Similar Linear Association Research Articles

Validating a universal measurement scale and standardized, reproducible unit for gross motor development.

To validate a universal measurement scale and unit for gross motor development across multiple instruments. Retrospective cohorts SETTING: Community and clinic PARTICIPANTS: Item difficulty calibrations were extracted from three published studies. 4,445 children from Brazil and Taiwan between the ages of 0 to 77 months with similar percentages of males and females were included. Majority were typically developing children with 655 having atypical development due to a variety of medical conditions. None MAIN OUTCOME MEASURES: Gross Motor Units (GMU) and observed item difficulty calibrations for items on the Peabody Developmental Motor Scales-2 locomotor and stationary subscales and the Denver II gross motor subscale. There was a strong linear association between observed item difficulty for a sample of children with typical development and a mixed sample of typical and atypical development for the PDMS-2 locomotor and stationary subscales, respectively (locomotor subscale, disattenuated r = 0.97; stationary subscale, disattenuated r = 0.98). GMUs had strong linear associations with observed difficulty for items on the PDMS-2 locomotor and stationary subscales (disattenuated r = 0.88-1.00) for each scale when correcting for measurement error. A similar linear association was found between GMUs and observed difficulty for items on the Denver II gross motor subscale (r = 0.90). The results of this study found that GMUs have a strong linear association with observed difficulty for gross motor development items from the PDMS-2 locomotor and stationary subscales and Denver II gross motor subscale. The strong association between observed item difficulties for children with typical and atypical development, across multiple scales suggests the GMU and construct specification equation can provide a means for consolidating all gross motor development items onto the same scale.

Dose-response association between transportation noise exposure and type 2 diabetes: A systematic review and meta-analysis of prospective cohort studies.

To examine the longitudinal association between transportation noise exposure (road traffic, aircraft, and railway noise) and T2D in a meta-analysis. We systematically searched PubMed, Embase, Scopus, Cochrane, and Web of Science published up to February 2022. The GRADE approach was used to evaluate the study quality, and the pooled effect estimate was calculated by the fixed-effects model or the random-effects model. We included 10 prospective studies with a total of 4,994,171 participants and 417,332 T2D cases in the meta-analysis. According to the Navigation guide, 8 studies out of 10 were rated as having a probably high or high risk of bias. For road noise, the pooled relative risk (RR) per 10dB higher Lden for developing T2D was 1.06 (95% CI:1.03, 1.09) with high heterogeneity (I2 =90.1%, p<0.001). Similar associations were also observed in aircraft and railway noise: the pooled RR were separately were: 1.01 (1.00, 1.01) and 1.02 (1.01, 1.03) separately. A 'dose-response' analysis found a similar linear association between road noise exposure and the risk of T2D. An overall 6% increase in the risk of T2D per 10dB increase in road exposure was observed. Further studies are needed to confirm our findings, especially for aircraft and railway noise, and to identify the mechanisms involved.

Impact of Different Measures of Body Size on the Radiation Dose During Coronary Angiography and Percutaneous Coronary Intervention: Results from a Large Single Center Cohort.

Efforts to reduce and optimize the radiation exposure during coronary angiography and intervention have pointed at patients' body size as a major determinant of irradiation for the patients and operators. We aimed at comparing body weight and body mass index (BMI) among consecutive patients undergoing angiographic procedures (coronary angiography and/or interventions) in a single center. Patients were divided in normal weight (NW, BMI <25Kg/m2) and overweight (OW, BMI ≥25Kg/m2). Patients' dose exposure was evaluated as dose area product (DAP), time of exposure (fluoroscopy duration), and relative DAP (DAP/minutes of exposure). We included 748 patients, 61.6% undergoing percutaneous coronary interventions and 56.8% classified as OW. OW patients were more often men (P < .001), with history of hypertension (P < .001) and diabetes (P = .001). Mean DAP and relative DAP were significantly higher among OW compared with NW patients (P < .001). DAP and relative DAP were directly related with body weight (both r = .22, P < .001); a similar linear association was also described for BMI (r = .18, P < .001 and r = .19, P < .001, respectively). At multivariate analysis, however, body weight, but not BMI, independently predicted the DAP. Therefore, body weight should be considered as the preferred indicator of body size in the setting and optimization of radiation exposure during coronary diagnostic and intervention procedures.

Improvement in VO2peak predicts readmissions for cardiovascular disease and mortality in patients undergoing cardiac rehabilitation.

Improvement in exercise capacity is a main goal of cardiac rehabilitation but the effects are often lost at long-term follow-up and thus also the benefits on prognosis. We assessed whether improvement in VO2peak during a cardiac rehabilitation programme predicts long-term prognosis. We performed a retrospective analysis of 1561 cardiac patients completing cardiac rehabilitation in 2011-2017 in Copenhagen. Mean age was 63.6 (11) years, 74% were male and 84% had coronary artery disease, 6% chronic heart failure and 10% heart valve replacement. The association between baseline VO2peak and improvement after cardiac rehabilitation and being readmitted for cardiovascular disease and/or all-cause mortality was assessed with three different analyses: Cox regression for the combined outcome, for all-cause mortality and a multi-state model. During a median follow-up of 2.3 years, 167 readmissions for cardiovascular disease and 77 deaths occurred. In adjusted Cox regression there was a non-linear decreasing risk of the combined outcome with higher baseline VO2peak and with improvement of VO2peak after cardiac rehabilitation. A similar linear association was seen for all-cause mortality. Applying the multi-state model, baseline VO2peak and change in VO2peak were associated with risk of a cardiovascular disease readmission and with all-cause mortality but not with mortality in those having an intermediate readmission for cardiovascular disease. VO2peak as well as change in VO2peak were highly predictive of future risk of readmissions for cardiovascular disease and all-cause mortality. The predictive value did not extend beyond the next admission for a cardiovascular event.

The Role of Post-Neoadjuvant Chemotherapy Tumor Volume for Prognostication and Treatment Guidance in Loco-Regionally Advanced Nasopharyngeal Carcinoma.

The value of post-neoadjuvant chemotherapy (NACT) tumor volume for prognostication in loco-regionally advanced nasopharyngeal carcinoma (LA-NPC) is unascertained. Here, we recruited 4109 histologically proven LA-NPC (stage III-IVA) that were treated with radical chemo-intensive-modulated radiotherapy (IMRT). Post-NACT gross primary tumor (GTVp) and lymph node (GTVnd) volumes of each patient were calculated from planning computed tomography (CT). We observed similar linear association between GTVp/GTVnd and overall survival (OS); thresholds of 52 cm3 for GTVp and 12 cm3 for GTVnd were consistent for risk discretization for OS, disease-free survival (DFS), distant metastasis-free survival (DMFS), and local relapse-free survival (LRFS). Recursive partitioning analysis (RPA) modelling incorporating T-/N-categories and GTVp/GTVnd yielded four T-N-volume (TNV) risk groupings with disparate OS (p < 0.001). TNV risk stratification outperformed GTVp/GTVnd and eighth edition TNM for predicting OS (AUC 0.643 vs. 0.541–0.591; p < 0.001), DFS (0.629 vs. 0.545–0.580; p < 0.001), and DMFS (0.652 vs. 0.522–0.621; p < 0.001). NACT + concurrent chemoradiotherapy (CCRT) over NACT + IMRT was not superior for low- and low–intermediate-risk groupings (p > 0.05 for both), but superior for intermediate- and high-risk groupings in terms of OS (HR 0.68 (95% CI 0.47–0.99) for intermediate risk, 0.73 (0.55–0.97) for high risk; both p < 0.05). Overall, GTVp/GTVnd represent effective indicators for prognostication and decision-making in LA-NPC after NACT.

Blood pressure levels and risk of cardiovascular disease mortality among Japanese men and women: the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study).

To examine the association of blood pressure (BP) with cardiovascular mortality in real-world settings and investigate whether that association varied by use of antihypertensive medication at baseline. Data from 27 728 Japanese men and women, aged 40-79 years, free of stroke, coronary heart disease, cancer, and kidney disease at entry (1988-1990) were used in this study. Mortality surveillance was completed through 2009, resulting in 449 800 person-years of follow-up. Hazard ratios for cardiovascular mortality were analysed by BP category (based on 2018 European guidelines) at admission. There were 1477 deaths from cardiovascular diseases (CVDs). Relative to high-normal BP at admission, the multivariable hazard ratios (95% confidence intervals) of CVD were 0.85 (0.69-1.04) for optimal BP; 0.96 (0.81-1.15) for normal BP; 1.26 (1.09-1.46) for Grade 1 hypertension; and 1.55 (1.31-1.84) for Grade 2-3 hypertension. A similar linear association was observed among persons not taking antihypertensive medication at admission. Among patients treated for hypertension, a U-shaped association with CVD mortality was observed; hazard ratios = 2.31 (1.25-4.27), 1.68 (1.05-2.69), 1.56 (1.10-2.22), and 1.63 (1.13-2.36), respectively. Similar patterns were observed for stroke and coronary heart disease, although not always statistically significant. BP categories at baseline were linearly and positively associated with CVD mortality overall and also among participants not taking antihypertensive medication. A higher risk of mortality from CVD was observed among patients already treated for hypertension with optimal and normal BPs than those with high-normal BP, suggesting the importance of careful monitoring of BP and comorbidities of such patients.

Dietary glycemic index, glycemic load, and refined carbohydrates are associated with risk of stroke: a prospective cohort study in urban Chinese women

Epidemiologic evidence on dietary carbohydrates and stroke risk remains controversial. Very few prospective cohort studies have been conducted in Asian populations, who usually consume a high-carbohydrate diet and have a high burden of stroke. We examined dietary glycemic index (GI), glycemic load (GL), and intakes of refined and total carbohydrates in relation to risks of total, ischemic, and hemorrhagic stroke and stroke mortality. This study included 64,328 Chinese women, aged 40-70 y, with no history of cardiovascular disease, diabetes, or cancer. A validated, interviewer-administered food-frequency questionnaire was used to assess usual dietary intakes at baseline and during follow-up. Incident stroke cases and deaths were identified via follow-up interviews and death registries and were confirmed by review of medical records and death certificates. During mean follow-ups of 10 y for stroke incidence and 12 y for stroke mortality, we ascertained 2991 stroke cases (2750 ischemic and 241 hemorrhagic) and 609 stroke deaths. After potential confounders were controlled for, we observed significant positive associations of dietary GI and GL with total stroke risk; multivariable-adjusted HRs (95% CIs) for high compared with low levels (90th compared with 10th percentile) were 1.19 (1.04, 1.36) for GI and 1.27 (1.04, 1.54) for GL (both P-linearity < 0.05 and P-overall significance < 0.05). Similar linear associations were found for ischemic stroke, but the associations with hemorrhagic stroke appeared to be J-shaped. Similar trends of positive associations with stroke risks were suggested for refined carbohydrates but not for total carbohydrates. No significant associations were found for stroke mortality after multivariable adjustment. Our results suggest that high dietary GI and GL, primarily due to high intakes of refined grains, are associated with increased risks of total, ischemic, and hemorrhagic stroke in middle-aged and older urban Chinese women.

Association between amount of sleep, daytime sleepiness and health-related quality of life in schoolchildren.

To analyse the association between amount of sleep and daytime sleepiness and health-related quality of life in schoolchildren during adolescence and to study the effect of age on this association. Sufficient sleep is essential for the health of children and adolescents. Sleep influences almost all dimensions of life. A 5-year prospective follow-up study (2004-2010) following 568 Finnish schoolchildren aged between 10-15. The amount of sleep and perceived daytime sleepiness were assessed by a special questionnaire added to The Health Behaviour in School-aged Children questionnaire. The Finnish version of the Paediatric Quality of Life Inventory was used to assess health-related quality of life. The data were collected in 2004, 2006 and 2009/2010. Data were analysed with hierarchical linear mixed models. The more daytime sleepiness occurred, the lower the health-related quality of life was and similar linear association was seen in every age group. The amount of sleep was significantly positively linearly associated with health-related quality of life but not persistent across age groups. Positive association was significant at 15years of age but not at other age groups. Similar linear association between daytime sleepiness and school-related sub scores was also found. Sufficient sleep is essential for health-related quality of life and should be protected and measured in the school health service.

Lean Body Mass and Survival in Hemodialysis Patients and the Roles of Race and Ethnicity

Lean body mass (LBM) represents the "fat-free" muscle mass in hemodialysis (HD) patients and is an important nutritional measure. Previous studies have found that both higher LBM and body mass index (BMI) were related to greater survival in HD patients. Additional studies have shown differences in survival across racial-ethnic groups of HD patients. However, the association of LBM and mortality across racial-ethnic subgroups has not been examined. We hypothesize that racial differences in LBM affect the mortality in HD patients. Chronic HD patients from a large dialysis organization in the United States. Estimated LBM (eLBM), self-identified racial subgroups. 5-year survival. We examined the association between baseline eLBM and survival using Cox proportional hazard models adjusted for demographics, comorbidities, and laboratory measures. Associations were examined across subgroups of race-ethnicity (non-Hispanic white, African American, and Hispanic) and BMI. The final cohort included 117,683 HD patients, who were 62±15 (mean±standard deviation) years old, 43% women and 59% with diabetes mellitus. Higher eLBM was linearly associated with lower mortality. Compared with the reference group (48.4-<50.5kg), patients with the lowest eLBM (<41.3kg) had a 1.4-fold higher risk of mortality (hazard ratio: 1.37; 95% confidence interval: 1.30-1.44) in the fully adjusted model. A similar linear association was seen among patients with BMI < 35kg/m(2) and in non-Hispanic whites and African American subgroups. However, higher eLBM was not associated with improved survival in Hispanic patients or patients with BMI ≥ 35kg/m(2). Potential residual confounding. Higher eLBM is associated with a lower mortality risk in HD patients, especially among non-Hispanic white and African American groups. Hispanic patients do not demonstrate a similar inverse relationship. The association between LBM and mortality among different racial groups of HD patients deserves additional study.

Dietary fibre intake and risks of cancers of the colon and rectum in the European prospective investigation into cancer and nutrition (EPIC).

BackgroundEarlier analyses within the EPIC study showed that dietary fibre intake was inversely associated with colorectal cancer risk, but results from some large cohort studies do not support this finding. We explored whether the association remained after longer follow-up with a near threefold increase in colorectal cancer cases, and if the association varied by gender and tumour location.Methodology/Principal FindingsAfter a mean follow-up of 11.0 years, 4,517 incident cases of colorectal cancer were documented. Total, cereal, fruit, and vegetable fibre intakes were estimated from dietary questionnaires at baseline. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models stratified by age, sex, and centre, and adjusted for total energy intake, body mass index, physical activity, smoking, education, menopausal status, hormone replacement therapy, oral contraceptive use, and intakes of alcohol, folate, red and processed meats, and calcium. After multivariable adjustments, total dietary fibre was inversely associated with colorectal cancer (HR per 10 g/day increase in fibre 0.87, 95% CI: 0.79–0.96). Similar linear associations were observed for colon and rectal cancers. The association between total dietary fibre and risk of colorectal cancer risk did not differ by age, sex, or anthropometric, lifestyle, and dietary variables. Fibre from cereals and fibre from fruit and vegetables were similarly associated with colon cancer; but for rectal cancer, the inverse association was only evident for fibre from cereals.Conclusions/SignificanceOur results strengthen the evidence for the role of high dietary fibre intake in colorectal cancer prevention.

Prospective Evaluation of the Mucosa-Associated Microbiota Using 454 Pyrosequencing at Crohn's Surgery and 6 Months Later Reveals Loss of Diversity and Specific Phyla Changes Associated With Disease Recurrence

outcome of CDI (Figure 1). Validation in a separate cohort of 150 CDI patients demonstrated a similar linear association between higher scores and worse clinical outcome of CDI (Figure 2). In the combined cohort, individuals with a score of 1 had a risk of severe clinical outcomes of 5%, individuals with scores of 2-4 had a risk of severe clinical outcome of 13%, while individual with scores 5-7 had a risk of severe clinical outcome of 36%. Conclusions: We derived and validated a clinical prediction rule for severe CDI that can be used to identify high risk patients who will be likely to benefit from early administration of vancomycin.

Racial and Ethnic Differences in the Relationship Between Depression Severity and Functional Status

Major depression has a negative impact on functional status and quality of life, but little is known about racial or ethnic differences in the relationship between depression and functional disability. This study compared the association between depression severity and functional status among three different racial or ethnic groups. Data were from participants in the original Patient Health Questionnaire (PHQ) Primary Care Study and PHQ Obstetrics-Gynecology Study (N=5,427). Among the study participants, 62.0 percent were non-Hispanic white, 14.8 percent were African American, and 23.1 percent were Latino. Depression severity was assessed with the PHQ-9, the self-administered DSM-IV criteria-based depression module of the PHQ diagnostic instrument for mental disorders. Functional status was measured with the scales of the Medical Outcomes Study 20-item Short Form Health Survey (SF-20), self-reported disability days, clinic visits, and symptom-related difficulty. Groups were compared in terms of mean PHQ-9 scores and functional status at varying levels of depression severity. Linear regression was used to control for age, gender, education level, and language. Mean PHQ-9 scores were not significantly different between the three different racial or ethnic groups. Similar linear associations were found in all three racial or ethnic groups between increasing PHQ-9 scores (more severe depression) and worsening function on the SF-20 scales and an increased number of disability days and clinic visits. Latinos reported significantly less functional impairment on all measures of functionality compared with non-Hispanic whites. Functional impairment increased with increasing levels of depression severity in all three racial or ethnic groups, although Latinos consistently reported fewer functional disturbances compared with non-Hispanic whites.

Exposure-Effect Relations between Aircraft and Road Traffic Noise Exposure at School and Reading Comprehension

Transport noise is an increasingly prominent feature of the urban environment, making noise pollution an important environmental public health issue. This paper reports on the 2001-2003 RANCH project, the first cross-national epidemiologic study known to examine exposure-effect relations between aircraft and road traffic noise exposure and reading comprehension. Participants were 2,010 children aged 9-10 years from 89 schools around Amsterdam Schiphol, Madrid Barajas, and London Heathrow airports. Data from The Netherlands, Spain, and the United Kingdom were pooled and analyzed using multilevel modeling. Aircraft noise exposure at school was linearly associated with impaired reading comprehension; the association was maintained after adjustment for socioeconomic variables (beta = -0.008, p = 0.012), aircraft noise annoyance, and other cognitive abilities (episodic memory, working memory, and sustained attention). Aircraft noise exposure at home was highly correlated with aircraft noise exposure at school and demonstrated a similar linear association with impaired reading comprehension. Road traffic noise exposure at school was not associated with reading comprehension in either the absence or the presence of aircraft noise (beta = 0.003, p = 0.509; beta = 0.002, p = 0.540, respectively). Findings were consistent across the three countries, which varied with respect to a range of socioeconomic and environmental variables, thus offering robust evidence of a direct exposure-effect relation between aircraft noise and reading comprehension.

Evaluation of Simmental carcass EPD estimated using live and carcass data1

This study was conducted to compare carcass EPD predicted using yearling live animal data and/or progeny carcass data, and to quantify the association between the carcass phenotype of progeny and the sire EPD. The live data model (L) included scan weight, ultrasound fat thickness, longissimus muscle area, and percentage of intramuscular fat from yearling (369 d of age) Simmental bulls and heifers. The carcass data model (C) included hot carcass weight, fat thickness, longissimus muscle area, and marbling score from Simmental-sired steers and cull heifers (453 d of age). The combined data model (F) included live animal and carcass data as separate but correlated traits. All data and pedigree information on 39,566 animals were obtained from the American Simmental Association, and all EPD were predicted using animal model procedures. The genetic model included fixed effects of contemporary group and a linear covariate for age at measurement, and a random animal genetic effect. The EPD from L had smaller variance and range than those from either C or F. Further, EPD from F had highest average accuracy. Correlations indicated that evaluations from C and F were most similar, and L would significantly (P < 0.05) re-rank sires compared with models including carcass data. Progeny (n = 824) with carcass data collected subsequent to evaluation were used to quantify the association between progeny phenotype and sire EPD using a model including contemporary group, and linear regressions for age at slaughter and the appropriate sire EPD. The regression coefficient was generally improved for sire EPD from L when genetic regression was used to scale EPD to the appropriate carcass trait basis. The EPD from C and F had similar linear associations with progeny phenotype, although EPD from F may be considered optimal because of increased accuracy. These data suggest that carcass EPD based on a combination of live and carcass data predict differences in progeny phenotype at or near theoretical expectation.

Evaluation of Simmental carcass EPD estimated using live and carcass data.

This study was conducted to compare carcass EPD predicted using yearling live animal data and/or progeny carcass data, and to quantify the association between the carcass phenotype of progeny and the sire EPD. The live data model (L) included scan weight, ultrasound fat thickness, longissimus muscle area, and percentage of intramuscular fat from yearling (369 d of age) Simmental bulls and heifers. The carcass data model (C) included hot carcass weight, fat thickness, longissimus muscle area, and marbling score from Simmental-sired steers and cull heifers (453 d of age). The combined data model (F) included live animal and carcass data as separate but correlated traits. All data and pedigree information on 39,566 animals were obtained from the American Simmental Association, and all EPD were predicted using animal model procedures. The genetic model included fixed effects of contemporary group and a linear covariate for age at measurement, and a random animal genetic effect. The EPD from L had smaller variance and range than those from either C or F. Further, EPD from F had highest average accuracy. Correlations indicated that evaluations from C and F were most similar, and L would significantly (P < 0.05) re-rank sires compared with models including carcass data. Progeny (n = 824) with carcass data collected subsequent to evaluation were used to quantify the association between progeny phenotype and sire EPD using a model including contemporary group, and linear regressions for age at slaughter and the appropriate sire EPD. The regression coefficient was generally improved for sire EPD from L when genetic regression was used to scale EPD to the appropriate carcass trait basis. The EPD from C and F had similar linear associations with progeny phenotype, although EPD from F may be considered optimal because of increased accuracy. These data suggest that carcass EPD based on a combination of live and carcass data predict differences in progeny phenotype at or near theoretical expectation.