Significant Negative Association Research Articles

Effect of Red Blood Cell Transfusion on Central Venous-to-Arterial Carbon Dioxide Difference in Anemic Surgical Patients – A Pilot Study

Background: Biochemical markers for monitoring adequacy of cardiac output and tissue perfusion such as blood lactate and central venous oxygen saturation (ScvO2) are meanwhile well established in clinical routine. In addition, in recent years, the central venous-to-arterial carbon dioxide difference (dCO2) has been evaluated as a further marker, and studies meanwhile have demonstrated the validity of an increased dCO2 to identify capillary perfusion mismatches. However, results from animal studies suggest that dCO2 may be influenced by altered hemoglobin values during severe bleeding. It was the aim of our study to evaluate if dCO2 changes upon Red Blood Cell (RBC) transfusion in humans. Methods: Patients of the ongoing LIBERAL trial were prospectively evaluated. Participants were aged ≥70 years and scheduled for elective intermediate or high risk orthopedic or trauma surgery with the clinical need for invasive blood pressure monitoring and central venous catheterization. During surgery, drop of hemoglobin triggered administration of one single RBC unit, together with arterial and central venous blood analysis immediately before as well as after transfusion. Results: In total, 46 patients were analyzed. Baseline median hemoglobin before RBC transfusion was 8.35 (7.48–8.73)g/dl, while dCO2 was 6.2 (3.4–9.6)mmHg. According to Spearman correlation, there was a linear association between pre-transfusion dCO2 and ScvO2. Transfusion of one RBC unit resulted in a significant increase of median hemoglobin by 1.2 (0.7–1.63)g/dl (p<0.0001), and hemoglobin increase was more pronounced when pre-transfusion hemoglobin was low, as evidenced by a significant negative association between both parameters (r=-0.61, p <0.0001). Neither lactate nor ScvO2 nor dCO2 were significantly influenced by transfusion. When the whole cohort was divided according to pre-transfusion dCO2 levels using a cut-off value of 6 mmHg, median dCO2 decreased significantly more pronounced following RBC transfusion when pre-transfusion values were high (>6 mmHg), compared to those patients with a pre-transfusion dCO2 below 6 mmHg. Conclusions: The results of our study suggest that crude dCO2 is not influenced by moderate hemoglobin increases in orthopedic and trauma surgery patients. However, including dCO2 into the decision whether to administer RBC or not may be an interesting reasonable approach for further investigations on the way towards more individualized transfusion regimens.

Cardiorespiratory fitness associates negatively with arterial stiffness in a cohort of industrial workers followed up for 4 years.

Previously we have found increased carotid-to-femoral pulse wave velocity (cfPWV) among shift workers compared to day workers in industry, and a decline in maximal oxygen uptake (V̇O2max) in all 86 workers. Utilizing all available measurements in 2018, 2021 and 2022, this study investigated associations between V̇O2max and measures of arterial stiffness. Using a mixed model approach, we analysed the cross-sectional association between all V̇O2max (outcome) and measures of arterial stiffness (covariates). We observed a significant association between V̇O2max and cfPWV of -1.59 (95%CI -3.03, -0.16), augmentation pressure (AP) and augmentation index (Aix) of -0.32 (95%CI -0.58, -0.06) and -0.12 (95%CI -0.23, -0.005), respectively. We found a significant negative association between cardiorespiratory fitness and measures of arterial stiffness. The former and present results pose challenges for shift workers' future macro and microvascular health.

Saturation effects of the relationship between physical exercise and systemic immune inflammation index in the short-sleep population: a cross-sectional study

BackgroundShort sleep can lead to an increase in inflammation and regular exercise has been shown to have a mitigation effect. However, the association between physical exercise (PE) and inflammation in the short sleep population is an unknown and intriguing issue.MethodsNHANES dataset spanning the years 2007 to 2018 were analyzed. To investigate the relationship mentioned above, we carried out multivariate linear regression models controlling for sociodemographic and lifestyles factors. The systemic immune inflammation index (SII) served as a reflection of inflammatory potential, calculated as the product of platelet count, neutrophil count, and divided by the lymphocyte count. Self-reported questionnaires were used to collect sleep and exercise information.ResultsA total of 14,664 participants were included for final analysis. Across the three models, PE showed significant negative associations with SII as a continuous variable [Crude Model, β (95% CI): -1.261(-1.600, -0.922), p < 0.001; Model 1, β (95% CI): -1.005(-1.344, -0.666), p < 0.001; Model 2, β (95% CI): -0.470(-0.827, -0.112), p = 0.011]. The consistent nature of the findings persisted when investigating physical exercise (PE) as a categorized variable. By two-piecewise linear regression model, we calculated a saturation effect of PE with the inflection point as 2400 MET-minutes/week.ConclusionThis study suggested that performing no more than 2400 MET-minutes/week of PE was associated with lower SII levels in the short sleep population, while more PE might not bring additional benefits.

The impact of the COVID-19 pandemic on academic performance among developmental age students: a systematic review with meta-analysis.

The COVID-19 pandemic has disrupted educational systems worldwide, raising concerns about its impact on academic performance, particularly among developmental age students. A systematic review with meta-analysis aimed to evaluate the association between the COVID-19 pandemic and the academic performance in this population was performed according to PRISMA 2020 guidelines. PubMed/MEDLINE, Scopus and Embase were searched on December 2023 to identify relevant studies. Both fixed and random effect models were performed. The Effect size was reported as Cohen's d with a 95% Confidence Interval. Studies' quality was assessed using the Newcastle-Ottawa scale. The protocol was registered in PROSPERO. A total of 30 studies met the inclusion criteria, but only 13 could be combined in the meta-analysis. Based on a sample size of 4,893,499 students, pooled Cohen's d was -0.07 [(95% CI = -0.10; -0.03); p-value <0.001]. Subgroup analyses by subject suggested that performance in math was affected the most, Cohen's d= -0.14 [(-0.18; -0.10); p-value <0.001]. The findings revealed a significant negative association between the COVID-19 pandemic and academic performance among developmental age students. Interventions to mitigate the adverse effects of the pandemic on educational outcomes in this population are needed.

Bereavement and Loss in Older Adulthood: Associations Between Meaning-Making, Spirituality and Grief

Losing a loved one in older adulthood affects one's emotional well-being profoundly. The grief experienced by older adults, who may have shared significant experiences and memories with their loved ones, can be intensified by cumulative losses and is often not acknowledged by themselves or their caregivers. This study uses a descriptive quantitative cross-sectional design to determine the relationships between potential predictors and grief among older adults. This cross-sectional study uses purposive sampling and involves 134 older adults aged 60 years or above who had experienced significant loss within the past 60 months. A self-administered questionnaire assessed participants' demographic characteristics, loss experiences, grief, spirituality, and meaning-making. Multiple linear regression analysis was carried out to determine the significant predictors of meaning-making and spirituality regarding grief. The findings indicated significant negative associations between spirituality, meaning-making, and grief. This study emphasizes the importance of addressing the spiritual and meaning-making dimensions in supporting older adults in effectively managing grief-related distress. Future studies should consider longitudinal designs and further explore additional predictors to provide a more comprehensive understanding of the complex factors influencing grief and the healing process.

Actions chains and intention understanding in 3- to 6-year-old children

In intentional behavior, the final goal of an action is crucial in determining the entire sequence of motor acts. Neurons have been described in the inferior parietal lobule of monkeys, which besides encoding a specific motor act (e.g., grasping), have their discharge modulated by the final goal of the intended action (e.g., grasping-to-eat). Many of these "action-constrained" neurons have mirror properties responding to the observation of the motor act they encode, provided that this is embedded in a specific action. Thanks to this mechanism, the observers have an internal copy of the whole action before its execution and may, in this way, understand the agent's intention. The chained organization of motor acts has been demonstrated in schoolchildren. Here, we examined whether this organization is already present in very young children. To this purpose, we recorded EMG from the mylohyoid (MH) muscle in the children aged 3 to 6 y. The results showed that preschoolers, like older children, possess the chained organization of motor acts in execution. Interestingly, in comparison to older children, they have a delayed ability to use this mechanism to infer others' intentions by observation. Finally, we found a significant negative association between the children's age and the activation of the MH muscle during the grasp-to-eat phase in the observation condition. We, tentatively, interpreted it as a sign of an immature control of motor acts.

Hypermetabolic state is associated with circadian rhythm disruption in mouse and human cancer cells

Crosstalk between metabolism and circadian rhythms is a fundamental building block of multicellular life, and disruption of this reciprocal communication could be relevant to disease. Here, we investigated whether maintenance of circadian rhythms depends on specific metabolic pathways, particularly in the context of cancer. We found that in adult mouse fibroblasts, ATP levels were a major contributor to signal from a clock gene luciferase reporter, although not necessarily to the strength of circadian cycling. In contrast, we identified significant metabolic control of circadian function across a series of pancreatic adenocarcinoma cell lines. Metabolic profiling of congenic tumor cell clones revealed substantial diversity among these lines that we used to identify clones to generate circadian reporter lines. We observed diverse circadian profiles among these lines that varied with their metabolic phenotype: The most hypometabolic line [exhibiting low levels of oxidative phosphorylation (OxPhos) and glycolysis] had the strongest rhythms, while the most hypermetabolic line had the weakest rhythms. Pharmacological enhancement of OxPhos decreased the amplitude of circadian oscillation in a subset of tumor cell lines. Strikingly, inhibition of OxPhos enhanced circadian rhythms only in the tumor cell line in which glycolysis was also low, thereby establishing a hypometabolic state. We further analyzed metabolic and circadian phenotypes across a panel of human patient-derived melanoma cell lines and observed a significant negative association between metabolic activity and circadian cycling strength. Together, these findings suggest that metabolic heterogeneity in cancer directly contributes to circadian function and that high levels of glycolysis or OxPhos independently disrupt circadian rhythms in these cells.

Effects of diets on risks of cancer and the mediating role of metabolites

Research on the association between dietary adherence and cancer risk is limited, particularly concerning overall cancer risk and its underlying mechanisms. Using the UK Biobank data, we prospectively investigate the associations between adherence to a Mediterranean diet (MedDiet) or a Mediterranean-Dietary Approaches to Stop Hypertension Diet Intervention for Neurodegenerative Delay diet (MINDDiet) and the risk of overall and 22 specific cancers, as well as the mediating effects of metabolites. Here we show significant negative associations of MedDiet and MINDDiet adherence with overall cancer risk. These associations remain robust across 14 and 13 specific cancers, respectively. Then, a sequential analysis, incorporating Cox regression, elastic net and gradient boost models, identify 10 metabolites associated with overall cancer risk. Mediation results indicate that these metabolites play a crucial role in the association between adherence to a MedDiet or a MINDDiet and cancer risk, independently and cumulatively. These findings deepen our understanding of the intricate connections between diet, metabolites, and cancer development.

Association of blood trihalomethane concentrations with diabetes mellitus in older adults in the US: a cross-sectional study of NHANES 2013–2018

BackgroundPrevious studies have demonstrated that there is a correlation between trihalomethanes and disease progression, such as allergic diseases. As we know, only few studies focused on the relationship between trihalomethanes and metabolic diseases, such as diabetes mellitus.ObjectiveThe aim of this study was to further explore the associations between blood trihalomethane concentrations and diabetes mellitus in older adults in the US.MethodsData were collected from the National Health and Nutrition Examination Study (NHANES) database in the survey cycle during 2013 to 2018, including 2,511 older adults in the US whose blood trihalomethane concentrations were measured, involving chloroform (TCM) and brominated trihalomethanes (Br-THMs). Br-THMs include bromodichloromethane (BDCM), dibromochloromethane (DBCM), and bromoform (TBM). Meanwhile, the concentration of total trihalomethanes (TTHMs) was also measured later. A multivariate logistic regression and restricted cubic spline were used to examine the relationship between blood THMs and diabetes mellitus. Meanwhile, we performed a subgroup analysis, which aims to explore the stability of this relationship in different subgroups. In order to further consider the impact of various disinfection by-products on diabetes, we also used weighted quantile sum (WQS). To explore the correlation in trihalomethanes, we plot a correlation heatmap.ResultsAdjusting for potential confounders, we found that there was a significant negative association between chloroform and diabetes mellitus [Model 1 (adjusted for covariates including age, sex, and race, OR = 0.71; 95% CI: 0.50–1.02; p = 0.068; p for trend = 0.094); Model 2 (adjusted for all covariates, OR = 0.68; 95% CI: 0.48–0.96; p = 0.029; p for trend = 0.061)]. In the bromodichloromethane, we reached a conclusion that is similar to TCM [Model 1 (adjusted for covariates including age, sex, and race, OR = 0.54; 95% CI: 0.35–0.82; p = 0.005; p for trend = 0.002); Model 2 (adjusted for all covariates, OR = 0.54; 95% CI: 0.35–0.82; p = 0.003; p for trend = 0.002)]. Meanwhile, the restricted cubic spline curve also further confirms this result (p overall = 0.0027; p overall&amp;lt; 0.001). Based on the analysis in the subgroups, we found that the value p for interaction in the majority of subgroups is higher than 0.1. Trihalomethanes and diabetes were inversely associated, and in the WQS, chloroform and bromodichloromethane were found to be the major contributors to this relationship. In the correlation analysis, we found that most trihalomethanes have a weak correlation, except for TBM and TCM with a strong correlation.ConclusionOur results in this study showed that blood chloroform, bromodichloromethane concentrations, and diabetes mellitus in older adults in the US are negatively correlated, suggesting that chloroform and bromodichloromethane can be protective factors for diabetes.

Effectiveness of a Counseling Intervention to Increase Vaccination Uptake among Men Who Have Sex with Men during the Mpox Outbreak

Men who have sex with men (MSM) are disproportionately impacted by sexually transmitted infections (STIs), including HIV and those preventable through vaccination such as mpox, HPV, HAV, and HBV. A retrospective cohort study was conducted to evaluate the effectiveness of counseling provided during mpox vaccination on the uptake of other recommended vaccines (HPV, HAV, and HBV) and to identify associated factors. Relevant covariates such as nationality, age, HIV status, and use of PrEP were retrieved from electronic medical records. Vaccination status data were retrieved from the regional vaccination registry. Of the 330 participants, 98.8% were males and the mean age was 40.6 years (SD: 11.2). Following consultation, a statistically significant increase for both HPV (from 25.8% to 39.1%) and HAV (from 26.7% to 36.1%) was observed (p &lt; 0.001). The multivariate analysis showed a significant negative association between the uptake of HPV and HBV vaccines and foreign nationality (aOR 0.25 (95%CI 0.08–0.69), p = 0.012; and aOR 0.31 (95%CI 0.11–0.81), p = 0.021). The HBV vaccine uptake was negatively associated with increasing age. Our results suggest that tailored counseling can effectively bridge the gap in vaccine acceptance among vulnerable populations, thereby improving overall public health outcomes.

Effectiveness of a Counseling Intervention to Increase Vaccination Uptake among Men Who Have Sex with Men during the Mpox Outbreak

Men who have sex with men (MSM) are disproportionately impacted by sexually transmitted infections (STIs), including HIV and those preventable through vaccination such as mpox, HPV, HAV, and HBV. A retrospective cohort study was conducted to evaluate the effectiveness of counseling provided during mpox vaccination on the uptake of other recommended vaccines (HPV, HAV, and HBV) and to identify associated factors. Relevant covariates such as nationality, age, HIV status, and use of PrEP were retrieved from electronic medical records. Vaccination status data were retrieved from the regional vaccination registry. Of the 330 participants, 98.8% were males and the mean age was 40.6 years (SD: 11.2). Following consultation, a statistically significant increase for both HPV (from 25.8% to 39.1%) and HAV (from 26.7% to 36.1%) was observed (p &lt; 0.001). The multivariate analysis showed a significant negative association between the uptake of HPV and HBV vaccines and foreign nationality (aOR 0.25 (95%CI 0.08–0.69), p = 0.012; and aOR 0.31 (95%CI 0.11–0.81), p = 0.021). The HBV vaccine uptake was negatively associated with increasing age. Our results suggest that tailored counseling can effectively bridge the gap in vaccine acceptance among vulnerable populations, thereby improving overall public health outcomes.

A prospective cohort study of multimetal exposure and risk of gestational diabetes mellitus

The relationship between co-exposure to multiple metals and gestational diabetes mellitus (GDM) and the mechanisms involved are poorly understood. In this nested case-control study, 228 GDM cases and 456 matched controls were recruited, and biological samples were collected at 12–14 gestational weeks. The urinary concentrations of 10 metals and 8-hydroxydeoxyguanosine (8-OHdG) as well as the serum levels of malondialdehyde (MDA) and advanced glycation end products (AGEs) were determined to assess the association of metals with GDM risk and the mediating effects of oxidative stress. Urinary Ti concentration was significantly and positively associated with the risk of GDM (odds ratio [OR]:1.45, 95 % confidence interval [CI]: 1.12, 1.88), while Mn and Fe were negatively associated with GDM risk (OR: 0.67, 95 % CI: 0.50, 0.91 or OR: 0.61, 95 % CI: 0.47, 0.80, respectively). A significant negative association was observed between Mo and GDM risk, specifically in overweight and obese pregnant women. Bayesian kernel machine regression showed a significant negative joint effect of the mixture of 10 metals on GDM risk. The adjusted restricted cubic spline showed a protective role of Mn and Fe in GDM risk (P < 0.05). A significant negative association was observed between essential metals and GDM risk in quantile g-computation analysis (P < 0.05). Mediation analyses showed a mediating effect of MDA on the association between Ti and GDM risk, with a proportion of 8.7 % (P < 0.05), and significant direct and total effects on Ti, Mn, and Fe. This study identified Ti as a potential risk factor and Mn, Fe, and Mo as potential protective factors against GDM, as well as the mediating effect of lipid oxidation.

Achieving sustainable development in ECOWAS countries: the impact of trade openness, poverty and human capital

This study investigates the relationship among trade openness, poverty, and human capital development in the pursuit of sustainable development across a panel of ten ECOWAS economies over a 34-year period (1987–2020). Specifically, it examines the roles of trade openness, poverty, and human capital development in sustainable development, while also exploring the moderating role of trade openness on the poverty-sustainable development relationship within the ECOWAS region. To conduct this analysis, the study employs panel autoregressive distributed lag (ARDL) using both the Pool Mean Group (PMG) estimator and Cross-Sectional Autoregressive Distributed Lag (CS-ARDL) techniques, taking into account cross-sectional dependence, cointegration, and other relevant diagnostic tests. The findings indicate that poverty has a consistent negative long-run impact on sustainable development, while human capital is positively associated with sustainability over the long term. Trade openness lacks a significant relationship with sustainability in both the short and long run. Inflation is insignificantly related to sustainability. Exchange rates demonstrate mixed effects. In terms of moderation, trade openness positively and significantly moderates the poverty-sustainability relationship in the long run but not the short run. Robustness testing using the AMG and P-OLS models further validates the significant positive impact of human capital and the insignificant effect of trade openness on sustainable development. Given poverty’s significant negative association and human capital’s positive link with sustainable development, the findings suggest the need for integrated policy mixes prioritizing multidimensional poverty reduction and human capability enhancement to promote sustainability objectives across both short- and long-term horizons in ECOWAS countries. Furthermore, prudent management of exchange rates and well-designed trade policies should complement these efforts to mitigate potential risks and harness any benefits for sustainability.

The Concealment of Health Information at the Intersection of Sexual Orientation and Race.

Purpose: Sexually and racially minoritized people often have mistrust toward the healthcare system due to both perceived and actual experiences of discrimination. This may result in increased privacy concerns and a reluctance to share health-related information with health care providers. Drawing upon minority stress and an intersectionality framework, this study examines how rates of concealing health information differ between non-Hispanic White heterosexual people, non-Hispanic White lesbian, gay, and bisexual (LGB) people, racially minoritized heterosexual people, and those who are both sexually and racially minoritized. Methods: Using nationally representative cross-sectional data from the Health Information National Trends Survey from 2017 and 2018 (n = 4575), we fit logistic regression models to examine (1) whether sexually and racially minoritized people conceal health information from their providers more than their counterparts and (2) whether this tendency increases for those with multiple marginalized identities. Furthermore, we fit linear regression models to examine whether and how concealing health information from providers are linked to health outcomes. Results: Sexually and racially minoritized people had higher odds of concealing health information from providers than their counterparts. Those with multiple marginalized identities had even higher odds of withholding health information than other groups. Finally, we found a significant negative association between concealing health information and mental health. Conclusion: Our findings underscore the need to consider how the intersection of multiple marginalized identities shape health experiences and concerns over privacy in health care matters. We call for further research to better understand the complex dynamics of patient-provider relationships for marginalized populations.

Chorio-retinal vessel density in women affected by functional hypothalamic amenorrhea: a monocentric observational cross-sectional study to evaluate the impact of hypoestrogenism on chorio-retinal vascularization.

Functional hypothalamic amenorrhea (FHA) is characterized by an estrogen deficiency which in turn can cause vascular dysfunction. The aim of this study is to evaluate any changes in the chorio-retinal circulation in patients affected by FHA. 24 patients with FHA and 24 age-matched controls underwent a gynecological evaluation and an OCT angiography (OCTA) to study chorio-retinal vascularization. OCTA in FHA patients showed an increase in vessel density in the choriocapillaris (CC) layer (both in the fovea area, at 5% p value = 0.037 and in the whole area, at 5% p value = 0.028) and an increase in vascular density in the deep fovea (DVP) (at 10% p value = 0.096) in the whole district compared to controls. Simple linear regressions show a significant negative association between CC vessel density and insulin (p = 0.0002) and glucose values (p = 0.0335) for the fovea district and a negative association between DVP vessel density and endometrial thickness (at 10%, p value: 0.095) in the whole district. Our study shows that CC vessel density is increased in women affected by FHA. This could represent a compensation effort to supply the vascular dysfunction caused by estrogen deficiency. We also found an increasing trend in vascular density in DVP associated with the decrease of endometrial thickness, an indirect sign of estrogenization. Considering that these changes occur in absence of visual defects, they could be used as a biomarker to estimate hypoestrogenism-induced microcirculation changes before clinical appearance.

O-019 Outcomes and correlations between traditional Intracytoplasmic Sperm Injection (ICSI) method and a new AI-enhanced system

Abstract Study question In the context of ICSI, how does the Sperm Tracer Deep Neural Network analysis compare to the embryologist’s sperm selection technique? Summary answer Sperm Tracer AI system significantly improves fertilization rates, offering a standardized, objective approach to sperm selection, but nuanced correlations highlight complexities in sperm parameters. What is known already Traditional sperm selection during ICSI relies on subjective, manual methods, introducing variability and affecting pregnancy success. In response, AI applications, aim to enhance objectivity, potentially improving pregnancy rates. Study design, size, duration Between September and December 2023, the study examined 26 fresh ICSI cycles in a total of 268 sibling oocytes. Men aged 18 years and above with 34.4 mean women’s age. The Sperm Tracer group underwent single embryo culture, while the Embryologists' group underwent group embryo culture. The study analyzes statistical differences in fertilization rates, day 3 and day 5 embryo development. The study duration aligns with the analyzed cycles. Participants/materials, setting, methods The study compared real-time AI-assisted sperm evaluation with the Sperm Tracer system to the traditional ICSI method by embryologists. Correlation analysis was performed for the following kinematic parameters: Amplitude of Lateral Head displacement (ALH), Dance (DNC), Linearity (LIN), Straightness (STR), Wobble (WOB), Curvilinear Velocity (VCL), Linear Velocity (VSL) and Average Path Velocity (VAP). Statistical analysis involved Odds Ratios (OR) with 95% confidence intervals, Mann-Whitney U tests and correlation analyses by Pearson’s coefficient. Main results and the role of chance The Sperm Tracer system exhibited a noteworthy enhancement in fertilization rates (OR: 0.46, 95% Confidence Intervals (CI) [0.23, 0.89], p = 0.0224) but no significant differences in cleavage stages, blastocyst formation, or the production of good-quality embryos compared to conventional methods. For correlation analysis used two groups of sperm population. Group A comprises spermatozoa subjected to ICSI with the Sperm Tracer system, resulting in unsuccessful oocyte fertilization and Group B consists of spermatozoa that achieved successful fertilization. In Group A, correlation analysis identified significant negative associations between DNC and linear parameters (LIN, STR, WOB) (p &amp;lt; 0.001), highlighting the clinical relevance in sperm motility. Group B displayed a distinct negative correlation between DNC and LIN (p = 0.03941), indicating potential effects on sperm linear velocity. LIN in Group A exhibited strong negative correlations with WOB (p = 0.0001), moderate negative correlations with STR (p = 0.0028), and VCL (p = 0.0773). Moreover, ALH analysis in Group A unveiled robust negative correlations with LIN, STR, and WOB, suggesting clinical significance in sperm motility. These intricate findings underscore the Sperm Tracer system's primary advantage in optimizing fertilization rates, offering valuable insights for refining sperm selection strategies in assisted reproduction. Limitations, reasons for caution The study faces limitations due to a small sample, impacting generalizability. Divergence in culture embryo strategies introduces bias, necessitating validation in larger studies. The system includes morphology analysis, but no data analysis has been conducted. Exploring the correlation between morphology, considering embryo culture variations, and motility could provide valuable insights. Wider implications of the findings This study highlights AI applications like Sperm Tracer, showcasing their potential to improve assisted reproduction outcomes. Recognizing AI's impact on IVF success is vital for adoption. Integrating AI into clinic protocols may boost IVF efficiency, requiring training for embryologists to ensure effective utilization. Trial registration number Not applicable

The effect of air pollution on selected immune system parameters, 8-isoprostane, and alpha-1-antitrypsin of people living in environmentally distinct regions

BackgroundAir pollution is associated with adverse health effects, especially on the respiratory and cardiovascular systems, but according to recent research, even in cognitive health, metabolic, and immune systems. The objective was to analyse the effect of long-term exposure to air pollution on selected immune system parameters, 8-isoprostane a parameter of oxidative stress, and alpha-1-antitrypsin a protease inhibitor.MethodsThe number of 381 probands aged 35–65 from two differently polluted regions was included. Lifetime exposures to PM10, PM2.5, NO2, B(a)P, and benzene for each proband were calculated based on historical pollutant concentrations observed. The selected blood parameters were analysed in relation to independent variables (air pollutants, socioeconomic factors, etc.) using multiple regression. Possible covariates were determined. In its end, the study was conceived as a case–control study, and the odds ratio was quantified, expressing the strength of the association of the monitored parameters with the region.ResultsThe average lifetime exposures to air pollution were significantly different between the two regions. Significant effects of the region were observed on IgM, IL-6, 8-isoprostane, and alpha-1-antitrypsin levels. The strongest positive association was observed between 8-isoprostane levels and benzene, PM2.5, PM10 and B(a)P. Odds ratio was 3.21 (95%CI 1.61–6.38). A significant negative association between all pollutants and IgM levels was observed even with covariate adjustment. Odds ratio was 1.80 (95%CI 1.15–2.82). A significant negative association between the alpha-1-antitrypsin levels and PM10, PM2.5, and benzene was found, independent of smoking as a covariate factor. Odds ratio was 1.77 (95%CI 1.09–2.87). In the case of IL-6, a significant effect of especially sleep as a covariate was observed. After covariates adjustment, a significant positive association between the IL-6 levels and PM10 and benzene was only observed. The odds ratio was 1.95 (95%CI 1.28–2.97).ConclusionsThe study confirmed that long-term exposure to air pollutants is associated with reduced levels of the protease inhibitor alpha-1-antitrypsin and decreased immune system performance by IgM. Furthermore, long-term exposure to air pollutants was associated with increased oxidative stress in humans, measured by 8-isoprostane levels. Residents who live in an industrial, environmentally polluted region showed elevated levels of IL-6.

Sex differences in physical functioning among older adults: cross-sectional results from the OUTDOOR ACTIVE study

BackgroundMaintaining good functional ability is a key component of healthy ageing and a basic requirement for carrying out activities of daily living, staying independent, and delaying admission to a nursing home. Even though women have a higher life expectancy and slower age-related muscle mass loss than men, they often show a higher prevalence of limitations in physical functioning. However, the reasons behind these sex differences are still unclear. Therefore, the aims of this study were to investigate sex differences among older adults regarding physical functioning and to study which factors are explaining these sex differences.MethodsCross-sectional data from participants of the OUTDOOR ACTIVE study residing in Bremen, Germany, aged 65 to 75 years, were included in the analyses. Physical functioning was assessed via a self-administered questionnaire using the SF-36 10-item Physical Functioning Scale. Social, lifestyle, and health-related factors were also assessed using the questionnaire. Physical activity was measured objectively using wrist-worn accelerometers over seven consecutive days. Descriptive analyses with absolute and relative frequencies, means and standard deviations, as well as T-tests and chi-square tests were carried out. To test for associations between sex, physical functioning, and several individual factors, linear regressions were performed.ResultsData of 2 141 participants (52.1% female) were included in the study. Women and men showed statistically significant differences in physical functioning, with men perceiving fewer limitations than women. On average, women had a physical functioning score of 81.4 ± 19.3 and men 86.7 ± 17.0. Linear regression showed a statistically significant negative association between physical functioning score and sex (β: -0.15, 95% CL: -0.19, -0.10). The association remained statistically significant when adding individual factors to the model. All factors together were only able to explain 51% of the physical functioning-sex association with health indicators and the presence of chronic diseases being the most influential factors.ConclusionsWe found sex differences in physical functioning, with older women having more limitations than older men. The results showed that health-related factors and chronic diseases played the biggest roles in the different physical functioning scores of women and men. These findings contribute to future longitudinal, more in-depth research.Trial registrationGerman Clinical Trials Register DRKS00015117 (Date of registration 17-07-2018).

End-tidal-to-arterial PCO2 ratio as a prognostic value in mechanically ventilated patients at respiratory intensive care unit

Background Dead space refers to the part of each tidal volume that does not contribute to gas exchange. It serves as an indicator of lung function efficiency. Aim To evaluate the end-tidal-to-arterial PCO2 ratio and Acute Physiological and Chronic Health Assessment (APACHE IV) scoring system as prognostic values in mechanically ventilated patients at the respiratory intensive care unit (ICU). Patients and methods This prospective cohort research was done on 40 mechanically ventilated patients due to different respiratory causes who were admitted at the respiratory ICU at Ain Shams University hospitals. Results This study found that decreasing end tidal PCO2 (PETCO2)/arterial carbon dioxide (PaCO2) is associated with higher mortality amongst mechanically ventilated cases in respiratory ICU. A significant negative association between APACHE IV score and end-tidal to arterial PCO2 ratio following 1 h and after 24 h of mechanical ventilation. APACHE IV score showed a significant relation with mortality, being higher in survivors than nonsurvivors. Conclusion PETCO2/PaCO2 is a relevant prognostic value that reflects dead space ventilation among mechanically ventilated patients in respiratory ICU. APACHE IV score is a good mortality predictor in respiratory ICU.

Harmony found: Serenity's crucial role in alleviating death anxiety through attachment styles among community-dwelling older adults

ObjectiveExplore the mediating effect of serenity in the relationships between attachment styles and death anxiety among older adults DesignA descriptive correlational research design following Strengthening Reporting of Observational Studies in Epidemiology guidelines. MethodsData were collected from 250 older adults attending three clubs. ToolsArabic Scale of Death Anxiety, Brief Serenity Scale, and Revised Adult Attachment Scale were used to collect data. ResultsMost participants exhibited high levels of serenity, with varying degrees of attachment styles and death anxiety. Correlation analysis indicates significant negative associations between death anxiety and serenity, as well as attachment styles. Secure attachment styles were positively correlated with serenity and negatively with death anxiety. Path analysis revealed that serenity partially mediated the relationship between attachment styles and death anxiety. Conclusion and implicationsFostering secure attachments and promoting serenity to mitigate death anxiety in older adults, enhancing later-life psychological well-being through informed interventions.