Standardized Regression Coefficients Research Articles

Brain structure and connectivity mediate the association of lifestyle and cognition: the Maastricht study

Abstract Life-course exposure to risk and protective factors impacts brain macro- and micro-structure, which in turn affects cognition. The concept of Brain Age Gap (BAG) assesses brain health by comparing an individual’s neuroimaging-based predicted age with their calendar age. Higher BAG implies accelerated brain aging and is expected to be associated with worse cognition. In this study, we comprehensively modelled mutual associations between brain-health and lifestyle factors, brain age, and cognition in a large, middle-aged population. For this study, cognitive test scores, lifestyle, and 3T MRI data for n=4881 participants (mean age (±SD) = 59.2 (±8.6), 50.1% male) were available from The Maastricht Study, a population-based cohort study with extensive phenotyping. Whole brain volumes (grey matter (GM), cerebrospinal fluid (CSF), white matter hyperintensity (WMH)), cerebral microbleeds (CMB), and structural white matter connectivity were calculated. Lifestyle factors were combined into an adapted LIfestyle for BRAin health (LIBRA) weighted sum score, with higher score indicating greater dementia risk. Cognition was calculated by averaging z-scores across three cognitive domains (memory, information processing speed, executive function and attention). BAG was calculated by comparing calendar age to predictions from a neuroimaging-based multivariable regression model. Paths between LIBRA tertiles, BAG and cognitive function were tested using linear regression and structural equation modelling, adjusting for sociodemographic and clinical confounders. Results show that CSF, GM, WMH and CMB best predicted BAG (R2 = 0.455, RMSE = 6.44). In regression analysis, higher LIBRA scores (greater dementia risk) were associated with higher BAG (standardized regression coefficient ß = 0.126, p < 0.001) and worse cognition (ß = -0.046, p = 0.013), while higher BAG was associated with worse cognition (ß=-0.163, p<0.001). In mediation analysis, 24.7% of the total difference in cognition between the highest and lowest LIBRA tertile was mediated by BAG (ßindirect = -0.049, p < 0.001; ßtotal = -0.198, p < 0.001), and an additional 3.8% was mediated via connectivity (ßindirect = -0.006, p < 0.001; ßtotal = -0.150, p < 0.001). Findings suggest that associations between health- and lifestyle-based risk/protective factors (LIBRA) and cognition can be partially explained by structural brain health markers (BAG) and white matter connectivity markers. Lifestyle interventions targeted at high-risk individuals in mid to late life may be effective in promoting and preserving cognitive function in the general public.

Characteristics of obstructive sleep apnea related to insulin resistance.

Obstructive sleep apnea (OSA) is associated with multiple comorbidities, including diabetes. Its development is preceded by alterations in the initial phase of carbohydrate metabolism characterized by insulin resistance. This study aims to evaluate the role of intermittent hypoxia and sleep fragmentation characteristic of OSA on the risk of insulin resistance among apneic patients without diabetes. 92 consecutive patients with OSA without evidence of diabetes were recruited. Overnight video polysomnography was performed and, the following morning, fasting blood glucose, insulin and glycosylated hemoglobin were determined. Insulin resistance was measured using the HOMA-IR index. Insulin resistance was present in 52.2% of OSA patients. In these subjects, insulin resistance was independently associated to the apnea index during REM sleep (adjusted odds ratio [aOR] 1.09; 95% CI, 1.03 to 1.16; p = 0.004), desaturation index (aOR 1.08; 95% CI: 1.04 to 1.13; p = 0.027), and sleep time with oxygen saturation below 90% (aOR 1.04; 95% CI 1.00 to 1.08; p = 0.049). Furthermore, the HOMA-IR level was also directly related to the desaturation index (standardized regression coefficient [B] = 0.514, p < 0.001) and to the apnea index during REM sleep (B = 0.344, p = 0.002). Intermittent hypoxia and disturbances in REM sleep emerge as main contributors to insulin resistance in OSA patients yet to experience diabetes onset.

Association between arterial health and cognition in adolescents: The PANIC study.

We investigated the associations of the measures of arterial health with cognition in adolescents and whether physical activity (PA) or sedentary time (ST) confounds these associations. One hundred sixteen adolescents (71 boys) aged 15.9 ± 0.4 participated in the study. PA and ST were assessed using a combined accelerometer/heart rate monitor. Overall cognition was computed from the results of psychomotor function, attention, working memory, and paired-associate learning tests. Pulse wave velocity was measured by impedance cardiography, carotid intima-media thickness, and carotid artery distensibility by carotid ultrasonography. Systolic and diastolic blood pressure (SBP and DBP) were measured using an aneroid sphygmomanometer. SBP was inversely associated with overall cognition (standardized regression coefficient [β] = -0.216, 95% confidence interval (CI) -0.406 to -0.027, p = 0.025). Pulse wave velocity (β = -0.199, 95% CI -0.382 to -0.017, p = 0.033) was inversely associated with working memory task accuracy. SBP was directly associated with reaction time in the attention (β = 0.256, 95% CI 0.069 to 0.443, p = 0.008) and errors in the paired-associate learning tasks (β = 0.308, 95% CI 0.126 to 0.489, p = 0.001). Blood pressure was inversely associated with overall cognition. PA or ST did not confound the associations. Results suggest that preventing high blood pressure is important for promoting cognition in adolescents.

Parameter sensitivity analysis of peak impact force for an actual flow-like landslide against a single rigid barrier

Strength parameters are key factors that influence the sliding process of landslides and further affect the impact force on structures. Many scholars have previously studied the influence of strength parameters on slope stability; however, the influence of strength parameters on the impact force of flow-like landslides has not been analyzed till date. Therefore, in this study, the smoothed particle hydrodynamics (SPH) method was used to simulate the flow process of landslides and estimate the impact force on the rigid barrier by adjusting the strength parameters of landslides. The proposed SPH model was validated by a model test of dry sand impacting rigid barriers. The Gaoloucun landslide was selected as the study case and simulated to study the influence of parameters on the impact force. Finally, a multiple linear regression analysis was conducted to explore the sensitivity of impact force to input parameters and obtain the standardized regression coefficient, which was compared to find the dominant strength parameter. According to the results, among two strength parameters, the internal friction angle has more influence on the peak impact force than the cohesion.

Effects of Dental Implant Diameter and Tapered Body Design on Stress Distribution in Rigid Polyurethane Foam During Insertion

Anchorage, evaluated by the maximum insertion torque (IT), refers to mechanical engagement between dental implant and host bone at the time of insertion without external loads. Sufficient anchorage has been highly recommended in the clinic. In several studies, the effects of implant diameter and taper body design under external loading have been evaluated after insertion; however, there are few studies, in which their effects on stress distribution during insertion have been investigated to understand establishment of anchorage. Therefore, the objective of this study was to investigate the effects of dental implant diameter and tapered body design on anchorage combining experiments, analytical modelling, and finite element analysis (FEA). Two implant designs (parallel-walled and tapered) with two implant diameters were inserted into rigid polyurethane (PU) foam with corresponding straight drill protocols. The IT was fit to the analytical model (R2 = 0.88-1.0). The insertion process was modelled using explicit FEA. For parallel-walled implants, normalized IT and final FEA contact ratio were not related to the implant diameter while the implant diameter affected normalized IT (R2 = 0.90, p<0.05, β1 = 0.20 and β2 = 0.93, standardized regression coefficients for implant diameter and taper body design) and final FEA contact ratio of tapered implants. The taper design distributed the PU foam stress further away from the thread compared to parallel-walled implants, which demonstrated compression in PU foam established by the tapered body during insertion.

Association of serum sclerostin levels with marrow adiposity in postmenopausal women with glucocorticoid-induced osteoporosis

BackgroundGlucocorticoids and sclerostin act as inhibitors of the Wnt signaling pathway, thereby hindering bone formation. Given the pathway's intricate association with mesenchymal stem cells, the hypothesis suggests that heightened sclerostin levels may be intricately linked to an augmentation in marrow adiposity induced by glucocorticoids. This study endeavored to delve into the nuanced relationship between circulating sclerostin and bone marrow adipose tissue in postmenopausal women grappling with glucocorticoid-induced osteoporosis (GIO).MethodsIn this cross-sectional study, 103 patients with autoimmune-associated diseases underwent glucocorticoid treatment, boasting an average age of 61.3 years (standard deviation 7.1 years). The investigation encompassed a thorough assessment, incorporating medical history, anthropometric data, biochemical analysis, and dual-energy X-ray absorptiometry measurements of lumbar and femoral bone mineral density (BMD). Osteoporosis criteria were established at a T-score of -2.5 or lower. Additionally, MR spectroscopy quantified the vertebral marrow fat fraction.ResultsBMD at the femoral neck, total hip, and lumbar spine showcased an inverse correlation with marrow fat fraction (r = –0.511 to – 0.647, P < 0.001). Serum sclerostin levels exhibited a positive correlation with BMD at various skeletal sites (r = 0.476 to 0.589, P < 0.001). A noteworthy correlation emerged between circulating sclerostin and marrow fat fraction at the lumbar spine (r = –0.731, 95% CI, –0.810 to –0.627, P < 0.001). Multivariate analysis brought to light that vertebral marrow fat fraction significantly contributed to sclerostin serum concentrations (standardized regression coefficient ß = 0.462, P < 0.001). Even after adjusting for age, body mass index, physical activity, renal function, BMD, and the duration and doses of glucocorticoid treatment, serum sclerostin levels maintained a significant correlation with marrow fat fraction.ConclusionsCirculating sclerostin levels exhibited a noteworthy association with marrow adiposity in postmenopausal women grappling with GIO.

Factors influencing civil servants' willingness to implement cardiopulmonary resuscitation in Chongqing, China: Based on the theory of planned behavior

BackgroundTimely bystander cardiopulmonary resuscitation is the key to improving the survival rate of out-of-hospital cardiac arrest. Civil servants are potential bystander CPR providers. This study aimed to explore civil servants' willingness to implement CPR in Chongqing, identify the influencing factors and mechanisms affecting civil servants' willingness to perform CPR, and then seek countermeasures to improve civil servants' willingness to implement CPR. MethodsWe introduced the theory of perceived risk into the theory of planned behavior, developed a 7-point Likert scale based on the extended theory of planned behavior, and conducted a questionnaire survey on civil servants in Chongqing, China. Descriptive statistical analysis and one-way ANOVA were employed to explore respondents' willingness and differences. Structural equation modeling was used to analyze the relationship between attitude, subjective norm, perceived behavioral control and perceived risk and respondents' willingness to implement CPR. ResultsA total of 1235 valid questionnaires were included for analysis. 50.1 % of respondents were willing to implement CPR. Male, over 40 years old, living with the elderly, having previous experience performing CPR on another person, and having higher CPR knowledge scores were associated with a more positive willingness to perform CPR. Attitude, subjective norm and perceived behavioral control had significant positive effects on willingness, and the standardized regression coefficients were 0.164, 0.326 and 0.313, respectively. The perceived risk has a significant negative effect on willingness, and the standardized regression coefficient was −0.109. The four latent variables accounted for 44.2 % of the variance in the willingness of civil servants to implement CPR. ConclusionsThe willingness of civil servants in Chongqing to implement CPR needs to be improved, and the countermeasures to enhance the subjective norm and perceived behavioral control of civil servants should be emphasized, such as developing a social support network for rescuing conduct, establishing regular training mechanisms and improving the practical applicability and popularization of the Chinese-style "Good Samaritan Law" etc., to improve the willingness of civil servants in Chongqing to implement CPR.

Relationship Between Job Embeddedness Factors with Job Engagement and Intentions to Stay of Employees: Research at Small and Medium Enterprises in Ho Chi Minh City

This study was conducted at small and medium-sized enterprises in Ho Chi Minh City, Vietnam, to provide additional insight into job embeddedness factors that affect employee engagement. with the job and the intention to stay and work at the enterprise. With the underlying theory of Mitchell et al. (2001), the authors conducted a direct employee survey at businesses and collected a valid survey of n=300 tables. The software used is SPSS 20.0 and AMOS 20.0 to process data. The result is that the factors of Job Embeddedness all have a direct impact on work engagement, with the strongest order being Sacrifice organization (SO) with beta = 0.384. The second is Organizational Fit (FO) with beta = 0.369. Third is Organizational links (OL) with beta=0.335. Sacrifice when leaving the organization directly impacts the intention to stay with the organization, with a regression coefficient of 0.126, this influence is quite low and almost insignificant. The standardized regression coefficient between job engagement and intention to stay with the organization is 0.597. The solutions proposed by the authors are intended to help business leaders gain insight into the current situation in the business and make appropriate decisions for operations, in order to improve and enhance employee engagement with business.

The Role of Cognitive Reserve in Protecting Cerebellar Volumes of Older Adults with mild Cognitive Impairment.

The present study aims to investigate the relationship between cerebellar volumes and cognitive reserve in individuals with Mild Cognitive Impairment (MCI). A description of proxies of cerebellar cognitive reserve in terms of different volumes across lobules is also provided. 36 individuals with MCI underwent neuropsychological (MoCA, MMSE, Clock test, CRIq) assessment and neuroimaging acquisition with magnetic resonance imaging at 3T. Simple linear correlations were applied between cerebellar volumes and cognitive measures. Multiple linear regression models were then used to estimate standardized regression coefficients and 95% confidence intervals. Simple linear correlations between cerebellar lobules volumes and cognitive features highlighted a significant association between CRIq_Working activity and specific motor cerebellar volumes: Left_V (ρ = 0.40, p = 0.02), Right_V (r = 0.42, p = 0.002), Vermis_VIIIb (ρ = 0.47, p = 0.003), Left_X (ρ = -0.46, p = 0.002) and Vermis_X (r = 0.35, p = 0.03). Furthermore, CRIq_Working activity scores correlated with certain cerebellar lobules implicated in cognition: Left_Crus_II, Vermis VIIb, Left_IX. MMSE was associated only with the Right_VIIB volume (r = 0.35, p = 0.02), while Clock Drawing Test scores correlated with both Left_Crus_I and Right_Crus_I (r = -0.42 and r = 0.42, p = 0.02, respectively). This study suggests that a higher cognitive reserve is associated with specific cerebellar lobule volumes and that Working activity may play a predominant role in this association. These findings contribute to the understanding of the relationship between cerebellar volumes and cognitive reserve, highlighting the potential modulatory role of Working activity on cerebellum response to cognitive decline.

Factors affecting operational risk management of Vietnam commercial banks in Dong Nai province

Operational risk management and supervision are essential as a bank's reliable shield to prevent violations of banking risk management principles. Using the convenient sampling method, the authors surveyed 336 valid answer sheets, corresponding to 350 managers and staff working at Vietnam commercial banks in Dong Nai province. Research results show that there are 5 factors affecting operational risk management with a significance level of 5%, with an adjusted R2 coefficient of 0.604, which means that the built multiple linear regression model. The fit for the data set is 60.4%, meaning the model explains 60.4% of the variation in operational risk management due to 5 impact factors. Finally, the authors propose five policy implications that contribute to improving operational risk management, corresponding to the five factors in order of priority: Operational risk management related to organizational structure the highest standardized regression coefficient of 0.468, and the leadership perspective on operational risk management with the lowest standardized regression coefficient of 0.159.

Accuracy of Global Geospace Simulations: Influence of Solar Wind Monitor Location and Solar Wind Driving

AbstractSome space weather models, such as the Space Weather Modeling Framework (SWMF) used in this study, use solar wind propagated from the first Lagrange point (L1) to the bow shock nose (BSN) to forecast geomagnetic storms. The SWMF is a highly coupled framework of space weather models that include multiple facets of the Geospace environment, such as the magnetosphere and ionosphere. The propagated solar wind measurements are used as a boundary condition for SWMF. The solar wind propagation method is a timeshift based on the calculated phase front normal (PFN) which leads to some uncertainties. For example, the propagated solar wind could have evolved during this timeshift. We use a data set of 123 geomagnetic storms between 2010 and 2019 run by the SWMF Geospace configuration to analyze the impact solar wind propagation and solar wind driving has on the geomagnetic indices. We look at the probability distributions of errors in SYM‐H, cross polar cap potential (CPCP), and auroral electrojet indices AL and AU. Through studying the median errors (MdE), standard deviations and standardized regression coefficients, we find that the errors depend on the propagation parameters. Among the results, we show that the accuracy of the simulated SYM‐H depends on the spacecraft distance from the Sun‐Earth line. We also quantify the dependence of the standard deviation in SYM‐H errors on the PFN and solar wind pressure. These statistics provide an insight into how the propagation method affects the final product of the simulation, which are the geomagnetic indices.

Analysis of factors affecting the formation characteristics of carbon dioxide hydrates in pure water system

As the oilfield fully enters the late stage of exploitation, the water content in the oil and gas transportation pipelines is rising. Meanwhile, the high-pressure and low-temperature environment inside the pipeline facilitate the formation of hydrates, which will seriously block the mixing pipeline and cause a series of production safety problems. Therefore, it is necessary to control the risk under the high water content system. In this paper, a high-pressure flow loop device with a viewable window was used to study the formation characteristics of carbon dioxide hydrate in a pure water system, and the effects of the liquid loading, pressure, volume flow rate, and two inhibitors, polyvinylpyrrolidone (PVP) and propylene glycol methyl ether (PM), on the induction time of carbon dioxide hydrate formation were investigated. The experimental results showed that the amount of liquid loading, pressure, volume flow rate, and inhibitor had a significant effect on the hydrate induction time. In addition, the ether compounds PM and PVP have inhibitory synergistic effects, which can significantly prolong the hydrate induction time, and the inhibitory synergistic effect is further enhanced with the increase of PM concentration, which further suggests the synergistic inhibition mechanism of the two. Based on the standard regression coefficient method, the factors affecting the induction time were subjected to sensitivity analysis, and it was found that the inhibitor was the most important factor affecting the induction time. Therefore, future research should also focus on finding better performance of inhibitors, synergists and their ratio.

Triglyceride glucose index is associated with functional coronary artery stenosis in hypertensive patients.

The triglyceride glucose (TyG) index is an effective method for determining insulin resistance (IR). Limited research has explored the connection between the TyG index and functionally significant stenosis in hypertensive patients. Furthermore, the connections between the TyG index, fat attenuation index (FAI) and atherosclerotic plaque characteristics are also worth exploring. The study screened 1622 hypertensive participants without coronary artery disease history who underwent coronary computed tomography angiography. The TyG index was calculated as ln (fasting glucose [mg/dL] * fasting TG [mg/dL]/2). Adverse plaque characteristics (HRPCs), high-risk plaques (HRPs), FAI, and CT-derived fractional flow reserve (FFRCT) were analyzed and measured for all patients. Functionally significant stenosis causing ischemia is defined as FFRCT ≤ 0.80. Two patient groups were created based on the FFRCT: the FFRCT < 0.80 group and the FFRCT > 0.80 group. In hypertensive patients, the association between the TyG index and FFRCT was examined applying a logistic regression model. The TyG index was higher for people with FFRCT ≤ 0.80 contrast to those with FFRCT > 0.80. After controlling for additional confounding factors, the logistic regression model revealed a clear connection between the TyG index and FFRCT ≤ 0.80 (OR = 1.718, 95% CI 1.097-2.690, p = 0.018). The restricted cubic spline analysis displayed a nonlinear connection between the TyG index and FFRCT ≤ 0.80 (p for nonlinear = 0.001). The TyG index increased the fraction of individuals with HRPs and HRPCs, FAI raised, and FFRCT decreased (p < 0.05). The multivariate linear regression analysis illustrated a powerfulcorrelation between high TyG index levels and FAI, FFRCT, positive remodeling (PR), and low-attenuation plaque (LAPs) (standardized regression coefficients: 0.029 [p = 0.007], -0.051 [p < 0.001], 0.029 [p = 0.027], and 0.026 [p = 0.046], separately). In hypertensive patients, the TyG index showed an excellent association with a risk of FFRCT ≤ 0.80. Additionally, the TyG index was also linked to FAI, FFRCT, PR, and LAPs.

Predicting tumor volume in primary hyperparathyroidism from preoperative clinical data.

Primary hyperparathyroidism (PHPT) is an endocrine disorder that is treated surgically, and some correlation between the size of the responsible lesion and preoperative clinical data is assumed. The purpose of this study was to predict tumor volume of the lesion responsible for PHPT from preoperative clinical data. Participants comprised patients with surgically treated PHPT who underwent initial surgery in our department between January 2000 and December 2021. The volume of parathyroid gland removed was used as the primary outcome and associations with preoperative clinical data were assessed by multivariable analysis. A positive correlation was identified between parathyroid tumor volume and both preoperative intact parathyroid hormone (PTH) (Spearman's r = 0.503) and calcium values (Spearman's r = 0.338). Data for intact PTH value and tumor volume were logarithmically transformed (ln-PTH = log-transformed intact PTH value; ln-volume = log-transformed tumor volume). Multiple regression analysis revealed male sex, ln-PTH and calcium values as significant predictors of ln-volume, with standardized regression coefficients of 0.213 (95% confidence interval [CI] 0.103-0.323), 0.5018 (95%CI 0.4442-0559) and 0.322 (95%CI 0.0339-0.149), respectively. The adjusted R2 for this model is 0.320. Preoperative serum intact PTH value is associated with tumor volume of the lesion responsible for PHPT. A rough estimation of the tumor size would provide responsible physicians with opportunities to add further imaging tests or plan appropriate surgical strategies.

Accumulating Sedentary Time and Physical Activity From Childhood to Adolescence and Cardiac Function in Adolescence.

Increased physical activity (PA) may mitigate the negative cardiovascular health effects of sedentary behavior in adolescents. However, the relationship of PA and sedentary time from childhood with cardiac function in adolescence remains underexplored. Therefore, we investigated the associations of cumulative sedentary time and PA from childhood to adolescence with cardiac function in adolescence. Participants were 153 adolescents (69 girls) who were aged 6 to 8 years at baseline, 8 to 10 years at 2-year follow-up, and 15 to 17 years at 8-year follow-up. Cumulative sedentary time and PA exposure between baseline and 2-year follow-up and between baseline and 8-year follow-up were measured using a combined accelerometer and heart rate monitor. Cardiac function was assessed using impedance cardiography at 8-year follow-up. The data were analyzed using linear regression analyses adjusted for age and sex. Cumulative moderate to vigorous PA (standardized regression coefficient [β]=-0.323 [95% CI, -0.527 to -0.119]) and vigorous PA (β=-0.295 [95% CI, -0.508 to -0.083]) from baseline to 8-year follow-up were inversely associated with cardiac work at 8-year follow-up. Conversely, cumulative sedentary time had a positive association (β=0.245 [95% CI, 0.092-0.398]). Cumulative vigorous PA from baseline to 8-year follow-up was inversely associated with cardiac work index at 8-year follow-up (β=-0.218 [95% CI, -0.436 to 0.000]). Higher levels of sedentary time and lower levels of PA during childhood were associated with higher cardiac work in adolescence, highlighting the importance of increasing PA and reducing sedentary time from childhood.

The LISA-PPV Formula: An Ensemble Artificial Intelligence-Based Thick Intraocular Lens Calculation Formula for Vitrectomized Eyes

PurposeTo investigate the relationship between effective lens position (ELP) and patient characteristics, and to further develop a new intraocular lens (IOL) calculation formula for cataract patients with previous pars plana vitrectomy (PPV). DesignCross-sectional study. MethodsA total of 2793 age-related cataract patients (group 1) and 915 post-PPV cataract patients (group 2) who underwent phacoemulsification with IOL implantation were included. The ELP of two groups was compared and the association between ELP and patient characteristics was further evaluated using standardized multivariate regression coefficients. An ensemble artificial intelligence-based ELP prediction model was developed using a training set of 810 vitrectomized eyes, and a thick-lens IOL formula (LISA-PPV) was constructed and compared with seven existing formulas on an external multi-center testing set of 105 eyes. ResultsCompared to eyes with age-related cataract, vitrectomized eyes showed a similar ELP distribution (P = 0.19), but different standardized coefficients of preoperative biometry for ELP. The standardized coefficients also varied with the type of vitreous tamponade, history of scleral buckling, and ciliary sulcus IOL implantation. The LISA-PPV formula showed the lowest mean and median absolute prediction error (MAE: 0.63 D; MedAE: 0.44 D), and the highest percentages of eyes within ± 0.5 D of prediction error (57.14%) in the testing dataset. ConclusionsThe ELP prediction required optimization specifically for vitrectomized eyes based on their biometric and surgical characteristics. The LISA-PPV formula is a useful and accurate tool for determining IOL power in cataract patients with previous PPV (available at http://ppv-iolcalculator.com/).

Age-specific comparisons in the rate of force development of toe pressure strength and its association with the timed up and go test.

It has recently been recommended that Rate of Force Development (RFD) be evaluated in addition to maximal muscle strength. There are no studies on RFD of toe pressure strength, and its importance in older adults and the extent to which it is associated with aging needs to be clarified. This study purpose was to examine the association between the RFD of toe pressure strength and timed up and go test (TUG) in an age-specific study. This study is a cross-sectional study. Participants in the study included 159 younger adults (26.3 ± 13.1years, 52% male) and 88 older adults (75.0 ± 6.2years, 26% male). The RFD of toe pressure strength was determined from the force-time curve obtained during the toe pressure strength assessment, and the ability to exert maximum muscle force in the shortest possible time was assessed. Regression analysis was performed for each group to test the association between RFD of toe pressure strength and TUG by age. Younger adults showed no association between TUG and RFD of toe pressure strength, and significant association between TUG and RFD of toe pressure strength was found only in the older adults (standard regression coefficient = - 0.19, p = 0.048). This study showed a significant association between TUG and RFD of toe pressure strength in older adults. These findings show that RFD is one of the functions that should be assessed, particularly in older adults. Furthermore, it was suggested that approaching RFD could improve gait, standing, and sitting movements.

The associations of depressive symptoms and perceived stress with arterial health in adolescents.

Cardiovascular and mental diseases are among the most important global health problems, but little is known on the associations between mental and arterial health in adolescents. Therefore, we investigated the associations of arterial health with depressive symptoms and perceived stress in adolescents. A total of 277 adolescents, 151 boys, 126 girls, aged 15-17 years participated in the study. Depressive symptoms were assessed using the Beck Depression Inventory and perceived stress by the Cohen Perceived Stress Scale. Arterial health was assessed by measures from carotid ultrasonography (carotid intima-media thickness, Young's Elastic Modulus, carotid artery distensibility, stiffness index), impedance cardiography (pulse wave velocity, cardio-ankle vascular index), and pulse contour analysis (reflection index, stiffness index). The data were analyzed using linear regression models adjusted for age and sex. Depressive symptoms or perceived stress were not associated with indices of arterial health in the whole study group (β = -0.08 to 0.09, p > 0.05), in boys (β = -0.13 to 0.10, p > 0.05) or in girls (standardized regression coefficient β = -0.16 to 0.08, p > 0.05). We found no associations of depressive symptoms and perceived stress with arterial health in adolescents. These observations suggest that the association between mental and arterial health problems develop in later life.

Neutrophil to lymphocyte ratio may predict efficacy of anti-PD-1 inhibitors in advanced EGFR-mutant non-small cell lung cancer: retrospective cohort study

This study aimed to investigate the associations between the clinical characteristics and effectiveness of anti-PD-1 inhibitors in patients with EGFR-sensitive mutations, aiming to identify the potential subgroup of patients who might benefit from anti-PD-1 inhibitor treatment. Patients with advanced non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR)-sensitive mutations who received subsequent anti-PD-1 inhibitors in combination with chemotherapy/antiangiogenic agents or alone after progression to tyrosine kinase inhibitors (TKIs) were screened. Clinical characteristics, including hematological parameters, were investigated for potential correlations with clinical outcomes. Subgroup and multivariate analyses were used for further confirmation of the relationship. Kaplan–Meier curves and Cox survival regression models using the log-rank test were used for progression-free survival (PFS) and overall survival (OS) assessments between the groups. Multiple regression analysis was performed using the standard regression coefficient values. The Wilcoxon test was used for the analysis of the variation in NLR. P ≤ 0.05 was considered to indicate statistical significance. This study was a retrospective study. Twenty-two patients met the inclusion criteria and were included in the study. The median PFS was 3.05 months (95% CI, 2.9–10.2 months). The median OS was 7.30 months (95% CI, 5.2–18.1 months). PFS in low neutrophil to lymphocyte ratio (NLR ≤ 4) was significantly longer than high NLR (NLR > 4, 5.7 months versus 2.0 months, HR, 0.35, 95% CI, 0.08–0.63, P = 0.0083). The OS in the low NLR group was also significantly better than that in the high NLR group (OS, 21.3 months versus 5.0 months, HR, 0.33; 95% CI, 0.09–0.74; P = 0.0163). In the multivariate analysis, NLR was the only significant factor for OS benefits (β = 3.535, 95% CI, 1.175–10.636, P = 0.025). Further investigation revealed that front-line TKIs exposure may contribute to the elevation or decrease of NLR, and finally lead to different efficacy outcomes by anti-PD-1 inhibitors. The findings suggest that a portion of advanced NSCLC patients with low NLR characteristics (NLR ≤ 4), even those harboring EGFR-sensitive mutations, could benefit from anti-PD-1 inhibitors as further line treatment after progression to EGFR-TKIs.

A Confidence Interval for the Difference Between Standardized Regression Coefficients

Researchers are often interested in comparing predictors, a practice commonly done via informal comparisons of standardized regression slopes. However, formal interval-based approaches offer advantages over informal comparison. Specifically, this article examines a delta-method-based confidence interval for the difference between two standardized regression coefficients, building upon previous work on confidence intervals for single coefficients. Using Monte Carlo simulation studies, the proposed approach is evaluated at finite sample sizes with respect to coverage rate, interval width, Type I error rate, and statistical power under a variety of conditions, and is shown to outperform an alternative approach that uses the standard covariance matrix found in regression textbooks. Additional simulations evaluate current software implementations, small sample performance, and multiple comparison procedures for simultaneously testing multiple differences of interest. Guidance on sample size planning for narrow confidence intervals, an R function to conduct the proposed method, and two empirical demonstrations are provided. The goal is to offer researchers a different tool in their toolbox for when comparisons among standardized coefficients are desired, as a supplement to, rather than a replacement for, other potentially useful analyses.