Unit Increase Research Articles

Genetic loci associated with sorghum drought tolerance in multiple environments and their sensitivity to environmental covariables.

Climate change can limit yields of naturally resilient crops, like sorghum, challenging global food security. Agriculture under an erratic climate requires tapping into a reservoir of flexible adaptive loci that can lead to lasting yield stability under multiple abiotic stress conditions. Domesticated in the hot and dry regions of Africa, sorghum is considered a harsh crop, which is adapted to important stress factors closely related to climate change. To investigate the genetic basis of drought stress adaptation in sorghum, we used a multi-environment multi-locus genome-wide association study (MEML-GWAS) in a subset of a diverse sorghum association panel (SAP) phenotyped for performance both under well-watered and water stress conditions. We selected environments in Brazil that foreshadow agriculture where both drought and temperature stresses coincide as in many tropical agricultural frontiers. Drought reduced average grain yield (Gy) by up to 50% and also affected flowering time (Ft) and plant height (Ph). We found 15 markers associated with Gy on all sorghum chromosomes except for chromosomes 7 and 9, in addition to loci associated with phenology traits. Loci associated with Gy strongly interacted with the environment in a complex way, while loci associated with phenology traits were less affected by G × E. Studying environmental covariables potentially underpinning G × E, increases in relative humidity and evapotranspiration favored and disfavored grain yield, respectively. High temperatures influenced G × E and reduced sorghum yields, with a ~ 100kgha-1 average decrease in grain yield for each unit increase in maximum temperature between 29 and 38°C. Extreme G × E for sorghum stress resilience poses an additional challenge to breed crops for moving, erratic weather conditions.

Gestational diabetes and future cardiovascular diseases: associations by sex-specific genetic data.

Observational studies have highlighted that gestational diabetes mellitus is associated with a higher risk of cardiovascular diseases, but the causality remains unclear. Herein, the causality between genetic predisposition to gestational diabetes mellitus and the risk of cardiovascular diseases was investigated using sex-specific Mendelian randomization analysis. Linkage disequilibrium score regression analysis and two-sample Mendelian randomization analysis were applied to infer the genetic correlation and causality, respectively. Mediation analysis was conducted using a two-step Mendelian randomization approach. Sensitivity analyses were performed to differentiate causality from pleiotropy. The genome-wide association study summary statistics for gestational diabetes mellitus were obtained from FinnGen consortium, while for cardiovascular diseases were generated based on individual-level genetic data from the UK Biobank. Linkage disequilibrium score regression analyses revealed that gestational diabetes mellitus had a significant genetic correlation with coronary artery disease and myocardial infarction after Benjamini-Hochberg correction in ever-pregnant women. In Mendelian randomization analyses, odds ratios (95% confidence interval) for coronary artery disease and myocardial infarction were 1.09 (1.01-1.17) and 1.12 (.96-1.31) per unit increase in the log-odds of genetic predisposition to gestational diabetes mellitus in ever-pregnant women, respectively. Further, Type 2 diabetes and hypertension were identified as mediators for the causality of genetic predisposition to gestational diabetes mellitus on coronary artery disease. In sensitivity analyses, the direction of odds ratio for the association between instrumental variables with gestational diabetes mellitus-predominant effects and the risk of coronary artery disease was consistent with the primary results in ever-pregnant women, although not statistically significant. This study demonstrated a suggestive causal relationship between genetic predisposition to gestational diabetes mellitus and the risk of coronary artery disease, which was mainly mediated by Type 2 diabetes and hypertension. These findings highlight targeting modifiable cardiometabolic risk factors may reduce the risk of coronary artery disease in women with a history of gestational diabetes mellitus.

Factors associated with neurological outcomes in patients experiencing out-of-hospital cardiac arrest and severe acidaemia: retrospective analysis of a nation-wide registry

Background and objectiveAcidaemia is common among individuals who experience out-of-hospital cardiac arrest (OHCA). While severe acidaemia is a strong predictor of unfavourable outcomes, a subset of patients exhibits dramatic recovery. Despite these conflicting outcomes, little is known about the factors associated with neurological outcomes in those who experience OHCA with severe acidaemia. MethodsThis retrospective analysis used data from a Japanese multicentre nationwide database, the Japanese Association for Acute Medicine OHCA Registry. The analysis included data from adult patients with OHCA for whom blood pH data were available upon arrival to hospital. The primary outcome was 30-day survival with favourable neurological outcomes, defined as a Glasgow-Pittsburgh cerebral performance category score of 1 or 2. Patients were categorised with severe acidaemia if their blood pH was ≤ 6.8. Factors associated with favourable outcomes were investigated using multiple logistic regression analysis. ResultsData from 49,044 patients were included in the analysis, of whom 16,620 exhibited severe acidaemia with a median pH of 6.70 (interquartile range [IQR] 6.61–6.76], and 0.5% (86/16,620) experienced a neurologically favourable outcome. After adjustment for important prognostic factors, witnessed status exhibited a strong association with favourable neurological outcome (adjusted odds ratio [aOR] 6.46 [95% confidence interval (CI) 2.64–15.8]), while initial blood pH exhibited no significant association (aOR 0.90 with every 0.1 unit increase [95% CI 0.71–1.14]). ConclusionAlthough the number is small, a notable number of patients with severe acidaemia exhibited good neurological recovery. Witness status was critical for the prognosis of these patients.

What is the optimal range of fasting stress hyperglycemia ratio for all-cause mortality in American adults: An observational study.

To date, no studies have been conducted to assess the impact of fasting stress hyperglycemia ratio (SHR) on all-cause mortality. Therefore, the objective of our study is to investigate the association between SHR and all-cause mortality in a population of American adults. The study population was derived from NHANES data spanning from 2005 to 2018. The exposure variable SHR was derived from fasting blood glucose (FBG) and glycosylated hemoglobin (HbA1c%), and the specific calculation formula was as follows: (FBG (mmol/L))/(1.59 × HbA1c (%) - 2.59). The outcome variable was all-cause mortality. A total of 18,457 participants were enrolled in this prospective cohort study. Following a median follow-up period of 90 months, all-cause mortality was observed in 10.32% of the subjects. Cox proportional hazards regression model indicates that there is no significant difference between SHR and all-cause mortality in the fully adjusted model, whether analyzed as a continuous or categorical variable (P for trend > 0.05). Through the 2-piecewise Cox proportional hazards regression model, we have determined that the inflection point of SHR in relation to all-cause mortality is 0.88. It has also been observed that when the value of SHR is on the left side of the inflection point (SHR ≤ 0.88), there is a significant 77% (HR: 0.23; 95% CI: 0.10-0.50) reduction in all-cause mortality for each additional unit increase in SHR. Conversely, when the value of SHR exceeds 0.88, there is a substantial 2.40-fold (HR: 2.40; 95% CI: 1.61-3.58) increase in the risk of all-cause mortality (P for log likelihood ratio test < .001). The subgroup analysis results demonstrate that sex has the potential to modify the association between SHR and all-cause mortality within the population exhibiting SHR ≤ 0.88. The relationship between SHR and all-cause mortality follows a U-shaped pattern, where in the lowest risk of death for the average American adult is observed at an SHR value of 0.88. Furthermore, in men with SHR ≤ 0.88, there is a significant inverse relationship between the increase in SHR and the risk of all-cause mortality.

Gestational organophosphate esters (OPEs) and executive function in adolescence: The HOME Study

BackgroundEvidence from toxicological studies indicate organophosphate esters (OPEs) are neurotoxic, but few epidemiological studies investigated associations between gestational OPEs and executive function. ObjectiveTo examine the associations between gestational concentrations of OPE urinary metabolites and executive function at 12 years MethodsWe used data from 223 mother-adolescent dyads from the Health Outcomes of Measures of the Environment (HOME) Study. Women provided spot urine samples at 16 weeks gestation, 26 weeks gestation, and at delivery for quantification of bis(1,3-dichloro-2-propyl) phosphate, bis-2-chloroethyl phosphate (BCEP), diphenyl phosphate (DPHP), and di-n-butyl phosphate (DNBP). Executive function was assessed at age 12 years using the parent- and self-report Behavior Rating Inventory of Executive Function (BRIEF2). Covariate-adjusted associations between specific gravity-corrected OPEs and BRIEF2 scores were estimated using multiple informant models. Bayesian Kernel Machine Regression (BKMR) was used to assess the impact of all OPEs simultaneously. ResultsParent- and self-report BRIEF2 indices and composite scores were weakly to moderately correlated (rs=0.32-0.41). A natural-log unit increase in BCEP at 26 weeks was associated with approximately a 1-point increase on the self-report Cognitive Regulation Index [CRI] (95% CI 0.4, 2.3), the Emotion Regulation Index [ERI] (95% CI 0.3, 2.2), and the Global Executive Composite [GEC] (95% CI 0.4, 2.2), indicating poorer performance. Higher DPHP at 16 weeks was associated with lower parent-report GEC score (β=-1.1, 95% CI -2.3, -0.003). BKMR identified BCEP and DNBP at 26 weeks as important contributors to CRI and ERI, respectively. ConclusionOPE metabolites during gestational development, particularly BCEP, may influence adolescent executive function. However, since the FDR p-values failed to reach statistical significance, additional studies would benefit from using larger cohorts.

Indirect and direct effects of nighttime light on COVID-19 mortality using satellite image mapping approach

The COVID-19 pandemic has highlighted the importance of understanding environmental factors in disease transmission. This study aims to explore the spatial association between nighttime light (NTL) from satellite imagery and COVID-19 mortality. It particularly examines how NTL serves as a pragmatic proxy to estimate human interaction in illuminated nocturnal area, thereby impacting viral transmission dynamics to neighboring areas, which is defined as spillover effect. Analyzing 43,199 COVID-19 deaths from national mortality data during January 2020 and October 2022, satellite-derived NTL data, and various environmental and socio-demographic covariates, we employed the Spatial Durbin Error Model to estimate the direct and indirect effect of NTL on COVID-19 mortality. Higher NTL was initially directly linked to increased COVID-19 mortality but this association diminished over time. The spillover effect also changed: during the early 3rd wave (December 2020 – February 2021), a unit (nanoWatts/sr/cm2) increase in NTL led to a 7.9% increase in neighboring area mortality (p = 0.013). In contrast, in the later 7th wave (July – September 2022), dominated by Omicron, a unit increase in NTL resulted in an 8.9% decrease in mortality in neighboring areas (p = 0.029). The shift from a positive to a negative spillover effect indicates a change in infection dynamics during the pandemic. The study provided a novel approach to assess nighttime human activity and its influence on disease transmission, offering insights for public health strategies utilizing satellite imagery, particularly when direct data collection is impractical while the collection from space is readily available.

Coordinating public and government responses to air pollution exposure: A multi-source data fusion approach

Aligning public demand with government supply of clean air aids in efficient air pollution control and enhancement of public happiness. However, comparative empirical analyses of public and government attention to air quality changes are still sparse due to data and methodological constraints. Here, we adopt multi-source data fusion approaches to assess the impacts of air pollution exposure on public and government attention. Specifically, remote and social sensing data, alongside keywords extracted from textual data, are utilized to quantify air pollution exposure and corresponding public and government attention levels in 273 Chinese cities from 2011 to 2019, and a two-stage least squares regression model is employed to tackle reverse causality issues underlying the exposure-response relationship. Our findings reveal that, on average, a unit increase in PM2.5 levels would result in a 17.7% growth in public attention and a 12.7% rise in government attention, respectively, suggesting that demand-driven public attention tends to be more sensitive to air quality changes than policy-driven government attention. Results for the spatial-temporal heterogeneity further demonstrate that public attention varies across time and space, whereas government attention remains relatively consistent. Additionally, we have identified 116 cities exhibiting disparities between the public and government responses to air quality changes, calling for environmental policy refinements to better serve the needs of residents. This study emphasizes the necessity of public engagement in environmental governance and offers rich policy implications for air pollution control in China.

Measurement and impact analysis of social vulnerability to geological disasters in Guizhou Province, China

Investigating social vulnerability is a crucial aspect of attaining an in-depth understanding of disasters and disaster risk. This study developed a measurement framework for social vulnerability to geological disasters, obtained a comprehensive social vulnerability index, and compared the spatial distribution patterns of fatalities, social vulnerability, and geological disaster-prone zones. These efforts assisted in determining the strength and character of the relationship between geological disaster fatality risk and social vulnerability at the county level. The findings show that: (1) the social vulnerability to geological disasters index varies significantly between counties. High social vulnerability is primarily concentrated in Bijie City, Guizhou province, which shows concentrated clustering. Conversely, low social vulnerability is mainly concentrated in Guiyang City: (2) the spatial distribution patterns reveal the limitations of disaster exposure in explaining fatality risk and demonstrate the ability of social vulnerability to amplify disaster risk; (3) the zero-inflated negative binomial regression model fit the data significantly better than the negative binomial regression model, suggesting that for every one unit increase in the social vulnerability index, there is a 6.33% increase in the risk of fatalities, holding all other variables constant. This study establishes a specific framework for measuring social vulnerability to geological disasters and provides new evidence of how social vulnerability influences disaster risk intensity. The county-level spatial measurement results can further assist disaster management personnel in formulating more localized mitigation strategies. The findings will further support the identification of core remediation sites and the implementation of management and relocation (avoidance) projects during Guizhou Province’s 14th Five-Year Plan for geological disaster prevention and control.

Impact of flooding at the early reproductive growth stage on soybean yield and seed composition

AbstractFlooding stress is a growing threat to global soybean [Glycine max (L.) Merr.] production as the frequency and intensity of extreme precipitations are increasing due to climate change. Soybean is highly sensitive to flooding and substantial yield losses are observed due to a cascade of negative physiological responses induced by hypoxia. Hence, there is a pressing need for the development of flood‐tolerant genotypes. This study evaluated the grain yield and seed protein and oil content of 31 soybean genotypes over 2 years under both non‐flooding and flooding conditions, where flooding entailed a 4‐day partial water submergence during the early reproductive growth stages R1/R2. Mixed‐effects linear models were utilized to assess the impact of flood damage scores (FDSs, 1–4 scale) on observed phenotypes, as well as differences in observed phenotypes between tolerant, moderate, and susceptible genotypes across flooding and non‐flooding treatments. No significant impact of FDS was observed for seed protein and oil content. In addition, no significant differences in these phenotypes were observed between flooding and non‐flooding treatments across the various genotype categories. On average, for each unit increase in FDS, grain yield decreased by 432.7 kg ha−1 (17.4%). Tolerant genotypes experienced roughly 33% yield losses between flooding and non‐flooding treatments, while moderate and susceptible genotypes experienced 44% and 51% yield losses, respectively. The advancements in genomics and phenomics are promising for the identification and incorporation of novel flood‐tolerant alleles through plant breeding, potentially mitigating flooding‐induced yield losses across diverse environmental conditions.

The impact of frailty on the use of social services, medication and mortality risk: a cross-sectional study

BackgroundFrailty is a common condition in older people, and its prevalence increases with age. With an ageing population, the adverse consequences of frailty cause an increasing appeal to the health care system. The impact of frailty on population level is often assessed using adverse health outcomes, such as mortality and medication use. Use of community nursing services and services offered through the Social Support Act are hardly used in assessing the impact of frailty. However, these services are important types of care use, especially in relation to ageing in place. In this cross-sectional study, we aimed to assess the impact of frailty on use of Social Support Act services, use of community nursing services, medication use, and mortality.MethodsWe used a frailty index, the FI-HM37, that was based on data from the Dutch Public Health Monitor 2016, for which respondents ≥ 65 years of age were included (n = 233,498). The association between frailty, the use of Social Support Act services, community nursing services and medication use was assessed using the Zero Inflated Poisson (ZIP) regression method. Survival analysis using Cox proportional hazards regression was conducted to estimate the hazard ratios for the association between frailty and mortality.ResultsThe ZIP regression with a final sample size of 181,350 showed that frailty affected care use even after correcting for several covariates mentioned in the literature. For each unit increase in frailty index (FI) score, the relative probability of using zero Social Support services decreased with 7.7 (p < 0.001). The relative chance of zero community nursing services decreased with 4.0 (p < 0.001) for each unit increase in FI score. Furthermore, for each unit increase in FI score, the likelihood of zero medication use decreased with 2.9 (p < 0.001). Finally, for each unit increase in FI score, the mortality risk was 3.8 times higher (CI = 3.4–4.3; p < 0.001).ConclusionsWe demonstrated that frailty negatively affects the use of Social Support Act services, the use of community nursing services, medication use, and mortality risk. This study is the first to demonstrate the impact of frailty on Social Support Act services and community nursing services in the Netherlands. Findings emphasize the importance of frailty prevention for older people and public health policy.

The association between the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and non-alcoholic fatty liver disease in US adults: a cross-sectional study

The ratio of non-high-density lipoprotein cholesterol (non-HDL-C) to HDL-C (NHHR) is a novel lipid parameter used to assess the risk of cardiovascular disease. Previous studies have demonstrated an association between the NHHR and risk of non-alcoholic fatty liver disease (NAFLD). Owing to the lack of research exploring this relationship in specific populations, this study aimed to determine the potential link between the NHHR and risk of NAFLD among American adults in the United States. Data were retrieved from the National Health and Nutrition Examination Survey (NHANES) spanning 2017–2020. After excluding individuals with other liver diseases, alcohol abuse, and missing lipid data, a total of 6809 eligible adults were included for analysis. The NHHR was calculated as the ratio of (non-HDL-C) to HDL-C, while NAFLD was identified by liver steatosis detected by transient elastography. Multivariable weighted logistic regression models and restricted cubic spline (RCS) models were employed to investigate the relationship between the NHHR and risk of NAFLD. Subgroup and sensitivity analyses were also conducted to test the robustness of the results. As the NHHR increased, the prevalence of NAFLD rose progressively (5.88% vs. 8.75% vs. 12.24% vs. 15.77%, p < 0.001). In the overall population, after adjusting for confounding factors, each unit increase in the NHHR was associated with a 25% increase in NAFLD risk (OR = 1.25, 95% CI: 1.03–1.53, p = 0.0372). When the NHHR was analyzed as a categorical variable (quartiles), participants in the highest quartile had a significantly higher risk of NAFLD than those in the lowest quartile (OR = 2.6, 95% CI: 1.75–3.85, p = 0.009). RCS analysis further indicated a nonlinear dose–response relationship between the NHHR and risk of NAFLD (p non-linearity < 0.0001). This association remained significant in both subgroup and sensitivity analyses. This study confirmed that the NHHR, particularly at higher levels, was an independent risk factor for NAFLD. As a comprehensive lipid indicator, the NHHR had the potential to predict NAFLD risk. These findings provided new insights for the prevention and clinical management of NAFLD.

Contribution of body adiposity index and conicity index in prediction of metabolic syndrome risk and components

Background and aimsBody adiposity index (BAI) and conicity index have been known as useful measures in predicting cardio-metabolic diseases. This study aimed to evaluate the predictive potential of BAI and conicity index for the risk of metabolic syndrome (MetS) in comparison with body mass index (BMI), waist circumference (WC), hip circumference (HC), and waist-hip ratio (WHR). MethodsIn this cross-sectional study, 174 adults (87 with MetS and 87 healthy individuals) were recruited from a medical weight loss center. Anthropometric parameters, systolic and diastolic blood pressures (SDP and DBP), lipid profile, and fasting blood sugar (FBS) were measured. ResultsAll anthropometric parameters were significantly higher in subjects with MetS than in healthy subjects. Both in MetS and healthy subjects, females had significantly higher BAI and BMI than males. In the fully adjusted model, the odds of MetS increased for each unit increase in BAI by 27 % (p = 0.001), in BMI by 33 % (p = 0.001), in WC by 13 % (p < 0.001), and in HC by 9 % (p = 0.005). ROC curve analysis showed that all the anthropometric parameters displayed clinical importance in predicting MetS, but WHR had the largest area under the curve (AUC) in total, male, and female patients. In participants with MetS, the conicity index was negatively correlated with FBS; BAI was positively associated with HDL level. ConclusionAll studied anthropometric parameters had acceptable accuracy for predicting MetS. Traditional parameters, particularly the WHR, exhibited a higher predictive power concerning MetS. The results underscore the reliability of conventional anthropometric measures in clinical and epidemiological settings.

Organic food consumption during pregnancy and symptoms of neurodevelopmental disorders at 8 years of age in the offspring: the Norwegian Mother, Father and Child Cohort Study (MoBa)

BackgroundPartially driven by public concerns about modern food production practices, organic food has gained popularity among consumers. However, the impact of organic food consumption during pregnancy on offspring health is scarcely studied. We aimed to investigate the association between maternal intake of organic food during pregnancy and symptoms of attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in offspring at 8 years of age.MethodsThis study was based on the Norwegian Mother, Father and Child Cohort Study (MoBa) and the Medical Birth Registry of Norway (MBRN). The total study sample included 40,707 mother–child pairs (children born 2002–2009). Organic food consumption during pregnancy was assessed by six questions from a food frequency questionnaire in mid-pregnancy (sum score 0–18). Symptoms of ADHD and ASD in the offspring aged 8 years were measured by ADHD (0–54) and ASD (0–39) symptom scores based on the Parent/Teacher Rating Scale for Disruptive Behaviour disorders and the Social Communication Questionnaire. Associations between maternal intake of organic food during pregnancy and symptoms of ADHD and ASD in the offspring were analyzed using regression models with adjustment for covariates such as maternal anxiety and depression, including sibling analysis.ResultsMean ADHD and ASD symptom scores in the offspring differed only slightly by maternal intake of organic food. The covariate-adjusted unstandardized regression coefficient (adjusted(Adj)beta) with 95% confidence interval for the ADHD symptom score with one unit increase in organic food sum score was 0.03 (0.01, 0.05). Similarly, Adjbeta for autism symptom score was 0.07 (0.04, 0.10). For ADHD, the adjusted estimates weakened when adjusting for maternal symptoms of ADHD. The sibling analyses showed no significant results with Adjbeta − 0.07 (− 0.15, 0.01) and − 0.001 (− 0.12, 0.12) for ADHD and ASD outcomes, respectively.ConclusionsWe observed weak positive associations between frequent maternal organic food consumption during pregnancy and offspring ADHD and ASD symptom levels at 8 years of age. This trend weakened or disappeared after adjusting for maternal symptoms of ADHD, and in sibling analyses, suggesting that the associations mainly reflect genetic confounding. Our study indicates that consumption of organic food during pregnancy should neither be considered a risk factor nor protective against symptoms of ADHD and ASD in offspring.

Empowering consumers to purchase safe ready-to-eat chicken from street restaurants in Ouagadougou, Burkina Faso: impact of a multi-media behavior change campaign

Foodborne disease resulting from food sold at urban informal markets is a major public health challenge in Sub-Saharan Africa. This study assessed the impact of an innovative nine-months multi-media campaign engaging a key influencer, aimed at empowering consumers to choose safer ready-to-eat chicken meat at informal street restaurants in Ouagadougou, Burkina Faso. A two-wave panel study assessed associations between recall of TV, radio, billboard, and social media advertisements, and self-reported behavior regarding purchasing and consumption of ready-to-eat chicken at outlets, consumer intentions, knowledge, attitudes, norms, and agency. A panel of randomly selected adult consumers (n = 852) were interviewed pre- and post-campaign, 12 months apart. 60% recalled at least one of the campaign channels when prompted. Mixed-effects models showed associations between prompted recall and feeling better informed about food safety (aOR 1.449) and increased knowledge (0.132 unit increase on total score). Social media recall was associated with higher perceived access to information (aOR 1.449) and knowledge. Billboard recall increased odds of higher perceived health benefits of paying attention to food safety behaviors when purchasing chicken (aOR 2.046). TV ad recall was associated with a 0.159 unit decrease in the gap between consumers’ intentions and behavior. An engaging consumer food safety multimedia campaign that engages key influencers improved food safety awareness and knowledge, ultimately supporting consumers to choose safer chicken at markets.

Factors affecting the syncopal episodes in pediatric vasovagal syncope.

To investigate factors that influence the syncopal episodes in pediatric vasovagal syncope (VVS). A retrospective analysis was performed on the clinical data of 2908 children who were diagnosed with VVS for the first time between January 2001 and February 2023. The study examined the linear relationships among age, sex, height, weight, heart rate (HR), blood pressure, hemodynamic type, and head-up tilt test (HUTT) mode in relation to the onset of syncope. (1) Comparative analysis of intergroup differences revealed statistically significant variations in sex, age, height, weight, HR, systolic blood pressure, hemodynamic classification, and HUTT mode among syncopal episodes groups (P < 0.05); (2) Univariate analysis identified age, female, height, weight, VVS-cardioinhibited type (VVS-CI), VVS-mixed type (VVS-M) as potential risk factors for syncope episodes. Conversely, HR and sublingual nitroglycerin HUTT (SNHUT) emerged as potential protective factors against syncope episodes. (3) Multivariate analysis indicated that the frequency of syncope episodes increased by 0.27/0.02 for each unit increase in age/weight. When females compared to males and VVS-CI and VVS-M compared to VVS-vasoinhibited type (VVS-VI), the frequency of syncope episodes increased by 1.36, 0.53, and 0.66 respectively. Furthermore, SNHUT was associated with a reduction in the number of syncope episodes by 0.34 relative to basic HUTT. Female, age, weight, VVS-CI, and VVS-M were identified as independent risk factors for syncopal episodes, while SNHUT was recognized as an independent protective factor against syncopal episodes.

Ultrasound as a Complementary Tool to Electrodiagnostics in the Evaluation of Compressive Neuropathy of the Common Fibular Nerve

Background: Compressive neuropathy of the common fibular nerve (CFN) is increasingly recognized as an etiology for foot drop and falls. Electrodiagnostic (EDX) studies are widely used to evaluate this condition, but such tests are invasive and costly. As with carpal and cubital tunnel syndromes, there may be patients with characteristic symptoms of CFN compressive neuropathy but normal EDX studies in which ultrasound may aid in decision-making. Purpose: We sought to examine the association between ultrasound and nerve conduction studies (NCS) and electromyography (EMG) in the diagnosis of compressive neuropathy of the CFN. Methods: We performed a retrospective review identifying 104 patients who underwent CFN decompression from January 1, 2015, to June 30, 2023. Patients were included if they had both ultrasound and NCS/EMG prior to CFN decompression for compressive neuropathy and if they were older than 18 years at time of surgery. Patients were excluded if they had entrapment secondary to trauma, iatrogenic injury, or if they had had superficial fibular decompression alone without CFN decompression. After applying exclusion criteria, 17 patients remained in the cohort. Results: Mean ultrasound cross-sectional area and side-to-side (STS) ratios were significantly higher in those with abnormal compound muscle action potential (CMAP) amplitudes versus those with normal CMAP amplitudes. The probability of having an abnormal CMAP amplitude when STS ratio was abnormal was 18 times greater compared with those with normal STS ratio. With each unit increase in STS ratio, CMAP amplitude was reduced by 2.79 mV. Conclusions: This retrospective review found that ultrasound may provide complementary diagnostic information to EMG/NCS for compressive neuropathy of the CFN. Further study is needed to examine the relationship between ultrasound findings for CFN compressive neuropathy and results of surgical decompression.

A longitudinal study of mass loads of quaternary ammonium compounds in sludge associated with COVID-19 Stringency Index indicators in Beijing, China

This study estimated population normalized mass loads (PNML) of quaternary ammonium compounds (QACs) including alkyltrimethylammonium chloride (ATMAC), benzylalkyldimethylammonium chloride (BAC), and dialkyldimethylammonium chloride (DADMAC) and assessed their associations with COVID-19 containment policies. We collected daily sludge specimens from five wastewater treatment plants in Beijing from July 2020 to May 2022. Using liquid chromatography-tandem mass spectrometry, we determined QAC concentrations and backward-estimated their PNML. We used COVID-19 Oxford Stringency Index and its metrics to measure containment policies. We analysed the relationship between QACs and containment measures using linear regression models. Among QACs categories, ΣBAC had median PNML of 94.54 μg/person/day, ΣDADMAC had 282.36 μg/person/day, and ΣATMAC had 802.55 μg/person/day. The ΣQACs median PNML was 1186.12 μg/person/day. The PNML of QACs appeared to have general increasing trend over time and were significantly different across seasons. PNML increased on average by 11 μg/person/day (95 % CI: 3.2, 19) for ΣBAC per 10-unit increase in Stringency Index score. Notably, higher stringency levels in three index indicators — workplace closures, internal movement restrictions, and public gathering restriction were positively associated with higher ΣQACs PNML. Sludge derived QACs may reflect the magnitude of disinfectant use at different stages of pandemic control response.

Increased physiologic dead space fraction is associated with mortality after comprehensive stage 2 operation.

Our objective was to assess the predictive value of physiologic dead space fraction for mortality in patients undergoing the comprehensive stage 2 operation. This was a single-centre retrospective observational study conducted at a quaternary free-standing children's hospital specialising in hybrid palliation of single ventricle cardiac disease. 180 patients underwent the comprehensive stage 2 operation. 76 patients (42%) underwent early extubation, 59 (33%) standard extubation, and 45 (25%) delayed extubation. We measured time to extubation, post-operative outcomes, length of stay and utilised Fine gray models, Youden's J statistic, cumulative incidence function, and logistic regression to analyse outcomes. Delayed extubation group suffered significantly higher rates of mortality (31.1% vs. 6.8%), cardiac arrest (40.0% vs. 10.2%), stroke (37.8% vs. 11.9%), and need for catheter (28.9% vs. 5.1%) and surgical intervention (24.4% vs. 8.5%) (P < 0.001). Physiologic dead space fraction was significantly higher in the delayed extubation group and in non-survivors with a value of 0.3, which was found to be the discriminatory point by Youden's J statistic. For a 0.1 unit increase in physiologic dead space fraction on post-operative day 1, the odds of a patient expiring increase by a factor of 2.26 (95% CI 1.41-3.97, p < 0.001) and by a factor of 3.79 (95% CI 1.65-11.7, p 0.01) on post-operative day 3. Delayed extubation impacts morbidity and mortality in patients undergoing the comprehensive stage 2 operation. Increased physiologic dead space fraction in the first 60 hours after arrival to the ICU is associated with higher mortality.

Association between dietary vitamin K and telomere length: Based on NHANES 2001 to 2002.

As an anti-inflammatory and antioxidant, vitamin K has the potential to reduce telomere attrition. However, the correlation between dietary vitamin K and telomere length (TL) has not been reported. We aimed to investigate the association between these 2 variables. This study included 3754 participants from the National Health and Nutrition Examination Survey 2001-2002 database. We used multivariate linear regression and restricted cubic splines to assess the relationship between dietary vitamin K intake and TL. Subgroup analyses and interaction tests were utilized to examine the stability of the results. After adjusting for all variables, each unit increase in daily dietary intake of vitamin K lengthened telomeres by 0.22 base pairs (β = 0.22, 95% CI: 0.09-0.36, P = .001). Individuals with the highest dietary vitamin K intake had significantly longer TL (β = 80.27, 95% CI: 20.83-139.71, P = .008). Subgroup analyses suggested that this association persisted in populations stratified by gender, age, diabetes, cardiovascular disease (CVD), body mass index and total energy intake (P for interaction > .05). A linear relationship between dietary vitamin K intake and TL was observed in restricted cubic splines (P for nonlinear = .554). In conclusion, our findings suggest that dietary vitamin K intake is positively associated with TL, providing recent evidence to guide the management of healthy diets.

Associations between systemic immune-inflammation index and heart failure: A cross-sectional study.

The detrimental effects of inflammation on cardiovascular health have received a lot of attention. However, the relationship between heart failure (HF) and the systemic immune-inflammation index (SII) has not been demonstrated. The authors sought to learn more about the relationship between HF and SII in US adults. Adults with complete SII and HF information from the 1999 to 2018 National Health and Nutrition Examination Survey participated in the current cross-sectional study. The calculation for SII involved multiplying the platelet count by the neutrophil count and then dividing it by the lymphocyte count. The relationship between SII and HF was studied using multivariate logistic regression, sensitivity analysis, and smoothed curve fitting. A total of 49,471 participants were enrolled in the study, and 1625 patients (3.28%) were diagnosed with HF. In the model that took all relevant factors into account, we observed that for every 100-unit increase in SII, there was a 2% higher likelihood of developing HF (OR = 1.02; 95% CI: 1.01-1.03, P < .0016). Furthermore, we discovered L-shaped associations between SII levels and HF. In subgroups stratified by smoking and diabetes, SII was found to be substantially associated with HF (P < .05). Interaction tests revealed that this positive association was not significantly influenced by gender, age, body mass index, smoking status, diabetes, or hypertension (all P for interaction > 0.05). In US adults, SII and HF had a positive association. Our study suggests that SII may be a convenient and readily available marker for identifying HF.