Receiver Operating Characteristic Analysis Research Articles

Higher Serum Levels of Lipoprotein-Associated Phospholipase A2 are Associated with Diabetic Foot Osteomyelitis.

BackgroundDiabetic foot osteomyelitis (DFO) is often difficult to detect in its early stages, making diagnosis challenging. This study is to investigate the relationship between lipoprotein-associated phospholipase A2 (Lp-PLA2) and DFO, while also evaluating the potential of Lp-PLA2 as an early diagnostic biomarker for DFO.MethodsA total of 265 patients with type 2 diabetes complicated by diabetic foot infections were selected for the study. Participants were divided into the Non-DFO group (184 cases) and the DFO group (81 cases). Serum Lp-PLA2 levels were measured. Logistic regression analysis was utilized to identify risk factors associated with DFO. Receiver Operating Characteristic curve analysis was performed to assess the diagnostic value of Lp-PLA2 in patients with DFO.ResultsLp-PLA2 in the DFO group were significantly higher than those in the Non-DFO group (P < .05). Lp-PLA2 (OR, 1.015 [95% CI, 1.011-1.019]; P < .001), lower extremity arterial disease (OR, 2.453 [95% CI, 1.147-5.247]; P < .05), and ESR (OR, 1.042 [95% CI, 1.026-1.059]; P < .001) were the independent risk factors for DFO. Lp-PLA2 and ESR were shown to be associated with DFO, with their respective areas under the curve (AUC) being 0.787 and 0.683. The sensitivity and specificity of Lp-PLA2 were 65.4% and 82.6%, respectively, while those of ESR were 48.1% and 95.1%. Combined Lp-PLA2 and ESR showed the best diagnostic performance (AUC 0.858, sensitivity 79.0%, specificity 84.2%).ConclusionAs a preliminary one, Lp-PLA2 demonstrates significant diagnostic value for DFO. The combination of Lp-PLA2 and ESR can significantly improve diagnostic accuracy of DFO.

The Diagnostic Value of Contrast-Enhanced Vessel Wall MRI for Diagnosing Neuropsychiatric Systemic Lupus Erythematosus.

Imaging biomarkers for neuropsychiatric systemic lupus erythematosus (NPSLE) are highly needed, and intracranial contrast-enhanced vessel wall imaging (CE-VWI) can potentially detect cerebral vessel wall abnormalities in lupus. To evaluate the diagnostic value of CE-VWI in differentiating NPSLE from non-NPSLE. Cross-sectional, retrospective. Forty-seven patients with NPSLE (mean age, 44.3 years ± 13.2 standard deviation [SD], 40 females, 85%) and 52 patients without NPSLE (mean age, 43.0 years ± 16.5 SD, 49 females, 89%). The non-NPSLE group consisted of SLE patients who had no NP symptoms or were diagnosed with comorbidities from other diseases. 3-T, three-dimensional (3D) contrast-enhanced vessel wall imaging (3D-T1-CUBE). Vessel wall lesions (VWLs) were visually assessed across 15 segments, from the internal carotid artery and basilar artery to A1-A2 for ACA, M1-M2 for MCA, and P1-P2 for PCA, for wall thickening and enhancement. Conventional MRI and MR angiography were also used to assess infarction, hemorrhage, atrophy, and arterial stenosis. Paired comparisons using the chi-square and unpaired t-tests were followed by multivariate logistic regression analysis incorporating factors with significant group differences to identify associations with NPSLE. Receiver operating characteristic (ROC) analysis with the area under the curve (AUC) assessed the diagnostic performance of CE-VWI. A p-value < 0.05 was considered statistically significant. The NPSLE group showed a significantly higher number of contrast-enhancing VWLs (CE-VWLs; median [interquartile range]: 2 [0.5-4] vs. 0 [0-1]). Cerebral infarctions and arterial stenotic lesions were more common in NPSLE, occurring in 12 (26%) vs. 2 (3%) and 19 (40%) vs. 5 (9%) of patients, respectively. A multivariate logistic regression analysis identified CE-VWLs as the sole significant factor associated with NPSLE (odds ratio, 1.97; 95% confidence interval, 1.23-3.16). The ROC analysis showed an AUC of 0.78 for CE-VWLs, with a sensitivity of 60% and a specificity of 87%. CE-VWI may demonstrate high specificity and good diagnostic performance in differentiating NPSLE from non-NPSLE. 3. Stage 2.

Prognostic value of MIB-1 index in meningioma: a retrospective cohort study to establish an optimal cutoff for recurrence and survival.

Predicting long-term outcomes after meningioma resection remains challenging. Ki-67/MIB-1 correlates with recurrence, yet its optimal cutoff is undefined. This study aims to establish a threshold that enhances risk stratification, improves recurrence prediction, and informs postoperative surveillance and adjuvant treatment strategies. This is retrospective study of patients who underwent meningioma resection. Receiver operating characteristic (ROC) analysis determined the optimal MIB-1 cutoff for predicting recurrence and survival, providing area under the curve (AUC). This cutoff was then applied in Kaplan-Meier survival analyses and multivariable Cox regressions, controlling for age, sex, tumor diameter, tumor location, extent of resection, and adjuvant radiotherapy. A total of 404 patients were included. Median age was 55.0 years (range: 16-85) and 72.3% were female. The cohort primarily consisted of WHO Grade 1 (69.6%) and Grade 2 (30.0%) meningiomas. An optimal MIB-1 index cutoff of 4.1% was identified using ROC analysis with the Youden index for predicting recurrence (AUC = 0.661, p < 0.001) and survival (AUC = 0.717, p < 0.001). 241 patients (59.7%) had a MIB-1 < 4.1%, and 163 (40.3%) had a MIB-1 ≥ 4.1%. Patients with MIB-1 ≥ 4.1% had a higher risk of recurrence (HR = 2.9, p = 0.009) and mortality (HR = 2.8, p = 0.036). Patients with MIB-1 ≥ 4.1% demonstrated shorter recurrence-free survival (RFS) (119.0 vs. 129.0 months, p < 0.001) and overall survival (OS) (163.0 vs. 229.0 months, p < 0.001). We identified an optimal and actionable MIB-1 index cutoff of 4.1% which independently predicted recurrence, mortality, and shorter RFS and OS for patients undergoing meningioma resection. As the first study to establish and validate this threshold, our findings highlight its potential as an adjunct prognostic tool to refine risk stratification and guide postoperative management.

Research on the functions and potential mechanisms of STAT3 in chronic myelogenous leukemia

ObjectiveTo explore the bioinformatics characteristics and potential mechanisms of signal transducer and activator of transcription (STAT3) in chronic myelogenous leukemia (CML). MethodsThrough the cancerSEA and CCLE databases, the expression of STAT3 in CML was verified and analyzed. Subsequently, K562 cells were treated with the STAT3 inhibitor Stattic. Western blotting, cell counting, and flow cytometry were utilized to observe its impact on the functions of K562 cells. Then, Gene Set Enrichment Analysis (GSEA) and Gene Set Variation Analysis (GSVA) were applied to deeply explore the regulatory mechanism of STAT3. The "LIMMA" software package was used to calculate STAT3-related differentially expressed genes (DEGs). Machine-earning methods were utilized to screen the STAT3-related hub genes. The "pROC" software package was employed to perform Receiver Operating Characteristic (ROC) curve analysis on the hub genes. The "corrplot" software package was used to conduct a correlation analysis of the hub genes. The "RMS" software package was applied to construct a nomogram of the hub genes. Based on the DisGENET database, a disease network of the hub genes was constructed, and the DGIdb database was used to construct a drug network of the hub genes. ResultsIn CML, the expression of STAT3 is upregulated compared to housekeeping genes. Among the 14 cell lines related to CML, STAT3 has the highest expression level in K562 cells. Stattic at a concentration of 5 μM can inhibit the proliferation of K562 cells, promote their apoptosis, and block the cell cycle at the S phase (P < 0.05). GSEA and GSVA indicates that amino acid metabolism, NOD-like receptor of STAT3. LASSO and SVM-RFE show that NCF4, PLAS1, IL7R, and TAGLN2 are hub differentially expressed genes (DEGs) related to STAT3. ROC and Nomogram indicate that the hub DEGs have high clinical diagnostic value. Correlation analysis shows that PLAS1 and NCF4 are negatively correlated, while PLAS1 and TAGLN2 are positively correlated. The construction of gene-disease networks reveals that these genes not only participate in the occurrence and development of CML but also jointly participate in multiple disease processes. The gene-drug network obtained 38 drugs targeting genes.ConclusionSTAT3 might serve as a potential target for the treatment of CML. In CML, NCF4, PLAS1, IL7R, and TAGLN2 are hub genes associated with STAT3. These findings offer a fundamental theory for comprehending the pathogenesis of CML.

The metabolic syndrome-insulin resistance index: a tool for identifying dyslipidemia across varied glucose metabolic score in patients with cardiovascular disease

PurposeThe METS-IR index, a non-insulin-based metabolic score, represents a new marker closely linked to insulin resistance. This study aimed to evaluate the relationship between the METS-IR index and dyslipidemia in individuals diagnosed with Cardiovascular disease (CVD), as well as to delve deeper into how varying glucose metabolic conditions influence this relationship.MethodsThis multicenter retrospective investigation encompassed 214,717 individuals diagnosed with CVD across China, spanning from September 1, 2014, to June 1, 2022, ultimately incorporating 17,632 cases in the conclusive analysis. All cases were grouped according to quartiles of METS-IR. The American College of Cardiology classifies dyslipidemia into four distinct categories: hyper-triglyceridemia (hyper-TG), hyper-cholesterolemia (hyper-TC), hypo-high-density lipoprotein cholesterolemia (hypo-HDL), and hyper-low-density lipoprotein cholesterolemia (hyper-LDL). Dyslipidemia is diagnosed when any one of these conditions is present. Logistic regression analysis was performed to estimate the odds ratio (OR) and 95% confidence interval (CI), assessing the relationship between the METS-IR index and dyslipidemia risk in patients with CVD. To evaluate the precision of the METS-IR index in identifying dyslipidemia, receiver operating characteristic (ROC) curve was produced.ResultsThe results of the baseline analysis showed that 11,934 cases had dyslipidemia, with notable variations observed in the clinical and biological attributes among CVD cases (P &amp;lt; 0.05 to &amp;lt; 0.001). Logistic regression analysis showed that the METS-IR index was significantly associated with the risk of dyslipidemia (odds ratio [OR]: 1.14; 95% confidence interval [CI] 1.13-1.15; P &amp;lt; 0.001). The OR for dyslipidemia in Q4 of the METS-IR index was 11.94 (95% CI 10.60-13.45; p &amp;lt; 0.001) compared to Q1. ROC analysis revealing an area under the curve (AUC) of 0.747 (95% CI 0.739-0.754; P &amp;lt; 0.001). The association between the METS-IR index and dyslipidemia proved significant across all glycemic status groups, with the highest OR observed in the Q4 subgroup of cases with NGR (OR: 15.43; 95% CI 12.21-19.49).ConclusionThe risk of developing dyslipidemia is positively associated with heightened METS-IR levels in individuals afflicted with CVD, and these relationships hold significance across all glycemic metabolic conditions. METS-IR could potentially aid in forecasting the risk of dyslipidemia development in individuals diagnosed with CVD.

Molecular imaging using 18F-FDG PET/CT and circulating inflammatory and immune indicators to predict pathological response to neoadjuvant camrelizumab plus chemotherapy in resectable stage IIIA-IIIB NSCLC.

This study aims to predict the pathological response of patients with non-small cell lung cancer (NSCLC) in prospective trials of neoadjuvant camrelizumab combined with chemotherapy by integrating the clinical characteristics, PET-associated parameters, and hematological indicators. A prospective analysis was conducted among 24 patients undergoing surgery after neoadjuvant camrelizumab plus chemotherapy. 18F-Fluorodeoxyglucose (FDG) scans were performed before and after neoadjuvant therapy (pre-NAT, post-NAT). Tumor and secondary lymphoid organ metabolic parameters, along with circulating inflammatory and immune indicators, were measured and correlated with pathological response. Receiver operating characteristic (ROC) curve was used to assess biomarkers' predictive accuracy. Major pathological response (MPR) and pathological complete response (pCR) were achieved in 45.8% (11/24) and 33.3% (8/24) of patients. Before treatment, patients who achieved a pCR had significantly greater SUVmax values (p = 0.011) than non-pCR patients. After treatment, the MPR group exhibited significantly lower SUVmax values than the non-MPR group (p = 0.048). The rate of change in the SUVmax (ΔSUVmax%) differed significantly between the pCR and non-pCR groups (p = 0.019) and between the MPR and non-MPR groups (p = 0.013). After NAT, the lymph nodes' SUVmax in the ypN0 group was significantly lower than that in the ypN + group (p = 0.032). ROC analysis indicated that pre-NAT SUVmax and ΔSUVmax% best distinguished pCR and MPR patients, respectively, with AUCs of 0.82 (p = 0.012) and 0.80 (p = 0.014). Pre-NAT SUVmax, and ΔSUVmax% are promising biomarkers for predicting pathological response to neoadjuvant camrelizumab and chemotherapy. NCT06241807.

Association between serum spexin levels and diabetic nephropathy in patients with type 2 diabetes: a cross-sectional study.

Diabetic nephropathy (DN) is a serious complication of diabetes, with a high prevalence ranging from 21.8% in China, 35.3% in African countries, and an overall prevalence of 20-40% worldwide. This study investigated serum spexin levels in patients with type 2 diabetes, comparing those with and without DN, and explored its association with metabolic parameters. This cross-sectional study was conducted among patients with type-2 diabetes according to ADA guidelines. After obtaining informed consent, urine albumin-to-creatinine-ratio (ACR) was determined and patients were categorized into two groups: with-nephropathy (ACR ≥ 30) and without-nephropathy (ACR < 30). The correlation between spexin and demographic, anthropometric, and biochemical variables was further determined. Logistic regression analysis was used to assess the relationship between spexin and the likelihood of DN. Receiver Operating Characteristic (ROC) curve analysis determined the optimal serum spexin cutoff for distinguishing between groups. A total of 97 diabetic individuals (33 with DN, 64 without) participated in the study. Serum spexin was significantly lower in patients with DN compared to those without DN (p < 0.001). Spexin concentrations showed an inverse correlation with LDL and ACR levels. Lower spexin levels were associated with a reduced likelihood of DN (OR 0.46, 95% CI 0.31-0.69; p < 0.001). ROC curve analysis identified a cutoff value of 81.10ng/ml, with an area under the curve of 0.986, demonstrating 95.3% sensitivity and 94.1% specificity for diagnosing DN. Lower serum spexin levels are associated with impaired kidney function, indicating its potential as a predictive biomarker for diabetic nephropathy. However, further validation in larger and more diverse cohorts is needed to address limitations such as sample size and unmeasured confounders.

Predictive Value of Bedside Ultrasound Evaluation of Venous Excess Ultrasound Grading System for Acute Kidney Injury in Children Undergoing Cardiac Surgery

AIM: This study aims to investigate the predictive value of bedside ultrasound evaluation of venous excess ultrasound grading system (VExUS) for acute kidney injury (AKI) in children after cardiac surgery. METHODS: This retrospective study included 122 pediatric patients who underwent cardiac surgery at the West China Second University Hospital of Sichuan University between January 2024 and November 2024. Based on the occurrence of AKI, patients were divided into the AKI (n = 42) and non-AKI (n = 80) groups. Univariate and binary logistics regression analyses were performed to identify factors influencing AKI. The predictive value of the VExUS grading system for AKI in children after pediatric cardiac surgery was evaluated using receiver operating characteristic (ROC) curve analysis. RESULTS: There were no statistically significant differences (p &gt; 0.05) between the two groups regarding age, gender, Body Mass Index (BMI), length of hospital stay, intraoperative blood loss, postoperative hypotension, 24-hour postoperative urine output, aortic cross-clamp time, preoperative left ventricular ejection fraction, postoperative inadequate circulating blood volume, and preoperative use of positive inotropic drugs, operation time, plasma input, congenital heart disease, radical operation, and emergency surgery. However, statistically significant differences were found in postoperative blood glucose levels, VExUS scores, cardiopulmonary bypass duration, and cyanosis (p &lt; 0.05). Binary logistics regression analysis revealed that blood glucose levels, VExUS, and cyanosis were significant factors influencing AKI after pediatric cardiac surgery (p &lt; 0.05). ROC analysis showed that the area under the curve (AUC) of 0.803 for VExUS, with a standard error of 0.043 (95% confidence interval (CI): 0.719–0.887), a Youden index of 0.48, sensitivity of 76.25%, and specificity of 71.43%. CONCLUSIONS: The VExUS grading system demonstrates significant clinical utility in predicting AKI in children undergoing cardiac surgery.

Pupillary Light Reflex Parameters as Predictors of Postoperative Nausea and Vomiting: A Prospective Study

AIM: This study aims to investigate whether pupillary light reflex (PLR) parameters in dynamic pupillometry can effectively predict postoperative nausea and vomiting (PONV). METHODS: In this prospective observational study, patients scheduled to undergo elective lobectomy under general anesthesia were enrolled from 1 August 2023 to 7 October 2023 at Yantai Yuhuangding Hospital, a large regional tertiary hospital in Yantai City, Shandong Province, China. Preoperative pupillary parameters were measured using a portable infrared pupillometer, and the patients were followed up within 24 hours postoperatively to assess postoperative nausea and vomiting (PONV) and recovery quality. Logistic regression analysis and receiver operating characteristics (ROC) curves were used to evaluate the predictive efficacy of pupillary parameters, and mediation analysis was conducted to explore the mediating role of PONV between pupillary parameters and recovery quality. RESULTS: Forty-six patients (29.9%) who experienced PONV had smaller maximum pupil diameter, average constriction velocity (ACV), maximum constriction velocity (MCV), and percentage pupil change. MCV was identified as an independent predictor of PONV, with each 1-unit increase in MCV reducing the risk of PONV by 87%. Gender was a protective factor, with males having a 65% lower risk of PONV compared to females. The ROC analysis showed that the area under the curve (AUC) value of MCV was 0.831 (95% confidence interval (CI): 0.760–0.902), indicating that the model has strong classification ability when using MCV as a predictor. Thus, PONV plays a full mediating role in the relationship between MCV and postoperative recovery quality. CONCLUSIONS: MCV is a reliable predictor of PONV, which plays a full mediating role in the relationship between MCV and postoperative recovery quality. Thus, with a capability in predicting PONV occurrence, preoperative MCV measurement can be employed for the purpose of improving patient recovery outcomes. CLINICAL TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR2300073869).

The potential of MCM8 as a biomarker in esophageal carcinoma: a comprehensive analysis integrating m6a methylation and angiogenesis

BackgroundEffective biomarkers for esophageal carcinoma (ESCA) are currently lacking. Here, we examined the role of minichromosome maintenance complex component 8 (MCM8) as a diagnostic and prognostic marker in ESCA and its association with m6a methylation and angiogenesis, and constructed a competing endogenous RNA (ceRNA) network.MethodsClinical data and gene expression profiles were obtained from The Cancer Genome Atlas and Gene Expression Omnibus datasets. Differential gene expression analysis was performed using DESeq2 and limma packages. The prognostic significance of MCM8 expression regarding overall survival (OS) was examined using the Cox proportional hazards model. Receiver Operating Characteristic (ROC) analysis was used to assess the diagnostic potential of MCM8. MCM8 expression in ESCA tissues was evaluated by immunohistochemical staining on a tissue microarray. Pearson correlation analysis identified co-expressed genes, followed by Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses. The GEPIA online tool was used to examine the relationship between MCM8 and m6a methylation as well as angiogenesis-related genes. MicroRNA and long noncoding RNA predictions were made using miRWalk, MicroT-CDS, ENCORI, and miRNet tools to construct the ceRNA network.ResultsMCM8 was significantly overexpressed in tumor tissues and showed high diagnostic accuracy in the ROC analysis with an area under the curve of 0.920. Kaplan–Meier survival analysis revealed that high MCM8 expression correlated with poorer OS and disease-specific survival. Pearson correlation analysis identified a significant correlation between MCM8 and several m6a methylation-related genes such as HNRNPA2B1 and YTHDF1, as well as PTK2, an angiogenesis-related gene. A ceRNA network including MCM8, PURPL/hsa-miR- 135a- 5p/MCM8 was successfully predicted and constructed.ConclusionsMCM8 is a promising biomarker in ESCA and it is associated with m6a methylation and angiogenesis, showing potential as a therapeutic target. The ceRNA network provided insight into the pathogenesis of ESCA.

Impact of preoperative nutritional status on morbidity and mortality in elderly patients undergoing spine surgery for metastatic spinal tumors: a role for the Geriatric Nutritional Risk Index.

The Geriatric Nutritional Risk Index (GNRI) is commonly used to assess malnutrition risk in elderly patients, but its impact on spine surgery for metastatic spinal tumors is not well understood. This study aimed to evaluate the associations between preoperative nutritional status, as measured by the GNRI, and postoperative morbidity and mortality in elderly patients undergoing spine surgery for metastatic spinal tumors. A retrospective cohort study was performed using the 2011-2022 National Surgical Quality Improvement Program database of the American College of Surgeons. Elderly (≥ 65 years of age) patients undergoing laminectomy or corpectomy for extradural spinal tumor metastases were identified using International Classification of Diseases, 9th and 10th Revision and Current Procedural Terminology codes. Patients with missing data on sex, preoperative albumin, height, or weight were excluded. The study population was categorized by GNRI score: normal, malnourished, or severely malnourished. Using receiver operating characteristic (ROC) and multivariable analyses, the authors compared the discriminative thresholds and independent associations of GNRI, the 5-item modified frailty index (mFI-5), and older patient age with any adverse event (AE), extended hospital length of stay (LOS), nonroutine discharge, and 30-day mortality. Of the 659 patients identified, 277 (42.0%) had normal nutritional status, 163 (24.7%) were malnourished, and 219 (33.2%) were severely malnourished. The severely malnourished cohort had significantly increased proportions of electrolyte abnormalities (p = 0.019) and anemia (p < 0.001), with a significant decrease in BMI and albumin levels across cohorts (p < 0.001). Malnourished and severely malnourished patients had significantly longer LOS (9.1 ± 6.2 days and 12.5 ± 8.6 days, respectively, vs 8.6 ± 7.1 days for patients categorized as normal, p < 0.001) and nonroutine discharge (57.9% and 66.7%, respectively, vs 39.7% for normal, p < 0.001). The severely malnourished cohort had significantly increased 30-day mortality (17.4% vs 6.5% for normal and 13.5% for malnourished, p = 0.001). On multivariable analysis, severely malnourished status was independently associated with any AE (adjusted odds ratio [aOR] 1.59, p = 0.036), extended LOS (aOR 2.17, p = 0.001), nonroutine discharge (aOR 1.99, p = 0.001), and 30-day mortality (aOR 2.28, p = 0.013). Malnourished status was independently associated with nonroutine discharge (aOR 1.84, p = 0.005). In ROC analysis, GNRI outperformed the mFI-5 (p = 0.318, p = 0.031, p < 0.009, and p = 0.026, respectively) and patient age (p = 0.018, p < 0.001, p = 0.014, and p = 0.034, respectively) in predicting 30-day AEs, extended LOS, nonroutine discharge, and 30-day mortality. This study suggests that preoperative GNRI-defined malnutrition is associated with a higher risk of adverse postoperative outcomes in elderly patients undergoing spine surgery for metastatic spinal tumors.

Violence in Psychiatric Inpatient Wards: Insights from the Persian Version of the Brøset Violence Checklist

This cross-sectional study evaluated the validity and reliability of the Brøset Violence Checklist (BVC) in predicting violent behaviour among psychiatric ward patients in Iran. Additionally, the study aimed to identify demographic and clinical predictors associated with violent acts. It addressed 147 patients in the psychiatric wards of a university hospital north-west of Iran through a descriptive design. Demographic forms, BVC and the Staff Observation Aggression Scale-Revised were assessed. In this context, the translation and content validity and inter-observer reliability of the BVC were also evaluated. The data was analysed using descriptive statistics, the Chi-squared test, logistic regression, and Receiver Operating Characteristic (ROC) curve analysis. Thirty-six patients committed acts of violence. Pre-violent behaviours including boisterousness, physical and verbal threats and attacking objects differed significantly between violent and non-violent patients (p &lt; 0.05), while confusion showed no significant difference. High BVC scores (OR = 6.705, 95% CI = 3.371–13.339, p &lt; 0.001), a diagnosis of bipolar mood disorder (OR = 6.387, 95% CI = 1.077–37.884, p = 0.041) and schizophrenia (OR=19.633, 95% CI= 2.191–175.859, p = 0.008) were significant predictors of violent behaviour. ROC curve analysis identified a BVC cut-off point of 1.5 with a sensitivity of 0.89 and specificity of 0.84. There was a statistically significant difference in the incidence of violence was found between the two groups categorised by this cut-off (X2 = 63.96, p &lt; 0.001). The BVC can be integrated into routine risk assessments during patient admission and hospitalisation in Iranian psychiatric wards.

Identification of genetic indicators linked to immunological infiltration in idiopathic pulmonary fibrosis.

This study employed bioinformatics to investigate potential molecular markers associated with idiopathic pulmonary fibrosis (IPF) and examined their correlation with immune-infiltrating cells. Microarray data for IPF were retrieved from the Gene Expression Omnibus database. Differentially expressed genes (DEGs) and module genes were identified through Limma analysis and weighted gene co-expression network analysis. Enrichment analysis and protein-protein interaction network development were performed on the DEGs. Machine learning algorithms, including least absolute shrinkage and selection operator regression, random forest, and extreme gradient boosting, were applied to identify potential key genes. The predictive accuracy was assessed through a nomogram and a receiver operating characteristic (ROC) curve. Additionally, the correlation between core genes and immune-infiltrating cells was assessed utilizing the CIBERSORT algorithm. An IPF model was established in a human fetal lung fibroblast 1 (HFL-1) through induction with transforming growth factor β1 (TGF-β1), and validation was conducted via reverse transcription-quantitative polymerase chain reaction. A sum of 1246 genes exhibited upregulation, whereas 879 genes were downregulated. Pathway enrichment analysis and functional annotation revealed that DEGs were predominantly involved in extracellular processes. Four key genes - cd19, cxcl13, fcrl5, and slamf7 - were identified. Furthermore, ROC analysis demonstrated high predictive accuracy for these 4 genes. Compared to healthy individuals, lung tissues from IPF patients exhibited an increased presence of plasma cells, CD4 memory-activated T cells, M0 macrophages, activated dendritic cells, resting NK cells, and M2 macrophage infiltration. The upregulation of cd19, cxcl13, fcrl5, and slamf7 in TGF-β1-treated HFL-1 cells was confirmed, aligning with the findings from the microarray data analysis. cd19, cxcl13, fcrl5, and slamf7 serve as diagnostic markers for IPF, providing fresh perspectives regarding the fundamental pathogenesis and molecular mechanisms associated with this condition.

Assessing childhood maltreatment exposure using the child behavior checklist

IntroductionChildhood maltreatment (CM) has broad and severe adverse effects in later life, but there are not enough studies conducted during childhood close to the time of maltreatment. Most studies have focused only on a single symptom and have not attempted to capture the global picture of CM.MethodsWe used the Child Behavior Checklist (CBCL) to assess children's behavioral/emotional problems more comprehensively. This study leveraged 32 CM children and 29 typically developing (TD) children who have been assessed using the CBCL 4–18 from our dataset. Group comparisons of the eight subscales were conducted to characterize each behavioral/emotional problem. Receiver Operating Characteristic (ROC) curve analysis was conducted to assess the classification performance. Finally, sensitive period and type analyses were performed based on the children's maltreatment history.ResultsThe CM group showed significantly higher behavioral/emotional problems in seven out of the eight subscales. Logistic regression analysis was performed using all combinations of CBCL subscale T-scores and age, sex, and IQ. We created 2047 models and performed ROC analysis for each. Three models were generated: the most accurate model (comprising CBCL T-score, age, sex, and IQ; sensitivity: 0.906, specificity: 0.966), a model excluding IQ (sensitivity: 0.875, specificity: 0.931), and a model consisting only of CBCL (sensitivity: 0.906, specificity: 0.862). The CBCL demonstrated robust predictive capacity for CM by utilizing information provided by caregivers, without directly inquiring about trauma. The sensitive period analysis revealed that the temporal predictor of severity for “withdrawn” and “thought problems” were exposure to CM at age five. Similarly, exposure to CM between the ages of five and seven predicted “somatic complaints”. In the case of type, physical abuse was the predictor for “somatic complaints” and “delinquent behavior”, and emotional abuse was the predictor for “anxious/depressed” and “thought problems”.ConclusionMaltreated children present a wider range of behavioral/emotional problems, which must be considered when supporting them. Perspectives gained from sensitive analyses of maltreatment history will help clinicians provide more appropriate interventions.

Association Between Type 2 Diabetes Mellitus and Heart Failure: A Retrospective Study from a Tertiary Care Diabetes Centre in India.

The study aimed to explore the association between type 2 diabetes (T2D) and heart failure (HF) using echocardiography and NT-proBNP. The study also derived an NT-proBNP cut-off for diagnosing HF by echo in Asian Indians with T2D. A retrospective study was performed using data from individuals with T2D, aged ≥ 18years, who visited diabetes clinics in India between March 2019 and December 2023. NT-proBNP levels were quantified by chemiluminescence, and left ventricular ejection fraction (LVEF) was assessed from echo using two-dimensional (2D) echocardiography. Heart failure was classified based on the European Society of Cardiology (ESC) guidelines. Receiver operating characteristic (ROC) curve was performed to determine the optimal NT-proBNP cut-off for diagnosing HF by echo. Among the 1189 study individuals included in the study (714 men and 475 women), 5.9% were identified as having HF with reduced ejection fraction (HFrEF), 5.5% had mildly reduced ejection fraction (HFmrEF), and 14.1% had HF with preserved ejection fraction (HFpEF) while the rest (74.5%) had LVEF > 50%. Elevated NT-proBNP levels were observed in those with reduced ejection fraction. ROC analysis identified an optimal NT-proBNP threshold of 398pg/mL for diagnosing HF, with 87% sensitivity and 78% specificity. HF prevalence increased with age, peaking at 30.6% in individuals aged 61-70years. Women with HF had higher NT-proBNP levels than men. In this diabetes clinic population, 11.5% of individuals with T2D had moderate to reduced LVEF. Early identification of HF using echocardiography and NT-proBNP in a diabetes clinic could help improve prognosis.

Thromboelastography Maximum Amplitude Is a Valuable Biomarker for Early Atherosclerosis in Rheumatoid Arthritis Patients: A Single-Center Cross-Sectional Study.

Hypercoagulability contributes to atherosclerosis (AS) progression in individuals suffering from rheumatoid arthritis (RA), and thromboelastography (TEG) is a valuable diagnostic tool. This hospital-based cross-sectional study assessed the clinical efficacy of TEG parameters in detecting hypercoagulability and subclinical AS by purposively sampling 372 RA patients and 105 healthy controls. TEG indices, conventional coagulation markers, and biochemical profiles were assessed. Multivariable logistic modeling and receiver operating characteristic (ROC) analyses were utilized to identify independent risk factors for early AS in patients with RA. Our results indicated that patients with RA experienced a hypercoagulable state in comparison to controls, which was particularly pronounced in RA patients with early AS compared to their non-AS counterparts. Logistic regression analysis revealed that the TEG maximum amplitude (MA) is an independent risk factor for early AS in patients with RA, with an odds ratio of 1.219 and a 95% confidence interval of 1.128-1.317. Additional independent risk factors identified are fibrinogen (FIB), low-density lipoprotein cholesterol (LDL-C), and the adjusted atherogenic index of plasma (aAIP). ROC analysis revealed that MA achieved an area under the curve (AUC) of 0.711 (sensitivity: 71.5%; specificity: 63.5%) for early AS diagnosis. Combining with FIB, LDL-C, and aAIP significantly enhanced diagnostic performance, with an AUC of 0.831 (sensitivity: 77.6%; specificity: 75.3%). These findings highlight MA as a valuable biomarker for early detection of AS in patients with RA. Furthermore, integrating MA with FIB, LDL-C, and aAIP improves diagnostic accuracy, supporting its clinical role in risk stratification and early intervention.

Prognosis Prediction of Facemask With Miniplate Therapy in Patients With Cleft Lip With/Without Palate.

To investigate the prognosis prediction of facemask with miniplate (FMMP) therapy in patients with cleft lip with/without palate (CL/P). The subjects were 103 CL/P patients treated with FMMP therapy. Twenty-five cephalometric variables were measured at preadolescence (T0) and young adulthood (T1). At T1, the subjects were allocated into the FMMP-surgery group (1) when three of the following conditions were met: ANB < -3°, Wits appraisal < -5 mm, APDI > 90° and AB-MP < 60° and (2) when patients were undergoing presurgical orthodontic treatment or had already undergone orthognathic surgery. The mean ages of T0 and T1 and the mean FMMP duration were 8.4, 19.5 and 5.2 years in the FMMP-surgery group (27.2%, n = 28) and 8.5, 18.1 and 4.1 years in the FMMP-nonsurgery group (72.8%, n = 75). Binary logistic regression analysis and receiver operating characteristics analysis were performed. Compared to the FMMP-nonsurgery group, the FMMP-surgery group exhibited a more forward mandibular position and a flatter maxillary occlusal plane at T0, a similar amount of change in the position of point-A, greater forward mandibular growth with larger counterclockwise rotation and an increase in posterior vertical dimension, leading to exacerbation of the skeletal Class III pattern during T1-T0. Four T0 cephalometric predictors (A to N-perpendicular, APDI, FMA and ODI) were identified with high prediction values of accuracy (85.4%) and sensitivity (prediction/actual FMMP-nonsurgery, 93.3%) and moderate value of specificity (prediction/actual FMMP-surgery, 64.3%). These four T0 cephalometric variables were identified as predictors for determining the prognosis in FMMP treatment for patients with CL/P.

Uncovering potential biomarkers and metabolic pathways in systemic lupus erythematosus and lupus nephritis through integrated microbiome and metabolome analysis

ObjectiveThis study aims to explore the relationship between gut microbiota and fecal metabolomic profiles in patients with systemic lupus erythematosus (SLE), with and without lupus nephritis (LN), in order to identify potentially relevant biomarkers and better understand their association with disease progression.MethodsFecal samples from 15 healthy controls (HC) and 36 SLE patients (18 SLE-nonLN and 18 SLE-LN) were analyzed using 16S rRNA gene sequencing and untargeted metabolomics. Differential microbial taxa and metabolites were identified using Linear Discriminant Analysis Effect Size (LEfSe) and Orthogonal Partial Least Squares Discriminant Analysis (OPLS-DA). Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway and Receiver Operating Characteristic (ROC) curve analyses were used to assess the potential clinical relevance of selected metabolites.ResultsBeta diversity analysis demonstrated distinct microbial clustering between groups (p < 0.05). SLE-LN samples showed an increased relative abundance of Proteobacteria and decreased Firmicutes compared to SLE-nonLN. Metabolomic profiling identified multiple differentially abundant metabolites, with notable enrichment in primary bile acid biosynthesis pathways (e.g., Glycocholic acid, AUC = 0.951). In the SLE-nonLN group, increased Glycoursodeoxycholic acid levels (AUC = 0.922) were observed in pathways related to taurine and hypotaurine metabolism. Correlation analysis indicated a negative association between Escherichia-Shigella and bile acid levels (p < 0.01).ConclusionThis integrative analysis suggests that patients with SLE and LN harbor distinct gut microbiota and metabolomic profiles. The identified microbial taxa and metabolites may have potential as non-invasive biomarkers and could contribute to a better understanding of SLE pathogenesis and progression.

Analyses of proximal adjacent segment degeneration and prognostic factors after lumbar fusion surgery: study based on proximal facet joint angle

ObjectiveLumbar fusion surgery is a common procedure for treating various degenerative spinal conditions. However, the incidence of proximal adjacent segment degeneration (PASD) remains a concern. This study aimed to investigate the effect of proximal facet joint angle (FJA) on PASD and then identify factors that influence prognosis after lumbar fusion surgery.MethodsIn this retrospective study, the cases of 192 patients who underwent lumbar fusion surgery between January 2020 and June 2022 were analysed. Patients were classified in accordance with their baseline proximal FJA into the high (≥ 40°) and low (< 40°) FJA groups. Prognosis was evaluated during the last follow-up by using clinical, imaging and functional recovery criteria. PASD was assessed using Weishaupt criteria, and imaging parameters were measured on postoperative computed tomography (CT) reconstructions. Statistical analyses, including univariate and multivariate logistic regression, were performed to identify prognostic factors. Receiver operating characteristic (ROC) curves were used to assess predictive value.ResultsThe high FJA group exhibited significantly higher rates of PASD compared with the low FJA group (P < 0.001). No significant differences were observed in sex, age, body mass index (BMI) or follow-up duration between the two groups. Poor prognosis was associated with higher BMI, larger FJA and wider facet joint diameter. Logistic regression analysis identified BMI (odds ratio [OR] = 1.801, P = 0.001), FJA (OR = 6.320, P < 0.001) and facet joint sagittal (OR = 1.888, P < 0.001) and coronal (OR = 1.462, P < 0.001) diameters as independent predictors of poor prognosis. A smaller screw inclination angle was associated with better outcomes (OR = 0.907, P = 0.017). Joint ROC analysis underscored the significant predictive power of these factors (area under the curve = 0.881).ConclusionThis study demonstrates that a larger proximal FJA is associated with increased PASD. It also identifies several prognostic factors that influence outcomes after lumbar fusion surgery. Patients with higher BMI, larger FJA and wider sagittal and coronal diameters are at increased risk for poor prognosis. These findings highlight the importance of comprehensive preoperative assessments to optimise surgical planning and improve outcomes in lumbar fusion surgery.

Correlation analysis between OCT evaluation and postoperative visual prognosis of patients with age-related macular degeneration complicated with cataract

ObjectiveTo explore the correlation between optical coherence tomography (OCT) evaluations and postoperative visual prognosis in individuals with AMD complicated with cataract, and to investigate the clinical applications of these evaluations for predicting visual outcomes.MethodsWe retrospectively analyzed the clinical data of 132 individuals (132 eyes) with AMD complicated by cataract, admitted to our hospital from April 2022 to January 2024. All patients underwent surgical treatment and were categorized into two groups based on their visual prognosis after 6 months: the “good prognosis (GP)” group (best corrected visual acuity decrease < 0.1 logMAR) and the “poor prognosis (PP)” group (best corrected visual acuity decrease ≥ 0.1 logMAR). We evaluated OCT parameters including central retinal thickness (CRT), central macular thickness (CMT), subfoveal choroidal thickness (SFCT), and total average macular thickness (TR). Pearson correlation analysis was employed to assess the relationship between these OCT parameters and postoperative visual outcomes. Additionally, receiver operating characteristic (ROC) were used to calculate the predictive value of OCT measurements for identifying poor postoperative visual prognosis in this patient cohort.ResultsPreoperative OCT results showed significantly higher values for CMT, CRT, TR, and SFCT in the PP group compared to the GP group (P < 0.05). Pearson correlation analysis revealed a positive association between postoperative visual acuity and these OCT parameters. Logistic regression modeling identified CMT, CRT, TR, and SFCT as key predictors of poor visual prognosis in AMD patients with cataract. ROC analysis showed that combining these parameters improved the prediction accuracy, with an area under the curve (AUC) of 0.993, sensitivity of 99.87%, and specificity of 95.30%, which were significantly higher compared to single-index evaluations (P < 0.05).ConclusionCMT, CRT, TR, SFCT are obviously related to the postoperative visual prognosis in patients with AMD complicated by cataract. The combined evaluation of these OCT parameters demonstrates high predictive efficiency for poor postoperative visual prognosis and can serve as an important assessment index for evaluating the postoperative visual prognosis in this patient population.