Spearman Regression Research Articles

Investigation of the Effect of Parents' Moral Maturity on Child Raising Styles

Throughout their lives, people live with the moral principles that come from their families. It takes a long time for them to realize this. The attitude of parents towards their children is directly effective in shaping the character traits of the child. In other words, the future of a person directly depends on his/her family. In this respect, the family, with its cognitive, emotional and social effects, is the most influential factor in the development of the child compared to most environmental factors. In this study, the effect of parents' moral maturity on their child-rearing styles is examined. Relational survey model, one of the methods based on quantitative research approaches, was used in the study. The sample of the study consisted of 258 parents reached through convenience sampling method. Mann-Whitney U test, Kruskal-Wallis H test, Spearman Correlation analysis and Regression analysis were used in data analysis. As a result of the analyzes, it was determined that there were statistically significant differences in all sub-dimensions of child rearing attitude except incompatibility according to gender, while there were no statistically significant differences in the moral maturity dimension according to gender. Moral maturity, child rearing attitude and all sub-dimensions differed statistically according to age and educational status. According to monthly income, there are statistically significant differences in moral maturity, child rearing attitude and all sub-dimensions except democratic attitude and equality recognition sub-dimension. There are statistically significant relationships between moral maturity and democratic attitude and recognizing equality, rejection of the role of housewife and strict discipline sub-dimensions. While there are positive relationships between moral maturity and democratic attitude and recognizing equality and strict discipline, there is a negative relationship between moral maturity and rejecting the role of housewife. Moral maturity significantly explains about 23 percent of the variance in the total score of child rearing attitude sub-dimensions.

Cardiovascular disease burden linked to particulate matter pollution in Latin America and the Caribbean: Insights from GBD 2021 and socio-demographic index analysis

ObjectivesThis study aimed to analyze the burden of cardiovascular disease (CVD) attributable to particulate matter (PM) pollution in Latin American and Caribbean (LAC) countries and territories, and its relationship with the Socio-Demographic Index (SDI). Study designA cross-sectional analysis was conducted. MethodsThe disability-adjusted life years (DALYs) and the SDI data were obtained from the Global Burden of Disease Study 2021. Spearman's regression coefficients (rho) and 95 % confidence intervals (CI) were used to evaluate the relationship of interest. ResultsWe computed a total of 22,231,164 disability-adjusted life years DALYs due to CVD in 2021, with an age-standardized rate of 3742 DALYs per 100,000 population. Ischemic heart disease and ischemic stroke were predominant. PM pollution was responsible for 2,974,358 DALYs (12.1 % of total CVD DALYs), varying widely across regions, with the highest attributable fractions observed in Haiti, Honduras, and Guatemala. A negative linear relationship (rho = −0.73, 95 % CI -0.95 to −0.51) was observed between PM pollution-attributable CVD burden and SDI, indicating a higher burden in regions with lower SDI. Public health interventions targeting PM pollution could substantially mitigate the burden of CVD, particularly in vulnerable populations identified in this study. ConclussionsThese findings underscore the critical importance of environmental policies and interventions aimed at reducing PM pollution, and underlying socio-economic disparities, to alleviate the health impact of CVD in LAC countries and territories.

Quantitative analysis of impact of human activities on soil erosion using the RUSLE model in a typical karst area in Guizhou, China.

Human activities have significant influence on soil erosion in karst areas. The spatial and temporal evolution of soil erosion in Guizhou Province was evaluated using the Revised Universal Soil Loss Equation (RUSLE), which revealed an increasing trend in the initial data analysis for the soil erosion modulus. To disclose the impact of human activities on regional soil erosion, the soil erosion in 2000, 2010, and 2020 was analyzed. The results show the following: (1) The average values of the soil erosion modulus in the study area for 2000, 2010, and 2020 were 4.479, 4.945, and 5.806 t·hm-2·a-1, respectively; when considering human activities without the influence of rainfall erosivity, these values were 4.679, 4.963, and 4.799 t·hm-2·a-1. The influence of human activities on soil erosion is gradually becoming a positive force. (2) According to the Spearman regression analysis, the top four factors related to soil erosion in 2000 and 2010 were soil loss risk (E, 0.721 and 0.737), anti-erosion factors (Pr, - 0.236 and - 0.221), rock exposure rate (0.222 and 0.279), and altitude (0.210 and 0.195). In 2020, the top four factors were Pr (0.725), land surface temperature (LST, 0.268), NDVI (- 0.232), and E (0.186). In the first two stages, soil erosion is closely related to natural factors, while in 2020, soil erosion is more closely related to human activities. (3) The geographically weighted regression (GWR) showed the highest range of regression coefficients for Pr (150), followed by E and NDVI (25), rock exposure rate (10), and land surface temperature (LST) (1.5). The rainfall erosivity is increasing annually as a consequence of global climate change. This rise in rainfall erosivity has resulted in a corresponding increase in soil erosion in the study area, which obscures the positive impact of human activities in the reduction of soil erosion.

Assessing osteoporosis and bone mineral density through 18F-NaF uptake at lumbar spine.

The use of 18F-Sodium fluoride (NaF) PET/CT is established in the detection of metastatic bone disease, yet its utility in osteoporosis remains underexplored. This research aims to assess the variations in 18F-NaF uptake among individuals with differing bone mineral density (BMD) and to examine the relationship between 18F-NaF uptake and BMD. In this retrospective study, 199 patients (average age 56 ± 6, comprising 52 males and 147 females) with a history of cancer were analyzed. Each participant underwent both 18F-NaF PET/CT and lumbar dual-energy X-ray absorptiometry (DXA) scans within a span of 7days. Based on DXA outcomes, patients and their lumbar vertebrae were categorized into normal BMD, osteopenia, and osteoporosis groups. The lumbar 18F-NaF uptake across these groups were compared, and to explore the association between lumbar standardized uptake values (SUV) values and BMD. The efficacy of 18F-NaF uptake in diagnosing osteoporosis or osteopenia was also evaluated. Analysis was conducted using Mann-Whitney U tests, Spearman regression, and receiver operating characteristic (ROC) curve analysis through GraphPad Prism 10.0. A total of 796 lumbar vertebrae from 199 patients were measured. It was observed that osteoporotic patients had significantly lower 18F-NaF uptake than those with osteopenia and normal BMD across the L1-L4 lumbar vertebrae (P < 0.0001). In a vertebra-based analysis, normal BMD vertebrae exhibited the highest maximum SUV(SUVmax) compared to osteopenic (8.13 ± 1.28 vs. 6.61 ± 1.01, P < 0.0001) and osteoporotic vertebrae (8.13 ± 1.28 vs. 4.82 ± 1.01, P < 0.0001). There was a positive correlation between lumbar 18F-NaF uptake and BMD across all vertebrae, with correlation coefficients exceeding 0.5 (range: 0.57-0.8). The area under the ROC curve values were notably high, at 0.96 for osteoporosis and 0.83 for osteopenia diagnosis. This study demonstrates distinct 18F-NaF uptake patterns among individuals with varying BMD levels, with a positive correlation between 18F-NaF uptake and BMD. These findings highlight the potential of 18F-NaF PET/CT as a supportive diagnostic method in the management of osteoporosis.

Variability in Liver Size Measurements Using Different View Angles in Ultrasound Imaging.

The aim of this study was to compare liver size measurements in different conventional B-mode ultrasound image (US) field views using magnetic resonance imaging (MRI) measurement as a reference. After receiving Institutional Review Board approval and informed consent, three operators measured the largest sagittal and transverse dimensions of adult livers on three US image field views (90°, 120°, and 140°) with a single curvilinear transducer. We analyzed the differences in liver size across three image field views using one-way analysis of variance (ANOVA) and examined the correlations between MRI and ultrasound measurements using Spearman regression. We used 95% Bland-Altman limits of agreement (95% LOA) to analyze the confidence interval for liver size measurements between MRI and US. Intra-observer and inter-observer reliability in measuring liver size were assessed using intraclass correlation coefficient (ICC). Based on sagittal liver length, 28 adult participants (7 men and 21 women, mean age 43 years) were divided into Group 1 (<17 cm, n = 10) or Group 2 (≥17 cm, n = 18). There was a significant difference in the liver size measurements across the three image field views (P < .001) in both groups. The highest correlation in liver size measurements between MRI and US was with ultra-wide-view (R2 = .87 in sagittal; R2 = .79 in transverse). Bland-Altman LOA also indicated good agreement between MRI and ultra-wide-view measurements. Intra-observer and inter-observer reliability in measuring liver size were good (ICC = 0.82-0.98). The study suggests that ultrasound ultra-wide-view provides the most accurate liver size measurement and good intra- and inter-operator reliability.

Unveiling the Link between Stress Levels and Job Performance among Women in Nepal Banking Sector

The banking sector in Nepal heavily relies on the contributions of female employees. However, concerns regarding the impact of stress levels on their job performance have emerged, given the industry's high-pressure nature and cultural dynamics. This study aims to explore the relationship between stress levels and productivity, efficiency, job satisfaction, and retention rates among female banking professionals in Nepal. A comprehensive investigation was conducted using a Likert scale questionnaire distributed among female employees at Nepal Bank I. The questionnaire assessed various dimensions of job performance, including interpersonal, job, and organizational performance. Spearman correlation analysis and regression techniques were employed to analyze the data and test hypotheses regarding the influence of stress factors on job performance. The study revealed moderate to strong positive correlations between stress factors (job burnout, occupational stress, and psychological stress) and different dimensions of job performance. All nine hypotheses proposed in the study were confirmed, indicating a significant impact of stress on job performance. Regression analysis further supported these findings, highlighting the positive influence of psychological and occupational stresses on organizational and interpersonal performance. The findings underscore the importance of addressing stress factors in the workplace to enhance the well-being and effectiveness of female banking professionals in Nepal. By implementing organizational support and gender-sensitive policies, institutions can create a conducive work environment, leading to increased job satisfaction, productivity, and retention rates among female employees. This study contributes to the existing literature by providing empirical evidence of the relationship between stress levels and job performance specifically among female employees in the banking sector of Nepal. The confirmation of hypotheses and the identification of positive correlations between stress factors and job performance dimensions offer valuable insights for practitioners and policymakers aiming to promote the well-being and effectiveness of female professionals in the industry.

Land Use Intensity Alters Ecosystem Service Supply and Demand as Well as Their Interaction: A Spatial Zoning Perspective

Clarifying the interaction between ecosystem service supply (ESS) and demand (ESD) and its response to land use change is essential for achieving ecological security. Previous research mainly focused on how land use change affects ESS, ignoring its impact on the interaction between ESS and ESD, making it difficult to guide regional sustainability in social–ecological coupled systems. Taking the Yangtze River Delta as the study area, after evaluating five types of ESS and ESD during 2000–2020, this study analyzed the interaction between changes in ESS and ESD using Geodetector from a spatial zoning perspective and subsequently explored the impact of land use intensity on ESS, ESD, and their interaction using Spearman correlation analysis and regression analysis. The results showed that there was obvious spatial–temporal heterogeneity in ESS and ESD. Different ecosystem services varied in their interaction between ESS and ESD, and the demand changes in water conservation and soil retention significantly influenced their supply changes, while supply changes in carbon sequestration were not influenced by its demand changes. The effect of ESD changes on ESS changes also showed spatial heterogeneity. All interactions between ESS changes and ESD changes, except carbon sequestration, were significant in the Supply Increases–Demand Increases zone. Soil retention and water conservation showed a significant supply–demand interaction in the Supply Decreases–Demand Decreases zone and the Supply Decreases–Demand Increases zone, respectively, while no ecosystem service showed significant supply–demand interaction in the Supply Increases–Demand Decreases zone. Land use intensity had linear and nonlinear effects on different ESS and ESD, and it was also found that the effect of ESD changes on corresponding ESS changes was relatively obvious in regions with dramatic land use change. Finally, this paper incorporated the changes in ESS and ESD, as well as their interaction, into land use management, which can provide implications for regional sustainability.

The Pivotal Role of Presepsin in Assessing Sepsis-Induced Cholestasis.

The serum levels of presepsin correlate with parameters indicating cholestasis in sepsis; however, the probability and significance of this association remain uncertain. We aimed to ascertain whether infection, as signaled by presepsin levels, is the primary determinant of elevated biliary parameters in sepsis. A unicenter, retrospective study included 396 COVID-free emergency-admitted patients, in which presepsin level was determined. Presepsin, neutrophil count, leukocyte count, C reactive protein, and fibrinogen evaluated the septic/inflammatory state. The statistically significant factors associated with cholestasis, ALT, and AST were analyzed by Fisher's exact test and Spearman regression with Bonferroni's correction. Presepsin emerged as the most likely variable correlated with all cholestasis markers: alkaline phosphatase (p = 7 × 10-8), gamma-glutamyl transferase (p = 5 × 10-10), and conjugated bilirubin (p = 4 × 10-15). Thrombocyte count, C reactive protein, age, creatinine, urea, lactate, and blood pressure, were associated with only one or two of these markers. In a sepsis setting, the increase in cholestasis-related parameters is associated with presepsin with a higher probability than hemodynamic, inflammatory, or coagulation-related variables. Determining this robust link between sepsis and cholestasis could eliminate unnecessary imaging procedures in critically ill patients, enabling clinicians to focus efforts on addressing the primary infectious cause.

Brain tumor detection in combined 3D MRI and CT images using Dictionary learning based Segmentation and Spearman Regression

Brain tumor detection in combined 3D MRI and CT images using Dictionary learning based Segmentation and Spearman Regression

Multiple sleep disturbances are associated with apathy in individuals with Parkinson's disease

BackgroundParkinson's disease (PD) is associated with both sleep disturbances and apathy, and within PD, apathy has been associated with REM behavior disorder and excessive daytime sleepiness. Whether other forms of sleep disturbance are similarly associated with apathy in PD remains unclear. This study explored associations between a broad array of sleep disturbances and apathy in 50 individuals with idiopathic PD (PD) and 48 matched controls (MC). MethodsParticipants were adults aged 53–80 (Mdn = 67), 23 % female, and 96 % white. Sleep disturbances were measured with various questionnaires (ISI, PSQI, PROMIS-SD, ESS, PROMIS-SRI, RBDSQ). Mood was measured with the STAI and BDI-II. Apathy was evaluated using the Apathy Scale (AS). Spearman correlations and regression analyses were performed between measures of sleep disturbance and AS in the total sample and each group. Group correlations were compared using 2-sample Fisher's z test. ResultsThe AS total score significantly correlated with PROMIS-SRI in the total sample and multiple measures of sleep disturbance in the PD group. The apathy subscales were each significantly correlated with sleep disturbance measures in the total sample, MC, and PD groups. The correlations between several sleep and apathy values were significantly stronger in the PD group than MC. When accounting for anxiety and depression most differences were no longer significant, only the PROMIS-SRI was significantly predictive of the behavioral apathy sub score. DiscussionEvidence supports an association between sleep disturbances and apathy in individuals with PD. Specifically, insomnia severity, poor sleep quality, and daytime sleepiness were uniquely associated with apathy in this group. We did not find these associations in the matched control group. Anxiety and depression are likely involved in the association between sleep and apathy in PD. Experimental studies that manipulate or improve sleep may further elucidate the mechanisms underlying the association between sleep disturbance and apathy in PD.

Application of the blastomere count variations "skip value" in the embryo AI assessment

Objective: To explore the correlation between blastomere count variations "skip value" which extracted from by time-lapse technology (TLT) combined with artificial intelligence (AI) and morphological features of in vitro fertilization (IVF) embryo, and to test its feasibility in clinical applications. Methods: This study was a diagnostic experiment (AI reassessment of embryo transferred patients), a total of 6 545 embryos from 1 226 patients who underwent IVF at the Women and Children's Hospital of Chongqing Medical University from December 2020 to December 2021 were retrospectively analyzed, of which 2 869 embryos were attempted to cultured to blastocyst stage by TLT. The embryo dynamic map (EDM) was drawn by Embryo Viewer, a TLT recording software, based on embryo developmental kinetics. The self-developed AI embryo evaluation software identified and recorded the number of cleavages in real time during embryonic development, and compared with the EDM, the correlation between the skip value formed by the change of cleavage sphere counts and the outcomes of the embryos was analyzed. The correlation among skip value, morphological score of embryo, implantation rate and live birth rate were performed by Spearman and step-up logistic regression. The receiver operating characteristic (ROC) curve was selected for reporting there relationship of skip value and morphology. Finally, predicting power of skip value for implantation and live birth rate were performed by ROC analysis. Results: The total skip values extracted from the blastomere count of embryos (72 hours post-fertilization) were negatively correlated with abnormal cleavage, blastocyst formation rate, day 3 (D3)-cell score, uneven size and fragmentation (the β values were -0.268, -0.116, -0.213, -0.159 and -0.222, respectively; all P<0.001); positively correlated with D3-cell number (β=0.034; P<0.001); negatively correlated with blastocyst formation rate and implantation rate (OR=0.97, 95%CI: 0.93-0.99, P=0.034; OR=0.96, 95%CI: 0.93-0.98, P=0.044). The power of predicting implantation were similar between the order selection of skip values and traditional morphology criteria [area under curve (AUC): 0.679 vs 0.620]. Live birth rate were negatively correlated with female age (OR=0.91, 95%CI: 0.88-0.93; P<0.001), D3 general score (OR=0.77, 95%CI: 0.59-0.99; P=0.045) and order selection of skip values (OR=0.98, 95%CI: 0.96-0.99; P=0.038), while positively correlated with retrieved oocyte number and endometrial thickness in embryo transferred (OR=1.08, 95%CI:1.05-1.11, P<0.001; OR=1.09, 95%CI:1.06-0.12, P<0.001, respectively) from multivariate regression analysis, and the power of predicting live birth was 0.666 for AUC. Conclusions: The skip value and its order form is a systematic quantification of embryo development, correlated with embryo developmental quality and clinical outcome. It could be an addition parameter for embryo culture and selection.

Disaster management competence, disaster preparedness belief, and disaster preparedness relationship: Nurses after the 2023 Turkey earthquake.

To examine the relationship between nurses' competency levels in disaster nursing management, their disaster preparedness and disaster preparedness beliefs. Nurses' competency in disaster nursing management makes disaster response easier. Factors that may affect this reason should be examined. The study was conducted between April and July 2023 with nurses working in a province in the first-degree earthquake zone in Turkey. The sample of the study consisted of a total of 207 nurses who were selected from primary, secondary, and tertiary care institutions by using the stratified sampling method. Data were collected with a personal information form, the Competencies for Disaster Nursing Management Questionnaire, the Disaster Preparedness Scale, and the General Disaster Preparedness Beliefs Scale. Mann-Whitney U and Kruskal-Wallis tests, Spearman regression coefficient, and multiple linear regression analysis were used to analyze the data. There was a positive correlation between nurses' competency levels regarding duties and responsibilities and their disaster preparedness levels. Having disaster-related training also positively affected the level of competence in duties and responsibilities. Belief in disaster preparedness and having "partial" knowledge about the disaster had no relationship with competencies. According to the International Council of Nurses and current studies on disaster nursing, "competence areas" are among the priority study subjects. According to the study results, disaster preparedness and having disaster-related education are effective factors in nurses' competencies related to duties and responsibilities. The results of this study may increase awareness in the healthcare system about nurses' disaster management competency levels and the factors that may affect this. It is recommended that disaster preparedness and disaster-related education factors should be taken into account in the initiatives and policies to be planned to improve the duty and responsibility competence of nurses.

The Impact of Illness Perception on Medication Adherence to Inhaler Therapy in Elderly Individuals With COPD.

Medication adherence to inhaler therapy is pivotal for optimizing the management of COPD. Individuals with COPD often have suboptimal adherence behaviors to inhaler therapy. Illness perception and beliefs about medicines have been proved to be associated with medication adherence. Nevertheless, the influence of illness perception and medication beliefs on adherence to inhaler therapy among elderly individuals with COPD in China remains unclear. A cross-sectional study was conducted in 252 elderly subjects with COPD in China from June 2022-September 2023. The Test of Adherence to Inhalers, the Brief Illness Perception Questionnaire, and the Belief About Medicines Questionnaire (BMQ) were utilized. Spearman correlations, regression analysis, and parallel mediation analysis were employed to assess the correlations and mediating effects among beliefs about medicines, illness perception, and medication adherence to inhaler therapy. Medication adherence to inhaler therapy exhibited a negative correlation with concerns beliefs, while showing positive correlations with illness perception, necessity beliefs, and total BMQ scores. Mediating effects of concerns beliefs and necessity beliefs were observed in the relationship between perception of illness and medication adherence to inhaler therapy. This study suggests that essential interventions targeting beliefs about medicines in elderly individuals with COPD should be implemented to optimize the level of their inhaler adherence, particularly in those with low levels of necessity beliefs or high levels of concerns beliefs.

Associations between sickness behavior, but not inflammatory cytokines, and psychiatric comorbidity in chronic pain

ObjectivesApproximately one in five adults experiences chronic pain, often in co-occurrence with depression, insomnia, anxiety, and lower self-rated health. Elevated levels of cytokines, e.g. tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6), interleukin 8 (IL-8), and interleukin 10 (IL-10), have been identified in patients with chronic pain. Depression, insufficient sleep, poor self-rated health, and pain intensity have also been associated with inflammatory biomarkers. This study aimed to investigate the interrelationships between inflammatory biomarkers and depression, insomnia, anxiety, self-rated health, sickness behavior, and pain intensity in patients with chronic pain. MethodsSelf-report questionnaires and blood samples analyzed for plasma levels of inflammatory biomarkers were collected from 80 adult patients with chronic pain. Associations between inflammatory biomarkers (TNF-α, IL-6, IL-8, IL-10, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR)) and depression, insomnia, anxiety, self-rated health, sickness behavior, and pain intensity, were analyzed using bivariate Spearman rank correlation coefficients and regression analyses. ResultsParticipants were mainly women (72.5 %), with a mean age of 50.8 years, and a reported mean pain duration of 16.7 years. There were significant correlations between insomnia and CRP (rs =.26, p <.05); sex and ESR (rs =.29, p <.05); age and IL-6 (rs =.29, p <.05) and IL-8 (rs =.30, p <.05); BMI and IL-6 (rs =.50, p <.001), CRP (rs =.63, p <.001) and ESR (rs =.42, p <.001). Ratings of depression were positively and significantly related to ratings of sickness behavior and anxiety (β =.32 and β =.40, respectively), explaining 49 % of the total variance in depression ratings. Insomnia was positively and significantly related to sickness behavior (β =.37) explaining 31 % of the total variance in insomnia ratings. Inflammatory biomarkers, however, did not contribute significantly to the models. ConclusionsParticipants reported high levels of symptoms, yet the associations between these ratings and the inflammatory biomarkers were either absent or weak. Also, despite high levels of self-reported sickness behavior, overall the inflammatory status remained within the normal range. Ratings of sickness behavior contributed more than inflammatory markers in explaining ratings of depression and insomnia. The present results point to the complexity of chronic pain, and the challenges of identifying biomarkers that explain symptomatology.

Cardiac substructure radiation dose study of conventional radiotherapy for stage N2-3 non-small cell lung cancer.

e20071 Background: There has been widespread reporting on predictive dose parameters for cardiac substructures in radiotherapy for non-small cell lung cancer (NSCLC). However, most advanced NSCLC patients are staged as N2-3, and there is a lack of research on the dose distribution, dose contribution and prognosis of the heart in conventional radiotherapy for N2-3 stage NSCLC. Methods: Retrospective analysis of 274 patients of stage N2-3 NSCLC treated with radiotherapy (RT) of prescription dose from 60Gy to 70Gy. Experienced radiation oncologists delineated the cardiac substructures. All patients were categorized according to different lymph node irradiation and tumor spatial locations. Spearman and linear regression were used for variation of dose-volume parameters, as well as the impact of different primary tumor locations and irradiated lymph nodes on the parameters of the entire heart and substructures. Receiver operating characteristic (ROC) curves, Kaplan-Meier, and Cox regression were performed on the influencing factors of adverse cardiac events after radiotherapy and prognosis analysis. Results: There are significant differences in the dose-volume parameters of the whole heart and its substructures. Mean heart doses (MHD),and the mean doses (Dmean) for the left atrium, right atrium, right ventricle, left ventricle and the left anterior descending coronary artery (LAD) were 15.7Gy (range 0.2-30.0Gy), 19.7Gy (range 0.3-55.0Gy), 9.7Gy (range 0.3-59.8Gy), 7.9Gy (range 0.1-48.2Gy), 6.4Gy (range 0.1-52.6Gy) and 5.2Gy (range 0.1-45.0Gy), respectively. The left atrium Dmean has the most significant impact on MHD compared to other substructures (B = 0.418, P &lt; 0.05). Dose-volume parameters of the whole heart and the left atrium were positively correlated with the irradiation of the 7th lymph node region (P &lt; 0.05). MHD and left atrium Dmean for tumors located in the lower region were significantly higher than those in the upper region (P &lt; 0.001). Patients with LAD V30 ≥ 26.9% had a significantly higher risk of mortality compared to those with LAD V30 &lt; 26.9% (P = 0.003, HR = 2.883, 95% CI = 1.436-5.788). Conclusions: With the dose distribution differences among the whole heart and its substructures. We observed the base of the heart received the highest dose, the dose to the left atrium is particularly required attention. The irradiation of different lymph nodes and different primary lesions has an impact on the dose variations of different cardiac structures. LAD V30 is an independent influencing factor of overall survival (OS) for N2-3 stage NSCLC. This study provides considerable information for the dose optimization of cardiac substructure in radiotherapy planning for N2-3 stage NSCLC.

Quantitative computed tomography assessment of bone mineral density in adolescent idiopathic scoliosis: correlations with Cobb angle, vertebral rotation, and Risser sign.

Adolescent idiopathic scoliosis (AIS) is a prevalent spinal disorder that can potentially influence bone mineral density (BMD), thereby increasing the susceptibility to osteoporosis and fractures. Early identification of reduced bone mass in AIS patients is crucial for clinicians to develop effective preventive strategies against fractures. This study aims to elucidate the correlation between BMD, as measured by quantitative computed tomography (QCT), and various clinical parameters in AIS, including the Cobb angle, vertebral rotation, and the Risser sign. By revealing the potential influences of these factors on BMD, our findings aim to assist clinicians in making informed and timely decisions regarding AIS management, particularly in situations where QCT is unavailable. A cross-sectional study was conducted on 129 adolescents with AIS who were enrolled at The Third People's Hospital of Chengdu, Sichuan, China, between 2021 and 2023. QCT was employed to assess BMD and vertebral rotation. The Cobb angle and Risser sign were determined through radiographic evaluation, while anthropometric and biochemical data were also collected. Statistical analyses, including Pearson and Spearman rank correlation and regression models, were used to investigate the associations between BMD and clinical measures. A significant negative correlation was found between BMD and Cobb angle (coefficient =-0.663; P<0.001), as well as between BMD and vertebral rotation angle (coefficient =-0.442; P<0.001) in patients with AIS. BMD was positively correlated with increased height (coefficient =0.355; P<0.001) and BMI (coefficient =0.199; P=0.02). A significant association was detected between BMD and the Risser sign (P=0.002). No significant sex-based differences in BMD were observed (P=0.052). No significant correlations were observed between BMD and levels of potassium (K), calcium (Ca), inorganic phosphate (P), and iron (Fe) (P>0.05 all). The binary logistic regression analysis identified Cobb angle as a risk factor of lower BMD presence in AIS patients (coefficient =0.072; OR=1.075; P<0.001). Furthermore, the receiver operating characteristic (ROC) analysis of the combined model for predicting low BMD in AIS patients yielded an area under the curve (AUC) value of 0.900, with an optimal threshold determined as 0.398. The sensitivity and specificity were calculated as 0.816 and 0.900, respectively, indicating a robust predictive capacity. This study highlights the significant inverse correlation observed between BMD measured by QCT and both Cobb angle and vertebral rotation angle in patients with AIS. Furthermore, a notable variation in BMD was found across different Risser sign categories, with BMD values generally increasing as Risser sign levels increased. Additionally, our findings indicate that Cobb angle serves as a risk factor for low BMD presence. Moreover, a combined model was developed to predict the likelihood of low BMD occurrence in AIS patients.

Value of DUSP6 in peripheral blood mononuclear cells in predicting adverse cardiovascular events after peritoneal dialysis in diabetic nephropathy.

Adverse cardiovascular events are the leading cause of death in peritoneal dialysis patients. Identifying indicators that can predict adverse cardiovascular events in these patients is crucial for prognosis. This study aims to assess the value of dual-specificity phosphatase 6 (DUSP6) in peripheral blood mononuclear cells as a predictor of adverse cardiovascular events after peritoneal dialysis in diabetic nephropathy patients. A total of 124 diabetic nephropathy patients underwent peritoneal dialysis treatment at the Department of Nephrology of the First Affiliated Hospital of Hebei North University from June to September 2022 were selected as study subjects. The levels of DUSP6 in peripheral blood mononuclear cells were determined using Western blotting. Patients were categorized into high-level and low-level DUSP6 groups based on the median DUSP6 level. Differences in body mass index, serum albumin, high-sensitivity C-reactive protein, and dialysis duration were compared between the 2 groups. Pearson, Spearman, and multiple linear regression analyses were performed to examine factors related to DUSP6. Patients were followed up to monitor the occurrence of adverse cardiovascular events, and risk factors for adverse cardiovascular events after peritoneal dialysis were analyzed using Kaplan-Meier and Cox regression. By the end of the follow-up, 33 (26.61%) patients had experienced at least one adverse cardiovascular event. The high-level DUSP6 group had higher body mass index, longer dialysis duration, and higher high-sensitivity C-reactive protein, but lower serum albumin levels compared to the low-level DUSP6 group (all P<0.05). DUSP6 was negatively correlated with serum albumin levels (r=-0.271, P=0.002) and positively correlated with dialysis duration (rs=0.406, P<0.001) and high-sensitivity C-reactive protein (rs=0.367, P<0.001). Multiple linear regression analysis revealed that dialysis duration and high-sensitivity C-reactive protein were independently correlated with DUSP6 levels (both P<0.05). The cumulative incidence of adverse cardiovascular events was higher in the high-level DUSP6 group than in the low-level DUSP6 group (46.67% vs 7.81%, P<0.001). Cox regression analysis indicated that low serum albumin levels (HR=0.836, 95% CI 0.778 to 0.899), high high-sensitivity C-reactive protein (HR=1.409, 95% CI 1.208 to 1.644), and high DUSP6 (HR=6.631, 95% CI 2.352 to 18.693) were independent risk factors for adverse cardiovascular events in peritoneal dialysis patients. Dialysis duration and high-sensitivity C-reactive protein are independently associated with DUSP6 levels in peripheral blood mononuclear cells of diabetic nephropathy patients undergoing peritoneal dialysis. High DUSP6 levels indicate a higher risk of adverse cardiovascular events.

Physician estimate of inflammation vs global assessment in explaining variations in swollen joint counts in rheumatoid arthritis patients.

To analyse patients with RA for inflammatory activity by physician estimate of global assessment (DOCGL) vs an estimate of inflammatory activity (DOCINF) to explain variation in the swollen joint count (SJC). Patients with RA were studied at routine care visits. Patients completed a multidimensional health assessment questionnaire (MDHAQ) and the physician completed a 28-joint count for swollen (SJC), tender (TJC) and deformed (DJC) joints and a RheuMetric checklist with a 0-10 DOCGL visual numeric scale (VNS) and 0-10 VNS estimates of inflammation (DOCINF), damage (DOCDAM) and patient distress (DOCSTR). The disease activity score in 28 joints with ESR (DAS28-ESR), Clinical Disease Activity Index (CDAI) and Routine Assessment of Patient Index Data 3 (RAPID3) were calculated. Individual scores and RA indices were compared according to Spearman correlation coefficients and regression analyses. A total of 104 unselected patients were included, with a median age and disease duration of 54.5 and 5 years, respectively. The median DAS28-ESR was 2.9 (Q1-Q3: 2.0-3.7), indicating low activity. DOCINF was correlated significantly with DOCGL (ρ = 0.775). Both DOCGL and DOCINF were correlated significantly with most other measures; correlations with DOCGL were generally higher than with DOCINF other than for SJC. In regression analyses, DOCINF was more explanatory of variation in SJC than DOCGL and other DAS28-ESR components. Variation in SJC is explained more by a 0-10 DOCINF VNS than the traditional DOCGL or any other measure in RA patients seen in routine care. DOCINF on a RheuMetric checklist can provide informative quantitative scores concerning inflammatory activity in RA patients monitored over long periods.

A patient centered assessment of the 2016 ACR-EULAR Myositis Response Criteria: evaluating the meaningfulness of response.

The ACR-EULAR Myositis Response Criteria (Total Improvement Score [TIS]) is a composite measure calculated using changes in myositis core set measures. It is unclear if achieving improvement per TIS reflects improvement in any symptoms of myositis patients. In this study, we examined the association between achieving TIS improvement and patient-centered outcome measures (PCOMs). Adults with myositis were enrolled in a prospective study with baseline and 6-month visits. Six core set measures were collected at each visit along with the following PCOMs: Fatigue (visual analogue scale [VAS] and short form 36 [SF36]), pain (VAS, SF36), health-related quality of life (SF-36), physical function (PROMIS-physical function, SF36, sit-to-stand, timed up-and-go, and six-min walk) and physical activity (actigraphy). Mann-Whitney U was used to compare PCOMs between improvement groups. Spearman correlation and regression models were used for correlation and association between TIS and PCOMs, respectively. Of 50 patients (six polymyositis, 24 dermatomyositis, 9 necrotizing myopathy, 11 anti-synthetase syndrome) enrolled (mean age: 52, 60% female), 21 patients satisfied the TIS improvement criteria at 6-months. PCOMs including fatigue, pain, quality of life, physical activity and physical function demonstrated significantly greater improvement in patients who had minimal TIS improvement compared with those with no improvement. Greater PCOM improvements were seen with moderate-major TIS improvement. TIS correlated moderately-strongly with most PCOMs. Achieving improvement criteria was accompanied by significant clinical improvements in fatigue, pain, health-related quality of life, physical function, and physical activity. These results support the use of TIS as a clinically meaningful metric of improvement.

Minimally Invasive Method of Measuring Anti-Müllerian Hormone Level in Dried Blood Spots of Indonesian Infertile Population

This study aims to evaluate the certainty of anti-Müllerian hormone (AMH) levels in dried blood spots (DBS) compared to serum AMH. A total of 109 infertile women who planned to undergo their controlled ovarian stimulation cycle were recruited. Serum and DBS samples were collected from each patient for the quantification of AMH levels. Serum AMH was measured with an automated clinical chemistry assay (Roche) while DBS AMH was measured using the Ansh Labs DBS AMH ELISA reagent kit. Mean AMH level in DBS was [Formula: see text][Formula: see text]ng/mL, which ranged from 0.01 to 17.3[Formula: see text]ng/mL, while the mean AMH in serum samples was [Formula: see text][Formula: see text]ng/mL (0.01–10.8[Formula: see text]ng/mL). Comparable accuracy for low AMH quantification was observed between the two methods over basal antral follicle counts (AFC) as a clinical comparator (AUC 86%, cutoff [Formula: see text][Formula: see text]ng/mL, [Formula: see text], [Formula: see text] vs. 85%, cutoff [Formula: see text][Formula: see text]ng/mL, [Formula: see text], [Formula: see text], respectively for DBS and serum sample). Likewise, DBS AMH achieved high concordance for low AMH discrimination in comparison to serum AMH method (AUC 99% vs. 93%, respectively). A strong linear Spearman regression ([Formula: see text], [Formula: see text]) and sufficient agreement (94.5%, mean difference of −1.6, 2.7 to −5.9) was demonstrated among studied groups with mathematical Passing and Bablok regression equation of [Formula: see text]. The confidence interval of intercept (−0.12, 95% CI [−0.29 to −0.01]) and slope (1.80, 95% CI [1.66–1.94]) indicated a constant and proportional difference between the two methods but it was not significant ([Formula: see text]). AMH measurement in DBS could be useful as an alternative approach to screening ovarian reserve through a more convenient remote sample collection.