Standard Score Research Articles

Optimal Cut-off Points of the Standardized Continuous Metabolic Syndrome Severity Score (cMetS-S) for Predicting Cardiovascular Disease (CVD) and CVD Mortality in the Tehran Lipid and Glucose Study (TLGS)

Background: Metabolic Syndrome (MetS) is a prevalent condition associated with an increased risk of cardiovascular disease (CVD) and CVD mortality. Due to the limited clinical applicability of MetS, the standardized continuous metabolic syndrome severity score (cMetS-S) has the potential to provide continuous assessment of metabolic risk. Objectives: This study evaluated the optimal cMetS-S cut-off points in the Tehran lipid and glucose study (TLGS) for predicting CVD and CVD mortality. Methods: The study included 7,776 participants over 30 years old at baseline, followed for 18 years. Sex-specific sensitivity (SS) and specificity (SP) of cMetS-S measures for predicting CVD and CVD mortality were evaluated using a receiver operating characteristic (ROC) curve, along with the area under the curve (AUC), employing a naive estimator and considering event failure status and MetS variables. Results: The cut-off point of cMetS-S for CVD was 0.13 (SS: 65.5%, SP: 59.6%) for the total population, 0.44 (SS: 49.6%, SP: 68.1%) for males, and 0.27 (SS: 64.2%, SP: 69.2%) for females. The cut-off point of cMetS-S for CVD mortality was 0.53 (SS: 51.3%, SP: 71.9%) for the total population, 0.76 (SS: 35.1%, SP: 76.2%) for males, and 0.28 (SS: 78.8%, SP: 66.4%) for females. The AUC (95% CI) of MetS based on the International Diabetes Federation (IDF) and Joint Interim Statement (JIS) definitions were 60.0 (65.3 - 56.8) and 61.1 (59.6 - 56.8) for CVD, and 59.3 (56.0 - 62.5) and 59.4 (56.3 - 62.6) for CVD mortality. Conclusions: The cut-off points of cMetS-S for CVD and CVD mortality differ between men and women. The cMetS-S could be a better predictive tool for CVD and CVD mortality than MetS.

Economic evaluation of adding dapagliflozin to standard care in the treatment of chronic kidney disease: a systematic review

IntroductionChronic kidney disease is a significant public health issue. Dapagliflozin has been shown to improve the quality of life for patients with chronic kidney disease. This review aimed to systematically assess the cost-effectiveness of adding dapagliflozin to standard care compared with standard care alone for treating chronic kidney disease.MethodsThe relevant studies were searched in PubMed, Web of Science, Scopus, Embase, and Cochrane from the inception date to June 1, 2024. The titles, abstracts, and full texts were independently evaluated and screened by two authors. Additionally, the economic evaluation studies were assessed independently by two authors using the consolidated health economic evaluation reporting standards checklist.Results14 studies were included which were about the economic evaluations of adding dapagliflozin in the treatment of chronic kidney disease. The minimum consolidated health economic evaluation reporting standards score for the studies was 0.77, indicating very good quality. Adding dapagliflozin to the standard of care would be more effective and cost-saving in Mexico, Malaysia, Canada, Thailand, and China. The highest incremental cost-effectiveness ratio of dapagliflozin ($67962.75/QALY) originated from the USA. According to the available studies, adding dapagliflozin to standard of care for the treatment of chronic kidney disease is considered cost-effectiveness from both the healthcare system and the payer’s perspective.ConclusionAdding dapagliflozin to standard care in the treatment of chronic kidney disease is cost-effective from both the healthcare system and the payer’s perspective in well-developed countries.

Exploring the Role of Early Diagnosis of Hearing Loss in Children and Its Impact on Educational Outcomes, Language Development, and Social Integration in Special Education Settings

The study explores the impact of early diagnosis of hearing loss on children's educational outcomes, language development, and social integration in special education settings. The research involved 150 children with early hearing loss, comparing the differences between early diagnosis (0-2 years) and late diagnosis (more than 2 years after birth). A quantitative research design was employed, using standardized test scores, teacher assessments, speech development tests, and social interaction surveys for data collection. The findings show that early diagnosis positively influences academic performance, language development, and peer interactions. Children diagnosed early demonstrated better academic outcomes (p < 0.05), more advanced language skills (p < 0.05), and improved social interactions (p < 0.05) compared to those diagnosed later. A strong positive correlation was found between early diagnosis and the effectiveness of support services (r = 0.65, p < 0.05). These results emphasize the importance of early intervention and robust support systems for children with hearing loss, highlighting the need for expanded newborn hearing screening programs and improvements in educational practices. Further research is recommended on long-term outcomes, the role of assistive technologies, and the influence of family involvement on improving outcomes following early diagnosis.

SERIAL HEALTH ASSESSMENT WITH STANDARDIZED EXTERNAL SCORING AND HEMOLYMPH EVALUATION IN THE AMERICAN HORSESHOE CRAB (LIMULUS POLYPHEMUS).

Serial health assessment of a managed population of American horseshoe crabs (HSC; Limulus polyphemus) was performed. Twenty HSC were examined once a month for 7 mon; this included a physical exam with a standardized scoring sheet, HR, morphometrics, and hemolymph evaluation with hemocyte count, copper concentration, and biochemistry panel. The HSC in this population had varying levels of external lesions at enrollment. All HSC were clinically and behaviorally stable over the study period, with no apparent differences in evaluated parameters in relation to degree of external lesions. Although the standardized scoring sheet was found to be helpful to complete the evaluation, the qualitative criteria potentially masks clinically important gradations in some parameters. HR ranged from 4 to 60 bpm, with high intra- and interindividual variability. Increased prosomal widths (PW) were found to be correlated with lower HR. Plots of weight (W) in grams divided by PW in centimeters are roughly linear, and W:PW shows promise as a method of body condition evaluation in a hard-shelled animal. Serial collection of ∼2 ml of hemolymph led to no appreciable clinical decline in any animal. Total protein levels were stable and higher than previously reported for HSC in managed care. Glucose values were stable throughout the study period, which is interpreted as reflecting adequate nutritional intake in the study animals. Further studies are needed to determine the clinical utility of standardized vertebrate biochemistry panels in invertebrate species.

Machine learning and network analysis for financial crime detection: Mapping and identifying illicit transaction patterns in global black money transactions

The detection and prevention of malicious financial activities should be paramount for organizations in the US. Global economic integration, online banking, and increasing cases of cryptocurrency transactions have just increased the complexity of tracing illegal transactions. This research project examines the combined application and deployment of machine learning and network analysis in detecting black money transactions in the USA and globally. Machine learning and network analysis have emerged as a powerful mechanism in the fight against financial crime. Machine learning techniques, whereby systems learn through supervised and unsupervised learning, differ in that they can recognize patterns of financial data indicative of potentially fraudulent behavior. On the other hand, network analysis is one of the unique methods of detecting financial crimes, which derives power from presented relationships and interactions between sets of entities constituting transactional networks, such as people, companies, and accounts. This study used the Global Black Money Transactions dataset which revolved around financial transaction records involving unreported or illicit money, frequently for evading taxes, laundering money, or conducting illegal activities. Data come from financial institutions, government surveillance, whistleblowers, or investigations by the concerned law enforcement agencies. Rigorous data preprocessing steps were performed for the machine learning pipeline. In the current research project experiment, three machine learning algorithms were used: Logistic Regression, Random Forest, and XG-Boost. The performance indicators involved a set of standard metrics, including accuracy, precision, recall, F1 score, and AUC, which stands for Area Under the Curve. Despite lower accuracy, the XG-Boost algorithm was the best-performing algorithm. In terms of Precision, it correctly detected and predicted crimes, while the other models failed. Concerning the F1 Score, XG-Boost had the highest F1 score, balancing precision and recall. As per the AUC outcome, slightly better than Random Forest, XG-Boost was more capable of distinguishing between crime and non-crime transactions. Keywords: Black Money Transactions, Financial Crime, Machine Learning, Network Analysis, Mapping Illicit Transactions, XG-Boost, Random Forest, Logistic Regression

Взаимосвязь миокинов и саркопенического ожирения с неалкогольной жировой болезнью печени при конституционально-экзогенном ожирении у детей

Obesity in children is associated with high risk for development and progression of nonalcoholic fatty liver disease (NAFLD). NAFLD has common pathogenetic mechanisms with sarcopenic obesity (SO), in the development of which such myokines as fibroblast growth factor 21 (FGF-21) and irisin play an important role. The study of their secretion peculiarities is relevant to the prospects of using myokines as diagnostic markers or indicators for drug therapy and physical activity control as well as in the development of target therapy for NAFLD. The connection between NAFLD and SO and changes in myokine profile in children is an understudied issue. The purpose of this research was to determine differences between groups of pediatric patients with the presence v. those with the absence of NAFLD in constitutional-exogenous obesity in myokine and SO levels. Methods used: a single-stage comparative single-center uncontrolled study of 95 children aged 12 to 18 y/o with constitutional-exogenous obesity: body mass index (BMI) standard deviation score (SDS)≥+2.0. Results: NAFLD was detected in 48% (n=50/95) [95% CI (42; 63)] of whom steatohepatitis was detected in 40% (n=20/50) [95% CI (26; 55)]. SO was detected in 96% (n=48/50) [95% CI (86; 99)] with NAFLD including children with steatohepatitis (n=20). The combination of SO with elevated FRF-21 levels and decreased irisin was associated with NAFLD (AUC=0.761, [95% CI (0.65; 0.87)]). The SO frequency was statistically significantly higher in NAFLD than in the SO absence (p<0.001). The predictive ability of the SO presence in relation to the detection of NAFLD was found to be high (PCPR=96%, [95% CI (88; 99)]). FRF-21 values above 60 pg/mL (AUC=0.689, [95% CI (0.57; 0.81)]) and irisin values below 7.86 μg/mL (AUC=0.703, 95% CI (0.58; 0.82)]) were associated with the presence of NAFLD. When comparing operational characteristics, no differences were found for AUC value while the best performance was demonstrated by regression model and cut-off point of irisin equal to 7.86 μg/mL. Conclusion: SO combined with changes in myokine profile is associated with NAFLD. Identification of the main factors influencing the NAFLD development in childhood is crucial in preventing the progression of liver damage.

Bone Health Determinants in Ambulant Prepubertal Boys With Duchenne Muscular Dystrophy Treated With Deflazacort: Findings From a 3-Year Study.

Duchenne muscular dystrophy (DMD) is complicated by bone fragility. This study aimed to elucidate changes in bone mineral density (BMD) and body composition over time and to explore associations with adiposity measures in DMD. A three-year follow-up analysis was performed of total body (TB) and lumbar spine (LS) dual-energy x-ray absorptiometry (DXA) measurements, anthropometric measures, Tanner stage and bone turnover biomarkers assessments, and the incidence of fragility fractures in 26 ambulant prepubertal DMD patients treated with deflazacort (DFZ). Age at baseline was 7.7 years (interquartile range: 6-9.2). The TB BMD Z-score declined over time and was negatively related to the TB fat mass percentage and fat mass index (p < 0.05), but not to body mass index (BMI) standard deviation score (SDS). In contrast LS bone mineral apparent density (BMAD) Z-score remained stable and normal. The cumulative incidence of fragility fractures was 19.2%; DMD boys with fractures displayed a 1.5-fold higher decline of TB BMD Z-score/year (p < 0.05) and a worse adiposity profile compared to fracture-free patients. No difference was found in DFZ dose or duration between the two groups. We observed a high incidence of fragility fractures, and identified fat tissue as a potential detrimental factor for bone health, suggesting a need for monitoring in DMD patients with excessive adiposity. Fat mass measures assessed by DXA could help to identify those at risk, enabling targeted interventions for better bone health. The co-occurrence of multiple glucocorticoid side effects might characterize patients at higher risk of fractures.

Development of a forest healing program for individuals with musculoskeletal disease risk and verification of its preventive effects.

Preventive treatment is crucial in averting the onset of musculoskeletal diseases, particularly among individuals in high-stress occupations. This study aimed to develop a forest healing program and a standardized survey index to gauge its efficacy in mitigating stress and preventing musculoskeletal disorders. Service-oriented workers who engage in repetitive tasks but are not traditional office workers at risk of musculoskeletal issues were recruited. The forest healing program was crafted through a review of existing initiatives and identification of factors alleviating muscle tension and stress. A comprehensive survey index encompassing stress, depression, anxiety, quality of life, and somatization was designed. Participants were assessed using the Perceived Stress Scale (PSS), Somatization Scale (SOM), and the newly devised survey index before and after engaging in the developed forest healing program. Evaluation of 42 participants pre- and post-program revealed significant reductions in PSS (25.857 ± 8.120/17.905 ± 5.958; P < .001), SOM (27.905 ± 8.839/20.286 ± 8.019; P < .001), and standard survey index scores (33.857 ± 10.280/23.333 ± 8.703; P < .001). The developed forest healing program demonstrated substantial stress relief and muscle relaxation benefits, proving effective in preventing musculoskeletal diseases. Moreover, the standardized survey index emerged as a valuable tool for assessing stress related to such disorders, exhibiting correlations with PSS and SOM.

Dental Anomalies in the Past: Fusion, Gemination, and Talon Cusp in Two Archeological Samples.

Disruption in odontogenesis can influence the normal development of both deciduous and permanent dentition resulting in anomalies in morphology, number, and position of teeth. Although dental anomalies are frequently reported in clinical practice, their occurrence in past populations from archeological contexts is rarely acknowledged. To describe two cases of dental anomalies on two non-adult individuals from Italian archeological sites. Individual sex diagnosis was performed by analyzing amelogenin peptides from the dental enamel through liquid chromatography mass spectrometry (LC-MS/MS). Age-at-death estimation was based on stages of dental formation and eruption. Dental twinning and talon cusp were morphologically evaluated and classified following standardized scoring systems proposed by clinical literature. The first individual, a 3-4-year-old female from the Imperial Roman necropolis of Isola Sacra, presents the fusion of the upper right deciduous central incisor with a supplementary tooth; the second individual, a 3-3.5-year-old male from a Late Antiquity catacomb, shows a case of bilateral gemination on the upper permanent central incisors with a co-occurrence of dental gemination and talon cusp on the right one. The cases reported here (the two anomalies in the individuals presented) are useful into understanding these dental conditions within past/archaeological populations.

Frequency, sociodemographic, and neuropsychological features of patients with subjective cognitive decline diagnosed using different neuropsychological criteria

BackgroundSubjective Cognitive Decline (SCD) is recognized as a risk stage for future cognitive impairment and dementia. The criteria for SCD include normal performance on neuropsychological testing; however, there is a lack of consensus regarding standard score cut-offs for neuropsychological tests to define cognitive impairment and to differentiate between SCD and Mild Cognitive Impairment (MCI). This study aimed to assess the frequency of SCD diagnosis using various neuropsychological definitions of cognitive normality and to characterize the sociodemographic and neuropsychological features of SCD patients diagnosed under these criteria.MethodsThe Cognitive Complaints Cohort (CCC) participants were diagnosed following Subjective Cognitive Decline Initiative (SCD-I) criteria. Normal cognitive performance was defined by the absence of Mild Cognitive Impairment (MCI) according to the five sets of MCI neuropsychologically based criteria defined by Jak and Bondi. Descriptive statistics were used to analyze sociodemographic, clinical, and neuropsychological data. A bootstrap methodology was employed to estimate the mean and 95% confidence intervals (CI) for specific parameters of interest, namely the SMC scale (subjective memory complaints scale), Mini-Mental State Examination (MMSE), Blessed Dementia Rating Scale – first part (BDRS first part), and Geriatric Depression Scale (GDS).ResultsAmong the 1268 subjects included, the prevalence of SCD diagnosis exhibited substantial variation across SCD-I criteria using different neuropsychological definitions of cognitive normality (ranging from 16.4 to 81.3%). When using the most conservative criteria to define cognitive impairment (2 tests within a cognitive domain > 1.5 SD below age-adjusted means), the resulting Conservative SCD group had poorer global cognitive function (MMSE: mean 27.15, 95% CI 27.00-27.31), whereas when using the most liberal criteria to define cognitive impairment (only one test > 1 SD below age-adjusted means) the resulting Liberal SCD group had superior performance in daily-life functioning (BDRS first part: mean 0.30, 95% CI 0.23–0.38). However, subjective cognitive complaints and neuropsychiatric symptoms did not significantly differ among SCD diagnostic groups.ConclusionsThe utilization of diagnostic criteria using distinct neuropsychological definitions of cognitive normality significantly impacts the frequency of SCD diagnosis and characterizes different patient populations. Consequently, it is essential to specify the criterion when diagnosing a SCD patient and to understand the risks and benefits of using different criteria to define cognitive impairment.

Development and validation of the Transgender Adolescent Stress Survey-Minority Stress (TASS-MS).

This study aimed to create and validate a novel measure of gender-related minority stress in transgender and non-binary adolescents (TNBA). TNBA face higher risks of varied behavioral health concerns compared to their cisgender peers, a disparity often attributed to the presence of minority stress due to discrimination. To date, no comprehensive measures of gender-related minority stress exist for use with TNBA. The present study recruited a U.S. national sample (N = 444, aged 12-17; 65.5% White, 9.5% Black, 9.5% Latine, 15.5% other ethnicity; 34.7% transmasculine, 17.3% transfeminine, 38.3% non-binary, 9.5% agender) of TNBA. An initial item pool was developed from life history calendars, a modified Delphi process, and cognitive interviews with TNBA. Analytic methods including principal components analysis, item response theory, measurement invariance testing, and reliability analyses were conducted to establish the final scale. Concurrent validity was established across behavioral outcomes (mental health, suicidal thoughts and behavior, substance use), and convergent and divergent validity compared the Transgender Adolescent Stress Survey-Minority Stress (TASS-MS) to existing measures of gender-related minority stress. The TASS-MS and its subscales (disaffirmation, visibility and internalized transnegativity, family) were significantly associated with anxiety and depressive symptoms, PTSD symptoms, suicidal behaviors, non-suicidal self-injury, marijuana, and prescription drug use. The TASS-MS was moderately and weakly correlated with convergent and divergent measures, respectively, indicating specificity to minority stress. The TASS-MS is a reliable and valid measure for future research with TNBA. It is inclusive and usable by all gender minority adolescents, uses a standard simple scoring system, and assesses adolescent-specific stressors.

Association between Slow and Rapid Weight Gain before 36 Weeks of Corrected Age and 6-Year-Developmental Quotient in Infants Born at

The postnatal growth of preterm infants is influenced by various factors; however, the association between growth and long-term outcomes in extremely preterm infants remains unclear. Therefore, we aimed to determine the association between 6-year development and body weight (BW) at 36 weeks of corrected age (CA) in extremely preterm infants. We conducted a retrospective observational study including extremely preterm infants born at < 26 weeks of gestation. We defined the key standard deviation score (SDS) using BW at birth and evaluated the association between BW-related values at 36 weeks of CA and the 6-year developmental quotient (DQ). This study included 90 infants. The absolute difference between changes in the BW SDS from birth and the median changes in DQ ≥ 85 infants was significantly greater in infants with a DQ < 85 than ≥85 (median [interquartile range]: 0.80 [0.29, 1.31] vs. 0.34 [0.13, 0.55]; p = 0.001). After adjustment by the logistic regression analysis for DQ < 85, the absolute difference was statistically significant (odds ratio: 4.99, 95% confidence interval: 1.71-14.5). The correlation coefficient between the absolute difference and DQ was -0.35 (p < 0.001). There were no significant associations between a DQ < 85 and SDS or changes in SDS from birth. For infants born at <26 weeks of gestation, slow and rapid weight gain were associated with a low 6-year DQ when using values representing individual body sizes at birth. Individual backgrounds should be considered to avoid both slow and rapid weight gain for the growth management of these infants for at least up to 36 weeks of CA. Further research is needed to determine which body size has a positive impact on the long-term outcomes of infants. · The median change in BW SDS was a key factor for DQ.. · Slow/rapid weight gain were related to a low 6-year DQ.. · Individual backgrounds may be important in neonatal intensive care unit care..

Improving mathematics outcomes for multilingual learners in dual language programs through targeted teacher professional development

AbstractProviding instruction in a student's home language through bilingual education has proven to be academically beneficial for multilingual learners (MLLs). The present study contributes to this literature by examining the possibilities and limits of a professional development program (Mathematics and Language Literacy Integration [MALLI] in Dual Language settings) with dual language (Spanish/English) teachers and the impact on elementary grade MLLs' state mathematics and English language proficiency assessment outcomes. MALLI was a year‐long professional development project that included models for integrating language and literacy into Spanish‐language mathematics instruction using Lesson Study with Video Clubs. Coarsened exact matching was utilized to establish a treatment and unbiased comparison group. MLLs taught by MALLI teachers had state mathematics assessment average standardized scores of 0.374 standard deviation units higher than comparison students whose teachers did not participate in MALLI. These results were statistically significant, equivalent to moving the performance of an average MLL from the 50th percentile to the 64.6 percentile rank. However, the effect on State English language proficiency scores was small and not statistically significant. This study illustrates the potential impact of specially designed professional development to improve MLLs' mathematics outcomes.

ChatGPT-4o's performance on pediatric Vesicoureteral reflux.

Vesicoureteral reflux (VUR) is a common congenital or acquired urinary disorder in children. Chat Generative Pre-trained Transformer (ChatGPT) is an artificial intelligence-driven platform offering medical information. This research aims to assess the reliability and readability of ChatGPT-4o's answers regarding pediatric VUR for general, non-medical audience. Twenty of the most frequently asked English-language questions about VUR in children were used to evaluate ChatGPT-4o's responses. Two independent reviewers rated the reliability and quality using the Global Quality Scale (GQS) and a modified version of the DISCERN tool. The readability of ChatGPT responses was assessed through the Flesch Reading Ease (FRE) Score, Flesch-Kincaid Grade Level (FKGL), Gunning Fog Index (GFI), Coleman-Liau Index (CLI), and Simple Measure of Gobbledygook (SMOG). Median mDISCERN and GQS scores were 4 (4-5) and 5 (3-5), respectively. Most of the responses of ChatGPT have moderate (55%) and good (45%) reliability according to the mDISCERN score and high quality (95%) according to GQS. The mean±standard deviation scores for FRE, FKGL, SMOG, GFI, and CLI of the text were 26±12, 15±2.5, 16.3±2, 18.8±2.9, and 15.3±2.2, respectively, indicating a high level of reading difficulty. While ChatGPT-4o offers accurate and high-quality information about pediatric VUR, its readability poses challenges, as the content is difficult to understand for a general audience. ChatGPT provides high-quality, accessible information about VUR. However, improving readability should be a priority to make this information more user-friendly for a broader audience.

Taste and smell are associated with dietary intake, eating behavior, nutritional status, and health-related quality of life in children with cancer

Background & aimsSmell and taste changes are frequently reported bothersome treatment symptoms during treatment for childhood cancer and assumed to influence outcomes such as food intake. Since nutritional status of children with cancer is already vulnerable, any detrimental effects on food intake should be prevented. Therefore, understanding the exact relationship between chemosensory changes and dietary intake, eating behavior, and other domains such as health-related quality of life (HRQoL), is important for improving outcomes. MethodsIn this longitudinal study, we followed 87 childhood cancer patients treated for hematological, solid, or brain malignancies. Smell (odor threshold and odor identification) and taste function (total taste score) were objectively investigated using commercial Sniffin’ Sticks and Taste Strips respectively, and by self-report. Dietary intake was measured using a 3-day food dairy. For nutritional status, BMI expressed as standard deviation scores was derived from medical records. Eating behavior and HRQoL were assessed by the Behavioral Pediatrics Feeding Assessment Scale (BPFAS) and PedsQL 4.0 Generic Core Scales, respectively. Measurements were taken approximately 6 weeks (T0), 3 months (T1), 6 months after starting chemotherapy (T2), and 3 months after termination of chemotherapy or maintenance phase for children with acute lymphoblastic leukemia (ALL) (T3). Dietary intake, eating behavior, nutritional status, and HRQoL were modelled over time using mixed model analysis. Associations between smell and taste (objective and self-report), as well as patient characteries were studied. ResultsEnergy intake significantly increased during the study period, with a higher age, BMI, and total taste scores associated to this increase. Boys had higher energy intake compared to girls. Eating behavior scores significantly declined, indicating less eating problems. Age, pre-diagnosis eating behavior, self-reported smell changes, and tube feeding were associated to eating behavior. BMI significantly increased, with a higher BMI at diagnosis to be related to a higher BMI during the study period. A lower BMI was found in children receiving tube feeding and self-reported taste changes. HRQoL improved during the study period, with lower HRQoL in children receiving tube feeding and self-reported taste changes. ConclusionBoth objective and subjective measures of taste and smell influence dietary intake, eating behavior, nutritional status, and HRQoL. Individual dietary advice and coping strategies are warranted to prevent detrimental effects of chemosensory changes on food intake and clinical outcomes in children with cancer.

Identifying modifiable factors and their joint effect on brain health: an exposome-wide association study.

Considerable uncertainty remains regarding the associations of multiple factors with brain health. We aimed to conduct an exposome-wide association study on neurodegenerative disease and neuropsychiatry disorders using data of participants from the UK Biobank. Multivariable Cox regression models with the least absolute shrinkage and selection operator technique as well as principal component analyses were used to evaluate the exposures in relation to common disorders of central nervous system (CNS). Restricted cubic splines were conducted to explore potential nonlinear correlations. Then, weighted standardized scores were generated based on the coefficients to calculate the joint effects of risk factors. We also estimated the potential impact of eliminating the unfavorable profiles of risk domains on CNS disorders using population attributable fraction (PAF). Finally, sensitivity analyses were performed to reduce the risk of reverse causality. The current study discovered the significantly associated exposures fell into six primary exposome categories. The joint effects of identified risk factors demonstrated higher risks for common disorders of CNS (HR = 1.278 ~ 3.743, p < 2e-16). The PAF varied by exposome categories, with lifestyle and medical history contributing to majority of disease cases. In total, we estimated that up to 3.7 ~ 64.1% of disease cases could be prevented.This study yielded modifiable variables of different categories and assessed their joint effects on common disorders of CNS. Targeting the identified exposures might help formulate effective strategies for maintaining brain health.

Impact of the International Tumor Budding Consensus Conference Recommendations in Oral Cancer

ABSTRACTObjectivesTumor budding was suggested as a valuable prognostic factor in oral squamous cell carcinoma (OSCC) but lacks a standardized scoring system. This study evaluates tumor budding in OSCC using the scoring system recommended by the International Tumor Budding Consensus Conference (ITBCC) 2016.Materials and MethodsThe study included 114 patients with resected OSCC. Tumor budding was evaluated according to ITBCC criteria and assigned to three categories (low, intermediate, and high tumor budding). The associations between tumor budding and clinicopathological parameters were examined and survival rate analyses were performed by the Kaplan–Meier method. The prognostic value of tumor budding was assessed by Cox regression analysis.ResultsSignificant correlations of tumor budding with clinicopathological parameters including lymph node metastasis, grade, stage, perineural and lymphovascular invasion, and local recurrence were found. Intermediate and high tumor budding were significantly and independently associated with worse disease‐free survival. High tumor budding was identified as an independent prognostic factor for disease‐specific and overall survival.ConclusionsThe ITBCC scoring system represents a simple, feasible, and reproducible method to evaluate tumor budding in OSCC. Tumor budding, according to ITBCC criteria, showed its prognostic value in resected OSCC, and its incorporation into the histopathological reporting guidelines should be considered.

Effect of serum antioxidants on cognitive dysfunction in first-episode and drug-naïve patients with major depressive disorder.

Cognitive dysfunction is a persistent and difficult-to-treat symptom of major depressive disorder (MDD) and is receiving increasing attention. A balanced state of oxidative stress sustained by antioxidants is essential for normal functioning of brain, including learning capacity, emotional regulation, and cognitive function. The correlation between cognition and oxidative stress may also be altered in patients with mental disorders. This study aimed to explore the relationship between serum antioxidant levels and cognitive dysfunction in patients with MDD. We collected and matched cognitive performance data using the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery (MCCB), serum antioxidants, and demographic and clinical characteristics of 105 first-episode drug-naïve patients with MDD and 53 healthy controls (HC) from February 2022 to October 2023, and then analyzed the differences between the two groups. HamiltonDepressionScale-17 and Young Mania Rating Scale (YMRS) were used to evaluate the clinical symptoms of the participants with MDD. Serum antioxidants, including albumin (ALB), uric acid (UA), and superoxide dismutase (SOD) were used to detect the level of oxidative stress in participants and its correlation with cognitive function. We then used a threshold for cognitive dysfunction of 1.5 standard deviations below the mean of the standard score to divide the participants with MDD into two groups to detect the relevant elements of the five different domains of cognitive dysfunction in MDD. ALB levels were significantly lower in the MDD group (p = 0.001) after adjusting for years of education. The performance in all five domains of cognitive function was significantly worse in the MDD group than in the HC group (p < 0.001). Speed of processing (SOP) in the MDD group correlated with ALB (r = 0.261, p = 0.008), and UA (r = 0.295, p = 0.002) levels. We also explored the correlation between the attention/vigilance (AV) domain and the UA (r = 0.239, p = 0.015). YMRS score was risk factor of impairment of SOP domain in patients with MDD. Yet UA was a protective factor against SOP impairment, with a 0.006-fold reduction in the risk of SOP impairment for each 1-unit increase in UA. As serum antioxidants, ALB and UA may serve as biomarkers of cognitive function in patients with MDD. Our findings contribute to the understanding of the potential ability of serum antioxidants to predict cognitive decline in patients with MDD.

Exploring the effects of a 12-Week functional training program on fundamental motor skills for primary school children aged 6–7

BackgroundFundamental motor skills (FMS) are the foundation of children’s movement. Professional guidance and customised training methods are essential to effectively acquiring and mastering fundamental motor skills. Recently, functional training has gained widespread popularity and is associated with numerous benefits. Therefore, this study aims to evaluate the effect of functional training on fundamental motor skills in children aged 6–7. MethodsThis study was conducted at a primary school. One hundred children were randomly selected from 382 who met the criteria and allocated to a functional training or regular physical education group, with 25 boys and 25 girls in each group. The research program lasted 12 weeks, with two weekly sessions, each lasting 40 min. The assessment of fundamental motor skills utilises the Test of Gross Motor Development and Pediatric Balance Scale. The pre-test and post-test data were analysed using generalised estimating equations. ResultsThe data analysis showed statistically significant differences between and within groups. There was a significant interaction effect of time and group on the gross motor quotient (x2 = 51.603, p = 0.001), locomotor subtest standard scores (x2 = 22.259, p = 0.001), object control subtest standard scores (x2 = 29.283, p = 0.001), and PBS balance scores (x2 = 24.881, p = 0.001). Furthermore, the main effect of time was significant for the four variables. However, the main effects of the group varied. Significant effects of the group were observed for the gross motor quotient (x2 = 8.662, p = 0.003) and object control subtest standard scores (x2 = 7.471, p = 0.006), but not for locomotor subtest standard scores (x2 = 2.558, p = 0.110) or PBS balance scores (x2 = 1.188, p = 0.276). Discussion and ConclusionsFunctional training can positively impact the development of fundamental motor skills in children aged 6–7, demonstrating greater effectiveness than regular physical education courses. These findings provide evidence that incorporating functional training into early childhood physical education can be an effective intervention for enhancing the development of fundamental motor skills.

Factors Associated with Burst Abdomen in Patients of Midline Laparotomy, Assessed using Risk Scoring System: A Retrospective Observational Study

Introduction: Burst abdomen can result in evisceration (protrusion of abdominal viscera), requiring immediate treatment. If, left untreated, it can cause perioperative mortality. Some studies have been conducted in the past to develop risk scoring systems to identify patients who have a significant risk of developing a burst abdomen. The Rotterdam score considers all three risk factors (i.e., preoperative, intraoperative, and postoperative) and is a standard scoring system for predicting the risk of burst abdomen in the Western population. The Krishna Institute of Medical Sciences (KIMS) 14 score compares only preoperative and intraoperative factors. Aim: To evaluate the demographic and clinical profile of patients developing burst abdomen following laparotomy for peritonitis and to assess their Rotterdam and KIMS 14 risk scores. Materials and Methods: This retrospective observational study was conducted in the Department of Surgery at GTB Hospital, New Delhi, India, from January 2024 to March 2024. The case sheet records of patients operated on in the last three years (January 2021 to December 2023) were evaluated. A total of 100 patients were enrolled as per inclusion and exclusion criteria. A total of 50 patients were classified as cases (who developed burst abdomen) and 50 patients as controls (who did not have burst abdomen). The outcome measures included demographic and clinical data of patients, associated co-morbidities, preoperative status, and intraoperative findings (organ affected, type of contamination, postoperative complications). The Rotterdam score and KIMS 14 score were calculated. For qualitative variables, the Chi-square test or Fisher’s-exact test was used. Statistical significance was set at p&lt;0.05. Results: Most subjects in the dehiscence group were males (40), and the rate was higher in the older age group (17 patients). The maximum number of dehiscences occurred postoperatively on day 6, with a mean of 6.66±2.66 days. The duration of surgery exceeding two hours was higher (80%) in the dehiscence group. The total leucocyte count (11074.00±6238.35 /mm3 ) and liver enzymes {Serum Glutamic Oxaloacetic Transaminase (SGOT) 68.72±58.90 U/L and Serum Glutamic Pyruvic Transaminase (SGPT) 68.22±75.62 U/L} were elevated in the dehiscence group. The incidence of Surgical Site Infection (SSI) in the postoperative period was higher (98%) in the dehiscence group. The mean Rotterdam and KIMS 14 scores were higher in patients who developed wound dehiscence (Rotterdam score of 5.05 and KIMS 14 score of 11.76) compared to patients who did not develop dehiscence (Rotterdam score of 3.73 and KIMS 14 score of 8.92). The p-values were 0.001 and 0.002 for the Rotterdam and KIMS 14 scores, respectively. Conclusion: Rotterdam and KIMS 14 scores were found to be statistically significant in patients developing burst abdomen. The mean score in both scoring systems was higher in patients who developed burst abdomen.