Significant Linear Association Research Articles

Abstract 4181: Geospatial heterogeneity in colorectal cancer screening among Hispanic subgroups

Abstract The U.S. Hispanic population has significantly lower colorectal cancer (CRC) screening rates than any other racial/ethnic group, resulting in unchanged incidence and mortality rates over recent decades. Recent studies have identified geographic variation in Hispanic CRC screening rates, but little is known about patterns among Hispanic subgroups. Here, we examine statistical and geographic relationships between broadly defined racial groups, Hispanic subgroups, and nationwide CRC screening rates. USPSTF guideline-adherent CRC screening rates for census tracts were obtained from 2018 CDC Places. Tract race/ethnicity %s, including non-Hispanic White (NHW), non-Hispanic Black (NHB), Asian, and Hispanic subgroups (Mexican, Cuban, Puerto Rican (PR), Dominican, Central/South American (CSAm), and other Hispanic), female %, and area deprivation index (ADI) were obtained from 2015-2019 American Community Survey 5-year estimates. Race/ethnicity %s were transformed using additive log ratios to account for the compositional nature of racial categories. A linear model and geographically weighted regression (GWR) were fit with CRC screening rate as the outcome. The mean CRC screening rate for 72,117 U.S. census tracts (99% of tracts) was 63.7% (SD=7.0). Linear modeling (R2=0.68) showed significant positive linear associations between CRC screening and female % (p&lt0.001), NHW % (p&lt0.001), NHB % (p&lt0.001), and Asian % (p=0.002), and significant negative associations between screening and ADI (p&lt0.001) and all Hispanic subgroups (p&lt0.001). Mexican, Cuban, PR, Dominican, and CSAm subgroups had significant screening rate drops of -1.48%, -0.26%, -0.15%, -0.30%, and -0.52%, respectively, per 1 unit increase in subgroup %. ADI had strong effects on all screening-race associations, with a flip in directionality for NHB% (negative to positive) and weakening of slopes for all other racial categories after adding ADI in the final adjusted model. GWR results (R2=0.94) displayed spatial heterogeneity in local coefficients of all predictor variables, with distinct regional patterns in relationships between screening and ADI (strongly negative local coefficients in OH and OK), Mexican % (strongly negative in TX, AZ, NV, and CA), and NHB % (strongly negative in FL, GA, MS and WI; positive in SC and NC). This work suggests Mexican, CSAm, and Dominican subpopulations may be driving the low CRC screening rates among Hispanics overall. Local variability suggested the importance of where subpopulations live in determining guideline-concordant screening. ADI strongly altered screening-race relationships, with directionality changing for NHB %, further displaying the importance of area deprivation in CRC screening. Future work should explore micro-level drivers of spatial heterogeneity in screening rates across both broadly defined racial groups and Hispanic subgroups in the U.S. Citation Format: Robert Blake Buchalter, Johnie Rose, Mariana C. Stern, Jane C. Figueiredo, Stephanie L. Schmit. Geospatial heterogeneity in colorectal cancer screening among Hispanic subgroups. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4181.

Nexus between human resource management practice and employees’ attitudes and behavior

This study aims to evaluate the impact of human resource management practices (HRMPs) on employee attitudes and behavior (EAB). The population of this study was all employees of cement manufacturing firms (CMC) in the southern region of Bangladesh. Data was gathered using structured questionnaires following convenient sampling technique. The data was analyzed using SPSS-23 statistical package program. A robust and significant linear association between HRMPs and EAB was found. Further, HRM practices, including compensation & rewards (CR) and motivation (MV) were discovered to be dominant predictors of EAB. According to the study, variations in EAB of 77.10% were caused by independent predictors such as recruitment and selection (RS), training and development (TD), performance appraisals (PA), compensation and rewards (CR), motivation (MV), and maintenance (MT) in CMC in the southern part of Bangladesh. Nevertheless, it is apparent from the study's findings that manufacturing organizations that have implemented progressive HRM practices in a systematic and integrated manner are having an enormous influence on EAB. This study only focused on one industry and one type of organizational structure. According to the study, findings should not be extensively generalized. Future research should incorporate other aspects, such as organizational learning and organizational capacity, to construct a new model of HRM practices.

Composite Assessment Using Intestinal Ultrasound and Calprotectin Is Accurate in Predicting Histological Activity in Ulcerative Colitis: A Cohort Study.

Beyond endoscopic remission, histological remission in ulcerative colitis (UC) is predictive of clinical outcomes. Intestinal ultrasound (IUS) may offer a noninvasive surrogate marker for histological activity; however, there are limited data correlating validated ultrasound and histological indices. Our aim was to determine the correlation of IUS activity in UC with a validated histological activity index. Twenty-nine prospective, paired, same-day IUS/endoscopy/histology/fecal calprotectin (FC) cases were included. Intestinal ultrasound activity was determined using the Milan Ultrasound Criteria, histological activity using the Nancy Histological Index, endoscopic activity using Mayo endoscopic subscore and Ulcerative Colitis Endoscopic Index of Severity, and clinical activity using the Simple Clinical Colitis Activity Score. Histological activity demonstrated a significant linear association with overall IUS activity (coefficient 0.14; 95% CI, 0.03-0.25; P = .011). Intestinal ultrasound activity was also significantly associated with endoscopic activity (0.32; 95% CI, 0.14-0.49; P < 0.001), total Mayo score (0.31; 95% CI, 0.02-0.60; P = .036) but not FC (0.10; 95% CI, -0.01 to 0.21; P = .064) or clinical disease activity (0.04; 95% CI, -0.21 to 0.28; P = .768). A composite of IUS and FC showed the greatest association (1.31; 95% CI, 0.43-2.18; P = .003) and accurately predicted histological activity in 88% of cases (P = .007), with sensitivity of 88%, specificity 80%, positive predictive value 95%, and negative predictive value 57%. Intestinal ultrasound is an accurate noninvasive marker of histological disease activity in UC, the accuracy of which is further enhanced when used in composite with FC. This can reduce the need for colonoscopy in routine care by supporting accurate point-of-care decision-making in patients with UC.

Is there any association between early trimester Triglyceride-glucose index and incidence of hypertensive disorder of pregnancy and adverse pregnancy outcomes?

Insulin resistance (IR) is a normal feature of pregnancy and plays a crucial role in the pathophysiology of hypertensive disorder of pregnancy (HDP). The triglyceride-glucose index (TyG index) has been shown as a simple and reliable alternative IR marker. This work aimed to investigate the association between the TyG index and the incidence of HDP and adverse pregnancy outcomes. From January 2016 to December 2018, 289 women with HDP and 861 women without HDP were recruited at Shanghai Fifth People's Hospital, Fudan University to determine the relationship between the TyG index and the incidence of HDP and adverse pregnancy outcomes. In the case-control study, the incidence of HDP was found to be significantly associated with the TyG index. Moreover, logistic regression indicated that the TyG index is an independent risk factor for HDP development and incidence of low birth weight (LBW) and fetal distress. In the cohort study, the results showed that the TyG index increased, there was a stepwise increase in HDP incidence, SBP, and DBP levels one week before delivery as well as in LBW and fetal distress incidence. The early trimester TyG index was positively associated with pre-pregnancy BMI, systolic blood pressure (SBP), and diastolic blood pressure (DBP) one week before delivery. Spline regression showed that there was a significant linear association between HDP incidence and early trimester TyG index when it was >8.5. This work suggested that the early trimester TyG index was closely associated with the development of HDP and adverse pregnancy outcomes.

The thickness of glomerular basement membrane predicts complete remission in primary membranous nephropathy

Objective Glomerular basement membrane (GBM) thickening is a typical and essential histopathological characteristic for the diagnosis of primary membranous nephropathy (PMN). The present study aimed to explore the relationship between GBM thickness and treatment response in PMN patients. Methods A total of 128 patients with nephrotic syndrome concurrent with PMN were studied. The highest GBM thickness was measured from at least five glomerular capillary loops using an electron microscope, and the mean value was obtained. Patients were categorized into three groups according to the tertiles of GBM thickness as follows: Group 1 (GBM thickness ≤ 1100 nm, n = 48), Group 2 (1100 nm < GBM thickness ≤ 1300 nm, n = 40), Group 3 (GBM thickness >1300 nm, n = 40). Clinicopathological features and treatment response were compared among the three groups. The associations of GBM thickness with complete remission (CR) were assessed by Cox proportional hazard analyses and a cubic spline curve. Results During a median follow-up period of 25.80 months, 69 (53.9%) patients achieved CR. Kaplan–Meier analysis showed that the non-CR probability was significantly higher in the highest tertile of GBM thickness (p˂0.001). Univariate Cox proportional hazard analysis indicated that GBM thickness was associated with CR (HR per SD 0.617, 95% CI [0.471–0.809], p˂0.001). After adjusting for age, duration of PMN, estimated glomerular filtration rate (eGFR), urinary protein excretion, grade of C3 deposition, and titer of serum anti-phospholipase A2 receptor (PLA2R) antibody, GBM thickness remained an independent predictor of CR (HR per SD 0.580, 95% CI [0.436–0.772], p˂0.001). Further multivariable-adjusted restricted cubic spline analysis confirmed a significant reverse linear association between GBM thickness and CR (p for nonlinear = 0.1261). Conclusions GBM thickness is an independent risk factor of CR. PMN patients with an increased level of GBM thickening at diagnosis have a lower probability of achieving CR.

ФАКТОРЫ РИСКА ЗАБОЛЕВАЕМОСТИ РАКОМ ПИЩЕВОДА В КОГОРТЕ РАБОТНИКОВ ПРЕДПРИЯТИЯ АТОМНОЙ ПРОМЫШЛЕННОСТИ

Purpose: To assess the influence of non-radiation factors and occupational radiation exposure on the incidence risk of esophageal cancer in nuclear workers considering various histological types of the cancer. Material and methods: The study was designed as a retrospective analysis that considered data on the cohort of workers employed at reactors, radiochemical and plutonium production facilities of the Mayak Production Association (PA) who had been hired during 1948–1982. The total number of workers included in the cohort was 21645. Using the EPICURE software, the relative risk (RR) and excess relative risk of the esophageal cancer incidence per unit of the accumulated gamma dose from external exposure (ERR/Gy) were estimated based on the Poisson regression. Results: By 31.12.2018, 47 esophageal cancers were reported in members of the study cohort; the majority of these cancers were squamous cell carcinomas. The incidence risk of esophageal cancer was lower in females than in males and it increased with attained age. The increased risk of esophageal cancer (all cases) was associated with current smoking (RR=12.6, 95 % CI 4.21, 42.13), gastroesophageal reflux disease (GERD) (RR=3.96, 95 % CI 1.60, 8.48), excess body weight and obesity (RR=1.21, 95 % CI 1.13, 2.08). The significantly increased RR of squamous cell esophageal carcinoma was found in current smokers and workers had GERD. The significantly increased RR of esophageal adenocarcinoma was found in current and former smokers. The risk of esophageal cancer (all cases and squamous cell carcinomas) was higher in workers who abused alcohol but the RR estimates were not statistically significant. A significant linear association of the esophageal cancer risk with gamma dose from external exposure was found: ERR/Gy=1.28 (95 % CI 0.21, 4.11) for all cases and ERR/Gy=1.01 (95 % CI 0.01, 3.95) for squamous cell carcinoma; these estimates are the risks adjusted for sex, age, smoking, alcohol, GERD and body mass index. No effect of occupational radiation exposure on the esophageal adenocarcinoma risk was found. Conclusion: This study confirmed obtained earlier data on the impact of occupational external gamma exposure on the risk of esophageal cancer in Mayak PA workers. The estimates of ERR/Gy of external gamma-ray exposure were updated having made adjustments for the most important non-radiation factors.

Dementia in the incarcerated population: a retrospective study using the South Carolina Alzheimer’s disease registry, USA

PurposeResearch about the prevalence of dementia among older adults in the incarceration system is currently lacking, and further investigation is warranted. Considering the high level of healthcare needs, unique behavioural issues and difficulty to rehabilitate within the system due to its punitive approach and lack of effective rehabilitation programs, further investigation is warranted to characterize and determine the number of incarcerated older adults with dementia. The purpose of this study is to estimate the prevalence of individuals with dementia in the prison system while also describing the incarceration, demographic and offence-related characteristics of this unique population.Design/methodology/approachSouth Carolina (SC) Alzheimer’s Disease and Related Dementias Registry (1992–2016) and South Carolina Department of Corrections (SCDC) data (Fiscal years 1992–2019) were cross-referenced. The prevalence of Alzheimer’s disease and related dementias (ADRD) cases in the corrections system was calculated using South Carolina Alzheimer's Disease (SC AD) SC ADRD Registry and SCDC data. Pearson’s correlation coefficients were calculated to determine strength and direction of relationships between year of incarceration and frequency of ADRD cases both prior to and after incarcerations, respectively. Significant differences by age group, race, gender and dementia type were determined using a two-tailed pooled t-test and Bonferroni approach where appropriate. Count data for types of crimes committed are also presented.FindingsThe linkage showed that there were 2,171 individuals within the SC AD Registry who have been in the corrections system, about 1% of those in the Registry. Of these individuals, 1,930 cases were diagnosed with ADRD after incarceration and 241 prior to incarceration. In 2016, 317 individuals with ADRD were incarcerated. For ages 55 and above in South Carolina, the prevalence of ADRD is 6.7% in the general, non-incarcerated population compared to 14.4% in the incarcerated population. Additional results showed that those diagnosed with ADRD between 55 and 65 years of age had a significantly lower mean age at first incarceration (34.6 years of age) than those diagnosed between 66 and 74 years of age (55.9 years of age), indicating that those incarcerated earlier in life had an earlier dementia diagnosis. Additionally, African Americans had a significantly lower mean age at first incarceration (43.4 years of age) than Whites (46.2 years of age) and females had significantly lower mean age at first incarceration (42.9 years of age) than males (45 years of age). When investigating trends, results showed a significant positive linear association between year and frequency of ADRD diagnoses (p-value < 0.05) for those with ADRD diagnosis prior to incarceration and a significant decreasing linear association (p-value < 0.0001) in the number of individuals with an ADRD diagnosis after corrections. Findings also showed that a large percentage of older adults with ADRD in prison did not commit a violence offence.Originality/valueThis study links a population-based Alzheimer’s disease registry and state-wide corrections data to estimate the prevalence of individuals with dementia in the prison system. This linkage presents an opportunity to fill in significant gaps and contribute to the body of literature on dementia among people in prison in the USA.

Nurse Staffing and Veteran Outcomes in the Veterans Health Administration's Community Living Centers.

The demand for nursing care is rising in the long-term care setting. Nurse staffing is a crucial measure linked to health care quality measure outcomes. To assess for associations between nursing hours per patient day (NHPPD) and outcome measures in the Veterans Health Administration Community Living Centers. A retrospective data review of NHPPD and quality measures for 134 community living centers was conducted. Linear regression was used to assess for linear associations between average total NHPPD and 6 quality measures. A significant linear association was found between average total NHPPD and falls with major injury ( P = .02) and help with activities of daily living ( P = .01). No associations were found between nurse staffing and 4 other quality measures. This study adds to the body of literature regarding the impact of nurse staffing on quality measures.

Association of objective and subjective parameters of obstructive sleep apnea with plasma aldosterone concentration in 2,066 hypertensive and 25,368 general population.

Obstructive sleep apnea (OSA) severity has been suggested in aldosterone elevation in resistant hypertension, whereas it is undetermined in the rest population. We explored the association of OSA parameters with plasma aldosterone concentration (PAC) in participants with and without hypertension. We enrolled clinically hypertensive patients with polysomnography and PAC data under no interfering agents, compared (log) PAC, and assessed the linearity of log PAC by tertiles (T1/2/3) of sleep parameters and their association using linear regression by gender and age. We enrolled participants with and without hypertension who had No-SAS scale and PAC data from the community and duplicated the observations from clinical setting considering age, gender, and presence of hypertension. Of the 2,066 clinical patients with hypertension (1,546 with OSA), men participants (n=1,412), log apnea-hypopnea index (p=0.043), apnea index (AI, p=0.010), and lowest oxygen saturation (LSaO2, p=0.013) showed significant linearity with log PAC. Log AI (B=0.04, 95%CI: 0.01,0.07, p=0.022) and log LSaO2 (B=-0.39, 95%CI: -0.78,-0.01, p=0.044) showed significant positive and negative linear associations with log PAC in regression. In community dwellers, 6,417 participants with untreated hypertension (2,642 with OSA) and 18,951 normotensive participants (3,000 with OSA) were included. Of the men participants with and without hypertension, the OSA group showed significantly higher (log) PAC than did their counterparts, and log No-SAS score showed positive association with log PAC (hypertension: B=0.072, 95%CI: 0.002,0.142, p=0.043; normotension: B=0.103, 95%CI: 0.067,0.139, p<0.001) in linear regression analysis, which were consistent in all age groups. OSA parameters were positively associated with PAC in normotensive and hypertensive participants, indicating that OSA may increase circulating aldosterone, especially in men.

Too much is too little: Estimating the optimal physical activity level for a healthy mental state.

Although physical activity and exercise are generally thought to have favorable effects on mental health, excessive physical activity may have unfavorable effects. In this study, the associations between physical activity and the states of mental health with U-shaped dose-response curves were hypothesized, and the ranges of physical activity resulting in optimal effects on mental health were investigated. A cross-sectional survey was conducted on 1,237 adult volunteers in 2017 and 2018. Of these volunteers, 526 participants validly answered the self-administered questionnaires asking about physical activity, depression, anxiety, resilience, insomnia vulnerability, and life events. A comparison of mental health measures by physical activity levels and quadratic equation model regressions were performed. No significant linear associations between physical activity levels and mental health measurements were observed; however, the U-shaped, quadratic equation models indicated a significance. The following levels of physical activity per week optimized the mental health measurements values of the participants: 6,953 MET-minutes and 25.70 h for depression, 5,277 MET-minutes and 21.60 h for state anxiety, 5,678 MET-minutes and 22.58 h for trait anxiety, 25.41 h for resilience, and 9,152 MET-minutes and 31.17 h for insomnia vulnerability. Physical activities in the optimal range were associated with more favorable mental health measurements. Physical activities that were too much or too long and outside of the optimal range were associated with less favorable mental health measurements.

Interaction of genotype-ecological type-plant spacing configuration in sorghum [Sorghum bicolor (L.) Moench] in China.

Grain sorghum has been a significant contributor to global food security since the prehistoric period and may contribute even more to the security of both food and energy in the future. Globally, precise management techniques are crucial for increasing grain sorghum productivity. In China, with diverse ecological types, variety introduction occasionally occurs across ecological zones. However, few information is available on the effect of ecological type on genotype performance and how plant spacing configuration influences grain yield in various ecological zones. Hence, a series of two-year field experiments were conducted in 2020 and 2021 in four ecological zones of China, from the northeast to the southwest. The experiments included six widely adapted sorghum varieties under six plant spacing configurations (two row spacing modes: equidistant row spacing (60cm) mode and wide (80cm)-narrow (40cm) row spacing mode; three in-row plant spacings: 10cm, 15cm, and 20cm). Our results indicated that ecological type, variety, and plant spacing configuration had a significant effect on sorghum yield. Ecological type contributed the highest proportion to the yield variance (49.8%), followed by variety (8.3%), while plant spacing configuration contributed 1.8%. Sorghum growth duration was highly influenced by the ecological type, accounting for 87.2% of its total variance, whereas plant height was mainly affected by genotype, which contributed 81.6% of the total variance. All test varieties, developed in the south or north, can reach maturity within 94-108d, just before fall sowing in central China. Generally, sorghum growth duration becomes longer when a variety is introduced from south to north. A late-maturing variety, developed in the spring sowing and late-maturing regions, possibly could not reach maturity in the early-maturing region. The row spacing modes had no significant affect on sorghum yield, but the equal-row spacing mode consistently caused higher yields with only one exception; this might imply that equal-row spacing mode was more advantageous for boosting sorghum yield potential. In contrast, decreasing in-row plant spacing showed significant positive linear associations with sorghum grain yield in most cases. In addition, these results demonstrated that sorghum is a widely adapted crop and enables success in variety introduction across ecological zones.

Plasma eicosapentaenoic acid, a biomarker of fish consumption, is associated with perfluoroalkyl carboxylic acid exposure in residents of Kyoto, Japan: a cross-sectional study.

Per- and polyfluoroalkyl substances (PFASs) are highly fluorinated organic compounds that have been widely used in industry during the past few decades. The main exposure routes for PFASs are thought to be the diet, drinking water, and dust. In this study, we aimed to evaluate the relationship between perfluoroalkyl carboxylic acids (PFCAs, members of the PFAS family) and the plasma eicosapentaenoic acid-to-arachidonic acid ratio (EPA/AA), a biological indicator of seafood intake, to determine whether seafood intake may represent a means of exposure to PFASs in the Japanese population. We performed a cross-sectional study using 131 plasma samples collected from residents of Kyoto, Japan in 2013 and held in the Kyoto University biological sample bank. The concentrations of perfluoroheptanoic acid (PFHpA), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluoroundecanoic acid (PFDA), perfluoroundecanoic acid (PFUnDA), perfluorododecanoic acid (PFDoDA), perfluorotridecanoic acid (PFTrDA), EPA, and AA were quantified by gas chromatography-mass spectrometry, and multiple linear regression was used to analyze the results. In multiple linear regression analyses with age and eGFR, PFOA showed a significant positive linear association with age (p = 0.0005); PFHpA showed a significant negative linear association with estimated glomerular filtration rate (eGFR; p = 0.0338); and PFHpA, PFOA, PFNA, PFUnDA, and PFDoDA exhibited significant positive linear associations with EPA/AA (p = 0.0358, 0.0056, 0.0242, <0.0001, and <0.0001, respectively). Because only PFHpA and PFOA were associated with smoking, their concentrations were examined again with smoking variable included and neither showed an association with smoking habit. PFOA showed a significant linear association with EPA/AA ratio (p = 0.0072), but PFHpA did not (p = 0.051). The plasma concentrations of PFOA, PFNA, PFUnDA and PFDoDA significantly associated with the EPA/AA ratio in residents of Kyoto.

Associations of Estradiol With Mortality and Health Outcomes in Patients Undergoing Hemodialysis: A Prospective Cohort Study

Background: Both lower and higher estradiol (E2) levels have been associated with increased mortality among women with kidney failure. However, robust data are still lacking. Objective: We investigated the interaction of diabetes and age on linear and nonlinear associations between E2 levels, adverse outcomes, and health-related quality of life (HRQOL) in Canadian women undergoing hemodialysis (HD). Design: Population-based cohort study; data from Canadian Kidney Disease Cohort Study (CKDCS). Setting &amp; patients: A total of 427 women undergoing HD enrolled in the CKDCS. Measurements: Baseline E2 (in pmol/L) and E2 tertiles (&lt;38 pmol/L, 38-95 pmol/L, &gt;95 pmol/L). Methods: Cox-proportional hazards used for all-cause and cardiovascular disease (CVD) mortality. Fine-Gray models used for incident CVD. Mixed models used for Health Utilities Index Mark 3 (HUI3), Kidney Disease Quality of Life Physical Component Scores (KDQOL12-PCS), and Mental Component Scores (KDQOL12-MCS). Results: Over a median follow-up of 3.6 (interquartile range [IQR]: 1.6-7.5) years, 250 (58.6%) participants died; 74 deaths (29.6%) were CV-related. Among 234 participants without prior CV events, 80 (34.2%) had an incident CVD event. There were no significant linear associations between E2 and all-cause mortality, CVD mortality, and incident CVD. However, E2 showed a significant concave association with all-cause mortality, but not with CVD mortality and incident CVD. Among patients aged ≥63 years, higher E2 levels were associated with lower HUI3 scores, mean difference (MD) = –0.062 per 1 – SD pmol/L, 95% confidence interval (CI) = –0.112 to –0.012, but the opposite was observed in younger patients (&lt;63 years) in whom higher E2 levels were associated with higher HUI3 scores (MD = 0.032 per 1 – SD pmol/L, 95% CI = 0.008-0.055), Pinteraction = .045. No associations were observed among E2, KDQOL12-PCS (MD = –0.15 per 1 – SD pmol/L, 95% CI = –1.15 to 0.86), and KDQOL12-MCS (MD = –0.63 per 1 – SD pmol/L, 95% CI = –1.82 to 0.57). Limitations: Unmeasured confounding and small sample size. Conclusions: The association between E2 and all-cause mortality may be nonlinear, while no association was observed for CVD mortality, incident CVD, KDQOL12-PCS, and KDQOL12-MCS. Furthermore, the association between serum E2 and HUI3 was modified by age: Higher levels were associated with higher utility among women aged &lt;63 years and the converse observed among older women.

Prediction of Intracranial Temperature Through Invasive and Noninvasive Measurements on Patients with Severe Traumatic Brain Injury.

The brain's temperature measurements (TB) in patients with severe brain damage are important, in order to offer the optimal treatment. The purpose of this research is the creation of mathematical models for the TB's prediction, based on the temperatures in the bladder (TBL), femoral artery (TFA), ear canal (TΕC), and axilla (TA), without the need for placement of intracranial catheter, contributing significantly to the research of the human thermoregulatory system.The research involved 18 patients (13 men and 5 women), who were hospitalized in the adult intensive care units (ICU) of Larissa's two hospitals, with severe brain injury. An intracranial catheter with a thermistor was used to continuously measure TB and other parameters. The TB's measurements, and simultaneously one or more of TBL, TFA, TEC, and TA, were recorded every 1h.To create TB predicting models, the data of each measurement was separated into (a) model sample (measurements' 80%) and (b) validation sample (measurements' 20%). Multivariate linear regression analysis demonstrated that it is possible to predict brain's temperature (PrTB), using independent variables (R2 was TBL=0.73, TFA=0.80, TEC=0.27, and TA=0.17, p<0.05). Significant linear associations were found, statistically, and no difference in means between TB and PrTB of each prediction model. Also, the 95% limits of agreement and the percent coefficient of variation showed sufficient agreement between the TB and PrTB in each prediction model.In conclusion, brain's temperature prediction models based on TBL, TFA, TEC, and TA were successful. Its determination contributes to the improvement of clinical decision-making.

Assessment of cellular immunity by CD4+ and CD8+ lymphocyte counts in 2–12-year-old children with iron-deficiency anemia

Background: Iron-deficiency anemia (IDA) in children and infants can have long-term adverse consequences on neurodevelopment and behavior, which can be irrevocable in some cases and detrimental to the immune system. Aim: The aim of this study was to investigate the role of IDA and its effects on immunity in CD8 and CD4 lymphocytes. Settings and Designs: This was a prospective study. Materials and Methods: A total of 40 pediatric cases (2–12 years) were first time diagnosed as IDA based on complete blood count (CBC) parameters, peripheral blood smear, and serum ferritin levels. Flow cytometric immune assays were used to determine the number of CD4+ and CD8+ lymphocytes and the ratio of CD4+/CD8+. Statistical Analysis: Pearson's correlation coefficient and Students' unpaired t-test were used. Results: The difference between the case and control groups in hemoglobin (Hb), red blood cell (RBC) indices, red cell distribution width, RBC count, and serum ferritin is highly significant. A significant linear positive association between CD3+ and CD4+ cell counts and serum ferritin and a significant linear positive correlation between CD4+ cell counts and Hb were observed. However, there was a nonsignificant linear positive association of both parameters, hemoglobin (Hb) and mean corpuscular volume (MCV) with CD3+ cell count, CD4+ cell count, and CD4+/CD8+ cell ratio. Conclusion: Iron deficiency does not affect total white blood cell count or differential leukocyte count on routine CBC, but it can alter cellular immunity (CD3+ cell count, CD4+ cell count, and CD4+/CD8+ cell ratio).

Vitamin D and suicidality: a Chinese early adolescent cohort and Mendelian randomization study.

Previous cross-sectional and case-control studies have proposed that decreased vitamin D levels are positively correlated with the risk of suicidality in adults. However, limited studies have examined the association between vitamin D and suicidality in adolescents. This study aimed to investigate the relationship between serum vitamin D and suicidality risk among early adolescents. Data were obtained from a Chinese early adolescent cohort. In this cohort, seventh-grade students from a middle school in Anhui Province were invited to voluntarily participate in the baseline assessments and provide peripheral blood samples (in September 2019). The participants were followed up annually (in September 2020 and September 2021). Serum 25-hydroxyvitamin D [25(OH)D] and vitamin D-related single-nucleotide polymorphisms at baseline were measured in November 2021. Traditional observational and Mendelian randomization (MR) analyses were performed to examine the relationship between serum 25(OH)D at baseline and the risk of baseline and incident suicidality (i.e., suicidal ideation [SI], plans and attempts). Traditional observational analysis did not reveal a significant linear or non-linear association of serum 25(OH)D concentration with the risks of baseline and 2-year incident suicidality in the total sample (P>.05 for all). Sex-stratified analysis revealed a non-linear association between the 25(OH)D concentration and the risk of baseline SI in women (Poverall=.002; Pnon-linear=.001). Moreover, the risk of baseline SI in the 25(OH) insufficiency group was lower than that in the 25(OH) deficiency group in the total sample (odds ratio [OR]=0.69, 95% confidence interval [CI]=0.51-0.92, P=.012). This difference remained significant in women (OR=0.59, 95% CI=0.40-0.87, P=.008) but not in men (OR=0.78, 95% CI=0.53-1.15, P=.205). Additionally, both linear and non-linear MR analyses did not support the causal effect of serum 25(OH)D concentration on the risk of baseline, 1-year and 2-year incident suicidality (P>.05 for all). This study could not confirm the causal effect of vitamin D on suicidality risk among Chinese early adolescents. Future studies must confirm these findings with a large sample size.

The possibility of predicting the performance of advanced ski elements based on the performance of basic ski elements

The aim of this research was to predict the success of the performance of advanced ski elements based on the level of performance of basic ski elements, with the ultimate purpose of improving training programmes for alpine ski beginners. The sample of participants consisted of 250 students of the Faculty of Kinesiology University of Zagreb who attended their mandatory classes of the university study subject of Skiing in the academic year 2021/22. The sample of variables consisted of the grades the students earned for their performance of four exam elements, two basic ski elements and the other two belonging to the advanced ski elements group. The basic ski elements were uphill turn (UT), for which the mean of two grades was taken for further analysis due to its performance to both sides – left and right, and snowplough turn (SPT). Advanced ski elements were parallel turn (PT) and short turn (ST). Besides descriptive statistics for each variable, two ordinal logistic regression models were constructed for determining the relationship between the performance of short turn based on the level of performance of snowplough turn, on the one hand, and on the other, between the performance of parallel turn based on the performance of uphill turn. The results of the first ordinal logistic regression analysis (short turn performance based on snowplough performance) showed the existence of a statistically significant linear association of the two ski elements performance (b=2.15, SE=0.72, p=.03). Similar results were obtained in the second ordinal logistic regression analysis for the other pair of ski elements (parallel turn performance based on uphill turn performance): b=2.36, SE=0.24, p&amp;lt;.001. Well acquired dynamic motor stereotypes, reflected in good performance of basic ski elements, are the basis for good performance of advanced ski elements, therefore skipping any step in the teaching process based on progression could have a negative impact on achieving the desired goals.

The modulation of Plasma Levels of Dopamine, Serotonin, and Brain-derived neurotrophic factor in response to variation in iron availability.

In the context of iron deficiency anemia, central dopamine, serotonin, and brain-derived neurotrophic factor (BDNF) are intensively investigated. However, peripheral isoforms are poorly investigated. This study aimed to investigate the modulation of plasma levels of dopamine, serotonin, and BDNF among children with iron deficiency anemia. A total of seventy-three iron-deficient (n=38) and iron-sufficient (n=35) children were included in the study. Twenty-nine subjects were showing clinical presentations and were diagnosed with iron deficiency anemia and forty-four were asymptomatic normal children. Plasma levels of dopamine, serotonin, and brain-derived neurotrophic factor were determined by enzyme-linked immunosorbent assay. As compared to corresponding levels among control subjects, Anemic subjects were having significantly higher plasma dopamine and lower plasma brain-derived neurotrophic factor levels. A significant linear and monotonic association of plasma dopamine and brain-derived neurotrophic factor with hemoglobin concentration (r=-0.520, P < 0.001 and ρ = 0.411, P = 0.001), respectively. Furthermore, there were significantly higher plasma serotonin levels among iron-deficient subjects with a significant inverse linear association with serum ferritin levels (r = -0.337, P = 0.005). Iron deficiency anemia is associated with the modulation of peripheral dopamine, serotonin, and brain-derived neurotrophic factor. Upregulation of dopamine and downregulation of brain-derived neurotrophic factor are correlated to the anemic status. The upregulation of plasma serotonin levels is iron-dependent and, probably, is attributed to the impairment of its metabolic fate. Further investigation is required to explore the pathophysiological and clinical association of these peripheral biomolecules in the context of iron deficiency anemia. (www.actabiomedica.it).

Estimated glucose disposal rate and risk of cardiovascular disease: evidence from the China Health and Retirement Longitudinal Study

ObjectivesPrevious studies had reported that insulin resistance (assessed by estimated glucose disposal rate; eGDR) was associated with higher risk of cardiovascular events (CVD) in diabetes patients. The aim of present study was to investigate the potential association between eGDR and CVD in general population.MethodsThe China Health and Retirement Longitudinal Study with 8,267 individuals were included in analysis. Participants were divided into four subgroups according to eGDR quartile. Cox proportional hazards regression models were used to examine the associations of eGDR with CVD (stroke or cardiac events).ResultsDuring 6 years of follow-up, a total of 1,476 respondents experienced a CVD (494 stroke and 1,110 cardiac events). In multivariable-adjusted analyses, the corresponding hazard ratio (95% confidence intervals) for the highest eGDR versus lowest quartile of eGDR was 0.58(0.49–0.67) for CVD. Each 1-SD increase of eGDR was associated with 16% (HRs = 0.84; 0.79–0.88) decreased risk of CVD. There was also a significant linear association between eGDR and CVD (P for linearity < 0.001). Similar associations were also found between eGDR and stroke and cardiac events.ConclusionA higher eGDR (a measure of insulin resistance) was associated with a decreased risk of CVD, stroke and cardiac events in general Chinese population, suggesting that eGDR could be considered as a preferential predictor and treatment target of CVD. Future well-designed prospective clinical studies are needed to verify our findings and to assess the effect of eGDR interventions in CVD prevention and therapy.

Association of the magnitude of the difference in blood pressure between office and ambulatory measurements with blood pressure variability in untreated individuals

ObjectivesWe evaluated the association between cardiovascular risk factors and the magnitude of the difference in systolic blood pressure (SBP) between office and ambulatory measurements (masked effect) in untreated individuals without apparent hypertension-mediated organ damage (HMOD).MethodsThe inclusion criteria were 1) age ≥ 20 years, 2) blood pressure ≥ 140/90 mmHg at the outpatient clinic, and 3) not receiving antihypertensive medications. The difference between office and ambulatory SBP was calculated by subtracting the ambulatory daytime SBP from the office SBP. The association between the masked effect and SBP variability was analyzed in individuals without HMOD (no electrocardiographic left ventricular hypertrophy, spot urine albumin-to-creatinine ratio < 30 mg/g, and estimated glomerular filtration rate ≥ 60 mL/min/1.73 m2, n = 296).ResultsAmong the cardiovascular risk factors, ambulatory BP variability was significantly correlated with the SBP difference. The standard deviation (SD) and coefficient of variation (cv) of 24-h SBP exhibited a significant negative linear association with the SBP difference in univariate and multivariate analyses adjusted for age, sex, presence of diabetes, and 24-h ambulatory SBP. A significant association was observed in patients with ambulatory daytime hypertension. In the multivariate analysis, individuals with a negative SBP difference > -5 mmHg exhibited a higher SD and cv of 24-h SBP than those with a negative SBP difference ≤ -5 mmHg or a positive SBP difference.ConclusionsThe results of our study suggest that the magnitude of the negative difference in office and ambulatory SBP may be a potential risk factor, even in individuals without apparent HMOD.Trial registrationThis trial is registered with ClinicalTrials.gov (NCT03855605).