Stepwise Multiple Regression Analysis Research Articles

Preoperative factors associated with patient satisfaction after modified kinematically aligned total knee arthroplasty in varus knees

PurposeKinematically aligned-total knee arthroplasty (KA-TKA) has recently attracted significant interest because it delivers better clinical outcomes than mechanically aligned (MA)-TKA. However, the optimal preoperative factors that maximize the effectiveness of KA-TKA remain controversial. Therefore, we aimed to determine the preoperative factors that are appropriate for and might benefit from modified KA-TKA, based on patient-reported outcome measures (PROMs). MethodsThe relationships between postoperative satisfaction and other variables in 84 patients with varus-type osteoarthritis of the knee who underwent primary modified KA-TKAs were investigated using stepwise multiple regression analysis. Patients were assigned to groups that were satisfied or dissatisfied with their outcomes after KA-TKA according to the 2011 Knee Society Scores. The cutoff for preoperative advanced activities scores (AASs) for excellent satisfaction were determined by analyzing receiver operating characteristic (ROC) curves. The variables correlated with excellent satisfaction were identified using logistic regression models. ResultsA preoperative variable relevant to patient satisfaction was AAS (β ​= ​0.465). The results of the ROC curve analysis revealed eight optimal cut-offs for preoperative AASs that predicted excellent satisfaction, with a sensitivity and specificity of 0.700 and 0.625, respectively. Logistic regression analysis revealed that AASs significantly contributed to excellent patient satisfaction (odds ratio, 1.181; p ​= ​0.001). ConclusionsIndividuals who were highly active preoperatively were good candidates for KA-TKA. This modified kinematically aligned surgical technique can satisfy the demands of highly active patients.

Water quality evaluation based on water quality index and multiple linear regression: A research on Hanyuan Lake in southern Sichuan Province, China.

This study aims to understand the changes in the water quality of Hanyuan Lake and to show these changes over time. In this study, monthly sampling was conducted at three sampling sites in Hanyuan Lake, and water samples were measured for water quality indicators in the laboratory according to the methods specified in the Environmental Quality Standards for Surface Water (GB3838-2002). Based on the monitoring data from January to December 2019, the WQI comprehensive evaluation method was used to conduct multiple linear stepwise regression analysis, extract key indicators, and establish the WQImin model. The results show that according to the WQI comprehensive evaluation method, the WQI values of Hanyuan Lake are all above 90, and the grade is excellent. The overall water quality of Hanyuan Lake is excellent, and most of the water quality indexes reach the Class I standard in the Environmental Quality Standards for Surface Water (GB3838-2002). WQImin1 (R2 = 0.86, p < 0.001, PE = 4.28) as the best WQImin model. In this study, a model with fewer parameters was established by multiple linear regression method, which is conducive to better monitoring of water quality at monitoring stations while saving costs. PRACTITIONER POINTS: According to the WQI comprehensive evaluation method, the WQI values of Hanyuan Lake are all above 90, the rating is excellent. From January 2019 to September 2020, the monthly change trend of each section is roughly the same, showing a trend of first decreasing, then rising, then decreasing, and finally rising and flattening. The WQImin model was developed to completely describe the change in the water body.

The Injury Risk Prediction of Firefighters with Biomechanical Parameters during Single- and Double-Leg Jumps

The incidence of knee injuries during firefighter training is high, but there is a lack of research on predictive factors and risk assessment for such injuries. Biomechanical assessments can provide a better understanding of how the body’s load changes during exercise, which may alter the risk of injury. Ten firefighters were recruited for our study. Each participant completed the FMS test and the single- and double-leg jump tasks. Motion information was collected and musculoskeletal models of the participants were constructed using OpenSim 4.4 to obtain the joint angle and joint moment. The peak GRF and CoM-CoP angle were also calculated. The findings showed a significantly larger PKFM (p = 0.0195), VAFM (p = 0.0039), and peak AP GRF (p = 0.0039) during the single-leg jump. The opposite performance was observed for KFA (p = 0.0098) and MPA (p = 0.0273). A stepwise multiple linear regression analysis was used to explore the relationship between these parameters and both the FMS score and the times of injuries. The risk of injury is higher in the single-leg jump compared to the double-leg jump. The biomechanical parameters of these two jumps can be used to assess sports injuries and to provide methods and references for injury risk monitoring during firefighter occupational training.

Using Image Analysis Technique for Predicting Light Lamb Carcass Composition

Over the years, numerous techniques have been explored to assess the composition and quality of sheep carcasses. This study focuses on the utilization of video image analysis (VIA) to evaluate the composition of light lamb carcasses (4.52 ± 1.34 kg, mean cold carcass weight ± SD). Photographic images capturing the lateral and dorsal sides of fifty-five light lamb carcasses were subjected to analysis. A comprehensive set of measurements was recorded, encompassing dimensions such as lengths, widths, angles, areas, and perimeters, totaling 21 measurements for the lateral view images and 29 for the dorsal view images. K-Folds stepwise multiple regression analyses were employed to construct prediction models for carcass tissue weights (including muscle, subcutaneous fat, intermuscular fat, and bone) and their respective percentages. The most effective prediction equations were established using data from cold carcass weight (CCW) and measurements from both dorsal and lateral views. These models accounted for a substantial portion of the observed variation in the weights of all carcass tissues (with K-fold-R2 ranging from 0.83 to 0.98). In terms of carcass tissue percentages, although the degree of variation explained was slightly lower (with K-fold-R2 ranging from 0.41 to 0.78), the VIA measurements remained integral to the predictive models. These findings underscore the efficacy of VIA as an objective tool for assessing the composition of light lamb carcasses, which are carcasses weighing ≈ 4–8 kg.

Association between urinary metals and prostate-specific antigen in aging population with depression: a cross-sectional study

ObjectiveThis study aims to investigate the impact of depression and urinary metals on Prostate-Specific Antigen (PSA).MethodsAnalysis was conducted on 1901 samples collected from the National Health and Nutrition Examination Survey (NHANES) database between 2001 and 2010. Analytical methods included stepwise multiple linear regression (MLR) analysis of the overall population’s urinary metals and PSA relationship, analysis of urinary metals and PSA relationship in older adults and BMI subgroups, analysis of urinary metals and PSA relationship in the depressed population, and restricted cubic spline (RCS) analysis. A significance level of p &amp;lt; 0.05 was considered statistically significant.ResultsIn the stepwise multiple linear regression, beryllium (Be) showed a dose–response association with PSA (third quartile: β = 0.05, 95%CI (0.02, 0.09); fourth quartile: β = 0.07, 95%CI (0.02, 0.12), p trend = 0.048). Subgroup analysis indicated that in individuals aged &amp;gt;60, Be at Q4 level [β = 0.09, 95%CI (0.05, 0.21)] exhibited a dose–response correlation with PSA. In the population with 25 ≤ BMI &amp;lt; 30, Be might more significantly elevate PSA, with Q4 level having a pronounced impact on PSA levels [β = 0.03, 95%CI (0.02, 1.27)]. In the depressed population, urinary cadmium (Cd) levels showed a significant positive dose–response relationship, with Q4 level of Cd having the maximum impact on PSA [β = 0.3, 95%CI (0.09, 0.49)].ConclusionIndividuals exposed to beryllium (Be), especially the older adults and overweight, should monitor their PSA levels. In depressed patients, cadmium (Cd) levels may further elevate PSA levels, necessitating increased monitoring of PSA levels among males.

#1943 The association of uncarboxylated, non-phosphorylated Matrix Gla protein with arterial stiffness in hemodialysis and peritoneal dialysis patients

Abstract Background and Aims Vitamin K deficiency has been identified as a marker of vascular calcification AND STIFNESS and an independent cardiovascular risk factor in hemodialysis (HD) and peritoneal dialysis (PD) patients, as the most powerful inhibitor of vascular calcification, Matrix Gla Protein requires vitamin K to become activated. However, until to date, it has not yet been clarified whether hepatic or extrahepatic markers of vitamin K status reflect the arterial status of dialysis patients. In this study we aimed to investigate the association of vitamin K deficiency with arterial stiffness in End-Stage Kidney Disease (ESKD) patients. Method In 42 ESKD patients undergoing either HD or PD, we measured plasma levels of the inactive vitamin-K dependent Matrix Gla Protein (dp-ucMGP) and serum levels of prothrombin (PIVKA-II) as markers of extrahepatic and hepatic insufficiency of vitamin K (CARIM Institute, Maastricht, Netherlands). In these patients we determined arterial stiffness parameters (pulse wave velocity-PWV) by the Mobil-O-Graph device (IEM, Stolberg, Germany). Results Serum PIVKA-II was associated with T2D duration (r = −0.38, p = 0.013), phosphorus levels (r = −0.41, p = 0.009) serum albumin (r = −0.33, p = 0.036) Spearman's rho test, and the type of transporter in PD patients (p = 0.039), Kruskal-Wallis test. Plasma dp-ucMGP was associated with PWV (r = 0.51, p = 0.001), peripheral (r = −0.37, p = 0.016) and central diastolic blood pressure (BP) (r = −0.34, p = 0.026) and age (r = 0.41, p = 0.007), Spearman's rho. Patients with T2DM, history of acute myocardial infarction and those receiving warfarin had significantly increased levels of circulating dp-ucMGP (p = 0.036, p = 0.039 and p &amp;lt; 0.0001, respectively, Kruskal-Wallis). Warfarin was associated with a 2.5-fold and a 23-fold increase in dp-ucMGP and PIVKA-II levels, respectively. Stepwise multiple regression analysis showed that PWV (p = 0.001, B = 494, 95% CI: 242-746) was an independent predictor of dp-ucMGP, independent of age, T2T2, history of myocardial infraction and diastolic BP. Conclusion Elevated plasma dp-ucMGP levels (suggesting extrahepatic vitamin K deficiency) were associated with increased arterial stiffness in dialysis patients.

Trait-anxiety and glial-related neuroinflammation of the amygdala and its associated regions in Alzheimer's disease: A significant correlation

BackgroundPositron emission tomography, which assesses the binding of translocator protein radiotracers, 11C-DPA-713, may be a sensitive method for determining glial-mediated neuroinflammation levels. This study investigated the relationship between regional 11C-DPA713 binding potential (BPND) and anxiety in patients with Alzheimer's disease (AD) continuum. MethodsNineteen patients with AD continuum determined to be amyloid-/p-tau 181-positive via cerebrospinal fluid analysis were included in this cross-sectional study (mild cognitive impairment [MCI, n = 5] and AD [n = 14]). Anxiety was evaluated using the State-Trait Anxiety Inventory (STAI). A whole-brain voxel-based analysis was performed to examine the relationship between 11C-DPA-713-BPND values at each voxel and the STAI score. Stepwise multiple regression analysis was performed to determine the predictors of STAI scores using independent variables, including 11C-DPA-713-BPND values within significant clusters. 11C-DPA-713-BPND values were compared between patients with AD continuum with low-to-moderate and high STAI scores. ResultsVoxel-based analysis revealed a positive correlation between trait anxiety severity and 11C-DPA713-BPND values in the centromedial amygdala and the left inferior occipital area [P < 0.001 (uncorrected) at the voxel-level]. 11C-DPA713-BPND values in these regions were a strong predictor of the STAI trait anxiety score. Specifically, patients with AD continuum and high trait anxiety had increased 11C-DPA713-BPND values in these regions. ConclusionsThe amygdala–occipital lobe circuit influences the control of emotional generation, and disruption of this network by AD pathology-induced inflammation may contribute to the expression of anxiety. Our findings suggest that suppression of inflammation can help effectively treat anxiety by attenuating damage to the amygdala and its associated areas.

Aluminum dynamics in nitrogen‐saturated Andisols in Tokyo

AbstractThe debate over whether forests around the Tokyo metropolitan area are nitrogen (N) saturation persists, as atmospheric N deposition in throughfall has decreased. This decrease is evidenced by a notable decline in samples collected in the 1990s (especially 1991–1992 and 1995). This decline can be attributed to a reduction in nitrogen oxide (NOx) emissions from automobiles. The acidity derived from N deposition can increase aluminum (Al) mobility. We conducted a monitoring study from September 2010 to December 2021 to elucidate the effects of decreased N deposition on Al concentrations and flux in a forested Andisol. Throughfall and soil‐percolated water samples were collected under stands of Japanese cedar and Japanese cypress in Hachioji, Tokyo (Field Museum Tamakyuryo). Major inorganic ions were determined by ion chromatography. Total Al concentrations were determined using atomic absorption spectrometry after concentration under acidic conditions. Aluminum and nitrate () concentrations were significantly correlated in the both Japanese cedar and Japanese cypress stands. In the case of the Japanese cedar stand, Al concentrations tended to decrease over time from November 2010 to May 2015. Based on stepwise multiple regression analysis, acid load associated with N transformation ([H+]load) was chosen as the sole factor affecting Al mobilization in the Japanese cedar stand. Decreased N deposition affects Al dynamics via a decrease in [H+]load.

Presence of Self-Reported Sleep Alterations After Stroke and Their Relationship With Disability: A Longitudinal Study.

Sleep disorders have a prevalence of 30% to 70% in post-stroke individuals. The presence of sleep disorders and poor sleep quality after stroke can affect important functions and lead to worse outcomes. However, most studies are restricted to the acute post-stroke stage only. To investigate the frequency of self-reported sleep alterations in a sample of chronic stroke individuals and to identify which self-reported sleep alterations were associated with disability. Prospective exploratory study. Self-reported sleep alterations were measured by the Pittsburgh Sleep Quality Index, Insomnia Severity Index, Epworth Sleepiness Scale, and STOP-Bang Questionnaire. The dependent variable was measured 3 years after the first contact by the Modified Rankin Scale (mRS). Step-wise multiple linear regression analysis was employed to identify which sleep alterations were associated with disability. Sixty-five individuals with stroke participated. About 67.7% of participants had poor sleep quality, 52.4% reported insomnia symptoms, 33.9% reported excessive daytime sleepiness, and 80.0% were classified as intermediate or high risk for obstructive sleep apnea. Only risk for obstructive sleep apnea was significantly associated with disability and explained 5% of the variance in the mRS scores. Self-reported sleep alterations had a considerable frequency in a sample of chronic stroke individuals. The risk of obstructive sleep apnea was associated with disability in the chronic stage of stroke. Sleep alterations must be considered and evaluated in the rehabilitation process even after a long period since the stroke onset.

Quantitative ultrasound techniques and biochemical markers to assess liver steatosis and fibrosis in newly diagnosed acromegaly.

The liver is known to be protected from steatosis under the influence of high GH/IGF-1. Cytokeratin 18 (CK18) and insulin-like growth factor binding protein 7 (IGFBP7) increase in liver steatosis and fibrosis. The aim of this study was to use quantitative ultrasound techniques and biochemical markers to assess liver steatosis and liver fibrosis in newly diagnosed acromegaly. This single-center, cross-sectional study included 23 patients with newly diagnosed acromegaly and 46 age, sex, body mass index (BMI) and waist circumference (WC)-matched controls. Liver steatosis was assessed using tissue attenuation imaging (TAI), and stiffness, indicative of fibrosis, was assessed by shear wave elastography (SWE). Serum IGFBP7 and CK18 were studied by ELISA. The acromegaly group had significantly lower liver steatosis (p = 0.006) and higher liver stiffness (p = 0.004), serum IGFBP7 (p = 0.048) and CK18 (p = 0.005) levels than the control group. The presence of fibrosis (p = 0.012) was significantly higher in the acromegaly group than in the control group. Moreover, CK18 was positively correlated with liver stiffness, WC, HOMA-IR, HbA1c, and triglyceride. In the acromegaly group, liver steatosis was negatively correlated with GH level. Stepwise multiple linear regression analysis revealed that BMI (p = 0.008) and CK18 (p = 0.015) were independent risk factors for increased liver stiffness. This study showed that there was an increased presence of liver fibrosis independent of liver steatosis in newly diagnosed acromegaly. Serum CK18 appears to be a potential marker of increased liver fibrosis in acromegaly.

Influence of acetabular and femoral morphology on pelvic tilt.

The aim of this study was to investigate whether anterior pelvic plane-pelvic tilt (APP-PT) is associated with distinct hip pathomorphologies. We asked: is there a difference in APP-PT between young symptomatic patients being evaluated for joint preservation surgery and an asymptomatic control group? Does APP-PT vary among distinct acetabular and femoral pathomorphologies? And does APP-PT differ in symptomatic hips based on demographic factors? This was an institutional review board-approved, single-centre, retrospective, case-control, comparative study, which included 388 symptomatic hips in 357 patients who presented to our tertiary centre for joint preservation between January 2011 and December 2015. Their mean age was 26 years (SD 2; 23 to 29) and 50% were female. They were allocated to 12 different morphological subgroups. The study group was compared with a control group of 20 asymptomatic hips in 20 patients. APP-PT was assessed in all patients based on supine anteroposterior pelvic radiographs using validated HipRecon software. Values in the two groups were compared using an independent-samples t-test. Multiple regression analysis was performed to examine the influences of diagnoses and demographic factors on APP-PT. The minimal clinically important difference (MCID) for APP-PT was defined as > 1 SD. There were no significant differences in APP-PT between the control group and the overall group (1.1° (SD 3.0°; -4.9° to 5.9°) vs 1.8° (SD 3.4°; -6.9° to 13.2°); p = 0.323). Acetabular retroversion and overcoverage groups showed higher mean APP-PTs compared with the control group (p = 0.001 and p = 0.014) and were the only diagnoses with a significant influence on APP-PT in the stepwise multiple regression analysis. All differences were below the MCID. The age, sex, height, weight, and BMI showed no influence on APP-PT. APP-PT showed no radiologically significant variation across different pathomorphologies of the hip in patients being assessed for joint-preserving surgery.

Influence of Individual Characteristics on Critical Environmental Limits in Middle-aged and Older Adults (PSU HEAT Project)

Critical environmental limits represent the temperature/humidity combinations at which heat balance can no longer be maintained for a given metabolic rate. Individual characteristics (e.g., sex, body weight and size, and aerobic fitness) are known to alter environmental heat exchange as well as thermoregulatory effector responses and therefore may modify critical environmental limits. PURPOSE: To determine which individual characteristics, if any, may be associated with higher or lower critical environmental limits [combinations of ambient dry-bulb temperature (Tdb) and relative humidity (rh)] in middle-aged and older adults. Methods: Forty-eight male (n=16) and female (n=32) participants (63±11 yrs; range: 40-92 yrs) were exposed to progressive heat stress at a low metabolic rate designed to reflect activities of daily living. Experiments were conducted in both hot-dry (HD; up to 53°C; ≤25% rh) and warm-humid (WH; ~35°C; ≥50% rh) environments. After determining critical limits for each age group and condition, forward stepwise multiple linear regression analyses were conducted with net metabolic rate (Mnet) and age entered into the model first, followed by sex, body mass, Vȯ2max, body surface area, and LDL cholesterol. Results: After accounting for Mnet and age, both sex and body mass further significantly improved the regression model in the HD environment (R2adj = 0.41, p &lt; 0.001) whereas only sex (R2adj = 0.51, P &lt; 0.001) added significantly to the WH model. Sex explained 11% of the variance in critical environmental limits in HD conditions and 14% of the variance in WH conditions. In both WH and HD environments, females exhibited lower critical combinations of Tdb and rh than their male counterparts. Additionally, body mass was negatively related to critical environmental limits in the HD environments and accounted for 8% of the variance after metabolic rate and age were accounted for. CONCLUSION: These data indicate a modest influence of individual characteristics, specifically sex and body mass, on critical environmental limits in both WH and HD environments in adults between the ages of 40 and 92. SIGNIFICANCE/NOVELTY: These results contrast previously published data in young adults showing no significant contribution of individual characteristics to the upper limits of heat balance at low metabolic rates reflecting activities of daily living. This reflects the heterogeneity of thermal-balance thresholds associated with aging relative to those seen in young adults. NIH R01 AG067471 (WLK) and NIA Grant T32 AG049676 (RMC). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Association of anhedonia with brain-derived neurotrophic factor and interleukin-10 in major depressive disorder

BackgroundAnhedonia, a core symptom of major depressive disorder (MDD), manifests in two forms: anticipatory and consummatory, reflecting a diminished capacity to anticipate or enjoy pleasurable activities. Prior studies suggest that brain-derived neurotrophic factor (BDNF) and interleukin-10 (IL-10) may play key roles in the emergence of anhedonia in MDD. The specific relationships between these biomarkers and the two forms of anhedonia remain unclear. This study investigated the potential links between BDNF, IL-10, and both forms of anhedonia in MDD patients. MethodsThis study included 43 participants diagnosed with MDD and 58 healthy controls. It involved detailed assessments of depression and anxiety levels, anticipatory and consummatory pleasure, cognitive functions, and a broad spectrum of plasma biomarkers, such as C-reactive protein, various interleukins, and BDNF. Using partial correlation, variables related to pleasant experiences were identified. Stepwise multiple linear regression analysis was applied to pinpoint the independent predictors of anhedonia in the MDD group. ResultsDemographically, both groups were comparable in terms of age, sex, body mass index, educational year, and marital status. Individuals with MDD displayed markedly reduced levels of anticipatory and consummatory pleasure, higher anxiety, and depression scores compared to healthy controls. Additionally, cognitive performance was notably poorer in the MDD group. These patients also had lower plasma diamine oxidase levels. Analysis linked anhedonia to impaired delayed memory. Regression results identified IL-10 and BDNF as independent predictors of anticipatory and consummatory anhedonia, respectively. ConclusionThese findings demonstrate that anticipatory and consummatory anhedonia are influenced by independent factors, thereby providing critical insights into the distinct neuroimmunological mechanisms that underlie various forms of anhedonia.Clinicl Trial Registration Number: NCT03790085

Body Compositions Correlate With Overt Hepatic Encephalopathy after Transjugular Intrahepatic Portosystemic Shunt: A Multicentre Cohort Study.

The relationship between body composition and the risk of overt hepatic encephalopathy (OHE) following transjugular intrahepatic portosystemic shunt (TIPS) needs to be investigated. Overall, 571 patients from 5 medical centers were included. To assess body compositions, we evaluated skeletal muscle indices, adipose tissue indices, sarcopenia, and myosteatosis at the third lumbar vertebral level. Univariate and Multivariate logistic regression analyses were performed to identify independent risk factors for post-TIPS OHE. An integrated score was then constructed using stepwise multiple regression analyses, with a cut-off value selected using the best Youden index. Finally, the Akaike information criterion (AIC) was performed to compare the integrated score and independent risk factors on their ability in predicting post-TIPS OHE. Sarcopenia and all skeletal muscle indices had limited associations with post-TIPS OHE. The index of the subcutaneous adipose tissue (SATI) (P=0.005; OR: 1.034, 95% CI: 1.010-1.058) and myosteatosis (297 cases, 52.01%, 125 with OHE, 42.09%; P=0.003; OR: 1.973; 95% CI: 1.262-3.084) were both ascertained as independent risk factors for post-TIPS OHE. The integrated score (ScoreALL=1.5760 + 0.0107 * SATI + 0.8579 * myosteatosis) was established with a cutoff value of -0.935. The akaike information criterion (AIC) of ScoreALL, SATI, and myosteatosis was 655.28, 691.18, and 686.60, respectively. SATI and myosteatosis are independent risk factors for post-TIPS OHE. However, the integrated score was more significantly associated with post-TIPS OHE than other skeletal muscle and adipose tissue factors.

Identifying the Predictors of School Improvement Plan Implementation by School Administrators

This study aimed to identify the level of managerial capabilities, human resource management, and quality assurance practices of school administrators on the implementation of School Improvement Plan (SIP). The respondents of the study were the 489 public school administrators of Northern Mindanao, Philippines. The data were gathered through survey questionnaires and was treated through descriptive statistics, Pearson product-moment correlation, and stepwise multiple regression analysis. School administrators exhibit remarkable managerial capabilities, earning high praise for their adept handling of operations, finances, and for fostering a conducive learning environment. Their strong human resource management skills are evident in nurturing collaborative communities, managing staff effectively, and conducting recruitment efficiently. Quality assurance practices are notably well-developed, indicating the school's ability to deliver top-notch education and support. Implementation of the SIP receives glowing reviews, showcasing the administrators' proficiency in enhancing learning environments, community engagement, resource allocation, curriculum, and staff management. Thus, the data highlights the school administrators outstanding performance and excellence across multiple crucial areas. The correlation analysis revealed significant relationships among managerial capabilities, human resource management, quality assurance practices, to the SIP implementation. Particularly, strong correlations were observed, indicating that schools excelling in one management area tend to perform well in others. Regression analysis highlighted five significant predictors of SIP implementation by administrators: school operation management, teacher and staff performance, leadership, processes, and partnerships/resources. These findings emphasize the significant role of effective management practices, especially in areas like staff performance, quality assurance, and resource allocation, in driving SIP implementation.

Analysis of the Correlation Between Visceral Fat Area and Insulin Resistance in Patients with Type 2 Diabetes and Abdominal Obesity

Objective: To analyze the correlation between visceral fat area and insulin resistance index (HOMA-IR) in patients with type 2 diabetes mellitus (T2DM) and abdominal obesity and to provide a reference for screening and related research of such patients. Methods: Two hundred patients with T2DM admitted to Guandu People’s Hospital of Kunming were included. The study was carried out from October 2022 to December 2023. The patients were divided into three groups according to different abdominal visceral fat areas (VFA): Group A (n = 65) was less than 75cm2, Group B (n = 75) was 75–100 cm2, and Group C (n = 60) was greater than 100 cm2. The subjects in the three groups were all tested for glycated hemoglobin (HbA1c), fasting insulin (FINS), and fasting blood glucose (FPG). Height and weight were measured to calculate body mass index (BMI). The HOMA-IR and TYG (fasting triglyceride and glycemic index) were also calculated. Changes in the BMI, VFA, HOMA-IR, and TYG levels were observed in the three groups. Results: The VFA, BMI, HbA1c, FPG, FINS, HOMA-IR, and TYG of the patients all increased, with a more significant increase in the BMI, FINS, HOMA-IR, and TYG levels (P &lt; 0.01). Multiple linear stepwise regression analyses used visceral fat area (VFA) as the dependent variable. The results showed that VFA was closely related to BMI, FINS, HOMA-IR, and TYG. Conclusion: Early reduction of VFA to reduce insulin resistance may be a better treatment and effective method for T2DM, providing powerful measures and new strategies for effective blood sugar control and early prevention in the treatment of metabolic diseases.

Mediolateral Postural Sway Velocity as a Possible Indicator of Ground Reaction Force-Derived 180⁰ Turn Performance in Male Soccer Players: A Cross-Sectional Study

The main aim of the study was to investigate the relationship between ground reaction force (GRF) derived postural sway and 180° turn performance in soccer players on the axis of dominant and non-dominant legs. Twenty-seven male soccer players (mean age 22.45 ± 2.7 years) from the same league level agreed to participate in the study. The participants underwent GRF-derived postural sway and 180⁰ turn tests using a force plate in separate sessions, with at least 24-hour intervals between sessions. Postural sway was assessed in anteroposterior and mediolateral directions during a single-leg stance, while the 180° turn performance was evaluated through GRF-derived turn time and turn sway. The correlation, multiple regression, and group differences were computed to test study hypotheses. Positive correlations were observed between postural sway measures and 180⁰ turn time for dominant and non-dominant legs (r-range from 0.384 to 0.550). No measure of postural sway was significantly related to the 180⁰ turn sway (p&amp;gt; 0.05). Multiple stepwise regression analysis indicated that mediolateral sway velocity explained 30% and 17% of the variance of 180⁰ turn time for dominant and non-dominant legs, respectively. No statistical inter-limb differences were noted for 180⁰ turn and postural sway parameters. The results suggest that improving single-leg postural performance may enhance male soccer players' 180° turn performance. Therefore, unilateral stability in the mediolateral direction should be considered a potential indicator of change of direction-based performances.

Mechanisms of microbial coexistence in a patchy ecosystem: Differences in ecological niche overlap and species fitness between rhythmic and non-rhythmic species

Resource patchiness caused by external events breaks the continuity and homogeneity of resource distribution in the original ecosystem. For local organisms, this leads to drastic changes in the availability of resources, breaks down the co-existence of species, and reshuffles the local ecosystem. West Lake is a freshwater lake with resource patchiness caused by multiple exogenous disturbances that has strong environmental heterogeneity that prevents clear observation of seasonal changes in the microbial communities. Despite this, the emergence of rhythmic species in response to irregular changes in the environment has been helpful for observing microbial communities dynamics in patchy ecosystems. We investigated the ecological mechanisms of seasonal changes in microbial communities in West Lake by screening rhythmic species based on the ecological niche and modern coexistence theories. The results showed that rhythmic species were the dominant factors in microbial community changes and the effects of most environmental factors on the microbial community were indirectly realised through the rhythmic species. Random forest analyses showed that seasonal changes in the microbial community were similarly predicted by the rhythmic species. In addition, we incorporated species interactions and community phylogenetic patterns into stepwise multiple regression analyses, the results of which indicate that ecological niches and species fitness may drive the coexistence of these subcommunities. Thus, this study extends our understanding of seasonal changes in microbial communities and provides new ways for observing seasonal changes in microbial communities, especially in ecosystems with resource patches. Our study also show that combining community phylogenies with co-occurrence networks based on ecological niches and modern coexistence theory can further help us understand the ecological mechanisms of interspecies coexistence.

Repeated-sprint sets test: a new method for evaluating and forecasting fitness in elite young male soccer players

The objective of the current study was to explore the correlation between repeated sprint sets (RSS) ability and several physical attributes, including maximum sprint speed, maximal aerobic speed, maximal anaerobic speed, aerobic capacity, and explosive strength. Moreover, the aim was to assess the suitability of RSS as a comprehensive evaluation tool for physical qualities and to determine which physical field tests most accurately predict RSS in elite young male soccer players. A total of thirty-two young elite male soccer players (mean age 14.6 ± 0.3 years; predicted years from peak height velocity (PHV): − 0.4 ± 0.3; years in training: 3.7 ± 0.5) voluntarily participated in the study. The players participated in eight consecutive specific physical tests, with a minimum 72-h recovery between each session to minimize the impact of fatigue during the second trial. The participants completed the tests in the following order: RSS test, Vam-Eval test, a constant velocity test performed until exhaustion at 100% of vVO2max (tlim100), 20-m Multi-Stage Shuttle Run test (VMSRT), Yo-Yo Intermittent Recovery Test level 1 (Yo-Yo IR1), Maximal Anaerobic Shuttle Running Test (VMASRT), Maximal Sprinting Speed Test (20-m flying sprint), Countermovement Jump (CMJ), and Standing Long Jump test (SLJ). The results of the study showed that there were very large negative correlations between tlim100 and SST (sum of sprint times), and large negative correlations between Yo-Yo IR1, Vam-Eval, and SST during RSS in young elite male soccer players (p < 0.05). Additionally, VMASRT and SLJ demonstrated a moderate negative correlation with SST (p < 0.05). In contrast, significant positive correlations were found between 20-m flying sprint and the SST (p < 0.05). According to the stepwise multiple linear regression analysis, the primary predictors of SST, ranked by importance, were tlim100 and Yo-Yo IR1. These two predictors collectively accounted for 72% of the variance in players’ SST (p < 0.0001). Due to the importance of aerobic capacity and short repeated accelerations/sprint sets for overall competitive performance in soccer, in conclusion, our results suggest that elite young male soccer players should perform both high intensity interval training and aeorobic capactity exercises as part of soccer training if the primary outcome is to improve repeated sprint ability performance.

Association of impulsive behavior and cerebrospinal fluid/plasma oxidation and antioxidation ratio in Chinese men

ObjectivesImpulsive behavior is the precursor of many psychiatric and neurological conditions. High levels of impulsive behavior will increase health risk behavior and related injuries. Impulsive behavior is produced and regulated by central and peripheral biological factors, and oxidative stress (OS) can aggravate it. However, previous studies only showed that impulsive behavior was related to the level of the peripheral OS. Therefore, this study aims to clarify the relationship between OS and impulsive behavior in the brain and peripheral blood. MethodsWe recruited 64 Chinese men. We measured superoxide dismutase (SOD) (including copper, zinc and manganese) and nitric oxide synthase (NOS) (including total, inducible and constitutive) in cerebrospinal fluid (CSF) and plasma. The Barratt Impulsiveness Scale version 11 (BIS-11) was used to evaluate impulsive behavior. The relationship between OS and impulsive behavior was evaluated by partial correlation analysis and stepwise multiple regression analysis. ResultsPartial correlation analysis showed that the ratio of total NOS-to-MnSOD and iNOS-to-MnSOD in CSF were negatively correlated with the BIS-11 motor scores (r = −0.431, p = −0.001; r = −0.434, p = −0.001). Stepwise multiple regression analysis showed that the ratio of CSF iNOS-to-MnSOD was the most influential variable on the BIS-11 motor scores(β = −0.434, t = −3.433, 95 %CI(−0.374, −0.098), p = 0.001). Conclusions and RelevanceThe imbalance of central oxidation and antioxidation is related to impulsive behavior, which broadens our understanding of the correlation between impulsive behavior and OS.