appearing white matter was related to cSVD diagnosis and older age, suggesting microvascular architecture alterations. Multi-b-value, multi-directional diffusion analysis using the IVIM-DTI model enables assessment of the cerebral microstructure, fluid flow, and microvascular architecture, providing information on neurodegeneration, glymphatic waste clearance, and the vasculature in one measurement.

The association between blood vitamin E and blood pressure in an adult population with and without diabetes mellitus

AimsPrevious studies on the association between vitamin E and blood pressure (BP) levels are controversial. Our study aimed to evaluate the association between blood vitamin E (alpha-tocopherol and gamma-tocopherol) levels and systolic and diastolic BP in an adult population with diabetes and without diabetes.MethodsOur study data were obtained from a biomarker project of the Midlife in the United States (MIDUS) study. A total of 1068 subjects were included, and the associations between alpha-tocopherol and gamma-tocopherol levels and systolic and diastolic BP were further analyzed by smooth curve and multivariate linear regression analyses.ResultsOur smooth curve analysis showed an almost linear correlation between blood vitamin E (alpha-tocopherol and gamma-tocopherol) levels and systolic and diastolic BP. Furthermore, we found that blood gamma-tocopherol levels were positively and independently associated with systolic BP (B=0.427, 95% CI 0.067-0.787, P=0.020) and diastolic BP (B=0.289, 95% CI 0.072-0.507, P=0.009) when the data were adjusted for age, gender, body mass index (BMI), ever smoked cigarettes regularly, number of years of consuming alcohol and regular exercise or activity for 20 minutes or more at least 3 times/week. Consistently, blood alpha-tocopherol levels were also positively associated with systolic BP (B=0.150, 95% CI 0.064-0.235, P=0.001) and diastolic BP (B=0.056, 95% CI 0.004-0.107, P=0.035) after these variables were adjusted. However, these significant relationships exist only in subjects without diabetes, but not in subjects with diabetes.ConclusionsWe observed for the first time that blood vitamin E (alpha-tocopherol and gamma-tocopherol) levels were positively associated with systolic and diastolic BP in subjects without diabetes.

BCAA was more closely associated with visceral fat area than subcutaneous fat area in patients of type 2 diabetes mellitus: a cross-sectional study

BackgroundBranched-chain amino acid (BCAA) has been reported to be associated with obesity, the association of BCAA with visceral fat area (VFA) and subcutaneous fat area (SFA) remained unclear in patients with type 2 diabetes.MethodsThis cross-sectional study was conducted in 284 patients with type 2 diabetes mellitus. Enzyme-linked immunospecific assay was used to measure levels of serum BCAA and branched-chain keto acid (BCKA). VFA and SFA were measured with bio-impedance analysis method. The association between BCAA and VFA was calculated using Pearson correlation and multivariable linear regression analysis.ResultsThere were significant differences in the means of body mass index, waist circumstance, SFA and VFA among the three groups divided by total BCAA tertiles (all p < 0.05). Compared to patients with lower levels of serum BCAA (the lower tertile group), the means of VFA and SFA were significantly larger in the middle and upper tertile groups (all p < 0.05). However, the differences in above obesity parameters were nonsignificant according to various BCKA tertiles. Pearson correlation analysis also demonstrated that BCAA levels were positive associated with each obesity parameter (p < 0.05). Nevertheless, multivariable linear regression analysis showed that levels of serum BCAA were correlated with VFA, BMI and WC (all p < 0.05) rather than SFA after adjusted for other confounders.Conclusionslevels of serum BCAA were more closely correlated with VFA than SFA, prospective studies should be warranted to further explore the mechanism mediating BCAA and visceral fat accumulation in Human beings.Clinical trial numberNot applicable.

Impact of perceived social support on anxiety and depression in women undergoing in vitro fertilization-embryo transfer: the role of psychological resilience.

This study aimed to analyze the current status of women's perception of social support levels, psychological resilience, anxiety, and depression levels during IVF-ET, as well as investigate the influence of perceived social support and psychological resilience on the anxiety and depression levels of women undergoing IVF-ET and the mediating role of psychological resilience in this process. In this study, a convenience sampling method was used to administer a questionnaire survey among 433 women undergoing IVF-ET. Then, multivariate linear regression models were applied to identify factors influencing anxiety and depression. Lastly, mediation effect analysis was conducted to explore the mediating role of psychological resilience. The incidence of anxiety and depression was 42% and 46.4%, respectively. The mean score of the Perceived Social Support Scale (PSSS) indicated a high to moderate level of support, while the mean score of the Conner-Davidson Resilience Scale (CD-RISC) suggested moderate psychological resilience. Perceived social support was positively correlated with psychological resilience, and both were negatively correlated with anxiety and depression. Perceived social support and psychological resilience were identified as influencing factors of anxiety and depression (P < 0.001). Moreover, there was a partial mediating effect of psychological resilience between perceived social support and both anxiety and depression (P < 0.01). These results highlight the need for healthcare providers to assess patients' levels of psychological resilience and perceived social support when developing mental health interventions in order to mitigate the risk of anxiety and depression and concomitantly enhance fertility outcomes.

Factors associated with nurses' self-efficacy in oral care at Oulu University Hospital, Finland.

This study aimed to investigate factors associated with nurses' self-efficacy in oral care among infection-sensitive patients in a university hospital. All the nurses working in five wards of internal medicine and one department of oncology at Oulu University Hospital, Finland (n = 114) were recruited. Data were collected with a questionnaire containing 10 self-efficacy items (scored 0 to 10) and nine knowledge items (five-point Likert scale) that were validated in an earlier pilot study. Factor analysis was performed for the self-efficacy scale and a mean score was calculated for the knowledge scale. A multivariate linear regression model was used to analyze the association between explanatory variables and self-efficacy factor scores. Factor analysis revealed self-efficacy factors: Practical skills, Self-confidence in taking care of patients' oral hygiene, and Confidence in detecting oral problems (factor scores varied between 4.9 and 8.8). A higher mean score for the knowledge scale was positively associated with the factor Practical skills (B = 0.5, p < 0.05). Longer working experience was associated with higher factor scores in Self-confidence in taking care of patients` oral hygiene and Confidence in detecting oral problems. Better oral health-related knowledge and longer working experience were positively associated with oral health-related self-efficacy.

Differential association between childhood trauma subtypes and neurocognitive performance in adults with major depression.

Neurocognitive impairment is one of the prominent manifestations of major depressive disorder (MDD). Childhood trauma enhances vulnerability to developing MDD and contributes to neurocognitive dysfunctions. However, the distinct impacts of different types of childhood trauma on neurocognitive processes in MDD remain unclear. This study comprised 186 individuals diagnosed with MDD and 268 healthy controls. Childhood trauma was evaluated using the 28-item Childhood Trauma Questionnaire-Short Form. Neurocognitive abilities, encompassing sustained attention, vigilance, visual memory, and executive functioning, were measured by the Cambridge Neuropsychological Testing Automated Battery. Multivariable linear regressions revealed that childhood trauma and MDD diagnosis were independently associated with neurocognitive impairment. Physical neglect was associated with impaired visual memory and working memory. MDD diagnosis is associated with working memory and planning. Interactive analysis revealed that physical/sexual abuse was associated with a high level of vigilance and that emotional neglect was linked with better performance on cognitive flexibility in MDD patients. Furthermore, childhood emotional abuse, physical abuse, and emotional neglect were revealed to be risk factors for developing early-onset, chronic depressive episodes. Thus, specific associations between various childhood traumas and cognitive development in depression are complex phenomena that need further study.

TINJAUAN PENGARUH KEPEMIMPINAN HEROIK DAN ORGANISASI PEMBELAJARAN TERHADAP PRESTASI KERJA PADA ANGGOTA GMNI BABEL

The purpose of this research is to identify the effects of Heroic Leadership and Learning Organization to GMNI members work performance. This research use a quantitative descriptive approach as its primary data. Subjects within this research involves 72 active GMNI members as respondents, and also using Likert scale questionnaire. The research also used multilinear regression analysis as its data analysis technique which is then processed using University of Amsterdam’s JASP (Jeffreys’s Amazing Statistics Program). The results of this research suggest: (1) Heroic leadership partially affects work performace with a significancy value of 0,0001 &lt; 0,05 and tvalue of 14,521 &gt; ttable 1,667. (2) Learning organization had no partial effect to work performance with a significancy value of 0,046 &lt; 0,05 and tvalue 0,550 &lt; ttable 1,667. (3) Heroic leadership and learning organization simultaneously affects work performance, with a significancy value of 0,001 &lt; 0,05 and fvalue 105,496 &gt; ftabel 3,13

Trends in Toddler Diet Quality in the United States: 1999 to 2018.

Diet quality has improved over time for US adults and youth aged ≥2 years. Trends over time and disparities in the diet quality of toddlers 12 through 23 months old have not been documented. Our objective was to investigate the direction and magnitude of toddler diet quality trends from 1999 to 2018 overall and by household socioeconomic status. This serial cross-sectional analysis of National Health and Nutrition Examination Survey (NHANES) data was performed with 2541 toddlers from 10 NHANES cycles from 1999 to 2018. Dietary intake was measured by NHANES study staff using proxy-reported 24-hour recalls. Healthy Eating Index-Toddlers-2020 total scores (0-100 points, higher scores indicate healthier diets) and component scores were calculated from the 24-hour dietary recalls using the population ratio method. Multivariable linear regression was used to evaluate the association between time in years (measured as the midpoint of each NHANES cycle) and diet quality. Toddler diet quality improved significantly from 1999 to 2018 (P < .001), from 63.7 points on average in 1999-2000 to 67.7 points in 2017-2018. A significant positive linear trend in total diet quality was observed for all socioeconomic status groups (P < .05). Several dietary component scores improved, as follows: Whole Fruits (P < .001), Whole Grains (P = .016), Fatty Acids (P = .002), Refined Grains (P = .009), and Added Sugars (P < .001). Scores did not significantly change for Total Fruit, Total Vegetables, Greens and Beans, Dairy, Total Protein Foods, Seafood and Plant Proteins, Sodium, or Saturated Fats. From 1999 to 2018, toddler diet quality improved significantly, but mean scores still fell short of dietary guidance.

Vision-Related Quality of Life After Fyodorov-Zuev Keratoprosthesis in China.

The purpose of this study was to assess vision-related quality of life (VR-QoL) and its determinants in patients with implanted Fyodorov-Zuev (MICOF) KPro. Eighty-eight patients with bilateral corneal blindness who underwent unilateral Fyodorov-Zuev (MICOF) KPro implantation were included in this cross-sectional study. VR-QoL was assessed using the National Eye Institute Visual Function Questionnaire-25 (NEI-VFQ-25). Univariate analyses and multivariate linear regression were used to identify VR-QoL determinants. Eighty-eight patients, aged 50.00 ± 13.72 years, with a mean postoperative time of 5.13 ± 3.31 years, were included. The composite NEI-VFQ-25 score improved from 17.04 ± 5.60 to 46.00 ± 19.21 (P < 0.01) after Fyodorov-Zuev (MICOF) KPro implantation. The multivariate linear regression analysis results showed that the postoperative composite score was correlated with postoperative visual acuity (VA) of the operative eye (B = -21.66, P < 0.01). Improvement in NEI-VFQ scores was associated with better postoperative VA of the operative eye (B = -18.67, P < 0.01) and poorer preoperative VA of the fellow eye (B = 7.11, P < 0.05). VR-QoL in patients with bilateral corneal blindness was significantly impaired but improved after Fyodorov-Zuev (MICOF) KPro implantation. Improvement in VR-QoL was inversely associated with postoperative VA of the operative eye but positively correlated with preoperative VA of the fellow eye. This study affirmed that Fyodorov-Zuev (MICOF) KPro was an effective alternative for patients with corneal blindness with respect to VR-QoL.

Variation in batch ordering of imaging tests in the emergency department and the impact on care delivery.

To examine heterogeneity in physician batch ordering practices and measure the associations between a physician's tendency to batch order imaging tests on patient outcomes and resource utilization. In this retrospective study, we used comprehensive EMR data from patients who visited the Mayo Clinic of Arizona Emergency Department (ED) between October 6, 2018 and December 31, 2019. Primary outcomes are patient length of stay (LOS) in the ED, number of diagnostic imaging tests ordered during a patient encounter, and patients' return with admission to the ED within 72 h. The association between outcomes and physician batch tendency was measured using a multivariable linear regression controlling for various covariates. The Mayo Clinic of Arizona Emergency Department recorded approximately 50,836 visits, all randomly assigned to physicians during the study period. After excluding rare complaints, we were left with an analytical sample of 43,299 patient encounters. Findings show that having a physician with a batch tendency 1 standard deviation (SD) greater than the average physician was associated with a 4.5% increase in ED LOS (p < 0.001). It was also associated with a 14.8% (0.2 percentage points) decrease in the probability of a 72-h return with admission (p < 0.001), implying that batching may lead to more comprehensive evaluations, reducing the need for short-term revisits. A batch tendency 1SD greater than that of the average physician was also associated with an additional 8 imaging tests ordered per 100 patient encounters (p < 0.001), suggesting that batch ordering may be leading to tests that would not have been otherwise ordered had the physician waited for the results from one test before placing their next order. This study highlights the considerable impact of physicians' diagnostic test ordering strategies on ED efficiency and patient care. The results also highlight the need to develop guidelines to optimize ED test ordering practices.

Collagen triple helix repeat-containing 1 protein: an emerging biomarker and its influence on the clinical and sonographic disease severity in Egyptian medicated female rheumatoid arthritis patients

BackgroundRheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease of synovial joints, with a multifactorial etiology. Collagen triple helix repeat-containing 1 protein (CTHRC1) is a biomarker produced by fibroblast-like synoviocytes, which was shown to be highly expressed in RA patients. The study aimed to measure serum CTHRC1 level in female RA patients currently on medical treatment and its influence on the clinical and sonographic severity of the disease.ResultsThe patients’ mean age was 43.39 ± 8.55 years and median RA disease duration of 5.5 (0.33–20) years. RA patients showed significantly higher serum CTHRC1 level [89.71 ng/ml (53.95–353.45)] in comparison to controls [87.38 ng/ml (44.47–110.3)] (U = 430, P = 0.014). Furthermore, higher serum CTHRC1 levels were recorded in seropositive versus seronegative patients (U = 76, P = 0.022) and in RA patients with severe disease activity compared to those with lower disease activity (H = 9.79, P = 0.007). Furthermore, serum CTHRC1 levels were lower in RA patients receiving biological therapy compared to those receiving conventional therapy; however, this difference did not reach statistical significance.Significant positive correlations were found between CTHRC1 and disease activity, acute-phase reactants, serological markers, functional assessment, fatigue, and erosions detected by ultrasound, while a significant negative correlation was recorded between CTHRC1 and duration of biologic intake (rs = − 0.45, P = 0.036). Furthermore, on multivariate linear regression analysis, serum CTHRC1 was the only significant predictor for higher disease activity (P = 0.028, B = 0.009, 95% CI 0.001 to 0.017).ConclusionRA patients showed higher CTHRC1 serum levels compared to healthy controls, especially those with seropositivity and highly active disease. Furthermore, it was positively associated with poor patient functional outcome, fatigability, and erosive findings by ultrasound, thus suggesting that serum CTHRC1 can be a good predictor for high RA disease activity and possibly severity. Moreover, biological therapy could influence serum CTHRC1 levels in these patients.

Masticatory function between chewing with and without wearing clear thermoplastic appliances

BackgroundClear thermoplastic materials are used in a variety of oral appliances. In some situations, patients may wear clear thermoplastic appliances while eating. However, the effect of wearing clear thermoplastic appliances on chewing efficiency is unknown. This study aimed to evaluate the differences in masticatory function between chewing with and without wearing clear thermoplastic retainers over a 6-month period, and its associated factors.MethodsThirty patients who received upper and lower clear retainers after debonding fixed appliances were examined for objective and subjective masticatory function at retainer delivery (T0), 3-month (T1), and 6-month follow-ups (T2) in two conditions: with and without wearing their retainers while chewing. The objective method used multiple sieves reported as the median particle size (MPS). The food intake ability (FIA) test served as the subjective method. Paired t-test was used to compare the outcomes between chewing with and without retainers at each evaluation time point. Repeated measures ANOVA followed by the Bonferroni post-hoc test was used to compare the outcomes between the three evaluating time points. Multivariable linear regression analysis was performed to assess whether age, sex, and extraction/non-extraction was associated with these effects.ResultsThe MPS was significantly greater when chewing with retainers compared with chewing without them at T0 (P < 0.05), however, it was not significantly greater at T1 and T2 (P > 0.05). The MPS with and without the retainers tend to decrease between T0, T1 and T2. In particular, the MPS while chewing with retainers significantly decreased between T0 and T1. The total FIA score and FIA subscores for hard and soft food were significantly lower when eating with retainers at T0 (P < 0.05), however, all FIA scores when eating without retainers did not significantly change between T0, T1, and T2. No significantly associated factors were identified.ConclusionsWearing clear retainers while chewing decreases objective and subjective masticatory function immediately after completing orthodontic treatment. However, this significantly improved to levels comparable to chewing without retainers after a 3-month follow-up. Age, sex, and extraction/non-extraction treatment were not associated with the difference in masticatory function while chewing with and without wearing the retainers.

Response inhibition as a critical executive function in differentiating attention-deficit/hyperactivity disorder from autism spectrum disorder: a comprehensive attention test study

BackgroundAutism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) are both associated with impairment in executive function, particularly in complex attention. Although previous studies using clinical assessments have attempted to delineate differences between these disorders, the findings have been inconclusive. Our study aims to elucidate the differences of endophenotype between ASD, ADHD, and their co-occurring condition utilizing a uniform computerized test.MethodsThe study included children diagnosed with ASD, ASD co-occurring with ADHD (ASD+ADHD), or ADHD who completed the comprehensive attention test (CAT) at Severance Hospital between October 2013 to May 2023. We excluded children with intellectual disability and comorbid major psychiatric or neurologic disorders possibly affecting attention measurement. The participants were categorized into three groups for the comparative analysis of CAT measures: (a) ASD (n=112), (b) ASD+ADHD (n=155), and (c) ADHD (n=104). The study also conducted an exploratory analysis utilizing multivariate linear regression analysis to examine the association between the CAT measures and parent-reported scales.ResultsNotably, the ASD+ADHD and ADHD groups exhibited higher frequency of commission errors (CE) and perseveration errors (PE) compared to the ASD group. In the exploratory analysis, a significant negative association was observed between reaction time (RT) and both the social communication questionnaire (SCQ) and the child behavior checklist (CBCL) externalization scores in the ASD+ADHD and ADHD groups. The ASD+ADHD group tended to show higher standard deviation of reaction time (RTSD) compared to the ASD group.ConclusionsOur findings suggest that impaired response inhibition is more pronounced in ADHD compared to ASD. We propose altered visual attention, reflecting response inhibition, may serve as potential endophenotypic markers differentiating ADHD from ASD in attentional assessment. Elevated RTSD in the ASD+ADHD group demonstrates additive pathology, suggesting that the neurological mechanisms underpinning impaired sustained attention may differ between the two conditions.

Home Mechanical Ventilation and Risk of Hospitalization in Obesity Hypoventilation Syndrome - The Population-based DISCOVERY Study.

Patients with obesity hypoventilation syndrome (OHS) have high risk of hospitalization, which might be decreased by home mechanical ventilation (HMV). To evaluate annualized hospitalization rate (AHR) and change in AHR in patients with OHS starting home mechanical ventilation (HMV), and explore if there were any difference in AHR by starting HMV acutely or electively. Population-based longitudinal study of patients with OHS starting HMV in the Swedish DISCOVERY cohort between 1996 and 2018, cross-linked with the National Patient Registry for national data on hospital admissions. AHR was calculated for each patient for three years before (Year -3, -2, -1) and three years after (Year 1, 2, 3) the year of starting HMV (Year 0; start date ± 6 months). Differences in AHR were analyzed using Wilcoxon signed-rank test (between years) and Mann-Whitney U test (between acute/elective). Proportion of patients hospitalized in each year was analyzed and comparison between years was done with McNemar´s test. Factors associated with change in AHR were identified using multivariate linear regression models. In total, 2,445 patients were included: 47% females, mean age 62.3 ± 12.2 years, and 1,418 (58%) started HMV electively. Overall, AHR decreased with 0.88 (95%CI 0.74-1.02) hospitalization/year after start of HMV and starting treatment acutely was associated with greater decrease in AHR. There was no statistically significant difference in AHR in Year 1 between acute and elective start (P=0.199). The year after start of HMV, proportion of patients hospitalized decreased from 84% to 54% (P<0.05). Initiation of HMV was associated with reduced hospitalization rate in patients with OHS, irrespective of acute or elective start. Majority of patients with OHS are hospitalized in the year of HMV initiation.

Understanding an emerging maker community in India: Socio-demographic traits, motivations, and satisfaction factors

Makerspaces are becoming increasingly popular due to their capacity for hands-on learning, innovation, collaboration, and the democratisation of technology. While numerous studies have explored makerspace users, they have largely focused on contexts within the Global North or China, leaving a significant gap in understanding the demographics and experiences of individuals who frequent these spaces in the Global South. The paper addresses this gap by understanding the factors influencing the motivations and satisfaction levels of an emerging community of makerspace users in India. Employing a cross-sectional survey methodology, data from 51 participants were collected via an online questionnaire and analysed using descriptive statistics and multivariate linear regression. Key findings indicate that access to specialised tools, expert guidance, and opportunities for personal and professional development are significant motivators for makerspace usage. Users expressed high satisfaction with the learning opportunities and resources provided. The study concludes that makerspaces play a crucial role in supporting innovation and professional growth in the Indian context, suggesting that policymakers and educators should consider these insights to enhance the effectiveness and reach of makerspaces, thus promoting broader innovation ecosystems. Future research should aim to include a more diverse participant pool to validate and expand upon these findings.

Predictive value of bone metabolism markers in the progression of diabetic kidney disease: a cross-sectional study

ObjectiveThis study aimed to investigate the relationship between bone metabolism markers, including serum klotho, fibroblast growth factor 23 (FGF23), 25(OH)D3, iPTH, calcium (Ca), and PHOS and the progression of diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM). Additionally, the predictive value of these markers for DKD progression was evaluated.MethodsThis study involved 126 patients with T2DM between May 2021 and March 2023. DKD staging was assessed based on urinary protein excretion rates and estimated glomerular filtration rate (eGFR). The study evaluated serum concentrations of klotho, FGF23, 25(OH)D3, iPTH, Ca and PHOS across various stages and examined their relationships with clinical parameters. Receiver operating characteristic (ROC) curve analysis was utilized to determine the predictive accuracy of these bone metabolism markers for DKD. Multivariate linear and logistic regression analyses identified risk factors linked to DKD severity.ResultsAmong the 126 participants, 30 had non-DKD with normal proteinuria, while 96 had DKD, categorized as 31 with stage III DKD (microproteinuria), 34 with stage IV DKD, and 31 with stage V DKD (massive proteinuria). With advancing DKD from stage III to V, levels of klotho, 25(OH)D3, and Ca decreased significantly, whereas FGF23, iPTH and PHOS levels increased markedly. Klotho is significantly positively correlated with eGFR (r = 0.285, P = 0.001.) and negative correlations with serum creatinine (Scr) and UACR (r = -0.255, P = 0.004; r = -0.260, P = 0.011). FGF23 was positively related to systolic blood pressure (SBP) (r = 0.224, P = 0.012), but negatively with eGFR (r = -0.294, P = 0.001). Additionally, 25(OH)D3 exhibited significant negative correlations with several adverse clinical biomarkers, and both iPTH, Ca and PHOS were strongly associated with DKD progression (P&amp;lt;0.05). ROC analysis showed high predictive accuracy for DKD using these bone metabolism markers, with a combined area under the curve (AUC) of 0.846. Multivariate logistic regression analysis reinforced the significance of these markers in DKD progression.ConclusionBone metabolism markers, such as klotho, FGF23, 25(OH)D3, iPTH, Ca and PHOS are intricately linked to DKD progression and may function as valuable predictive biomarkers.

Association of oxidative balance score with hyperuricemia and gout: NHANES 2009-2018

IntroductionOxidative stress plays a crucial role in the development and progression of hyperuricemia/gout. This study aims to explore the relationship between the Oxidative Balance Score (OBS) and hyperuricemia/gout.MethodsThe study utilized complete data from adult participants in the National Health and Nutrition Examination Survey (NHANES) spanning from 2009 to 2018. OBS, composed of scores for 20 dietary and lifestyle factors, served as the exposure variable. Multivariable linear regression model was applied to evaluate the association between OBS and uric acid (UA). Multivariable logistic regression, subgroup analyses, and restricted cubic spline (RCS) regression were conducted to explore the relationship between OBS and hyperuricemia/gout.ResultsA total of 18,998 participants were included. In the fully adjusted model, compared to the lowest quartile, the highest quartiles of OBS, dietary OBS, and lifestyle OBS were negatively correlated with UA (β=-0.31 (-0.36,-0.25), β=-0.18 (-0.24,-0.12), and β=-0.64 (-0.69,-0.59), respectively) and hyperuricemia (OR=0.63 (0.55,0.71), OR=0.76 (0.67,0.86), OR=0.37 (0.33,0.42), respectively). Moreover, the highest quartiles of OBS and lifestyle OBS exhibited a negative correlation with gout (OR=0.72(0.58,0.91), OR=0.54 (0.43,0.67), respectively). Subgroup analyses revealed differences in the negative association between OBS and hyperuricemia concerning hypertension (p for interaction =0.002) and diabetes (p for interaction= 0.004), while gender-related disparities were observed in the negative association between OBS and gout (p for interaction =0.008). RCS analysis demonstrated a linear negative association between hyperuricemia and OBS (p for non-linearity &amp;gt;0.05), while gout exhibited a non-linear negative association (p for non-linearity&amp;lt;0.05).ConclusionThe study found that a higher OBS was associated with a decreased risk of developing hyperuricemia/gout, underscoring its potential in the prevention and management of these conditions.

Association between serum albumin and pulmonary function in adolescents: analyses of NHANES 2007–2012

BackgroundPulmonary function tests (PFTs) are an important tool for assessing pulmonary diseases, although clinicians often find it challenging to accurately evaluate the pulmonary function of children.MethodsWe intend to investigate the association between serum albumin (SA) and lung function among U.S. adolescents. This cross-sectional study included 3,072 adolescents (aged 12 to 19) from 2007 to 2012National Health and Nutrition Examination Survey (NHANES). PFTs, including forced vital capacity (FVC)%predicted, forced expiratory volume in 1 s (FEV1)%predicted, FEV1/FVC%predicted, and maximum mid-expiratory flow (FEF25-75) % predicted, were utilized to assess the association between serum albumin levels and lung function. To explore the potential associations between SA and pulmonary function, we employed multivariate linear regression, subgroup analysis, smoothing curve fitting and threshold effect.ResultsA positive correlation was observed between serum albumin levels and pulmonary function. In the model with a fully adjusted, each 1 g/dL serum albumin increase in SA corresponded to an increase of 2.69% in FVC%pred, 5.8% in FEV1%pred, 10.99% in FEF25–75%pred and 2.98% in FEV1/FVC%pred. This association between SA and FEV1%pred differed across gender subgroups. A non-linear relationship was observed between SA and FEV1/FVC%pred.ConclusionOur results demonstrated a positive correlation between SA and lung function, suggesting a novel modality for evaluating pulmonary function, specifically in children.Clinical trial numberNot applicable.