Stratified Groups Research Articles

Effect of renal function on the diagnostic performance of plasma biomarkers for Alzheimer's disease.

Several blood-based biomarkers are promising to be used in the diagnosis of Alzheimer's disease (AD) including Aβ42/40, p-tau181, and neurofilament light (NfL). The kidney is associated with the clearance of proteins. It is crucial to evaluate the effect of renal function on the diagnostic performance of these biomarkers before clinical implementation, which is important for the establishment of reference ranges and the interpretation of results. This study is a cross-sectional analysis based on ADNI cohort. Renal function was determined by the estimated glomerular filtration rate (eGFR). Plasma Aβ42/40 was measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Plasma p-tau181 and NfL were analyzed by Single Molecule array (Simoa) technique. [18F] florbetapir-PET (Aβ-PET) was used as a reference standard to estimate the brain amyloid load. The cutoff of Aβ-PET positivity was defined as ≥1.11. Linear regression models were used to investigate the associations of continuous eGFR with each plasma biomarker separately. The diagnostic accuracies of plasma biomarkers for positive brain amyloid across different renal function groups were analyzed by Receiver operating characteristic (ROC) curve. Youden-Index was used to determine the cutoff levels. A total of 645 participants were included in this study. The levels and diagnostic performance of Aβ42/40 were not affected by renal function. eGFR was only found negatively associated with p-tau181 levels in Aβ-PET negetive sample (β = -0.09, p = 0.039). eGFR was found negatively associated with NfL levels both in whole sample and Aβ-PET stratified groups (β = -0.27, p < 0.001 in whole sample; β = -0.28, p = 0.004 in A-; β = -0.27, p < 0.001 in A+). The diagnostic accuracies of p-tau181 and NfL were not affected by renal function. But the cutoff values of p-tau181 and NfL changed in participants with mild to moderate eGFR decline compared to participants with normal eGFR. Plasma Aβ42/40 was a robust biomarker for AD which was not affected by renal function. Plasma p-tau181 and NfL levels were affected by renal function, specific reference values of them should be considered in populations with different renal function stages.

Accumulation of pTau231 at the Postsynaptic Density in Early Alzheimer's Disease.

Phosphorylated cytoplasmic tau inclusions correlate with and precede cognitive deficits in Alzheimer's disease (AD). However, pathological tau accumulation and relationships to synaptic changes remain unclear. To address this, we examined postmortem brain from 50 individuals with the full spectrum of AD (clinically and neuropathologically). Total tau, pTau231, and AMPA GluR1 were compared across two brain regions (entorhinal and middle frontal cortices), as well as clinically stratified groups (control, amnestic mild cognitive impairment, AD dementia), NIA-AA Alzheimer's Disease Neuropathologic Change designations (Not, Low, Intermediate, High), and Braak tangle stages (1-6). Significant co-existing pathology was excluded to isolate changes attributed to pathologic AD. Synaptosomal fractionation and staining were performed to measure changes in total Tau, pTau231, and AMPA GluR1. Total Tau and pTau231 were quantified in synaptosomal fractions using Quanterix Simoa HD-X. Increasing pTau231 in frontal postsynaptic fractions correlated positively with increasing clinical and neuropathological AD severity. Frontal cortex is representative of early AD, as it does not become involved by tau tangles until late in AD. Entorhinal total tau was significantly higher in the amnestic mild cognitive impairment group when compared to AD, but only after accounting for AD associated synaptic changes. Alterations in AMPA GluR1 observed in the entorhinal cortex, but not middle frontal cortex, suggest that pTau231 mislocalization and aggregation in postsynaptic structures may impair glutamatergic signaling by promoting AMPA receptor dephosphorylation and internalization. Results highlight the potential effectiveness of early pharmacological interventions targeting pTau231 accumulation at the postsynaptic density.

Is urban regeneration associated with antidepressants or sedative medication users: a registry-based natural experiment

BackgroundArea deprivation is associated with adverse mental health outcomes. In Denmark, urban regeneration is being used to dissolve concentrated socio-economic area deprivation and ethnic segregation. However, evidence on how urban...

External Validation of the National Surgical Quality Improvement Program Calculator Utilizing a Single Institutional Experience for Adult Spinal Deformity Corrective Surgery.

Identify the external applicability of the American College of Surgeons' National Surgical Quality Improvement Program (NSQIP) risk calculator in the setting of adult spinal deformity (ASD) and subsets of patients based on deformity and frailty status. ASD patients were isolated in our single-center database and analyzed for the shared predictive variables displayed in the NSQIP calculator. Patients were stratified by frailty (not frail <0.03, frail 0.3-0.5, severely frail >0.5), deformity [T1 pelvic angle (TPA) > 30, pelvic incidence minus lumbar lordosis (PI-LL) > 20], and reoperation status. Brier scores were calculated for each variable to validate the calculator's predictability in a single center's database (Quality). External validity of the calculator in our ASD patients was assessed via Hosmer-Lemeshow test, which identified whether the differences between observed and expected proportions are significant. A total of 1606 ASD patients were isolated from the Quality database (48.7 years, 63.8% women, 25.8 kg/m2); 33.4% received decompressions, and 100% received a fusion. For each subset of ASD patients, the calculator predicted lower outcome rates than what was identified in the Quality database. The calculator showed poor predictability for frail, deformed, and reoperation patients for the category "any complication" because they had Brier scores closer to 1. External validity of the calculator in each stratified patient group identified that the calculator was not valid, displaying P values >0.05. The NSQIP calculator was not a valid calculator in our single institutional database. It is unable to comment on surgical complications such as return to operating room, surgical site infection, urinary tract infection, and cardiac complications that are typically associated with poor patient outcomes. Physicians should not base their surgical plan solely on the NSQIP calculator but should consider multiple preoperative risk assessment tools.

Longitudinal dynamics of depression in risk groups of older individuals during the COVID-19 pandemic.

Older individuals are most at risk of severe COVID-19 and particularly require protection causing (self)restriction of psychosocial interaction in daily living. So far, the impact of psychosocial withdrawal on mental health seems less pronounced in community-dwelling older individuals compared to younger individuals. However, dynamics and adverse long-term effects of the pandemic, such as increases in depression, are still mostly unclear, especially for vulnerable subgroups. Pre-pandemic and 3-, 8-, 14-, 20-month peri-pandemic data were analyzed in 877 older participants (age at 3-month peri-pandemic: mean ± SD: 72.3 ± 6.3, range: 58-91 years) of the observational prospective TREND study in Germany. Severity of depression (Beck's Depression Inventory-II scores) and key factors of (mental) health were investigated for cross-sectional associations using path modeling. Risk groups defined by resilience, loneliness, history of depression, stress, health status and fear of COVID-19 were investigated for differences in depression between timepoints. The early pandemic (3-month) severity of depression was most strongly associated with history of depression, stress and resilience. Overall increases in clinically relevant depression (mild-severe) from pre- to 3-month peri-pandemic were small (% with depression at pre-/3-month peri-pandemic: 8.3%/11.5%). Changes were most pronounced in risk groups with low resilience (27.2%/41.8%), loneliness (19.0%/28.9%), fear of COVID-19 (17.6%/31.4%), high stress (24.4%/34.2%), a history of depression (27.7%/36.9%), and low health status (21.8%/31.4%). Changes in depression were largely observed from pre- to 3-month and were sustained to the 20-month peri-pandemic timepoint, overall and in stratified risk groups defined by single and cumulative risk factors. Changes between timepoints were heterogenous as indicated by alluvial diagrams. Only specific risk groups of older individuals showed a large increase in depression during the COVID-19 pandemic. Since these increases occurred early in the pandemic and were sustained over 20 months, these vulnerable risk groups need to be prioritized for counselling and risk mitigation of depression.

LH level on ovulation trigger day has a different impact on the outcomes of agonist and antagonist regimens during in vitro fertilization

BackgroundTo assess the impact of the luteinizing hormone level on ovulation trigger day (LHOTD) on in vitro fertilization (IVF) outcomes in gonadotropin-releasing hormone (GnRH) agonist and antagonist regimens during fresh embryo transfer cycles.MethodsA stepwise, progressive multivariate regression model was introduced to assess the effect of the LHOTD on clinical pregnancy and live birth rates. Mantel‒Haenszel stratification analysis was used to examine the association between the LHOTD and clinical outcomes with the antagonist regimen.ResultsThe LHOTD had different distributions in the agonist and antagonist regimens. The cycles were assigned into three LHOTD tertile groups. In the agonist regimen, compared with the 1st tertile (T1), in the 2nd (T2) and 3rd (T3) tertiles, the adjusted odds ratios (ORs) (95% confidence intervals [CIs], P value) were 1.187 (1.047–1.345, 0.007) and 1.420 (1.252–1.610, < 0.001) for clinical pregnancy, respectively, and 1.149 (1.009–1.309, 0.036) and 1.476 (1.296–1.681, < 0.001) for live birth. In the antagonist regimen, there was no significant difference in clinical pregnancy and live birth rates among the tertiles. However, in the stratified group of patients aged less than 35 years, the ORs (95% CIs, P value) of T2 and T3 were 1.316 (1.051–1.648, 0.017) and 1.354 (1.077–1.703, 0.009) for clinical pregnancy, respectively, and 1.275 (1.008–1.611, 0.043) and1.269 (0.999–1.611, 0.051) for live birth. Moreover, there was a discrepancy in the results among the subdivided LHOTD T1 groups adopting the antagonist regimen. Compared with that of the < 1.06 mIU/mL subgroup, the ORs (95% CIs, P value) of the > 1.5 mIU/mL subgroup were 1.693 (1.194–2.400, 0.003) for clinical pregnancy and 1.532 (1.057–2.220, 0.024) for live birth after eliminating potential confounders.ConclusionsThe LHOTD was profoundly suppressed in the agonist regimen, and its level was positively correlated with clinical pregnancy and live birth rates. In contrast, in the flexible antagonist regimen, the LHOTD was significantly higher than that in the agonist regimen and did not correlate with the outcome, except for women in the nonadvanced age group and those with an excessively suppressed LHOTD. Further investigation is required to determine the rationale for these findings.

Heat kernels and theory of Hardy spaces associated to Schrödinger operators on stratified groups

Let G be a stratified group and let ΔG be a sub-Laplacian on G. In this paper, we consider the Schrödinger operator L=ΔG+V, where the potential V is a nonnegative polynomial. We first prove the upper bound of the higher order derivatives of the heat kernel of L. We then establish a theory of Hardy spaces HLp(G) associated to L for the full range p∈(0,1]. Particularly, we prove that for any p∈(0,1], the Hardy space HLp(G) introduced in terms of nontangential or radial maximal functions associated to the semigroup e−tL admits a new atomic decomposition. Moreover, we provide the description of the dual spaces of these new Hardy spaces in terms of certain local Campanato spaces related to the potential V. As a byproduct, we obtain the maximal function characterizations for the local Hardy spaces associated to an arbitrary critical function.

Maxillary dimensions and arch shape with palatally displaced canines.

The aim of this study was to explore the effect of palatally displaced canines on maxillary dimensions and arch shape. Occlusal and skeletal landmarks were plotted on cone beam computed tomography (CBCT) images of 156 orthodontic patients: 78 with palatally displaced canines (PDC) (27 left, 28 right, and 23 bilateral) and 78 controls using Mimics™ (Materialise, Belgium). Arch forms were created, and arch width, depth, and skeletal dimensions were measured. T-test (P < 0.05) was used to compare the groups. Geometric Morphometrics (GM) analysis was used to compare the groups and to explore the pattern of covariation between two sets of landmarks. The unilateral PDC group showed an increased first premolar, second premolar, molar widths, and an increased molar depth. No significant difference was found in arch form. The skeletal measurements were generally larger in the PDC group, but the transverse measurements were the most significant. Discriminant Function Analysis (DFA) with cross-validation allowed an accurate classification of 85.9% of the control group and 66.7% of the PDC group. The Mahalanobis distance displayed significant differences among three combinations of groups. Strong covariance was found between the second premolar and all other landmarks. The small sample sizes of the stratified groups precluded recognition of statistical significance. Patients with unilateral PDC displayed significantly wider first, second premolar, and first molar widths, and increased first molar depths. There were no significant differences in arch form; however, GM showed significant differences between the groups and a prominent covariance function for the 2nd premolars.

Exploring the attitudes and behaviour of Gen Z students towards branded mobile apps in an emerging market: UTAUT2 model extension

PurposeWith the increasing mobile activity of the Generation Z market (born after 1994), marketers’ interest in this social group is rising. This research paper aims to uncover the relatively unknown attitudes and behaviour of the youth market in an emerging market, South Africa, towards branded mobile applications (apps). Previous studies on mobile marketing have focused on Generation X and Generation Y and generally with a quantitative focus.Design/methodology/approachThis study is based on the theoretical framework of the unified theory of acceptance and use of technology model 2. The study used a qualitative framework with stratified focus groups, aged between 18 and 21 years old at a private tertiary institution in South Africa.FindingsThe findings indicate that these South African Gen Z participants mainly used WhatsApp, Instagram, Facebook, Uber and Snapchat. The participants had more positive than negative attitudes towards mobile apps. The findings also showed that privacy was a major concern for the participant’s attitudes and behaviour towards mobile apps. The findings supported the UTAUT2 model, but also discovered new themes. As a recommendation, the issue of privacy and its effect on mobile app adoption is a factor to be researched in the future. The research also provides recommendations for marketers and app developers.Research limitations/implicationsThis study was of a qualitative nature, and thus, the sample size was smaller than that of a quantitative study. Future research could add to this study by increasing the sample size and adding a quantitative method such as surveys.Practical implicationsMarketers of mobile apps targeted towards the Gen Z market should aim to be convenient for their users, as well as be entertaining, functional, time-efficient while avoiding excessive in-app adverts, being honest upfront about their pricing strategy, incorporate an element of connectivity into the app and respect their privacy. This paper also provides practical recommendations for mobile app developers (targeted towards Gen Z users) including minimising notifications and updates within the app, developing a mobile app that requires less usage of data (due to the high expense of data in South Africa for the price-conscious Gen Z market) as well as less usage of memory space on the phone and incorporating universal symbols within the mobile app.Originality/valueThis study supported the UTAUT2 model effects of performance and effort expectancy, social influence, facilitating conditions, hedonic motivation, price value and habit on the behavioural intention of users towards a new technology, i.e. GenZ students’ attitudes and behaviour towards branded mobile apps in South Africa. However, an additional condition was discovered in this study, i.e. privacy and its impact on the attitudes and behaviour of GenZ mobile app users. Therefore, this study extends the UTAUT2 model framework. Furthermore, this study uses a qualitative design, which has not been used in previous studies, with a focus on the under-researched Gen Z market, and in particular in an emerging market, such as South Africa.

Local reference and achievable dose levels for vascular and enterostomy access procedures in pediatric interventional radiology.

Knowledge of radiation quantities delivered in routine practice is an essential responsibility of a pediatric interventional radiology department. To review radiation indices in frequently performed vascular and enterostomy access procedures at a quaternary pediatric hospital to formulate dosimetric reference levels and achievable levels. A retrospective review of patient demographics, procedure information and quantitative dose metrics over a 2-year period was performed. Dosimetric details forcommon procedures (central line insertions, gastrostomy/gastrojejunostomy insertions and maintenance) were evaluated, correlated with demographic data and stratified acrossfive weight groups (0-5kg, 5-15kg, 15-30kg, 30-50kg, 50-80kg).Achievable (50th percentile) and reference (75thpercentile)levels with confidence intervals were established for each procedure. Within the evaluation period, 3,165 studies satisfied the inclusion criteria. Five were classified as device insertions (peripherally inserted central catheter, n=1,145; port-a-catheter, n=321; central venous line, n=285; gastrostomy-tube [G-tube], n=262, and gastrojejunostomy-tube [GJ-tube], n=66),and two were classified as maintenance procedures (G-tube, n=358, and GJ-tube, n=728, checks, exchanges and reinsertions). Representative reference and achievable levels were calculated for each procedure category and weight group. This work highlights the creation of local reference and achievable levels for common pediatric interventional procedures. These data establish a dosimetric reference to understand the quantity of radiation routinely applied, allowing for improved relative radiation risk assessment and enriched communication to interventionalists, health care providers, parents and patients.

Methodology of optimal classification of regions by the level of industry development

The article describes the methodology of classification of multidimensional observations, according to which, in theory, development indices of regional industrial production were developed. According to this index, conditional regions are divided into lower, middle and upper classes. In the study, the development tendencies of the regions classified by the development index into stratified groups were also determined. At the end of the article, the theoretical and empirical conclusions obtained as a result of the research are presented.

Boundedness of square functions related with fractional Schrödinger semigroups on stratified Lie groups

&lt;abstract&gt;&lt;p&gt;In this paper, we consider a Schrödinger operator $ L = -\Delta_{\mathbb{H}}+V $ on the stratified Lie group $ \mathbb{H} $. First, we establish fractional heat kernel estimates related to $ L^{\beta} $, $ \beta\in(0, 1) $. By utilizing kernel estimations and the fractional Carleson measure, we are able to derive a characterization of the Campanato type space $ BMO_{L}^{v}(\mathbb{H}) $. Second, we demonstrate that both Littlewood-Paley $ {\bf g} $-functions and area functions are bounded on $ BMO^{v}_{L}(\mathbb{H}) $. Finally, we also obtain that the above square functions are bounded on the Morrey space $ L^{\gamma, \theta}_{p, \kappa}(\mathbb{H}) $ and the weak Morrey space $ WL^{\gamma, \theta}_{1, \kappa}(\mathbb{H}) $, respectively.&lt;/p&gt;&lt;/abstract&gt;

Characterizations of Lipschitz functions via the commutators of maximal function in Orlicz spaces on stratified Lie groups

Characterizations of Lipschitz functions via the commutators of maximal function in Orlicz spaces on stratified Lie groups

On criticality coupled sub-Laplacian systems with Hardy type potentials on Stratified Lie groups

&lt;abstract&gt;&lt;p&gt;In this work, our main concern is to study the existence and multiplicity of solutions for the following sub-elliptic system with Hardy type potentials and multiple critical exponents on Carnot group&lt;/p&gt; &lt;p&gt;&lt;disp-formula&gt; &lt;label/&gt; &lt;tex-math id="FE1"&gt; \begin{document}$ \begin{equation*} \left\{\begin{aligned} &amp;amp;-\Delta_{\mathbb{G}}u = \frac{\psi^{\alpha}|u|^{2^*(\alpha)-2}u}{d(z)^{\alpha}}+ \frac{p_{1}}{2^*(\gamma)}\frac{\psi^{\gamma}|u|^{p_{1}-2}u|v|^{p_{2}}}{d(z, z_{0})^{\gamma}} +\lambda h(z)\frac{\psi^{\sigma}|u|^{q-2}u}{d(z)^{\sigma}} \, \, &amp;amp; \text{in } \, \, \Omega, \\ &amp;amp;-\Delta_{\mathbb{G}}v = \frac{\psi^{\beta}|v|^{2^*(\beta)-2}v}{d(z)^{\beta}}+ \frac{p_{2}}{2^*(\gamma)}\frac{\psi^{\gamma}|u|^{p_{1}}|v|^{p_{2}-2}v}{d(z, z_{0})^{\gamma}} +\lambda h(z)\frac{\psi^{\sigma}|v|^{q-2}v}{d(z)^{\sigma}}\, \, &amp;amp;\text{in } \, \, \Omega, \\ &amp;amp;\quad u = v = 0\, \, &amp;amp;\text{on } \, \, \partial\Omega, \end{aligned}\right. \end{equation*} $\end{document} &lt;/tex-math&gt;&lt;/disp-formula&gt;&lt;/p&gt; &lt;p&gt;where $ -\Delta_{\mathbb{G}} $ is a sub-Laplacian on Carnot group $ \mathbb{G} $, $ \alpha, \beta, \gamma, \sigma\in [0, 2) $, $ d $ is the $ \Delta_{\mathbb{G}} $-natural gauge, $ \psi = |\nabla_{\mathbb{G}}d| $ and $ \nabla_{\mathbb{G}} $ is the horizontal gradient associated to $ \Delta_{\mathbb{G}} $. The positive parameters $ \lambda $, $ q $ satisfy $ 0 &amp;lt; \lambda &amp;lt; \infty $, $ 1 &amp;lt; q &amp;lt; 2 $, and $ p_{1} $, $ p_{2} &amp;gt; 1 $ with $ p_{1}+p_{2} = 2^*(\gamma) $, here $ 2^*(\alpha): = \frac{2(Q-\alpha)}{Q-2} $, $ 2^*(\beta): = \frac{2(Q-\beta)}{Q-2} $ and $ 2^*(\gamma) = \frac{2(Q-\gamma)}{Q-2} $ are the critical Hardy-Sobolev exponents, $ Q $ is the homogeneous dimension of the space $ \mathbb{G} $. By means of variational methods and the mountain-pass theorem of Ambrosetti and Rabonowitz, we study the existence of multiple solutions to the sub-elliptic system.&lt;/p&gt;&lt;/abstract&gt;

Balance Recovery Strategy in Children With and Without Hearing or Visual Impairments.

The purpose of this study was to examine the balance recovery strategy in children with hearing (HI) and visual impairments (VI) compared with those without these disorders. This study featured a cross-sectional design with subjects (N = 45) placed within one of three equally stratified purposive groups (HI, VI, and comparison) within the age range of 9-13years (mean = 11.43, SD = 1.5). Balance recovery strategy was measured in static and after-perturbation conditions by a four-camera Vicon system used to record three-dimensional lower body kinematic data. A repeated-measures analysis of variance (3 × 2, Group × Condition) was utilized to analyze data. Significance was set at p ≤ .05. In the static condition, the results of the study showed that there was no significant difference between the groups in the ankle joint sway (p > .05). In hip joint sway, VI children had greater sway compared with comparison (p = .001) and HI children (p = .02). Also, HI children had greater sways than comparison (p = .02). In the after-perturbation condition, the results showed that VI children had greater sway in the hip and ankle joints than HI children (p = .001) and comparison (p = .001) to restore and maintain balance. It seems that comparison as well as higher proportion VI children use a hip strategy to maintain and restore balance. Also, it seems that HI children use a different strategy (ankle strategy) to maintain and restore balance compared with comparison and VI children.

Critical problems with Hardy potential on Stratified Lie Groups

We prove existence and nonexistence results for positive solutions to the subelliptic Brezis-Nirenberg type problem with Hardy potential $$- \Delta_{\mathbb G} u -\mu \frac{\psi^2}{d^2} u =u^{2^*-1}+\lambda u\,\,\, \mbox{in}\,\,\, \Omega,\quad u=0\,\,\, \mbox{on}\,\, \partial \Omega, $$ extending to the Stratified setting well-known Euclidean results by Jannelli [J. Diff. Equ. 156, 1999]. Here, $\Delta_{\mathbb G}$ is a sub-Laplacian on an arbitrary Carnot group ${\mathbb G}$, $\Omega$ is a bounded domain of ${\mathbb G}$, $0\in \Omega$, $d$ is the $\Delta_{\mathbb G}$-gauge, $\psi:=|\Delta_{\mathbb G} d|$, where $\Delta_{\mathbb G}$ is the horizontal gradient associated to $\Delta_{\mathbb G}$, $0 \leq \mu < \bar \mu$, where $\bar \mu =\left ( \frac{Q-2}{2} \right )^2$ is the best Hardy constant on ${\mathbb G}$ and $\lambda\in {\mathbb R}$. The main difficulty in this abstract framework is the lack of knowledge of the ground state solutions to the limit problem $$- \Delta_{\mathbb G} u -\mu \dfrac{\psi^2}{d^2} u =u^{2^*-1}\,\, \mbox{on}\,\, {\mathbb G}, $$ whose explicit expression is not known, except for the case when $\mu=0$ and ${\mathbb G}$ is a group of Iwasawa-type. So, a preliminary refined analysis of qualitative properties of solutions to the above problem on the whole space is required, which has independent interest. In particular, Lorentz regularity and a priori decay estimates are obtained.

New reference values for maximum respiratory pressures in healthy Brazilian children following guidelines recommendations: A regional study.

To determine reference values for maximum static respiratory pressures in healthy children from a Brazilian region, following recommendations of the European Respiratory Society (ERS) and the Brazilian Society of Pneumology and Tisiology (SBPT). A cross-sectional observational study was conducted with healthy children (6 to 11 years) of both sexes. The maximum inspiratory and expiratory pressures (PImax and PEmax, respectively) were measured using a digital manometer. Each child performed a minimum of three and a maximum of five maneuvers; three acceptable and reproducible maneuvers were considered for analysis. Minimum time for each maneuver was 1.5 seconds, with a one-second plateau, and one minute of rest between them. A stepwise multiple linear regression analysis was conducted for PImax and PEmax, considering correlations between independent variables: age, weight, and sex. We included 121 children (62 girls [51%]). Boys reached higher values for maximum respiratory pressures than girls. Respiratory pressures increased with age showing moderate effect sizes (PImax: f = 0.36; PEmax: f = 0.30) between the stratified age groups (6-7, 8-9, and 10-11 years). Age and sex were included in the PImax equation (PImax = 24.630 + 7.044 x age (years) + 13.161 x sex; R2 = 0.189). PEmax equations were built considering age for girls and weight for boys [PEmax (girls) = 55.623 + 4.698 x age (years) and PEmax (boys) = 82.617 + 0.612 x weight (kg); R2 = 0.068]. This study determined new reference equations for maximal respiratory pressures in healthy Brazilian children, following ERS and SBPT recommendations.

Expression of MUC-2, MUC-6, NAPE-PLD, IL-6 and IL-13 in Healthy and Metaplastic Bronchial Epithelium

Background: The normal tissue structure of the respiratory system is necessary to provide adequate protection of the airways and lungs. Prolonged exposure to trigger factors can result in adaptive mechanism activation and lead to the development of chronic pulmonary diseases or even dysplastic changes. Materials and methods: Respiratory system material with a pseudostratified ciliated epithelium was obtained from 12 patients (aged 16 to 95), and material with a stratified squamosa epithelium was obtained from six patients (aged 23 to 93). Routine staining was performed, and an immunohistochemistry was conducted for MUC-2, MUC-6, NAPE-PLD, IL-6 and IL-13. Results: Inflammatory processes were not detected in any of the specimens. A number of correlations were identified, with the most important being a strong positive correlation for IL-13 between the alveolar epithelium and alveolar macrophages and a strong positive correlation for IL-6 between the alveolar epithelium and alveolar macrophages in the stratified squamous epithelium group. We also detected a statistically significant difference in IL-6 in alveolar macrophages. Conclusions: There were no signs of dysplastic changes in either group. Increased secretion of IL-13 in the stratified squamous epithelium group shows its involvement in metaplastic changes in the bronchial epithelium. The secretion of atypical factors by hyaline cartilage demonstrates its plasticity and adaptability.

Increasing prevalence of myopia and the impact of education in primary-school students in Xi'an, north-western of China.

The present study was performed to detect the prevalence of myopia among primary-school students in Xi'an, north-western of China. The present study was a school-based study with students aged from 6 to 13 years old. All the individuals underwent ophthalmological examination and spherical equivalent (SE) of refractive error were measured with non-cycloplegic refraction. Myopia was defined as a SE of ≤ -0.5 diopters (D), and further divided into three stratified groups based on SE: low myopia (≤ -0.5 to >-3.0 D), moderate myopia (≤ -3.0 to >-6.0 D), and high myopia (≤ -6.0 D). Relative risk factors, including age, sex, grade and ethnicity were investigated using questionnaire. A total of 4,680 individuals were eligible for this survey and 4,654 (99.4% participation rate) were finally included (51.2% boys). The mean age of participants was 8.756 ± 1.727 years. The whole city-level prevalence of total myopia was 57.1% (95% CI: 55.7-58.6%). Additionally, the prevalence of low, moderate, and high myopia was 45.0% (95% CI: 43.5-46.4%), 11.1% (95% CI: 10.2-12.0%), and 1.0% (95% CI: 0.7-1.3%), respectively. Moreover, grade (education level) instead of age, sex and ethnicity was the most essential risk factor for prevalence of overall myopia (OR = 1.844, 95% CI: 1.605-2.119), and an increase of prevalence by 84.4% per grade was seen. Furthermore, similar associations of grade were significant with low myopia (OR = 1.613, 95% CI: 1.385-1.877) and moderate myopia (OR = 2.186, 95% CI: 1.693-2.823), meanwhile, prevalence of low myopia and moderate myopia demonstrated an increase of prevalence by 61.3 and 118.6% per grade, respectively. None of the factors included in the present study was significant risk factor for high myopia. The present study investigated a non-negligible high prevalence of myopia among primary-school students in Xi'an, north-western of China, and a gradual increasing in proportion with education level.

Postoperative Nausea and Vomiting: A Descriptive Study

Postoperative Nausea and Vomiting (PONV) remains a problem, despite an evident clinical perception that their severity has diminished. We conducted a descriptive study in post-operative units in Sylhet M.A.G. Osmani Medical College and Hospital, Sylhet, Bangladesh during the period from January 2020 to December 2020. We aimed to find out the incidence of postoperative nausea and vomiting in patients aged 3–79 years. Nausea, emetic episodes, and the need for anti-emetic medication were recorded for 24 h postoperatively. In the postoperative unit, the incidence of nausea and vomiting was 32% and 12%, respectively. Over the whole 24-h period, these figures were 47% and 34%, respectively; severe nausea was experienced by 13%. The highest incidence of emetic sequelae was observed in gynecological patients; 52% of the patients who received general anesthesia and 38% of the patients who received regional anesthesia reported nausea. The most important predictive factors associated with an increased risk for nausea and vomiting were female gender, a previous history of postoperative sickness, a longer duration of surgery, smoking, and a history of motion sickness. Based on these five items, a simple score predicting the risk of nausea and vomiting was constructed with a moderately good discriminating power. Once the efficacy of agents or their combination has been established against stratified risk groups, it would then be appropriate to explore the risk-benefit of routine prophylactic antiemetic therapy.