Significant Inverse Correlation Research Articles

Correlation Between Magnesium and HbA1C in Type 2 Diabetes Mellitus

Background: Magnesium (Mg) is most abundant electrolyte with unlimited physiologic importance in the body, playing a vital role in many fundamental processes. Cellular magnesium is an essential cofactor for various enzymes involved in glucose transport, insulin release and glucose oxidation. Mg has potential role in improving insulin sensitivity and preventing diabetes and its complications. Hypomagnesemia promotes to the initiation and progression of DM and its macrovascular and microvascular complications. Objectives: The aim of this study was to evaluate the correlation of magnesium with HbA1C in T2DM. Material and Methods: This cross sectional study conducted at Tribhuvan University Teaching Hospital, included 85 diagnosed with type 2 diabetes Mellitus visiting Medicine OPD and 85 apparently healthy controls. Clinical and anthropometric characteristics were documented using clinical proforma. The fasting blood samples were collected for estimating serum glucose, HbA1C and magnesium. Results: The mean values of BMI, FBG, HbA1C were found to be significantly elevated in T2DM, but that of Mg were higher in healthy controls (p<0.05). The prevalence of hypomagnesemia in T2DM was found to be 32.94%. The Serum magnesium levels were moderate negatively correlated (r = -0.544, P<0.001) with HbA1C. Conclusion: Patient with Type 2 Diabetes Mellitus showed significantly low magnesium levels compared to heathy controls as well as uncontrolled HbA1C levels also showed significantly low magnesium level than controlled HbA1C level. There was significant inverse correlation between serum Mg level and HbA1C level in patients with T2DM. So if serum magnesium values are made to rise, HbA1C values will fall.

Conjunctival ultraviolet autofluorescence as a biomarker of outdoor time in myopic children

IntroductionThe prevalence of myopia has increased significantly in recent years including an earlier onset of myopia development on the pediatric population. The main objective of the study is to compare CUVAF (Conjunctival Ultraviolet Autofluorescence) in children with and without myopia to validate its usefulness as an outdoor protective biomarker.MethodsA case–control observational study was conducted in a child cohort from subjects that attended to the Ophthalmology Department of Clínica Universidad de Navarra for an ophthalmological examination. The general exclusion criteria were (among others): amblyopia, congenital myopia, general ophthalmic disease, and any conjunctival alteration that might difficult the measurement of the CUVAF area. All participants underwent an automatic objective refraction under cycloplegic effect, biometry to measure axial length (AL) and central corneal radius (CCR), and completed a questionnaire about their lifestyle habits. A total of 4 images of the bulbar conjunctiva were taken with blue light in order to quantify the CUVAF area.ResultsA total of 263 subjects (6 to 17 years old) were analyzed with no significant differences in demographic data between case group and control group. There were 50 non-myopic subjects (19%) and 213 myopic subjects (81%). In relation to the outdoor activities (OA), myopic subjects spent significantly fewer hours per week outdoors than the control-group (p = 0.03). About the CUVAF area, the differences between groups were statistically significant, showing that the myopic group has a significantly smaller CUVAF area than the control-group (0.33 ± 0.72 mm2 vs. 0.78 ± 1.22 mm2; p = 0.0023), likewise, the frequency of CUVAF area absence between both groups showed an odds ratio (OR) of 2.52 (CI95% 1.33–4.74). A Pearson correlation test was done, obtaining a strong significant inverse correlation between myopia degree-CUVAF area (r = 0.1877; IC95% 0.068–0.302), and also ratio (AL/CCR)-CUVAF area (p = 0.002 and p = 0.04) respectively.ConclusionCUVAF is a useful biomarker for OA and it has an inverse relationship with myopia degree also in pediatric age, especially after the age of 12, so it could be useful to differentiate the risk of developing myopia. Having a CUVAF area greater than that corresponding to age, protect to myopia 2.5 times, being almost 5 times the protection in case of high myopia.

Evaluation of Average Post-menarche Height Growth and Associated Factors: A Cross-Sectional Study

Background: Adolescents experience rapid height growth during puberty, which eventually slows down and ceases due to epiphyseal senescence. Menarche marks the final stage of puberty and often raises concerns about the cessation of height growth. Objectives: This study aims to examine post-menarche height growth and identify the factors associated with it. Methods: This retrospective cross-sectional study included adolescent females who visited pediatric endocrinology clinics in Hamadan between 2001 and 2018 and had a minimum follow-up period of three years. Data extracted from patients' medical records included demographic details, birth weight, birth order, height, weight, Body Mass Index (BMI), and stages of thelarche and pubarche. Data analysis was conducted using SPSS version 26. Results: The medical records of 91 girls were evaluated. The mean age of menarche was 11.93 ± 1.27 years. On average, the participants grew 7.98 ± 3.47 cm in height within three years after menarche. The study revealed a significant inverse correlation between post-menarche height growth and both the age at menarche and height at the onset of menarche. No correlation between height growth and other variables was observed. Conclusions: Post-menarche height growth was negatively correlated with height and age at menarche. However, there is limited research on post-menarche height growth in Iranian girls, highlighting the need for further studies.

Dietary antioxidant index and hypertension in the Iranian population: a nested case–control study within the Fasa adults cohort study

IntroductionHypertension (HTN) is a prevalent condition associated with numerous cardiovascular and non-cardiac complications. Lifestyle interventions, including dietary adjustments, offer promising avenues for hypertension management. However, the precise relationship between dietary antioxidants and hypertension risk necessitates further investigation. This study aimed to elucidate the association between the Dietary Antioxidant Index (DAI) and hypertension risk using a nested case–control design.MethodA matched nested case–control study was conducted within the Fasa Adult Cohort Study (FACS), comprising 975 participants aged 35–70 years. Cases (n = 325) were hypertensive patients, while controls (n = 650) were individuals without hypertension, matched for sex and age. Dietary intake was assessed using a validated food frequency questionnaire, and DAI was computed based on standardized intake of antioxidants. Conditional logistic regression models were employed to evaluate the association between DAI and hypertension risk, adjusting for confounding variables.ResultsA significant inverse correlation was observed between DAI and hypertension risk across all models (OR = 0.89; 95% CI = 0.86–0.93, p < 0.001). This association remained robust after adjusting for potential confounders, including BMI, smoking, lipid profile, blood glucose levels, and educational status. In conclusion, higher DAI values were associated with a reduced risk of hypertension, highlighting the potential benefits of antioxidant-rich diets in hypertension prevention.ConclusionThese findings underscore the importance of dietary interventions as a complementary approach to hypertension management.

A combined association of alanine aminotransferase, aspartate transaminase and bilirubin with sleep duration in aged 16-85 years (2005-2010).

Sleep is a vital restorative process that plays a pivotal role in maintaining the delicate equilibrium of mental and physical well-being. Both short and long sleep duration are associated with a range of adverse health outcomes. Numerous studies have consistently demonstrated a robust association between sleep duration and liver disease. In this study, we conducted statistical tests and performed subgroup analyses to explore potential variations in this association across different contexts, aiming to elucidate the correlation between ALT, AST, and TB with sleep duration. This cross-sectional investigation utilized datasets from the National Health and Nutrition Examination Survey 2005 to 2010. Multivariate linear regression models were used to examine the linear association between ALT, AST, and TB with sleep duration. Test for interaction is commonly conducted using multivariabte models to assess statistically significant subgroup disparities. Fitted smoothied curves and threshold effect analyses were employed to depict nonlinear relationships. The study enrolled 17,491 participants aged 16 to 85 years who met the inclusion and exclusion criteria, with a mean age of the participants was 45.58 ± 19.94 years. Multivariate linear regression analysis showed a significant positive association between sleep duration and ALT [-0.23 (-0.45, -0.00) 0.0455] and AST[-0.20 (-0.38, -0.01) 0.0338] in Model 3. Using a two-segment linear regression model, we found an U-shaped relationship and significant inflection point between between ALT and AST with sleep duration. The present study unveiled a significant inverse correlation between sleep duration and levels of ALT and AST, while no significant association was observed with TB levels. Furthermore, variations in the optimal sleep duration for liver function recovery were identified across diverse populations, thereby offering valuable healthcare recommendations to public.

Development and validation of Believers’ Death Anxiety Scale: integrating religious dimensions into death anxiety assessment

Background and objectivesDeath anxiety has traditionally been measured without considering religious beliefs related to death, such as afterlife, the grave, and punishment. The present study was aimed at developing and validating a new scale to address this limitation.MethodsThe study was carried out in four phases and recruited a total of 2250 conveniently selected participants aged 18–59. Believers’ Death Anxiety Scale (BDAS) was developed and validated according to the reputed standards for scale development and validation. Exploratory and confirmatory factor analyses were performed. The convergent validity was established by correlating BDAS with the Depression, Anxiety, and Stress Scale. Discriminant validity was established by correlating BDAS with the Satisfaction with Life Scale. Internal consistency and reliability were assessed through Cronbach’s alpha, item-total, and item-scale correlations.ResultsThe BDAS consists of fifteen items distributed across five subscales: worry, terror, despair, avoidance, and thoughts. The BDAS exhibited a strong factor structure, with five distinct factors consistently exceeding acceptable factor loadings. Convergent validity was confirmed through positive correlations with depression, anxiety, and stress, while discriminant validity was demonstrated through a significant inverse correlation with life satisfaction. The scale demonstrated excellent internal consistency and reliability across all phases of testing.ConclusionThe BDAS emerges as a valuable and innovative instrument for researchers and practitioners seeking to comprehensively assess death anxiety, considering the often-overlooked role of religious dimensions.

Experimental infection of purebred Saanen goats high pathogenicity and virulence of Babesia aktasi.

Small ruminant babesiosis remains a neglected disease despite causing significant economic losses to sheep and goat herds in many regions around the world. The pathogenesis and clinical manifestations of ovine babesiosis are well-known, but there is a lack of information regarding caprine babesiosis. Since the discovery of the first Babesia spp. in 1888, several species/subspecies/genotypes, including Babesia aktasi, have been described. Our recent molecular survey revealed that the parasite is highly prevalent (22.5%) in indigenous goats from Mediterranean region of Türkiye. The aim of this experimental study was to determine the pathogenicity and virulence of B. aktasi in immunosuppressed (n = 5) and immunocompetent (n = 7) purebred Saanen goats. The goats were experimentally infected with fresh B. aktasi infected blood, and examined for clinical, parasitological, hematological, and serum biochemical findings throughout the infection. Following the parasite inoculation, intra-erythrocytic parasites were detected from the 1st day post-infection, followed by an increase in rectal temperature and parasitemia. The parasitemia was detected ranging from 4.3% to 33.5% in the immunosuppressed group, while it was 2.1% to 7.6% in the immunocompetent. Severe clinical symptoms characterized by anemia, jaundice, and hemoglobinuria developed in both groups. A statistically significant inverse correlation was observed between the increase in parasitemia and RBC, WBC, HCT, and Hb values in the goats compared to pre-infection levels. Values of AST, ALT, GGT, Total bilirubin, and Albumin showed a significant increase, with all the immunosuppressed goats dying on the 4th and 7th days post-infection, while four out of seven immunocompetent goats died on between 6-8th days. Severe edema in the lungs, frothy fluid in the trachea, jaundice in the subcutaneous and mesenteric fat, and dark red urine were detected in necropsy. The results obtained in this study demonstrated that B. aktasi was highly pathogenic to purebred Saanen goats. Current work assures valuable insights into the pathogenesis and virulence of B. aktasi and serves as a foundation for future studies to develop effective control strategies against caprine babesiosis.

Local control and patient survival after stereotactic radiosurgery for esophageal cancer brain metastases: an international multicenter analysis.

This study aimed to evaluate local control (LC) of tumors, patient overall survival (OS), and the safety of stereotactic radiosurgery (SRS) for esophageal cancer brain metastases (EBMs). This retrospective cohort study used data from 15 International Radiosurgery Research Foundation facilities encompassing 67 patients with 185 EBMs managed using SRS between January 2000 and May 2022. The median patient age was 63 years, with a male predominance (92.5%). Most patients (64.2%) had a single brain metastasis, while 7.5% had more than 5 metastases. The median tumor volume was 0.9 cm3, and the median margin dose delivered to the tumor was 20 Gy. The median OS post-SRS was 15.2 months, with 1- and 2-year OS rates of 65.7% and 32.3%, respectively. A significant inverse correlation was found between the number of EBMs and OS in the univariable analysis. LC rates at 1 and 2 years were 89% and 76%, respectively. Adverse radiation effects (AREs) were observed in 17.9% of patients, with 13.4% being mild and transient and 4.5% severely symptomatic (Common Terminology Criteria for Adverse Events grade 3). New intracranial disease developed in 58.2% of patients, with 1- and 2-year rates of 58% and 73%, respectively. SRS for EBMs demonstrated high survival rates and effective tumor control, with a low incidence of severe AREs. These findings highlight the potential role of SRS in the multidisciplinary multimodality management paradigm of EBM.

Analysis of the response of AXL and/or MITF melanoma subpopulations to immunotherapy

BackgroundTumor heterogeneity is a hurdle to effective therapy, as illustrated by the “mixed responses” frequently seen in immunotherapy-treated patients. Previously, AXL+ tumor cells were identified to be highly resistant to targeted therapy, whereas more differentiated MITF+ tumor cells do respond to RAF and MEK inhibitors. MethodsIn this study we analyzed tumor heterogeneity, and explored the presence of the previously described AXL+ or MITF+ melanoma subpopulations, both at the mRNA and protein level, in metastatic tissues by Nanostring gene expression analysis, single-cell RNA sequencing, and by in situ multiplex immunofluorescence, respectively. Furthermore, we analyzed how these subpopulations correlate with immunological pressure and response to immunotherapy (immunomodulating antibodies or autologous tumor lysate-loaded dendritic cell vaccination). ResultsOur data demonstrate large inter patient variability and variable therapy-induced changes independent of the type of therapy. We identify the presence of previously described AXL+ and MITF+ subpopulations in metastatic tissues both at the mRNA and in situ at the protein level, and demonstrate that MITF+ melanoma cells are significantly decreased upon immunotherapy, while AXL+ melanoma cells numbers are stable. MITF+ tumor cells showed the most significant inverse correlation with CD8+ T cells. Our patient cohort also shows that immunotherapy-induced changes in the abundance of AXL+ or MITF+ tumor cells did not correlate with improved survival. ConclusionOverall, this study suggests that more differentiated MITF+ tumors are efficiently targeted by immunotherapy, while AXL+ tumor cells may be more resistant, analogous to their response to targeted therapy.

Association between Frequency of Seizures and Number of Antiseizure Medications (ASM) in Patients with Epilepsy.

The literature has shown the relevance of nutritional and metabolic aspects in patients with epilepsy. This study evaluated the relationship between clinical variables and plasma proteins and compared the variables between seizure frequency and neurological examination. A pilot study was carried out with eighty-four (n = 84) adults patients with epilepsy. The relationship between clinical variables of the disease (age at disease onset, neurological examination, current type and frequency of seizures, duration of disease, amount of antiseizure medications-ASM used and type and etiology of epilepsy) and plasma proteins (albumin and transferrin) was investigated. In the statistical analysis, the chi-square, Fisher, Mann-Whitney, Kruskal-Wallis tests, Spearman coefficient and univariate logistic regression were used. There was a significant association between the use of antiseizure medications (ASM) (p = 0.0105) and altered neurological examination (p = 0.0049), compared with the frequency of seizures, and between albumin and gender (p = 0.0005), and albumin and etiology of epilepsy (p = 0.0186). There was a significant low-intensity and inverse linear correlation (coefficient = -0.31363, p = 0.0037) between albumin and disease duration. In the logistic regression model, a significant association was only observed between the number of ASM and the frequency of seizures (p = 0.0120; OR = 3.368; 95% CI = 1.305-8.691). There was no association between plasma proteins and the outcomes of seizure frequency and neurological examination. The number of ASM and not protein metabolism was associated with frequency of seizures in patients with epilepsy.

Bluetongue In Brazil: A Spatiotemporal Analysis (2001- 2023)

Background: Bluetongue is a non-contagious viral disease caused by the bluetongue virus (Orbivirus), affecting domestic and wild ruminants, particularly sheep. Transmission occurs primarily through vectors of the genus Culicoides, with distribution influenced by environmental and climatic factors. In Brazil, disease outbreaks are sporadic; however, bluetongue is classified as a notifiable disease due to its economic and epidemiological significance and its potential to be mistaken for foot-and-mouth disease. Materials and Methods: This study analyzed the temporal and spatial distribution of bluetongue outbreaks in Brazil from 2001 to 2023, investigating possible associations with climatic variables such as temperature, precipitation, and wind speed. Data were obtained from the Zoosanitary Information System Panel (MAPA-SIZ) and organized into spreadsheets for statistical analysis. Pearson's correlation test and spatial lag regression were applied using the Jamovi and GeoDa software, respectively. Results: A total of 51 bluetongue virus infection outbreaks were recorded, comprising 482 cases predominantly concentrated in southern Brazil. Sheep were the most affected species (73% of cases), followed by wildlife (20%), goats (6%), and cattle (2%). The analysis revealed a significant inverse correlation between the annual mean temperature and the occurrence of cases and outbreaks (r2=0.306 and r2=0.379 respectively), indicating higher disease prevalence in states with lower temperatures. No statistically significant correlations were observed between disease occurrence and either precipitation or average wind speed. However, international studies suggest that wind can facilitate the long-distance dispersion of Culicoides, while mild temperatures extend vector survival. Conclusion: The results suggest that temperature is a determining factor in the spatial and temporal distribution of bluetongue in Brazil, whereas precipitation and wind speed have limited influence. The sporadic occurrence of the disease underscores the importance of continuous surveillance to prevent outbreaks and improve disease control. Strategies that account for vector population dynamics and climatic conditions could enhance the effectiveness of monitoring and control measures.

A Possible Protective Effect of IgA Against Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) in Bronchoalveolar Lavage in COVID-19 Patients Admitted to Intensive Care Unit

SARS-CoV-2 infection induces a humoral immune response, producing virus-specific antibodies such as IgM, IgG, and IgA. IgA antibodies are present at mucosal sites, protecting against respiratory and other mucosal infections, including SARS-CoV-2, by neutralizing viruses or impeding attachment to epithelial cells. Since SARS-CoV-2 spreads through the nasopharynx, the specific IgAs of SARS-CoV-2 are produced quickly after infection, effectively contributing to virus neutralization. Dimeric IgA has been reported to be 10 to 15 times more potent than its equivalent IgG, suggesting that this isotype may be particularly interesting in developing new monoclonal antibodies and/or new vaccines efficiently neutralizing the virus at the mucosal sites. It is still unclear whether IgA antibodies in BAL might play a role in the disease course and if their presence may have a prognostic significance. However, a harmful effect on diseases with high IgA titers has been reported. This study evaluated mucosal-specific IgA and IgG profiles in BAL of patients with COVID-19 acute respiratory failure admitted to the ICU. We included 57 patients (41 males and 16 females), admitted to the ICU of the University of Foggia. We used a commercially available ELISA assay to evaluate the presence of SARS-CoV-2 IgG and IgA antibodies in plasma and BAL of the 57 hospitalized patients with severe COVID-19 respiratory failure. However, 40/57 BAL and plasma from infected patients were available for the ELISA test; the remaining specimens were unsuitable. IgG and IgA antibodies against SARS-CoV-2 were detectable in 37 (92.5%) and 40 (100%) plasma specimens, respectively. IgG antibodies were found in a single sample, while IgAs were detected in 19 of 40 BAL samples analyzed. Correlations between these parameters and patient outcomes reveal a signature associated with survival. Interestingly, a statistically significant inverse correlation was found between the mortality rate and the presence of IgA to SARS-CoV-2 in BAL specimens. None of the 19 patients with a positive IgA died, compared to 7 out of 12 patients with a negative IgA-BAL (p: <0.0004). Despite being limited in size, this study suggests a significant protective effect of mucosal immunity in COVID-19 patients, even in advanced disease stages, and a role of IgA in the defense against the virus, as well as the possible use of effective vaccines and therapeutic strategies based on IgA antibodies.

Examining the Spatial and Temporal Variation of PM2.5 and Its Linkage with Meteorological Conditions in Dhaka, Bangladesh

This study investigates the temporal and spatial variations in PM2.5 concentrations in Dhaka, Bangladesh, from 2001 to 2023 and evaluates the impact of meteorological factors and the effectiveness of mitigation strategies on air pollution. Using satellite and ground-based data, this study analyzed the seasonal trends, daily fluctuations, and the influence of COVID-19 lockdown measures on air quality. Our findings reveal a persistent increase in PM2.5 levels, particularly during winter, with concentrations frequently exceeding WHO guidelines. Our analysis suggests significant correlations between meteorological conditions and PM2.5 concentration, highlighting the significant role of meteorological conditions, such as rainfall, humidity, and temperature, in modulating PM2.5 levels. Our analysis found that PM2.5 levels exhibited a significant inverse correlation with relative humidity (r = −0.72), rainfall (r = −0.69), and temperatures (r = −0.79), highlighting the role of meteorological conditions in mitigating pollution levels. Additionally, the study underscores the temporary improvements in air quality during lockdown periods, demonstrating the potential benefits of sustained emission control measures. The research emphasizes the need for comprehensive and multi-faceted air quality management strategies, including stringent vehicular and industrial emissions regulations, enhancement of urban green spaces, and public awareness campaigns to mitigate the adverse health impacts of PM2.5 pollution in Dhaka.

Association between serum neurofilament light chain levels and chronic kidney disease: a cross-sectional population-based study from the National Health and Nutrition Examination Survey (2013–2014 cycle)

Background The relationships of serum neurofilament light chain (NfL) levels with chronic kidney disease (CKD) and renal function indicators remain controversial, and comprehensive studies with large sample sizes are lacking. Methods In total, 2,051 participants aged 20 to 75 years were identified from the National Health and Nutrition Examination Survey (2013-2014 cycle). Logistic regression models were used to assess the associations between serum NfL levels and CKD, whereas multivariate linear models were used to investigate the relationships between serum NfL levels and two kidney function indicators, namely, estimated glomerular filtration rate (eGFR) and urinary albumin–creatinine ratio (UACR). Adjustments were made to account for potential confounding variables in the analysis. Subgroup analyses stratified by age and sex were conducted. When sNfL is incorporated into the model as continuous variables, a log transformation is applied. Results The present study included a cohort of 2,051 individuals ranging in age from 20 to 75 years. After covariate adjustment, multivariable logistic regression revealed a significant association between high serum NfL levels and an increased prevalence of CKD (OR 1.60; 95% CI 1.40–1.82; p < 0.0001), which remained significant when analyzed by quartiles (p for trend <0.0001). There was a statistically significant inverse correlation between the serum NfL level and the eGFR (β=-6.34; 95% CI −8.32 to −4.37; p < 0.0001), as well as a positive correlation between the serum NfL level and the UACR (β = 84.67; 95% CI 19.52-149.83; p < 0.0001). Furthermore, when stratified by age, there were significant interactions of serum NfL levels with CKD, the eGFR, and the UACR (p for interaction = 0.008, 0.016, and 0.020, respectively). Conclusion Serum NfL levels are positively associated with the prevalence of CKD and the UACR but negatively correlated with the eGFR, particularly in older patients.

Pulse wave analysis as a tool to assess endothelial function following lipid lowering intervention in hypercholesterolemia

BackgroundPulse wave analysis (PWA) assesses endothelial dependent vasodilation (EDV) via the change in augmentation index (AIx) and has been used as a tool to assess endothelial function. However, its effectiveness in assessing the response to lipid lowering treatment has not been evaluated. The study aimed to describe and correlate the change in EDV following lipid lowering intervention in patients with hypercholesterolemia. Methods48 newly diagnosed patients with hypercholesterolemia underwent 6 months intervention with statin and/or therapeutic lifestyle changes (TLC) in clinical setting. Lipid profile measurement and endothelial function assessment using PWA were performed pre- and post-intervention. ResultsSignificant reductions in low density lipoprotein cholesterol (LDL-C), non-high density lipoprotein cholesterol (non-HDL-C) and total cholesterol (TC) with corresponding significant improvement in EDV (2.94 ± 3.69 % to 7.50 ± 3.79 %, p < 0.001) were observed following intervention. Sub-analyses revealed greater LDL-C reductions and EDV improvements in the statin group compared to TLC. There was a significant inverse correlation between the change in EDV and the change in LDL-C after intervention (r = −0.298, p = 0.040). ConclusionEndothelial function assessed by PWA showed a parallel change with lipid profile pattern following lipid lowering intervention. The simple and non-invasive method may provide a potential tool for evaluating endothelial function and treatment outcomes in patients with hypercholesterolemia.

Exploring the bidirectional link between erectile dysfunction and 10-year cardiovascular risk in men with diabetes and hypertension

Erectile dysfunction (ED) shares common risk factors with cardiovascular (CV) disease, such as a sedentary lifestyle, obesity, and metabolic syndrome. However, the relationship between ED and CV risk in Vietnam remains unknown. To investigate this, we conducted a multi-center observational study, randomly selecting 2,936 men aged 40 to 69 years in Vietnam, with 385 participants included after exclusions. The study evaluated the 10-year CV risk using the Systematic Coronary Risk Evaluation 2-Diabetes (SCORE2-Diabetes) score and assessed ED using the International Index of Erectile Function (IIEF-5) score. Results showed that men with diabetes mellitus and hypertension had significantly lower IIEF-5 scores compared to healthy individuals (18 [15–22] vs. 23 [20–24], p < 0.001). Additionally, the IIEF-5 score proved effective in identifying patients at very high CV risk, with an area under the curve (AUC) of 0.747, a cutoff point of 18.5, sensitivity of 69.6%, and specificity of 69.9%. Furthermore, we found a significant inverse correlation between SCORE2-Diabetes and IIEF-5 (ρ = -0.45 and p < 0.001). These findings establish a significant connection between ED and CV risk in men with diabetes, underscoring the need for integrated screening and management strategies to address both conditions concurrently.

Normalization of the Constant score in the Spanish population

BackgroundNormal Constant score values for healthy shoulders can vary between regions and change over the years as life expectancy increases and physical condition improves. Spain’s population is one of the healthiest and has one of the highest life expectancies in the world, which could be reflected in its normal Constant score values. The purpose of this study is finding the normal Constant score values in the Spanish population. MethodsCross-sectional study completed between 2023-2024, including subjects older than 18 years of age without any previous or ongoing shoulder condition. Constant score was taken for both shoulders of every subject. A stratified analysis of total and subtotal scores was performed, grouping subjects by age and sex. ResultsA total of 505 subjects and 1010 shoulders were included, with a mean age of 52.3 ± 18.6 years and men/women ratio of 39.6%/60.4%. Five groups were formed according to age: 18-30 years-old (18.4%), 31-45 years-old (16.4%), 46-60 years-old (29.8%), 61-75 years-old (23.7%), and over 75 years-old (11.7%). Each of these groups were divided in two groups according to sex, making a total of 10 groups. Mean Constant score was 88.9 ± 10.9, the group of men between 18-30 years-old having the highest mean score (99.2 ± 3.0) and the group of women over 75 years-old having the lowest mean score (75.3 ± 8.8). A statistically significant inverse correlation was found between total score and age (r = -.47, p < .001). Total score was also significantly lower in the women (84.5 ± 8.2 vs 92.6 ± 8.5, p < .001). The decrease in mobility (r = -.45, p < .001) and strength (r = -.40, p < .001), and the difference in strength between the men and the women (10.6 ± 3.8 vs 6.0 ± 2.0, p < .001) were the main underlying causes of the difference in total Constant score between groups. ConclusionNormal values of the Spanish version of the Constant score in healthy shoulders of the Spanish population decrease with age and are lower in women, the main differences being found in shoulder mobility and strength. Global scores found in this population are higher than those previously published for English, American, and Swiss populations.

A study of the relationship between professional autonomy and professional quality of life among operating room personnel: A cross-sectional study

BackgroundHealthcare personnel's professional autonomy and professional quality of life can influence the quality of care provided to patients. However, there is scarce and contradictory information available about the relationship between these two factors. The present study aims to investigate the relationship between professional autonomy and professional quality of life among operating room personnel. MethodsThis cross-sectional study was conducted in teaching hospitals in the south of Iran in 2023. The sample consisted of 464 operating room personnel who were selected by quota sampling. Data were collected using Dempster Professional Autonomy Scale and Stamm's Professional Quality of Life Scale. The collected data were analyzed in SPSS v. 24. Level of significance was set at 0.05. ResultsThe participants’ professional autonomy mean score was found to be average (92.6 ± 73.32). Among the subscales of professional quality of life, the participants’ highest and lowest mean scores were for compassion satisfaction (35.3 ± 3.75) and secondary traumatic stress (31.2 ± 9.94) respectively. Also, the researchers found a significant inverse correlation between professional autonomy on the one hand and the professional quality of life subscales of burnout (p = 0.017, r = -0.111) and secondary traumatic stress (p = 0.005, r = -0.131) on the other. Moreover, there was a significant correlation between the operating room personnel's employment status on the one hand and professional autonomy (p = 0.004, r = -0.133) and burnout (p = 0.034, r = -0.099) on the other. The results also showed a significant inverse correlation between the subscale of burnout on the one hand and the variables of age (p = 0.021, r = -0.107) and work experience (p = 0.027, r = -0.103) on the other. ConclusionIn view of the findings of the study, the healthcare system administrators are recommended to adopt effective policies and strategies to promote operating room personnel's professional autonomy and professional quality of life.

Acupuncture improves the symptoms, serum ghrelin, and autonomic nervous system of patients with postprandial distress syndrome: a randomized controlled trial

BackgroundWhether gastrointestinal hormones in patients with postprandial distress syndrome (PDS) are altered by acupuncture, and whether such alterations are related to the autonomic nervous system (ANS), remains an open question.ObjectiveThis study aims to investigate the effects of acupuncture on symptoms, serum hormones, and ANS in PDS patients.MethodsThis randomized controlled clinical trial was conducted at Beijing Hospital of Traditional Chinese Medicine affiliated with Capital Medical University. Sixty-two PDS patients were randomly assigned equally to acupuncture or sham acupuncture arm (3 sessions per week for 4-week). The main outcome measures which were evaluated at baseline and 4-week included cardinal symptoms, serum hormones including ghrelin, vasoactive intestinal peptide (VIP), substance P (SP), and ANS.ResultsAmong the 62 randomly assigned participants, 51 (82%) were included in the baseline characteristics and outcome analysis. Gastrointestinal symptoms including response rate (p = 0.001) and dyspepsia symptom severity (p = 0.002) were significantly improved after acupuncture treatment. Serum ghrelin concentration was significantly higher in acupuncture group than in sham acupuncture group (8.34 ± 3.00 ng/ml versus 6.52 ± 2.00 ng/ml, p = 0.022) after 4-week treatment, instead of VIP and SP (p > 0.05). The acupuncture group had significantly higher vagal activity, showing with increasing of high-frequency component (HF, p ≤ 0.001) and decreasing of the ratio of low-frequency and HF (p ≤ 0.001). In relationship analysis, the HF component exhibited a significant inverse correlation with symptom severity (R = − 0.501, p ≤ 0.001), but not with ghrelin level (R = 0.026, p = 0.865).ConclusionAcupuncture may improve the symptoms and increase the ghrelin level of PDS patients, the therapeutic effect of acupuncture was associated with the alteration of vagal activity.Trial registration: The trial is registered with the ISRCTN registry, ISRCTN12511434. Registered 31 March 2017, https://www.isrctn.com/.

Antihypertensive effects and changes in extracellular water content by mineralocorticoid receptor antagonists in patients with primary aldosteronism.

In primary aldosteronism (PA), non-suppressible excessive aldosterone secretion due to dietary salt intake significantly contributes to hypertension and cardiovascular complications. Blocking the overactivation of mineralocorticoid receptors (MRs) with mineralocorticoid receptor antagonists (MRAs) is a cornerstone for the medical treatment of PA. However, the role of MRAs in controlling hypertension remains unclear. This study aimed to explore the relationship between changes in body composition parameters (determined by bioelectrical impedance analysis), blood pressure (BP) levels, serum potassium (K+) levels and Study 36-Item Short-Form Health Survey (SF-36) scores after MRA treatment in 50 patients with PA. Treatment with MRAs significantly decreased the systolic BP (SBP) and diastolic BP (DBP) levels and extracellular water (ECW) volume, while it increased the serum K+ levels, active renin concentrations (ARCs), and scores on several SF-36-based quality of life (QOL) subscales. ECW change (ΔECW) and serum K+ change were not significantly associated with changes in SBP and DBP levels. ΔECW showed a significant inverse correlation with ΔARC, suggesting that ARC increases with decreasing ECW volume due to renal MR activity blockade and that ARC is a highly sensitive indicator of ECW volume. In the stratified analysis of patients with PA, ECW volume was significantly decreased in those aged ≥60 years and those with a body mass index of ≥25 kg/m2. In conclusion, MRA treatment showed antihypertensive, biochemical, and QOL improvement effects in patients with PA. The antihypertensive effect may not be related to the decrease in ECW volume due to renal MR activity blockade. Evaluation of ECW using BIA in patients with PA treated with MRAs. Abbreviations: ARC, active renin concentration; BIA, bioelectrical impedance analysis; BMI, body mass index; BP, blood pressure; ECW, extracellular water; K+, serum potassium; MRA, mineralocorticoid receptor antagonist; PA, primary aldosteronism; QOL; quality of life; Δ, parameter changes after MRA treatment.