Control Study Research Articles

The adaptation of a single institution diabetes care platform into a nationally available turnkey solution.

Digital decision support and remote patient monitoring may improve outcomes and efficiency, but rarely scale beyond a single institution. Over the last 5 years, the platform Timely Interventions for Diabetes Excellence (TIDE) has been associated with reduced care provider screen time and improved, equitable type 1 diabetes care and outcomes for 268 patients in a heterogeneous population as part of the Teamwork, Targets, Technology, and Tight Control (4T) Study (NCT03968055, NCT04336969). Previous efforts to deploy TIDE at other institutions continue to face delays. In partnership with the diabetes technology non-profit, Tidepool, we developed Tidepool-TIDE, a clinic-agnostic, turnkey solution available to any clinic in the United States. We present how we overcame common technical and operational barriers specific to scaling digital health technology from one site to many. The concepts described are broadly applicable for institutions interested in facilitating broader adoption of digital technology for population-level management of chronic health conditions.

Untargeted Lipidomic Profiling of Amniotic Fluid Reveals Dysregulated Lipid Metabolism in Healthy Normal-Weight Mothers with Fetal Macrosomia

Background: Alterations in maternal lipid metabolism have been elucidated by several studies in relation to macrosomia. However, the lipidome of the intrauterine compartment associated with macrosomia, particularly in early pregnancy, remains largely unknown. Objectives: (1) To compare the lipidomic profile of early 2nd trimester amniotic fluid (AF) of healthy mothers with normal body mass index who gave birth to large-for-gestational age (LGA) versus appropriate-for-gestational age (AGA) infants; and (2) to examine if insulin and glucose concentrations in AF were associated with the AF lipidomic profile. Methods: In this nested case–control study, bio-banked AF samples were collected from pregnant women undergoing routine amniocentesis at 12–22 weeks of gestation. A subsample of 15 LGA infants (cases) were contrasted with 15 AGA infants (controls). An untargeted lipidomics analysis using liquid chromatography quadrupole time-of-flight mass spectrometry was conducted. Univariate and multivariate statistical analyses (principal component analysis and partial least-squares discriminant analysis) were used to extract differentially abundant (DA) features with high variable importance in projection (VIP) scores. Results: LGA AF was characterized by elevations of 30 phosphatidic acid species. Among other DA features, sphingomyelin (SM 14:0;O2/20:1) had the highest VIP score and was markedly elevated in LGA AF. Neither insulin nor glucose was associated with 2nd trimester AF lipidomic profiles in these healthy, normal-weight mothers. Conclusion: These findings provide evidence of early dysregulated lipid metabolism in healthy, normal-weight mothers with LGA infants.

The Impact of Cognitive Behavioral Therapy for Insomnia on Neurofilament Light and Phosphorylated Tau in Individuals with a Concussion.

Concussions damage neurologic tissue, increasing release of intercellular proteins including phosphorylated Tau (pTau) and neurofilament light (NfL). Disrupted sleep from a concussion negatively impacts the ability of the glymphatic system to remove cellular waste from the brain. The purpose of this study was to determine if enhancing sleep using Cognitive Behavioral Therapy for Insomnia (CBT-I) impacts pTau and NFL levels following a concussion. This is pre/post intervention analysis of a larger wait-list control study. Participants had their blood sampled pre/post the CBT-I intervention which was analyzed using SIMOA analytics. Paired sampling statistics and linear regression models were used to examine how insomnia severity impacts pTau181 and NfL. Twenty-eight participants were enrolled in this study. Age and baseline protein level were significantly associated with post-intervention protein levels, but post-intervention insomnia severity was not associated with post-intervention protein levels. About 50% of participants that had clinically meaningful change in insomnia and had a reduction in their NfL and pTau181 values. Post-intervention insomnia was not associated with post-intervention NfL or pTau. Yet, on an individual level, ~50% of participants had a clinically meaningful change in insomnia and reduced level of NfL and pTau 18.1. NCT04885205 https://clinicaltrials.gov.

Determinants of retroplacental hematoma at the Maradi mother and child health center, Niger: a case‒control study.

Retroplacental hematoma is a paroxysmal accident that threatens maternal and fetal prognosis. It is a major emergency in obstetric pathology. The objective of this study was to identify the factors associated with retroplacental hematomas at the Maradi Mother and Child Health Center in 2022. This was a case‒control cross-sectional analytical study that used patient records for the year 2022 from September 20 to October 20, 2023. The presence of a retropl placental hematoma was the outcome variable and was measured by a case (yes) or control (no) response. The exposure variables included sociodemographic characteristics, obstetric characteristics, care, progression of patients and neonatal characteristics. Pearson's chi-square tests at the 5% significance level were used to analyze differences between categorical variables. All variables that had a bilateral p value < 0.05 in the bivariate analysis were introduced into the binary logistic regression model to identify factors associated with retroplacental hematoma. A total of 246 cases of retroplacental hematoma were recorded out of 4731 deliveries recorded during the study period, for an estimated frequency of 5.20%. The mean age of the patients was 29.41 ± 6.94 years. Factors associated with retroplacental hematoma included multiple parity [adjusted odds ratio (ORA): 0.38, 95% confidence interval (CI) (0.24-0.61)], fewer than 4 antenatal visits [AOR: 10.70, 95% CI (1.14-99.74)], blood transfusion [AOR: 2.01, 95% CI (1.11-3.60)], a newborn birth weight less than 2500g [AOR: 1.92, 95% CI (1.53-2.42)] and fetal mortality in utero [AOR: 13.20, 95% CI (1.86-93.70)]. This study identified the factors associated with retroplacental hematoma. Prevention requires regular, high-quality prenatal care. Early diagnosis and cesarean section improve maternal-fetal prognosis. Not applicable.

Systemic Statin Use and Pulp Chamber Calcification: A Pilot Retrospective Case Control Study Using Cone-Beam Computed Tomography.

This pilot retrospective case-control study questioned whether systemic statin use causes pulp calcification using cone-beam computed tomography images from the patients prescribed oral statins and comparing those of healthy individuals. CBCT scans of 54 patients, including 27 age- and sex-matched patients for the study and control groups, were analysed using Mimics Innovation Suite software. The study included patients using statins regularly for at least 1 year. Only intact teeth with opposing teeth were selected for the study group and matched with the control group. Dental crown and pulp chamber volumes were calculated and proportioned. The data were analysed with chi-square and Shapiro-Wilk tests to assess normal distribution, followed by Mann-Whitney U test if necessary. Statistical analysis showed no difference between the study and control groups (p = 0.505). Statin use duration did not cause statistically significant difference in terms of the reduction of pulp chamber volume (p = 0.141). Within the limitations of the study, systemic statin use did not cause dental pulp calcification. The results suggest, oral administration of the statin drugs is not an unfavourable condition for dental practice. Further studies with larger numbers of patients are needed to support this conclusion.

Diagnostic and prognostic value of plasma lipocalin-2 levels in patients with metabolic dysfunction–associated steatotic liver disease

Abstract Background Non-Alcoholic Fatty Liver Disease, recently better recognised as Metabolic Dysfunction–Associated Steatotic Liver Disease, is the most prevalent form of chronic liver disease at present time. It is estimated to impact 32% of the world's population, hence representing a significant health burden. Aim of the work To assess the significance of plasma Lipocalin-2 (LCN2) levels in the diagnosis and prognosis of NAFLD patients. Patients and methods In this retrospective case–control study we recruited 102 subjects aged between 18 and 70 years. The included participants were split into two study groups. Group I: 51 NAFLD patients (61% men, 39% females) and Group II: 51 healthy controls (51% men and 49% females), for whom plasma LCN2 levels were assessed and correlated with NAFLD fibrosis score, FIB4 and fatty liver index. Results In this study, LCN2 levels in NAFLD patients were significantly greater compared to individuals in the control group (p &lt; 0.001), with a mean of 1893.214 ± 1002.852 ng/dL in the cases and a mean of 466.020 ± 397.699 ng/dL in the controls. This suggests the use of LCN2 as a possible diagnostic marker of NAFLD. The mean LCN2 levels in this study also significantly increased as the grade of fatty liver increased from I to III (p &lt; 0.001). This in turn proposes the use of LCN2 as a prognostic marker for NAFLD progression. LCN2 also significantly correlated with the fatty liver index and NAFLD Fibrosis scoring systems, but not with Fib-4. With an area under the ROC of 0.906, it demonstrated excellent diagnostic performance with 84% sensitivity, 90% specificity, 89.6% PPV and 85.2% NPV for the prediction of NAFLD patients. Conclusion Lipocalin-2 performs as a diagnostic and a possible prognostic marker for metabolic dysfunction-associated steatotic liver disease.

Tenascin-C-Matrix Metalloproteinase-3 Phenotype and the Risk of Tendinopathy in High-Performance Athletes: A Case–Control Study

Background/Objectives: Tendon structure is predominantly composed of the extracellular matrix (ECM), and genetic variants in non-collagenous ECM components may influence susceptibility to tendinopathy. We investigated the potential influence of single nucleotide polymorphisms (SNPs) in fibrillin-2 (FBN2), tenascin-C (TNC), and matrix metalloproteinase-3 (MMP3) on the tendon regeneration failure phenotype and impact on the susceptibility to tendinopathy in Brazilian high-performance athletes. Methods: This case–control study was conducted with 397 high-performance athletes from different sports modalities (197 tendinopathy cases and 200 controls), and they were analyzed by validated TaqManTM SNP genotyping assays of the SNPs FBN2 (rs331079), TNC (rs2104772), and MMP3 (rs591058). Results: Out of the 197 tendinopathy cases, 63% suffered from chronic tendon pain and 22% experienced more than three episodes of disease manifestation. The TNC-rs2104772-A allele was significantly associated with tendinopathy (OR: 1.4; 95% CI: 1.1–1.8), while athletes carrying the MMP3-rs591058-T allele were linked to an increased risk of more episodes of disease manifestation (OR: 1.7; 95% CI: 1.1–2.8). The TNC-MMP3 tendon regeneration failure phenotype (TNC-A/MMP3-T) was associated with an increased risk of tendinopathy (OR: 1.4; 95% CI: 1.1–2.0) and episodes of disease manifestation (OR: 2.0; 95% CI: 1.2–3.5). Athletes with tendinopathy who had the TNC-A/MMP3-T interaction were more prone to experiencing more than three disease exacerbations (OR: 4.3; 95% CI: 1.8–10.5) compared to TNC-A/TNC-C. Conclusions: This study suggests that rs2104772 and rs591058 SNPs could be involved in the tendon regeneration failure phenotype and may influence the molecular mechanism related to the regulation of the tendon ECM during training workload.

Evaluation of neurotransmitters (Gamma-aminobutyric acid and serotonin) and apoptosis factor (Caspase-7) as biomarkers for the diagnosis of autism spectrum disorder

Autism spectrum disorder (ASD) is a neurodevelopmental disability characterized by impaired communication and social skills along with restricted interests and repetitive behaviors. Biomarkers such as γ-aminobutyric acid (GABA), serotonin (5-Hydroxytryptamine, 5-HT) and caspase-7, showing potential for early diagnosis and management of ASD. To evaluate the effectiveness of GABA, serotonin and caspase-7 as novel biomarkers to predict autism at an early stage. A case- control study which started from November 2023 to June 2024, that involved 77 children’s patients, newly diagnosed with autism. The control group was comprised of 61 age- and sex-matched apparently healthy children, they had no history of autism and any other chronic diseases. Serum samples were analyzed for GABA, serotonin and caspase-7 by using enzyme linked immune-sorbent assay (ELISA) technique. The statistical package for social sciences (SPSS- 26) was used for data analyses. The study revealed significantly elevated GAMA and caspase-7 levels; while, no significant differences of serotonin level between the autistic children’s patients and the control group. This study provides a groundbreaking revelation of the biochemical markers (GAMA and caspase-7) and autism spectrum disorder, the myriad metabolic and neurochemical dysfunctions of which form a complex tapestry of ASD.

Plasma neurofilament light chain in fibromyalgia: A case control study exploring correlation with clinical and cognitive features.

Plasma neurofilament light chain (NFL) has been measured as a biomarker of neuronal damage in various neurological disorders. Elevated tau and β-amyloid levels have been found in patients with fibromyalgia (FM). The aim of the present study was to compare plasma neurofilament levels in fibromyalgia patients with normal controls and to investigate the correlation with clinical features and cognitive tests. Plasma NFL levels were assessed in 33 FM patients and compared with 22 age-matched controls. All patients were also assessed with clinical scales examining fibromyalgia disability, sleep quality and duration, fatigue, anxiety, and depression, and a neuropsychological battery examining executive function, verbal short-term memory, and working memory, as well as attentional executive function and selective attention, interference sensitivity, and inhibition of automatic responses. NFL levels were higher in FM patients (controls 6.19± 1.92; FM 17.28± 15.94 pg/mL ANOVA p 0.002). Working memory was the most impaired cognitive function significantly correlated with high NFL scores (Pearson p 0.034). Short sleep times also correlated with higher NFL scores (Pearson p 0.02) and poorer working memory performance (Pearson p 0.02). No correlation was found with indices of disease severity and duration. Plasma NFL levels are elevated in fibromyalgia patients, suggesting neuronal damage and correlating with a slight decrease in working memory and short sleep duration. Plasma neurofilament levels are elevated in patients with fibromyalgia, regardless of disease severity and duration. Neurofilament levels are higher in patients with mild working memory impairment and sleep disorders. Subgroups of patients with primary neuronal damage phenomena could be individualized for prospective evaluation with regard to the possible development of cognitive decline and sleep disturbances, which would justify a tailored therapeutic approach.

Association between serum neuregulin 4 and the risk of gestational diabetes mellitus: A 1:1 matched case–control study

Association between serum neuregulin 4 and the risk of gestational diabetes mellitus: A 1:1 matched case–control study

Genetic predisposition to thyroid dysfunction: a case–control study investigating TSHR gene polymorphism (rs2268458) in Indians

BackgroundVariations in the TSHR gene have been implicated in a spectrum of thyroid diseases. Previous studies have implicated variations in the TSHR gene, including SNPs rs179247, rs12101255, and rs2268458, in thyroid diseases, but their association with hypothyroidism and hyperthyroidism in the Indian population has not been investigated.AimIn this study, we aimed to examine the relationship between candidate SNP rs2268458 and susceptibility to hypothyroidism and hyperthyroidism in the Indian population. We carried out a case–control genetic screening of the TSHR gene.MethodsWe analyzed the variant of the TSHR gene using the PCR–RFLP technique in a total of 318 participants, including 130 controls and 188 individuals with thyroid disorders (124 hypothyroid and 64 hyperthyroid). Demographic information was collected, and biochemical parameters were assessed using enzymatic methods. Statistical analysis was performed using SPSS-23.ResultsThe SNP rs2268458 demonstrated a significant association with hypothyroid and hyperthyroid patients (p-value < 0.05). Using the dominant genetic model, we calculated an odds ratio of 3.52 (confidence interval: 2.09–5.93, p-value: 0.0001) for the risk of hypothyroidism and an odds ratio of 2.34 (confidence interval: 1.26–4.31, p-value: 0.0001) for the risk of hyperthyroidism.ConclusionThis pioneering study in the Indian population reveals a significant association between the C allele of TSHR gene SNP rs2268458 and an increased risk of developing both hypothyroidism and hyperthyroidism. Our findings suggest that the C allele may be a common genetic risk factor for thyroid dysfunction in Indians.

WOB fuzzy control and experimental study on horizontal well experimental setup

This paper developed a horizontal drillstring-wellbore-bit experimental setup based on the similarity of physical behaviors. A data acquisition and control system was established to achieve real-time control over the Rotations Per Minute (RPM) and Rate of Penetration (ROP). Combining experts’ experience and practical drilling experiments, a constant Weight on Bit (WOB) fuzzy controller was designed for rock-breaking experiment. To validate the reliability of the control system, control tests were conducted with different WOB settings at varying RPM. The results indicated that the WOB control error was within 60 N, with an error rate below 3%. Rock drilling experiments were conducted on different rocks. In sandstone drilling experiments, as WOB increased from 600N to 900 N, the ROP, Torque on Bit (TOB), and Stick-slip Vibration Intensity (SSVI) increased significantly, reaching 114.12, 3.6, and 2.97 times of the original values, respectively. When the RPM increased from 21 to 30 RPM, TOB, SSVI, and ROP changed to 1.43, 0.89, and 3.84 times of the original values. The increase in ROP during sandstone drilling was evident, suggesting a moderate increase in drilling parameters, with caution against stick-slip vibrations, which can be mitigated by increasing RPM. In limestone drilling experiments, as WOB increased from 900 to 3300 N, TOB, SSVI, and ROP increased by 2.45, 3.17, and 56.34 times, respectively. When RPM was increased from 45 to 63 RPM, TOB, SSVI, and ROP changed by 0.88, 0.74, and 1.68 times, respectively. Under conditions of high WOB and RPM, the limestone drilling speed increased more significantly.

Stress in Family Caregivers of Children with Chronic Health Conditions: A Case–Control Study

Objectives: This study analyzed the stress experienced by family caregivers of children with special healthcare needs and identified associated factors. Methods: A case–control study was conducted with the “cases” being caregivers of children with chronic conditions and the “controls” being caregivers of healthy children. Recruitment was carried out via social media and complemented by snowball sampling. A sociodemographic questionnaire and the Perceived Stress Scale were applied, with four saliva samples collected in one day (at 8:00 am, 30 min later, and 4 and 12 h later). The Area Under the Curve for total daily cortisol production was calculated using the log-trapezoidal method. The Wilcoxon test and repeated-measures ANOVA were used for statistical analysis. Results: In total, 100 caregivers participated, with 50 in the “case” group and 50 in the “control” group. Significant differences in stress scores and salivary cortisol levels were observed between the groups, with the other variables constant. In both groups, cortisol levels followed a typical circadian pattern. Family income was associated with perceived stress. Caregiver age significantly explained perceived stress (p = 0.0098) and total cortisol production. Caregiver occupation also influenced cortisol results. Conclusions: Caregivers of children with chronic conditions showed higher perceived stress and lower cortisol production compared to those of healthy children. Family income, occupation, and caregiver age were associated with stress.

The Significance of Albumin Concentration and some of its Altered Forms in Iraqi Patients with Chronic Hepatitis B Virus

Background: The liver synthesizes albumin, a pivotal protein with approximately 60-65% of total plasma proteins. During ischemic attacks linked to oxidative stress, reactive oxygen species, and acidosis, the properties of albumin undergo alterations. This leads to generation of ischemia-modified albumin, which is characterized by a diminished metal-binding capacity, particularly for transition metals like copper, nickel, and cobalt. Objectives: This study aimed to assess the significance of serum albumin and ischemia-modified albumin concentrations in Iraqi individuals with hepatitis B virus Methods: A case control study consisted of 50 patients with hepatitis B were recruited from Gastroenterology hospital in the Medical city/ Baghdad/ Iraq, during the period January to February in 2023, The patients group included males and females; whose ages ranged from 18 years to 77 years with a mean value 44 year. Meanwhile the study group consisted of 50 age- and sex-matched normal healthy individuals. Albumin concentration was determined in the serum samples, using a Biosystems kit, and ischemia modified albumin concentration were measured through the albumin cobalt binding test. The ischemia modified albumin/ [albumin] ratio and Ischemia modified albumin index were then calculated. Statistical Analysis: results were reported as a mean value ± standard deviation. The differences were considered highly significant if (p &lt; (0.001), and significant where (p = (0.002) and (p = (0.033) Results: lower serum albumin concentration was measured in the patients group, while the mean value of ischemia modified albumin concentration in the patients' group and healthy control were 0.466 ± 0.114 absorbance unit &amp; 0.395 ± 0.070 absorbance unit, respectively, with a statistically significant increase (P &lt; 0.001). The ischemia modified albumin ratio in the hepatitis B patients and control groups were 0.172 ± 0.073 and 0.117 ± 0.050, respectively, showing a significant increase as well (P &lt; 0.001). Additionally, the ischemia modified albumin index in the patients and the control groups were 0.491 ± 0.167 &amp; 0.390 ± 0.131, respectively, with a statically significant increase (p&lt;0.001) in the patients group. Conclusion: In the patients’ group with hepatitis B, serum albumin concentration is decreased, while the level of ischemia modified albumin, ischemia modified albumin ratio, and ischemia modified albumin index are increased. The elevation in ischemia modified albumin, ischemia modified albumin ratio, and ischemia modified albumin index were more prominent in younger patients and those with albumin concentration less than 4g/dl. Moreover, the prevalence of hepatitis B is higher in men compared to women.

CYP2C19 Loss-of-Function is an Associated Risk Factor for Premature Coronary Artery Disease: A Case–Control Study

CYP2C19 Loss-of-Function is an Associated Risk Factor for Premature Coronary Artery Disease: A Case–Control Study

Optical Coherence Tomography Study of Choroidal Response to Exercise-Induced Hypertension in Chronic Central Serous Chorioretinopathy

Background/Objectives: The aim of this study was to evaluate the choroidal vascular response using optical coherence tomography (OCT) in patients with chronic central serous chorioretinopathy (CSCR) during transient increases in blood pressure. Methods: This observational, case–control study enrolled chronic CSCR patients and age-matched healthy controls. OCT scans of the macula were performed at rest and during hand-grip (HG) isometric exercise. Mean ocular perfusion pressure (MOPP) and subfoveal choroidal thickness (SCT) were measured at baseline and during stress. Quantitative OCT assessment included the bright area (BA, stroma), dark area (DA, vascular lumen), and total choroidal area (CA). The choroidal vascularity index (CVI) was calculated as DA/CA to assess vascular response to stress. A comparative analysis between CSCR patients and controls was conducted. Conclusions: MOPP was significantly higher (p = 0.008) at baseline in CSCR patients and further increased under stress compared to controls. SCT and CA were both significantly higher in CSCR patients than in healthy subjects at rest and under stress (p &lt; 0.001), but no change occurred after HG. A significant decrease in CVI (p = 0.005) was noted in controls under stress, but not in CSCR patients. Additionally, a negative correlation between CVI and MOPP was found in healthy subjects (−0.648; p = 0.043). The study demonstrated a choroidal vasoconstrictive response to stress in healthy subjects, as evidenced by a decrease in CVI, but not in CSCR patients. This suggests that CSCR patients may experience impaired choroidal blood flow regulation, resulting in potentially higher perfusion pressures during stress without compensatory vasoconstriction, potentially affecting the choriocapillaris.

The value of renal color Doppler ultrasound as an objective tool in the diagnosis of renal affection in SLE patients

BackgroundSystemic lupus erythematosus (SLE) is an autoimmune disease with diverse manifestations, which resembles a clinical challenge to be managed. Lupus nephritis is a life-threatening condition as about 10% of patients develop chronic kidney disease.Aim of the workTo assess the role of resistive index (RI) as a noninvasive parameter in detecting renal affection in SLE patients.ResultsA case–control study included 3 matched groups: 30 patients, 15 SLE with no renal affection, and 15 SLE lupus nephritis patients, who were selected, diagnosed according to ACR criteria 2019 for SLE, beside 15 age- and gender-matched healthy controls without any risk factors of chronic diseases. Written informed consent was obtained from all the three groups, and the study was approved by ethical committee. There was a statistically significant increase in both SLEDAI and renal SLEDAI scores, serum BUN, creatinine, urinary pus cells, RBCs, casts and proteins, 24-h urinary proteins, and protein/creatinine ratio beside a statistically significant increase in both right and left resistive indices in the group of lupus nephritis than the other group. There was highly statistically significant difference between SLE without nephritis and SLE with nephritis regarding renal echogenicity. There was statistically significant positive correlation between average RI and SLEDAI, rSLEDAI, serum creatinine, BUN, 24-h urinary proteins, protein/creatinine ratio, and renal echogenicity. Relation between renal echogenicity and demographic, laboratory, and clinical data was highly statistically significant with rSLEDAI, serum creatinine, BUN, 24-h urinary proteins, and P/C ratio. Our study highlighted that the best cutoff point of Rt average RI to detect SLE with nephritis group was found > 0.68 with sensitivity of 86.7% and specificity of 100.0%, while the best cutoff point of left average RI to detect SLE with nephritis group was found > 0.7 with sensitivity of 80.0% and specificity of 100.0%.ConclusionRenal RI is a noninvasive technique that can be used for detection renal disease activity in SLE patients, together with renal parenchymal echogenicity by grayscale US.

Association between sleep quality and cognitive impairment in older adults hypertensive patients in China: a case–control study

BackgroundPrevious studies have found that poor sleep quality promotes the occurrence of cognitive impairment (CI), but this relationship has been rarely reported in older adults hypertensive patients. The purpose of this study was to investigate the relationship between sleep quality and CI in older adults hypertensive patients and the mediating effect of sleep quality between physical activity (PA) and CI.MethodsA total of 2072 older adults hypertensive patients were included in this case–control study. Five hundred and eighteen older adults hypertensive patients with CI were matched 1:3 by age and sex to 1,554 older adults hypertensive patients with normal cognitive function. The International Physical Activity Questionnaire-Long Form, Pittsburgh Sleep Quality Index, and Mini-Mental State Examination were used to evaluate PA intensity, sleep quality, and cognitive function in older adults hypertensive patients. Multivariate logistic regression and the mediation package in R Language were used to analyze the relationship between sleep quality and CI and the mediating effect of sleep quality between PA intensity and CI in older adults hypertensive patients.ResultsAfter adjusting for all confounding factors, sleep quality was positively correlated with CI in older adults hypertensive patients (OR = 2.565, 95%CI: 1.958–3.360, p &amp;lt; 0.001), and this relationship also existed in the older adults hypertensive patients with education levels of primary school and below and junior high school and above (OR = 2.468, 95%CI: 1.754–3.473, p &amp;lt; 0.001; OR = 2.385, 95%CI: 1.367–4.161, p = 0.002). In addition, sleep quality mediated part of the mediating effect between PA intensity and CI in older adults hypertensive patients (Za*Zb: - 17.19339; 95%CI: −0.37312, −0.04194).ConclusionPoor sleep quality was associated with the occurrence of CI in older adults hypertensive patients, and this relationship also existed in older adults hypertensive patients with education levels of primary school and below and junior high school and above.

Supervised Reinforcement Learning-Based Collaborative Master–Slave Harvest Control Study in Wheat

Supervised Reinforcement Learning-Based Collaborative Master–Slave Harvest Control Study in Wheat

Infertility treatments and risk of breast benign diseases: a case‒control study

BackgroundTheoretically, endocrine fluctuations occurring during infertility treatments, including ovulation induction (OI) and assisted reproductive techniques (ART), could be associated with an increased risk of benign breast diseases (BBDs). To date, no studies have been conducted on this association. Therefore, the present study investigated the association between different types of infertility treatments and BBDs.MethodsThis case‒control study was conducted in Arash Women’s Hospital, Tehran, Iran. The case group included infertile women diagnosed with BBDs without atypia, and the control group included infertile women without breast disease. Breast imaging studies (mammography/ultrasound) were performed for BBD screening, and the diagnosis was confirmed by histopathological examination. Study variables were collected retrospectively from medical records, hospital databases, and questionnaires.ResultsFinally, 154 infertile women, including 50 cases (BBDs) and 104 controls (no BBDs), were compared. Our data showed that 66% of cases and 61.4% of controls had undergone at least one course of infertility treatment. There was no association between BBD risk and previous infertility treatments (OR = 1.21; 95% CI = 0.59–2.46), ART (OR = 1.14; 95% CI = 0.90–1.44), or OI cycles (OR = 1.13; 95% CI = 0.98–1.32). Stratification by confounding variables did not change these results.ConclusionsIt seems that there is no association between BBDs in infertile women and the type, duration, or number of prior infertility treatments; however, considering the small sample size of the study, the clinical significance of this finding should not be neglected. Therefore, we consider it essential to carry out more extensive, detailed, and prospective studies to distinguish the association of BBDs with different infertility treatments and medications.