Multivariate Correlation Analysis Research Articles

Time-dependent electroretinogram, metabolomics and lipidomics screened metabolic markers for monitoring the process of diabetic retinopathy from scratch.

Diabetic retinopathy (DR) is a severe complication of diabetes mellitus (DM), and it is challenging to diagnose DR at an early stage by conventional methods. The aim of the present work is to propose an innovative approach to monitor the process of DR from scratch. The plasma metabolites changed with DM were obtained by time-dependent metabolomics and lipidomics; the change of retinal function was measured by b-wave amplitude and total Ops-wave amplitude in electroretinography (ERG). Multivariate statistical analysis, logistic regression and correlation analysis were employed to identify metabolic markers from metabolites for the monitoring of DR and investigate the relationship between metabolic markers and retinal function. The metabolic markers LPE18:0, LPC15:0, SM d14:2/26:0, SM d12:0/28:2 and MG 21:0 associated with DR can be utilized as metabolic markers to monitor the process of DR; The decrease in myo-inositol and LPC22:5 and increase in xylonic acid and TAG10:0/16:0/18:1 indicated retinal dysfunction. The levels of metabolic markers can be used as an indicator of the onset of DR or as a means of monitoring changes in retinal function.

The different impacts of pain-related negative emotion and trait negative emotion on brain function in patients with inflammatory bowel disease

Inflammatory bowel diseases (IBD) are a group of chronic, non-specific intestinal diseases that could comorbid with varieties of negative emotional constructs, including pain-related negative emotions and trait negative emotions; however, the link between brain functions and different dimensions of negative emotions remains largely unknown. Ninety-eight patients with IBD and forty-six healthy subjects were scanned using a 3.0-T functional magnetic resonance imaging scanner. The amplitudes of low-frequency fluctuation (ALFF), regional homogeneity (ReHo), and degree centrality (DC) were used to assess resting-state brain activity. Partial least squares (PLS) correlation was employed to assess the relationship among abnormal brain activities, pain-related and trait negative emotions. Compared to controls, patients with IBD exhibited higher values of ALFF in the right anterior cingulate cortex (ACC), lower values of ALFF in the left postcentral gyrus, and higher values of DC in the bilateral ACC. Multivariate PLS correlation analysis revealed the brain scores of the ACC were correlated with pain-related negative emotions, the brain salience in the left postcentral gyrus was associated with the higher-order trait depression. These findings can enhance our comprehension of how pain-related negative emotion and trait negative emotion affect the brains of patients with IBD in distinct ways.

Spectral reconstruction from RGB image to hyperspectral image: Take the detection of glutamic acid index in beef as an example

The use of spectral reconstruction (SR) to recovery RGB images to full-scene hyperspectral image (HSI) is an important measure to achieve real-time and low-cost HSI applications. Taking the detection of glutamic acid index for 360 beef samples as an example, the feasibility of using 11 state-of-the-art reconstruction algorithms to achieve RGB to HSI in complex food systems was investigated. The multivariate correlation analysis was used to prove that RGB is a projection of three-channel comprehensive coverage wide-band information. The comprehensive quality attributes (PSNR-Params-FLOPS) was proposed to determine the optimal reconstruction model (MST++, MST, MIRNet, and MPRNet). Moreover, SSIM values and t-SNE were introduced to evaluate the consistency of the reconstruction results. Finally, Lightweight Transformer was used to establish the detection models of Raw-HSI, RGB and SR-HSI for the prediction of glutamic acid index for beef. The results showed that the MST++ model exhibited the best performance in SR, with RMSE, PSNR, and SSIM values of 0.015, 36.70, and 0.9253, respectively. Meanwhile, the prediction effect of MST++ (R2P = 0.8422 and RPD = 2.46) reconstructed was close to the Raw-HSI (R2P = 0.8526 and RPD = 2.69). The results provide practical application scenarios and detailed analysis ideas for RGB-to-HSI.

Oral Breathing Facilitates Endoscopic Operability Compared With Nasal Breathing in Peroral Endoscopy: A Randomized Controlled Trial.

Unsedated peroral endoscopy, including ultrathin endoscopy (UE) and conventional endoscopy (CE), is feasible in clinical practice but requires improved endoscopic operability and patient tolerance. Currently, the impact of the breathing method on these factors remains unclear. We conducted the first randomized controlled trial comparing oral breathing (OB) and nasal breathing (NB) during both UE and CE to assess their influence. About 252 eligible patients undergoing CE or UE were randomly assigned to OB or NB groups. Endoscopists and patients rated endoscopic operability and patient tolerance using a 100-mm visual analog scale. Visibility from the oral cavity to the middle pharynx was recorded. OB led to a higher rate of improved visibility from the oral cavity to the middle pharynx compared with NB, ranging from 79.3% to 81.0%. Multivariate correlation analyses showed significantly lower visual analog scale scores for endoscopic operability with OB compared with NB in both UE and CE groups ( P < 0.05). No significant differences were found in the overall evaluation of patient tolerance between OB and NB groups in UE and CE, whereas the smaller diameter of UE exhibited better patient tolerance compared with CE. Discriminant analysis comparing endoscope types and breathing methods revealed that UE with OB outperformed other combinations in the overall evaluation of endoscopic operability and patient tolerance ( P < 0.05). OB facilitates endoscopic operability compared with NB in peroral endoscopy. UE with OB is recommended as the preferred choice for unsedated peroral endoscopy in daily practice.

Reduced Rate of Anemia after Transcatheter Aortic Valve Replacement.

Background/Objectives: We sought to evaluate changes in hemoglobin level and renal function in patients 5-12 months after transcatheter aortic valve replacement (TAVR), and to examine possible relationships between these changes. Anemia is common in older people with severe aortic stenosis (AS). The two most common etiologies for anemia in this population are iron deficiency due to gastrointestinal blood loss and renal failure. Angiodysplasia in the gastrointestinal system is a feature of AS syndrome. Methods: We collected clinical data, including hemoglobin level and renal function before and 5-12 months after TAVR in 315 consecutive patients. To examine whether calculated clinical predictors such as EuroScore 2 are associated with the persistence of anemia after TAVR, we performed multivariable correlation analysis with post-TAVR anemia as the dependent variable. Results: The mean hemoglobin level increased significantly (from 11.76 to 12.16 g/dL, p < 0.0001) 5-12 months after TAVR, and the number of patients with anemia decreased significantly (from 67.5% to 53.9%, p < 0.0001). At 5-12 months following TAVR, a small reduction in estimated glomerular filtration rate was observed (from 60.05 ± 24.1 to 58.30 ± 24.50 mL/min, p = 0.024). The multivariable correlation analysis did not identify clinical predictors of persistent anemia. Conclusions: A significant increase in hemoglobin was observed 5-12 months after TAVR, despite a reduction in renal function. Our findings imply that gastrointestinal blood loss, which occurs in patients with severe AS, is significantly reduced following TAVR.

The intentions and factors influencing university students to perform CPR for strangers based on the theory of planned behavior study

ObjectiveThe Theory of Planned Behavior (TPB) was used to compile a questionnaire to determine the relationship between knowledge, attitude, subjective norm, perceived behavioral control and the intention of university students to perform cardiopulmonary resuscitation (CPR) for strangers, and the factors influencing them. MethodsWe recruited 575 university students who completed an online questionnaire within 30 min to assess knowledge, attitude, subjective norm, and perceived behavioral control related to bystander CPR. Factor analysis was used to evaluate the reliability of the extended questionnaire. Multivariate analysis, correlation analysis, and path analysis were used to determine the differences of intra-group and inter-group. ResultsThe Cronbach's α of knowledge, attitude, subjective norm, perceived behavioral control and intention were 0.770, 0.797, 0.909, 0.619 and 0.899 respectively, indicating that the extended scale reliability of the TPB was adequate. χ2/df = 3.463, GFI = 0.977, CFI = 0.968, IFI = 0.969, RMSEA = 0.066, indicating that the extended scale of the TPB had a good fit. Path analysis showed that the influencing factors of intention were “Families of medical workers”, “Experience in administering CPR first aid training”, “Gender”, “Ability to master CPR skills”, “Knowledge”, “Subjective norm” and “Attitude”, with effect values of 0.019, 0.063, 0.069, 0.122, 0.187, 0.361 and 0.386, respectively. All the factors together accounted for 57.00 % of the variation in intention. ConclusionsKnowledge, attitude and subjective norm regarding to bystander CPR among university students are the determinants of intention, while perceived behavioral control does not play a major role. This study has implications for future CPR training. In order to improve the CPR implementation rate of university students, we should strengthen the relevant knowledge about CPR, maintain positive attitude and refine the related criteria of CPR implementation.

대구 경북지역 병원종사자의 직무스트레스가 직무만족도에 미치는 영향에서 자아탄력성의 매개효과

Objectives The purpose of this study is to verify the mediating effect of ego resilience in the relationship between job stress and job satisfaction of hospital workers in the Daegu and Gyeongbuk regions. Methods An online survey was conducted targeting hospital workers working in the Daegu and Gyeongbuk regions from October 8, 2023 to October 15, 2023, and 86 copies were used in the final statistical analysis. The collected data were subjected to reliability analysis, frequency analysis, descriptive statistical analysis, multivariate normal distribution verification, correlation analysis, and regression analysis using SPSS V27.0, and the Sobel Test was performed to verify statistical significance. Results First, job stress of hospital workers in the Daegu and Gyeongbuk regions was found to have a significant negative effect on job satisfaction and ego resilience, and ego resilience was found to have a positive effect on job satisfaction. Second, ego resilience was found to mediate the relationship between job stress and job satisfaction among hospital workers in the Daegu and Gyeongbuk regions. Conclusions Through the results of this study, the relationship between job stress, job satisfaction, and ego resilience of hospital workers in the Daegu and Gyeongbuk regions was verified, and the relationship between major variables was confirmed theoretically and empirically, and key variables that affect hospital workers' job satisfaction were confirmed. It is meaningful in that it can provide basic data for early screening of hospital workers with low levels of job satisfaction and effective intervention by uncovering these factors. It is also significant in that it provided implications for the development of counseling and education programs related to job stress and ego resilience that can increase the job satisfaction of hospital workers in the Daegu and Gyeongbuk regions.

Relationship between binocular vision and Govetto’s stage in monocular idiopathic epiretinal membrane

Govetto’s staging system (stages 1–4) for epiretinal membrane (ERM) based on optical coherence tomography images is a useful predictor of monocular visual function; however, an association between Govetto’s stage and binocular vision has not been reported. This study aimed to investigate the factors associated with Govetto’s stage among the monocular and binocular parameters. This retrospective study included consecutive patients with treatment-naïve eyes with unilateral ERM without pseudo-hole. We investigated Govetto’s stage, degrees of aniseikonia and metamorphopsia, foveal avascular zone area, central retinal and choroidal thickness, vertical ocular deviation, stereopsis, and binocular single vision (BSV). We compared the parameters between the BSV-present and BSV-absent groups and investigated correlations between Govetto’s stage and the monocular and binocular parameters. Twenty-eight eyes of 28 patients were examined (age, 66.6 ± 10.2 years). In multivariate correlation analyses, Govetto’s stage correlated with BSV (P = 0.04, β = − 0.36) and central retinal thickness (P < 0.001, β = 0.74). Of the eyes, 18 were assigned to the BSV-present group and 10 to the BSV-absent group. Govetto’s stage was significantly more advanced in the BSV-absent group than in the BSV-present group (3.2 ± 0.8 vs 2.5 ± 0.7, P = 0.03). Of the 28 patients, 11 (39%) showed small-angle vertical deviations (1–12Δ). In conclusion, our findings showed that Govetto’s stage correlated with binocular vision in patients with monocular ERM. Govetto’s staging is a useful parameter for predicting not only monocular but also binocular vision.

Etiologies and clinical characteristics of macular hole: An 8-year, single-center, retrospective study.

To investigate the etiologies and clinical characteristics of full-thickness macular hole (FTMH) cases at Shanxi Eye Hospital in North China. Patients diagnosed with FTMH who underwent surgery from 2012 to 2020 were included, and the etiologies and clinical features of MH types were analyzed in an 8-year, cross-sectional, retrospective study. A total of 752 cases (776 eyes) were analyzed. The top 3 subtypes of MH were idiopathic (IMH, 64.4%), myopic (MMH, 21.1%) and traumatic (TMH, 3.7%) MH. Among these, there were significant differences in sex, age, and baseline best-corrected visual acuity (BCVA) distributions. Females predominated in the IMH and MMH groups, while males predominated in the TMH group. The IMH onset age was older than the MMH and TMH onset ages. Baseline BCVA in the IMH (Z = 8.9, P < .001) and the other group (Z = 4.0, P < .001) was significantly better than that in the MMH group. In the IMH group, females were younger, had a shorter axial length (AL), and had a worse baseline BCVA than males, while in the MMH group, there were no significant sex differences. Multivariate correlation analysis showed that a smaller hole diameter in IMH, no retinal detachment in MMH, and a younger age in TMH may result in better baseline BCVA. The most common MH etiologies were IMH, MMH and TMH, which contributed to differences in clinical features. Females predominated in the IMH and MMH groups, and the onset of MMH occurred 6.5 years earlier than the onset of IMH. Therefore, early fundus monitoring in females and high myopia patients is helpful for the early detection and treatment of MH.

Contribution of physical-chemical variables and passion fruit production in Baixo Acre

This study investigated the production and physical and chemical characteristics of eight sour passion fruit genotypes cultivated in Baixo Acre, AC. Evaluation of fruit number (FN), productivity (PRO), longitudinal diameter, transverse diameter (LD and TD), peel thickness (PT), average fruit mass (AFM), pulp mass (PM), juice yield (JY), soluble solids (SS), titratable acidity (TA), ratio, and pH of genotypes H1, H3, R, V1, V2, V3, V4, and V5 was performed. Univariate, multivariate, and Pearson's correlation analyses were performed. Univariate analyses revealed that the genotype H1 stood out in terms of AFM, JY, and PRO; H3 for TD, LD, JY, and pH; H1, H3, V1, and R for LD; H3 and V5 for pH; and V4 and V5 for NF. A strong positive correlation was observed among the physical variables AFM, PM, LD, and TD. Four genotypes groups were obtained for both genetic divergence and PCA. The H1 genotype presented higher productivity, and the H3 genotype presented better fruit physical attributes.

Blood cytokines as potential predictors of the development of SARS-CoV-2 associated pneumonia in patients with stage II ESSENTIAL hypertension

The search for predictors of the severe course of COVID-19 was relevant both during the pandemic and at the present time. The aim of the study was to analyze the relationship of cytokine levels in patients with EН before SARS-CoV-2 infection with the incidence of coronavirus pneumonia. Materials and methods. From the database of 290 patients with stage II EAG who have been under observation for 8–12 years with annual blood sampling to determine cytokine levels, COVID-19 survivors were selected (mild without pneumonia and moderate to severe, pneumonia CT 1–2, CT-3). Anamnestic levels of IL-1β, IL-1α, IL-1ra, IL-18, IL-18 BP, IL-37, IL-6, sIL-6r, M-CSF, VEGF-A, IL-34 and HMGB1) in the blood serum of patients with stage II EH were analyzed (method ELISA). The analysis of the obtained results was carried out using Stat Soft Statistica 13.5. Results and discussion. Patients with EH and COVID-19 with pneumonia (CT I-II) after SARS-CoV-2 infection 2–6 months before the infectious disease had significantly higher serum levels: IL-1α (p 0.05) and a decrease in IL-37 (p 0.001). During multivariate correlation analysis, a statistically independent relationship between an increase in the incidence of viral pneumonia in patients with stage II EН was confirmed only for IL-37 with a blood level of less than 60.2 pg/ml (regression coefficient — 2.21, standard error — 0.28, t criterion — 6.12, relative risk — 2.52, criterion Walda — 7.92, p = 0.006). When studying circadian rhythms of cytokine content in blood serum in patients of the analyzed groups, calculating the strength of correlations of anamnestic evening IL-37 levels in patients with stage II EР at 19.00–20.00 with the frequency of pneumonia against the background of SARS-CoV-2 infection, it has greater specificity and sensitivity (specificity — 0.75, sensitivity — 0.82) than morning concentrations. Considering that data on circadian rhythms were obtained in a limited number of patients, further monitoring is necessary, which is carried out by our scientific group. It should be noted that patients with essential hypertension are pathogenetically heterogeneous, including in terms of cytokine regulation. The study of this area will make it possible to personalize cytokine phenotypes of the disease and develop new methods for calculating the prognosis of both cardiovascular complications and features of the course of infectious diseases.

Primary caregiver burden and undiagnosed mental health illness in out-patients with inflammatory bowel disease-A multicentric prospective survey from the IBD Emerging Nations' Consortium.

Mental health is an overlooked aspect of inflammatory bowel disease (IBD) patient care with limited data from the developing world. The primary caregiver burden is expected to be high, but has not been evaluated. We conducted a questionnaire-based survey of consecutive out-patients with no diagnosed mental health illness (n = 289) and their primary caregivers (n = 247) from 10 centers across eight countries (Bangladesh, India, Iran, Malaysia, Myanmar, Nepal, Pakistan, Thailand) of IBD-Emerging Nations' Consortium (ENC). Patients were assessed for anxiety (PHQ-9), depression (GAD-7), quality of life (SIBDQ, IBDCOPE) and medication adherence (MMAS-8). Caregiver burden was assessed by Zarit-Burden Interview (ZBI), Ferrans and Power Quality of Life (QOL) scores and coping strategies (BRIEF-COPE). Multivariate logistic regression and correlation analyses were performed to identify risk factors and theimpact on QOL in patients and caregivers. Moderate to severe depression and anxiety were noted in 33% (severe 3.5%) and 24% (severe 3.8%) patients, respectively. The risk factor for depression was active disease (p < 0.001, OR6.3), while male gender (p = 0.01, OR0.45) and medication adherence (p = 0.003, OR0.75) were protective. Risk factors for anxiety were unmarried status (p = 0.015, OR2.3), female gender (p = 0.004, OR0.41), steroid use (p = 0.016, OR2.1) and active disease (p < 0.001, OR7.97). High GAD-7 and PHQ-9 scores positively correlated with high disease activity (r = 0.55, p < 0.001, Crohn's disease; r = 0.52, p < 0.001 ulcerative colitis) and negatively with SIBDQ (r = - 0.63, p < 0.001; r = - 0.64, p < 0.001 CD; r = 0.36, p = 0.001,UC). Sixty-five percent (159/249) primary caregivers reported high burden (ZBI ≥ 21), which positively correlated with low educational status and low-income and negatively with QOL(r = - 0.33, p < 0.001). The primary adaptive coping strategy among caregivers was religion, while maladaptive strategy was self-distraction. Nearly two-thirds of primary caregivers reported high burden of care. There was also high prevalence of undiagnosed depression and anxiety in IBD out-patients. This highlights the need for patient-caregiver integrated mental-health services in the developing world.

Cerebellum and social abilities: A structural and functional connectivity study in a transdiagnostic sample.

The cerebellum has been involved in social abilities and autism. Given that the cerebellum is connected to the cortex via the cerebello-thalamo-cortical loop, the connectivity between the cerebellum and cortical regions involved in social interactions, that is, the right temporo-parietal junction (rTPJ) has been studied in individuals with autism, who suffer from prototypical deficits in social abilities. However, existing studies with small samples of categorical, case-control comparisons have yielded inconsistent results due to the inherent heterogeneity of autism, suggesting that investigating how clinical dimensions are related to cerebellar-rTPJ functional connectivity might be more relevant. Therefore, our objective was to study the functional connectivity between the cerebellum and rTPJ, focusing on its association with social abilities from a dimensional perspective in a transdiagnostic sample. We analyzed structural magnetic resonance imaging (MRI) and functional MRI (fMRI) scans obtained during naturalistic films watching from a large transdiagnostic dataset, the Healthy Brain Network (HBN), and examined the association between cerebellum-rTPJ functional connectivity and social abilities measured with the social responsiveness scale (SRS). We conducted univariate seed-to-voxel analysis, multivariate canonical correlation analysis (CCA), and predictive support vector regression (SVR). We included 1404 subjects in the structural analysis (age: 10.516 ± 3.034, range: 5.822-21.820, 506 females) and 414 subjects in the functional analysis (age: 11.260 ± 3.318 years, range: 6.020-21.820, 161 females). Our CCA model revealed a significant association between cerebellum-rTPJ functional connectivity, full-scale IQ (FSIQ) and SRS scores. However, this effect was primarily driven by FSIQ as suggested by SVR and univariate seed-to-voxel analysis. We also demonstrated the specificity of the rTPJ and the influence of structural anatomy in this association. Our results suggest that there is a complex relationship between cerebellum-rTPJ connectivity, social performance and IQ. This relationship is specific to the cerebellum-rTPJ connectivity, and is largely related to structural anatomy in these two regions. PRACTITIONER POINTS: We analyzed cerebellum-right temporoparietal junction (rTPJ) connectivity in a pediatric transdiagnostic sample. We found a complex relationship between cerebellum and rTPJ connectivity, social performance and IQ. Cerebellum and rTPJ functional connectivity is related to structural anatomy in these two regions.

Dementia Subtypes Defined Through Neuropsychiatric Symptom–Associated Brain Connectivity Patterns

Understanding the heterogeneity of neuropsychiatric symptoms (NPSs) and associated brain abnormalities is essential for effective management and treatment of dementia. To identify dementia subtypes with distinct functional connectivity associated with neuropsychiatric subsyndromes. Using data from the Open Access Series of Imaging Studies-3 (OASIS-3; recruitment began in 2005) and Alzheimer Disease Neuroimaging Initiative (ADNI; recruitment began in 2004) databases, this cross-sectional study analyzed resting-state functional magnetic resonance imaging (fMRI) scans, clinical assessments, and neuropsychological measures of participants aged 42 to 95 years. The fMRI data were processed from July 2022 to February 2024, with secondary analysis conducted from August 2022 to March 2024. Participants without medical conditions or medical contraindications for MRI were recruited. A multivariate sparse canonical correlation analysis was conducted to identify functional connectivity-informed NPS subsyndromes, including behavioral and anxiety subsyndromes. Subsequently, a clustering analysis was performed on obtained latent connectivity profiles to reveal neurophysiological subtypes, and differences in abnormal connectivity and phenotypic profiles between subtypes were examined. Among 1098 participants in OASIS-3, 177 individuals who had fMRI and at least 1 NPS at baseline were included (78 female [44.1%]; median [IQR] age, 72 [67-78] years) as a discovery dataset. There were 2 neuropsychiatric subsyndromes identified: behavioral (r = 0.22; P = .002; P for permutation = .007) and anxiety (r = 0.19; P = .01; P for permutation = .006) subsyndromes from connectivity NPS-associated latent features. The behavioral subsyndrome was characterized by connections predominantly involving the default mode (within-network contribution by summed correlation coefficients = 54) and somatomotor (within-network contribution = 58) networks and NPSs involving nighttime behavior disturbance (R = -0.29; P < .001), agitation (R = -0.28; P = .001), and apathy (R = -0.23; P = .007). The anxiety subsyndrome mainly consisted of connections involving the visual network (within-network contribution = 53) and anxiety-related NPSs (R = 0.36; P < .001). By clustering individuals along these 2 subsyndrome-associated connectivity latent features, 3 subtypes were found (subtype 1: 45 participants; subtype 2: 43 participants; subtype 3: 66 participants). Patients with dementia of subtype 3 exhibited similar brain connectivity and cognitive behavior patterns to those of healthy individuals. However, patients with dementia of subtypes 1 and 2 had different dysfunctional connectivity profiles involving the frontoparietal control network (FPC) and somatomotor network (the difference by summed z values was 230 within the SMN and 173 between the SMN and FPC for subtype 1 and 473 between the SMN and visual network for subtype 2) compared with those of healthy individuals. These dysfunctional connectivity patterns were associated with differences in baseline dementia severity (eg, the median [IQR] of the total score of NPSs was 2 [2-7] for subtype 3 vs 6 [3-8] for subtype 1; P = .04 and 5.5 [3-11] for subtype 2; P = .03) and longitudinal progression of cognitive impairment and behavioral dysfunction (eg, the overall interaction association between time and subtypes to orientation was F = 4.88; P = .008; using the time × subtype 3 interaction item as the reference level: β = 0.05; t = 2.6 for time × subtype 2; P = .01). These findings were further validated using a replication dataset of 193 participants (127 female [65.8%]; median [IQR] age, 74 [69-77] years) consisting of 154 newly released participants from OASIS-3 and 39 participants from ADNI. These findings may provide a novel framework to disentangle the neuropsychiatric and brain functional heterogeneity of dementia, offering a promising avenue to improve clinical management and facilitate the timely development of targeted interventions for patients with dementia.

New Insight into the Effects of Different Types of Midfoot and Hindfoot Deformities on the Functional Outcomes of Rheumatoid Arthritis Patients

In advanced stages of rheumatoid arthritis (RA), the pattern of joint involvement leads to varied types of foot deformities such as forefoot, midfoot, and hindfoot deformities. We aim to evaluate midfoot and hindfoot deformities and their effect on functional outcomes in RA patients. In this prospective cross-sectional study clinical and radiological evaluations of 100 adult RA patients were studied for midfoot and hindfoot deformities. The RA disease activity, functional disability level, specific foot and ankle assessments, gait speed, and balance tests were assessed. Radiological examinations of the weight-bearing feet in a standing position were done. We found that the most frequent deformity type was the planovalgus foot (24%). There were statistically significant differences between the types of foot deformities and disease duration, disease activity, falls, Tinetti and Berg balance Test, and health assessment questionnaire-disability index. The multivariate regression analysis of independent correlates of falling detected that patients with equinovarus deformity were 2.5 times more liable for falling with 63.5% predictive power. According to the predictive criteria of deformity type for falling, the equinocavovarus type had accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of 91%, 84.5%, 98.5%, 99%, and 84%, respectively. We found in RA patients, midfoot and hindfoot deformities cause a significant reduction of functional ability and quality of life. The early detection of foot deformities requires a good awareness of the clinical and radiographic diagnosis of different types of deformities thus reducing the possible functional disabilities via early management by combined orthotic, physiotherapy, and surgical treatments.

Understanding arsenic and manganese enrichment in the aquifers of the Ghaghara river basin, Middle Gangetic Plain (MGP), India: A multivariate statistical, compositional data analysis (CoDA), and receptor model approach

The focus of this study was to comprehend the spatial distribution, source apportionment, evaluation of natural background level (NBL), and mobilization mechanisms of arsenic (As) and manganese (Mn) in the Ghaghara river basin, located in the middle Gangetic plain (MGP) of India. A combination of analytical tools was employed, including multivariate statistical analysis (MSA), correlation analysis, and receptor models such as positive matrix factorization (PMF) and principal component analysis-multi linear regression (PCA-MLR). Taking into consideration the compositional constraints of the geochemical data, compositional data analysis (CoDA) methods were applied on the raw data prior to the correlation analysis and MSA. The results of MSA, correlation analysis and receptor models showed that major ion chemistry and As, Mn enrichment in groundwater were largely controlled by carbonate weathering, Fe and Mn oxyhydroxides dissolution. Anthropogenic activities, such as the infiltration of dissolved organic matter-rich water from local surface water bodies used as dumping sites and the infiltration of fertilizer-rich water from agricultural lands, were found to notably impact the groundwater geochemistry and release of As in the research area. The lower NBL of As (5.92 μg/L) compared to its mean concentrations (17.9 μg/L) in the study area also indicated that the rate of As release in groundwater through natural processes was comparatively low but various anthropogenic activities operating in the study region possibly acted as a trigger for the mobility of As from the mineral phases of the subsurface sediments. This study also highlighted the significance of applying CoDA techniques on geochemical data prior to statistical analysis, and the importance of receptor models, to better understand the nature and contribution of various natural and anthropogenic processes governing the hydrochemistry of groundwater in the alluvial aquifers.

Influence of climate variability and land cover dynamics on the spatio-temporal NDVI patterns in western hydrological regions of Bangladesh

Analyzing vegetation greenness considering climate and land cover changes is crucial for Bangladesh given the historically drier North-West and South-West regions of Bangladesh have shown prominent climatic and hydrological variations. Therefore, this study assessed the spatial and temporal variation of NDVI and its relationship with climate and land cover changes from 2000 to 2022 for these regions. In this study, Moran's I and Getis Ord Gi* were employed for spatial autocorrelation and Mann-Kendall, Sen's slope test along with Innovative Trend Analysis were deployed to identify temporal trends of NDVI. RMSE, MAE and R-squared values were assessed between computed and observed PET. Correlation of NDVI with climate variables were assessed through multivariate correlation analysis and correlation mapping. Additionally, Pearson product moment correlation was applied between different types of land cover and NDVI. Spatial autocorrelation outcomes showed that NDVI values have been clustered in distinct hotspots and cold-spots over the years. Temporal trend detection results indicate that NDVI values are rising significantly all over the regions. Multivariate correlation analysis identified no climate variable to be the limiting factor for NDVI changes. Similarly, the precipitation-NDVI correlation map displayed no significant correlation. Nonetheless, temperature-NDVI correlation map illustrated varying degrees of mostly moderate and strong positive correlations with distinct negative correlation results in the Sundarbans of South-West region. Land cover pattern analysis with NDVI showed a positive correlation to forest, cropland and vegetation area increasing and negative correlation to grassland and barren area decreasing. In this regard, Rangpur division exhibited stronger correlations than Rajshahi division in North-West. The findings indicate that NDVI changes in the regions are largely dependent on land cover changes in comparison to climate trends. This can instigate further research in other hydrological regions to explore the natural and man-made factors that can affect the greenery and vegetation density in specific regions.

Seasonal dynamics of antibiotic resistance genes and mobile genetic elements in a subtropical coastal ecosystem: Implications for environmental health risks

Antibiotic resistance poses a considerable global public health concern, leading to heightened rates of illness and mortality. However, the impact of seasonal variations and environmental factors on the health risks associated with antibiotic resistance genes (ARGs) and their assembly mechanisms is not fully understood. Based on metagenomic sequencing, this study investigated the antibiotic resistome, mobile genetic elements (MGEs), and microbiomes in a subtropical coastal ecosystem of the Beibu Gulf, China, over autumn and winter, and explored the factors influencing seasonal changes in ARG and MGE abundance and diversity. Results indicated that ARG abundance and diversity were higher in winter than in autumn, with beta-lactam and multidrug resistance genes being the most diverse and abundant, respectively. Similarly, MGE abundance and diversity increased in winter and were strongly correlated with ARGs. In contrast, more pronounced associations between microbial communities, especially archaea, and the antibiotic resistome were observed in autumn than in winter. The co-occurrence network identified multiple interactions between MGEs and various multidrug efflux pumps in winter, suggesting a potential for ARG dissemination. Multivariate correlation analyses and path modeling indicated that environmental factors driving microbial community changes predominantly influenced antibiotic resistome assembly in autumn, while the relative importance of MGEs increased significantly in winter. These findings suggest an elevated health risk associated with antimicrobial resistance in the Beibu Gulf during winter, attributed to the dissemination of ARGs by horizontal gene transfer. The observed seasonal variations highlight the dynamic nature of antibiotic resistance dissemination in coastal ecosystems, emphasizing the need for comprehensive surveillance and management measures to address the growing threat of antimicrobial resistance in vulnerable environments.

#770 Urinary PTM3 Fetuin-A in CKD patients with and without diabetic kidney disease

Abstract Background and Aims Fetuin-A is a member of the cystatins superfamily, primarily synthesized in the liver, which is involved in multiple physiological processes including calcium homeostasis, cell signaling, calcification inhibition and the regulation of insulin sensitivity. Diabetes mellitus may impact upon Fetuin-A regulation and kidney tubular cells produce Fetuin-A as part of stress and inflammatory response and release it in urine in case of kidney damage. A novel post-translational modification (PTM) fragment derived from the cleavage of Fetuin-A (PTM3) has recently emerged as a very sensitive biomarker for early kidney damage, but its usefulness in the context of CKD has not been assessed yet. In this study, we aimed at evaluating the clinical significance of urinary PTM3 fetuin A in a pilot cohort of CKD patients with or without diabetic kidney disease (DKD). Method We enrolled 47 adult patients with CKD (mean CKD-Epi 40.10 ± 16.5 mL/min/1.73 m2) due to DKD (n = 34) or other causes (n = 13). PTM3 levels were measured in the urine (uPTM3) using a commercially available ELISA kit. 15 healthy individuals served as controls. Clinical, anthropometric and laboratory parameters were also recorded. Results Collectively, all CKD patients displayed higher levels of uPTM3 than the ones of control group (0.84 [0.10-1.15] vs 29.68 [2.50-55.16] ng/mL p = 0.0005). Moreover, uPTM3 values were higher in DKD patients than in non-DKD CKD patients (39.4 [4.20-28.2] vs. 4.15 [0.29-1.38] p &amp;lt; 0.01). uPTM3 had a remarkable diagnostic capacity at ROC analysis to discriminate CKD patients from controls (AUC 0.776; p &amp;lt; 0.001; Fig. 1) and, within CKD patients, to discriminate between DKD and non-DKD patients (AUC 0.673; p = 0.02; Fig. 2). At multivariate correlation analyses, only proteinuria (β = 0.442; p = 0.02) and BMI (β = 0.334; p = 0.04) values remained significantly associated with uPTM3 Fetuin-A in the whole cohort, thus indicating that renal damage following metabolic syndrome may play a significant impact on the overall balance of this protein. Conclusion uPTM3 could be a novel sensitive biomarker reflecting renal damage in CKD patients and could also represent an additional tool for assessing the renal involvement in diabetic patients. Further studies are needed to evaluate whether uPTM3 measurement may predict different disease evolution in these patients.

In-depth analysis of volatolomic and odorous profiles of novel craft beer by permutation test features selection and multivariate correlation analysis

This research explored the impact of binary cereal blends [barley with durum wheat (DW) and soft wheat (CW)], four autochthonous yeast strains (9502, 9518, 14061 and 17290) and two refermentation sugar concentrations (6–9 g/L), on volatolomics (VOCs) and odour profiles of craft beers using unsupervised statistics. For the first time, we applied permutation test to select volatiles with higher significance in explaining variance among samples. The unsupervised approach on the 19 selected VOCs revealed cereal-yeast interaction to be the main source of variability and DW-9502-6/9, DW-17290-6, CW-17290-6 and CW-9518-6 being the best technological strategies. In particular, in samples DW-9502-6/9, concentrations of some of the selected volatiles were observed to be approximately three to more than seven times higher than the average. PLS-correlation between VOCs and odour profiles proved to be very useful in assessing the weight of each of the selected VOCs on the perception of odour notes.