Univariate Linear Regression Analysis Research Articles

Timing of Intracordal Trafermin Injection in Patients with Vocal Fold Paralysis: Recommendations for a New Treatment Time Course

ObjectiveTo identify factors correlated with the effect of intracordal trafermin injection. Study DesignRetrospective cohort study. MethodsHerein, 177 patients who received an intracordal trafermin injection at the Tokyo Voice Center for vocal fold paralysis were included. Medical records of patients were retrospectively reviewed. Information regarding age, sex, date of trafermin injection, date of vocal fold paralysis onset, and voice data indices (maximum phonation time, pitch range, mean flow rate, and Voice Handicap Index) was extracted. The primary endpoint was the rate of improvement in the Voice Handicap Index, defined as the difference in the Voice Handicap Index values before and after the injection. ResultsA total of 80 patients (49 men and 31 women; mean age, 61.6 years) were included. No correlations existed between the maximum phonation time (r=0.05, p=0.64), pitch range (r=0.03, p=0.77), or mean flow rate (r=-0.09, p=0.42) before injection and the rate of improvement in the Voice Handicap Index. Analyses of 74 cases with an interval of <1000 days between disease onset and injection revealed no correlation between the number of days from the onset to injection and the rate of improvement in the Voice Handicap Index. In 17 cases with an interval of <90 days, a moderate negative correlation existed between these parameters (r=-0.59, p<0.01). In a univariate linear regression analysis, within 90 days, a 1-week delay in trafermin injection resulted in a 4.87 decrease in the Voice Handicap Index. ConclusionsIntracordal trafermin injection may be an effective therapeutic strategy for severe vocal fold paralysis, with a particularly high efficacy when performed early after paralysis onset. In patients undergoing aortic surgery, intracordal trafermin injection post-surgery and before extubation may prevent or reduce postoperative voice disorders caused by vocal fold paralysis due to recurrent nerve palsy and prevent postoperative pulmonary complications.

Reporting of Search Strategy Among Systematic Reviews in Leading Dental Specialty Journals: A Research-On-Research Study.

Literature searching is one of the main determinants of a systematic review (SR)'s reliability. Thus, adequate reporting of search strategy is essential for the critical appraisal of SRs and evidence-based practice. To assess the reporting quality of search strategy among SRs in leading dental specialty journals, and to identify factors associated with quality of reporting. Six leading dental journals with the highest 5-year impact factors in their respective specialty were included. A hand search was undertaken to identify SRs published between 2017 and 2022. Full texts were reviewed by two authors to identify eligible SRs. Reporting quality was assessed and scored using a modified 15-item checklist based on Preferred Reporting Items for Systematic reviews and Meta-Analyses literature search extension (PRISMA-S). Univariable and multivariable linear regression analyses were then performed. A total of 152 reviews were included and assessed. As for information sources, only 'citation searching' was adequately reported in most reviews 110 (72.4%). Only 23 (15.1%) of the included reviews clearly reported search strategies. Information about peer review was provided in only 10 reviews (6.6%). Only 91 (59.9%) of the included reviews documented the total records clearly. According to multivariable regression analysis, industrial funding (p = 0.012), registration (p = 0.013) and librarian involvement (p = 0.004) were significantly associated with higher reporting quality. The reporting quality of search strategy among SRs in leading dental specialty journals is suboptimal. Researchers, librarians, reviewers and journal editors in dentistry need to be familiar with the PRISMA-S checklist, and make concerted efforts to improve the reporting of search strategy in SRs.

Prevalence and social determinants of self-reported health status among reproductive age women in Nepal.

The self-reported health status (SRHS) is a subjective evaluation of an individual's health and has been connected to mortality and future health outcomes in numerous studies. However, the determinants of SRHS among women in Nepal remain largely unclear. In Nepal, traditional gender norms often result in women bearing greater responsibilities in terms of household chores, child-rearing, and taking care of elderly family members, all of which may potentially contribute to lower self-perceived health. Therefore, this study aims to identify the factors influencing SRHS among women in Nepal. The study utilized data from 7,442 women aged between 15 and 49 who participated in the Nepal Demographic and Health Survey (NDHS) 2022. Both univariate and multiple linear regression analyses were employed to ascertain the factors influencing self-rated health status (SRHS) among women in Nepal. Women in the age groups 15-24years (AOR: 5.14, 95% CI: 3.07-8.62) and 25-34years (AOR: 2.71, 95% CI: 1.99-3.68) were more likely to report good health status compared to older age groups. Additionally, women who were never married (AOR: 4.89, 95% CI: 3.62-5.32) or currently married (AOR: 1.46, 95% CI: 1.11-2.20) and those from wealthy families (AOR: 1.54, 95% CI: 1.07-2.21), also had a higher likelihood of reporting good health status. Other factors associated with a higher probability of reporting good health included not having a history of terminated pregnancy (AOR: 1.48, 95% CI: 1.11-1.97), having no history of genital discharge (AOR: 1.75, 95% CI: 1.29-2.38), not visiting a health facility in the last 12months (AOR: 2.03, 95% CI: 1.43-2.88), and having no genital ulcers in the previous 12months (AOR: 2.02, 95% CI: 1.24-3.28). Conversely, women with mild to severe depression and anxiety were less likely to report good health status compared to those with no depression or anxiety. This study identified several social determinants of SRHS among Nepalese women. These socioeconomic determinants of health should be included in future research and health policy activities in Nepal and other comparable contexts.

Association between trandsferrin receptor and urine cobalt: NHANES 2015-2020

Abstract. The transferrin receptor protein 1 (TfR1) is a critical cellular membrane protein. It orchestrates the internal transport and metabolism of iron, a vital process for intracellular functions. Additionally, TfR1 has the capacity to bind with metals beyond iron, including cobalt and manganese; however, the specific mechanisms of this binding and subsequent interactions with other proteins remain elusive. This study delves into the potential correlation between TfR1 levels in humans and the presence of cobalt in urine. Drawing on data from 3,424 participants across three survey cycles spanning two years each, this paper meticulously contrasts the clinical features of individuals across diverse TfR1 and urinary cobalt levels. Through the lens of both univariate and multivariate linear regression analyses, the research uncovers an inverse connection between TfR1 concentrations and urinary cobalt, post exclusion of participants with incomplete biochemical profiles. This inverse relationship could shed light on the complex interplay between TfR1 and metal ions within the body, providing a deeper understanding that may inform future studies and potential clinical applications. In the multivariate linear regression analysis, it is found that with the increasing of TFR1 quartiles, the proportion of obese participants (P&lt;0.01), high level blood manganese, high cobalt level in urine and blood (P&lt;0.01) increased gradually. This association remained significant in sensitivity analysis, while in the stratified analysis, above association was not significant in men with samples aged 65 and over. Transferrin receptor protein levels might be positively associated with urinary cobalt in the general U.S. crowd.

Factors Associated with and Predictive Model for Resilience in Family Caregivers of Care-Dependent Adults.

Background: Caring for dependent people is an intense task that leads family caregivers to suffer physical or mental pathologies. Resilience is a protective factor that makes an individual more resistant to adverse events. Some characteristics of the caregiver or the care provided predispose the caregiver to be less resilient. Knowing these characteristics will allow us to detect vulnerable caregivers. Aim: The aim of this study was to explore the factors associated with caregiver resilience and establish a predictive model, including the relationship between preparedness, burden, resilience, and anxiety. Materials and Methods: The study design was descriptive, observational, and cross-sectional, with purposive sampling. The sample included 172 family caregivers of care-dependent patients in Spain. Questionnaires were administered to assess caregiver resilience, anxiety, burden, and the preparedness of care-dependent patients. Correlation, univariate, and multiple linear regression analyses were performed to identify the factors associated with resilience. Results: We found that there is a correlation between resilience, preparation, and burden. Factors related to resilience include age, the caregiver's health status, kinship, childcare, and state aid granted. Caregiver preparedness is the factor that most predicts caregiver resilience in our model. Caregivers with high levels of resilience also demonstrated high levels of preparedness and experienced less burden than those with low levels of resilience. Conclusions: These findings emphasize the relevance of improving the preparation of family caregivers to increase their resilience and, at the same time, the quality of care provided.

Identifying the Relationship Between CGM Time in Range and Basal Insulin Adherence in People With Type 2 Diabetes.

The study aimed to determine the relationship between basal insulin adherence and glycemic control evaluated by time in range (TIR) in people with insulin-treated type 2 diabetes (T2D), using data from both continuous glucose monitors (CGM) and connected insulin pens. Furthermore, the study aimed to determine the best basal insulin adherence metric. CGM data and basal insulin data were collected from 106 insulin-treated people (aged ≥18 years) with T2D. Three different adherence metrics were employed (dose deviation, dose deviation ≤20%, and a traditional metric) and a three-step methodology was used to measure insulin adherence level. The coefficient of determination (R2), based on a univariate linear regression analysis, was used to determine the relationship between each adherence metric and TIR. A statistically significant relationship was observed between TIR and adherence quantified as the dose deviation ≤20% metric (R2 = 0.67, P = .006). Neither the relationship between the dose deviation metric and TIR (R2 = 0.43, P = .08) nor the relationship between the traditional metric and TIR (R2 = 0.35, P =.23) was found to be statistically significant. Our study indicates a relationship between basal insulin adherence and TIR in people with insulin-treated T2D. This seems to underscore the role of basal insulin adherence for optimal glycemic outcomes and utilizing TIR as a clinical marker. Furthermore, the results suggest that the magnitude of deviation from the recommended basal insulin dose impacts glycemic control, indicating dose deviation ≤20% as a more accurate metric for quantifying adherence.

Muscle characteristics of lower limb in association with physical activity in candidates of total knee arthroplasty with knee osteoarthritis

Background&AimsThis study aimed to clarify the association between physical activity (PA) and physical functions, including both muscle quantity and quality of ankle plantar flexor muscles in patients with knee osteoarthritis (OA). MethodsA retrospective cohort study was conducted with ninety-two patients with knee OA. PA, leg muscle cross-sectional area (CSA), knee strength, passive knee angle, and knee pain of the affected side were assessed. PA was assessed by the 2011 Knee Society scoring system. CSA of the quadriceps and ankle plantar flexor muscles on the affected side was measured using a computed tomography image. Based on muscle attenuation assessed with Hounsfield units (HU), the muscle quality of targeted muscle was divided into 4 groups as follows: fat tissue (-190 to -30 HU), very low-density muscle (-29 to -1 HU), low-density muscle (0 to 34 HU), and normal-density muscle (NDM, 35 to 100 HU). The CSA was obtained for each of the 4 groups. Univariate and multivariate linear regression analyses were performed to determine the factors associated with PA. ResultsThe regression analysis revealed that higher PA was independently associated with the NDM CSA of ankle plantar flexor (β = 0.51), higher knee extension strength (β = 0.28), and milder knee pain (β = -0.29) after adjustment with age, sex, height, weight, and body mass index. ConclusionThe present study suggested that NDM CSA of ankle plantar flexor in addition to knee function is one of the factors determining the PA in patients with knee OA.

Relationship Between Social Isolation, Loneliness and Psychological Well-Being in Inflammatory Bowel Disease Patients: The Mediating Role of Disease Activity Social Isolation in Inflammatory Bowel Disease.

To evaluate the relationship between social isolation, loneliness and psychological well-being in patients with inflammatory bowel disease (IBD). Additionally, we examined the mediating effect of disease activity on the relationships between social isolation, loneliness and psychological well-being. Cross-sectional descriptive study. A total of 218 participants were recruited from outpatient clinic at a university hospital in Turkey and from the community membership of the patient support group. Participants provided their socio-demographic and disease-related information and completed (online and paper based) the Turkish Lubben Social Network Scale-6, the Turkish UCLA Loneliness Scale Short Form and the Turkish Psychological Well-being Scale. The data were analysed using univariate linear regression analysis. This study adhered to the STROBE checklist for reporting. The majority of the participants (72%) were socially isolated, and over half (54.1%) reported moderate to high levels of loneliness. Participants also had low psychological well-being. Linear regression analysis revealed that high loneliness level and social isolation were negative predictors of psychological well-being. The results revealed that the effect of social isolation and loneliness on psychological well-being was mediated by disease activity. In line with the findings, it can be recommended to enhance social support and networks, along with regular psychological evaluation, should be integrated into the holistic care approach for IBD patients. The findings of this study hold significant implications for the management and support of patients with IBD, particularly within clinical settings in Turkey. Patients were invited to complete questionnaires. The investigators explained the study's content and purpose, and addressed any concerns during the data collection process.

Combined activation of complement and coagulation is associated with myocardial injury in ST-elevation myocardial infarction

Abstract Introduction Experimental data indicates that the complement system and the coagulation cascade can activate each other. The magnitude of this interaction in acute myocardial infarction is not known. We aimed to investigate a possible association between complement activation and coagulation activation in patients with acute ST-elevation myocardial infarction (STEMI), as well as how they relate to myocardial injury estimated by troponin T (TnT) and myocardial function assessed by echocardiography. Purpose To increase the understanding of the interaction between complement activation and coagulation activation in STEMI, and the clinical relevance to myocardial injury. Methods Blood samples were drawn after percutaneous coronary intervention (PCI) in 864 patients with STEMI. Myocardial function was measured as left ventricular ejection fraction (LVEF), estimated by visual approximation or Simpson biplane method within 3 months. Complement activation was assessed by ELISA of circulating levels of the terminal complement complex (TCC). Activation of coagulation was assessed by ELISA of prothrombin fragment 1+2 (F1+2) and D-dimer, and endogenous thrombin potential (ETP), analyzed by calibrated automated thrombogram assay. Results TCC was weakly correlated to F1+2 (r=0.086, p=0.012), D-dimer (r=0.176, p&amp;lt;0.001) and ETP (r=0.144, p&amp;lt;0.001). In univariate linear regression analysis, this association persisted for D-dimer and ETP. When adjusting for associated covariables, the association only persisted for ETP (Table 1). Patients with above-median TCC and D-dimer had significantly higher peak TnT (Figure 1). In logistic regression, having combined above-median TCC and D-dimer was predictive of an LVEF ≤40% (Table 2). Conclusion In this large STEMI cohort, complement activation by TCC was weakly associated with coagulation activation. Combined high levels of TCC and D-dimer were linked to higher peak TnT and lower LVEF, possibly reflecting greater myocardial injury. The interaction between complement and coagulation activation might be relevant for clinical outcomes in STEMI patients and warrants further investigation.

Ethnic variations in post ST elevation myocardial infarction inflammatory kinetics

Abstract Introduction Sterile inflammation post myocardial infarction (MI) is essential to activation reparative mechanisms. However, excessive inflammation contributes to detrimental recovery and adverse outcomes(1). Several studies have reported an association between elevated leucocyte subpopulations and neutrophil-lymphocyte ratio (NLR) with poor prognosis after MI(2). In healthy volunteers, it is known that black individuals have a lower diurnal neutrophil, basophil, and monocyte count and the term ‘benign ethnic neutropenia’ has been used(3). However, the effect of ethnicity on leucocyte counts after MI is not known. Purpose We aimed to assess the interaction between ethnicity and leucocyte subpopulations and NLR. Understanding post-MI inflammation and its interaction with ethnicity is essential in providing personalised patient management and prognostication. Methods We conducted a single centre retrospective observational study of consecutive patients presenting with ST-segment elevation MI (STEMI) between 2016 and 2022. Patients were divided into white and other ethnic groups combined (‘ethnic minorities’) based on self-reported ethnicity. Leucocyte subpopulations, neutrophil and monocyte lymphocyte ratios (NLR and MLR, respectively) at baseline and for 4 days post admission were compared. Baseline variables were analysed with Shapiro-Wilk testing and presented as median (IQR). Area under the curve (AUC) was used to analyse magnitude of change in longitudinal analysis with smoothed conditional means (LOESS) to display trends in the data. Univariate and multivariate linear regression analyses were used to investigate for an association between ethnicity and baseline clinical variables. Results We included 1933 STEMI patients, of whom 1477 (76%) were white and 456 (24%) were from ethnic minority groups. Baseline neutrophils (7.73 [5.9-10] vs 9.04 [6.7-11.9] x109/L), monocytes (0.52 [0.38-0.69] vs 0.6 [0.44-0.82] x109/L), basophils (0.03 [0.02-0.04] vs 0.04 [0.02-0.06] x109/L), NLR (4.47 [2.93-7.19] vs 5.61 [3.64-8.89]) and MLR (0.3 [0.21-0.43] vs 0.36 [0.26-0.53]) were significantly lower (all p&amp;lt;0.001) in ethnic minority vs white patients. There were no differences in peak troponin T or CRP. Longitudinal assessment of leucocyte subgroups and NLR showed that white patients had a significantly higher AUC and difference between minimum and maximum values (delta) for neutrophils, monocytes, basophils and NLR (Panel 1). After correction, we observed a negative association between being in the ethnic minority group and baseline NLR (p=0.005) and basophil count (p&amp;lt;0.001). Conclusions Despite baseline differences in leucocyte subgroups and NLR according to ethnicity, there is a distinct interaction among patients with STEMI suggesting an ethnicity-specific inflammatory profile. Blunting of the magnitude and duration of leucocyte response is novel, and future work will focus on the implications for prognosis and tailored therapy.

Associate variables of coronary computed tomographic angiography-derived extracellular volume fraction and cardiac magnetic resonance-derived late-gadolinium enhancement

Abstract Background Coronary computed tomographic angiography (CCTA) with late-iodine enhancement enables the segmental quantification of extracellular volume (ECV) fraction which represents myocardial fibrosis. However, its association with cardiac magnetic resonance (CMR)-derived late gadolinium enhancement (LGE) has not been fully elucidated. Purpose We aimed to assess the concordance and discordance between CCTA-derived ECV and CMR-derived LGE and to investigate associated variables of each index. Methods This retrospective analysis included a total of 123 segments from 41 patients (anterior, inferior and lateral segments per patient) with known or suspected coronary artery disease (CAD) who underwent both clinically indicated CCTA and CMR. Patients with cardiomyopathy such as amyloidosis were excluded. Myocardial fibrosis was evaluated by CCTA-derived segmental ECV and by CMR-LGE with ischemic pattern on a per-segment basis (AHA 16 segments). Clinical and echocardiographic variables associated with CCTA-derived segmental ECV and CMR-LGE were studied by univariable linear and logistic regression analyses, respectively. Results Among the 123 segments, 21 segments showed ischemic CMR-LGE pattern. CCTA-ECV was significantly higher in segments with versus without CMR-LGE (42 [39, 47] % versus 34 [29, 39] %, P&amp;lt;0.01). Receiver-operating characteristic curve analysis showed that the best cut-off of CCTA-ECV to predict CMR-LGE was 38.9% (area under the curve 0.82 [95% confidence interval 0.74, 0.90], positive predictive value: 40.0%, negative predictive value: 96.2%). Univariable analyses revealed that male sex, prior history of revascularization, usage of statin, aspirin, angiotensin-converting enzyme inhibitor and beta-blockade, higher C-reactive protein, NT-pro BNP, lower left ventricular ejection fraction, greater left ventricular chamber size, shorter deceleration time, and larger segmental and global longitudinal strain were associated with both higher CCTA-ECV and the presence of CMR-LGE. Lower lipid profiles, higher high-sense troponin I, and greater left atrial volume index were associated with higher CCTA-ECV, while not with the presence of CMR-LGE. The frequency of CMR-LGE were significantly different according to CCTA-ECV tertiles. (P&amp;lt;0.05) Statin use and higher NT-proBNP were determinants of the highest ECV tertile without LGE. Conclusion We found a strong interrelationship between variables associated with ECV and the presence of LGE, although high ECV may not necessarily indicate the presence of LGE in patients with known or suspected CAD. Clinical factors associated with discordance, such as high-ECV without CMR-LGE, should be taken into account in the assessment of ECV and LGE. Further studies are needed to elucidate clinical significance of the concordance and discordance between ECV and LGE.

The Disaggregated Oswestry Disability Index: What is the Most Predictive Subsection for Patient Satisfaction After Lumbar Surgery?

Retrospective review of cohort studies. To analyze how different ODI subsections and their improvement affect patient satisfaction 2 years after elective lumbar surgery for degenerative lumbar spondylolisthesis (DLS). The Oswestry Disability Index (ODI) is crucial in evaluating outcomes of spinal disorders and provides valuable insights into a patient's preoperative status. There is limited information available on the individual characteristics of its subsections and their relation to postoperative patient satisfaction. Pre- and 2-year postoperative ODI and patient satisfaction were assessed. The analysis included preoperative scores and improvements in each ODI subsection 2 years postoperatively. Satisfaction was rated on a scale of 1 to 5, with scores ≥4 deemed satisfactory. Univariate linear regression and ROC analysis established cutoffs for subsection improvement and postoperative target values to achieve postoperative satisfaction. 265 patients (60% female, 67±8 years) were included. ODI improvement was achieved in 91%, and postoperative patient satisfaction in 73%. Patients with lower postoperative subsection scores and greater differences between pre- and postoperative scores were more likely to be satisfied (all P<0.001). A postoperative subsection target score of ≤1 was associated with patient satisfaction. Change in degree of pain was the most predictive subsection for satisfaction, with an AUC of 0.84 (sensitivity 79%, specificity 86%). Walking (AUC 0.83, sensitivity 87%, specificity 65%), pain intensity (AUC 0.82, sensitivity 79%, specificity 79%), personal care (AUC 0.82, sensitivity 83%, specificity 68%), and standing (AUC 0.82, sensitivity 83%, specificity 83%) all had an AUC greater than 0.80. The postoperative subsection with the lowest predictability was sleeping (AUC 0.69). Pain domains, walking, standing, and personal care were the subsections with the highest predictability for patient satisfaction. These findings on the correlation between different ODI subscales and patient satisfaction are valuable for improving preoperative education, addressing disability, and ensuring postoperative satisfaction.

Determinants of right ventricular - pulmonary arterial uncoupling in hypertrophic cardiomyopathy

Abstract Background Right ventricular (RV) – pulmonary arterial (PA) coupling, assessed by echocardiography, is a non-invasive surrogate on how the RV is adapted to an increased afterload in the pulmonary circulation. In cases of exhaustion of compensatory RV remodeling, the ratio decreases and there is RV-PA uncoupling. Our objective was to identify what are the determinants of this parameter in patients with hypertrophic cardiomyopathy (HCM). Methods This prospective cohort study enrolled patients with HCM without obstructive epicardial coronary artery disease, that underwent a comprehensive evaluation. Echocardiography was used to assess RV-PA coupling as the ratio of tricuspid annular plane systolic excursion (TAPSE) to pulmonary artery systolic pressure (PASP). In addition, coronary flow reserve in the left anterior descending artery (CFR_LAD) was also evaluated: diastolic coronary flow velocity was measured in basal conditions and in hyperemia and CFR was calculated as the ratio of hyperemic and basal peak diastolic flow velocities. This was used as a surrogate marker of coronary microvascular dysfunction. Cardiac magnetic resonance (CMR) was also performed to evaluate RV function (volumes and ejection fraction), and the extent of late gadolinium enhancement (LGE) in the left ventricle (LV). Results We enrolled 62 patients, with a mean age of 55 (15) years, 64% males. In 64% it was an asymmetrical septal hypertrophy phenotype, in 31% an apical hypertrophy, and in 27%, it was an obstructive HCM. Mean TAPSE/PASP was 0.556 (0.23) and median was 0.50. All patients had a normal LV ejection fraction. Univariable linear regression analysis showed that age, maximal wall thickness, E/E’, indexed left atrial volume (LAVi), CFR-LAD, %LGE and % hypoperfusion (by CMR) were correlated with RV-PA uncoupling. The HCM phenotype or the presence of obstruction were not associated with uncoupling. Multivariable stepwise linear regression analysis showed that the independent predictors of RV-PA uncoupling were age (b-estimate: - 0.180, p=0.009), LAVi (b-estimate: -0.645, p=&amp;lt;0.001), CFR-LAD (b-estimate: 0.183, p=0.011) and %LGE (b-estimate: -0.270, p=&amp;lt;0.001). Conclusion In patients with HCM, the presence of coronary microcirculation abnormalities and the extent of LGE in the LV are independent predictors of RV-PA uncoupling.

Clinical decision-making in patients with non-ST-segment-elevation myocardial infarction: more than risk stratification.

This study aims to explore the association between risk stratification and total occlusion (TO) of the culprit artery and multivessel disease (MVD) in patients with non-ST-segment-elevation myocardial infarction (NSTEMI) and to obtain more data on clinical decision-making in addition to risk stratification. We retrospectively collected data from 835 patients with NSTEMI admitted to our hospital between 1 January 2016 and 1 August 2022. All patients underwent percutaneous coronary intervention (PCI) within 72 h of admission. We excluded patients with a history of cardiac arrest, myocardial infarction, coronary artery bypass grafting, or PCI. Univariate and multivariate regression analyses were performed to determine the predictors of acute TO and MVD. A total of 349 (41.8%) patients presented with a TO culprit vessel, whereas 486 (58.2%) had a patent culprit vessel. Thrombolysis in myocardial infarction (TIMI) and Global Registry of Acute Coronary Events (GRACE) risk stratifications were similar between the two groups of patients (P = 0.712 and 0.991, respectively). The TO infarct vessel was more commonly observed in the left circumflex artery. Patients with TO were more likely to develop MVD (P = 0.004). Univariate and multivariate linear regression analyses were performed to evaluate the role of variables in the presence of TO and MVD in patients with NSTEMI. Regional wall motion abnormalities (RWMAs) [odds ratio (OR) = 4.022; confidence interval (CI): 2.782-5.813; P < 0.001] were significantly linked to TO after adjusting for potentially related variables. Furthermore, age (OR = 1.032; CI: 1.018-1.047; P < 0.001), hypertension (OR = 1.499; CI: 1.048-2.144; P = 0.027), and diabetes mellitus (OR = 3.007; CI: 1.764-5.125; P < 0.001) were independent predictors of MVD in patients with NSTEMI. TIMI and GRACE risk scores were related to MVD prevalence in the multivariate logistic regression model. Patients with a TO culprit vessel had a higher risk of out-of-hospital cardiac death after a 2-year follow-up compared with those without a TO culprit vessel (P = 0.022). TIMI and GRACE risk scores were not associated with a TO of the culprit artery; however, they correlated with the prevalence of MVD in patients with NSTEMI. RWMA is an independent predictor of acute TO in patients with NSTEMI. Patients with a TO culprit vessel had worse clinical outcomes than those without a TO culprit vessel.

Subthalamic Nucleus Deep Brain Stimulation for Meige Syndrome: Long-Term Outcomes and Analysis of Prognostic Factors.

The aim of this study was to explore the impacts of subthalamic nucleus deep brain stimulation (STN-DBS) on both motor and nonmotor symptoms in individuals with Meige syndrome, as well as further investigates prognostic factors for long-term postoperative outcomes. We retrospectively reviewed a consecutive cohort of patients with intractable Meige syndrome who underwent STN-DBS at our center from January 2016 to July 2023. Motor function, quality of life, neuropsychological status, and mood state were evaluated with standardized scales at baseline and every 3 to 6 months thereafter. Univariate and multivariate linear regression analyses were used to determine independent risk factors that affect long-term motor function after STN-DBS. Fifty-five patients were ultimately analyzed with a mean follow-up of 62.1 ± 25.7 months. At the final postoperative assessment, movement and disability scores of the Burke-Fahn-Marsden Dystonia Rating Scale demonstrated improvements of 61% (P < .001) and 57% (P < .001), respectively. Postoperative scores on the 36-item Short-Form General Health Survey showed significant improvement from baseline. Global cognitive function and neuropsychological status remained stable during continuous neurostimulation. Multivariate linear regression analysis revealed that longer disease duration (standardized β coefficient = -0.294, 95% CI -0.039 to -0.007, P = .006), older age at surgery (standardized β coefficient = -0.382, 95% CI -0.014 to -0.004, P = .001), and smaller volume of tissue activated within the sensorimotor subregion of STN (standardized β coefficient = 0.309, 95% CI 0.001-0.004, P = .004) were independently correlated with poorer long-term motor performance. Bilateral STN-DBS is an effective, safe, and promising treatment option for Meige syndrome, which can improve motor function and quality of life without cognitive and mood side effects. Early diagnosis, prompt intervention, and accurate lead placement in the dorsolateral STN are crucial to optimize long-term therapeutic outcomes.

Physical and Mental Health of Informal Carers from Culturally and Linguistically Diverse (CALD) and Non-CALD Groups in Australia.

Empirical evidence shows that many family carers, especially immigrants, experience considerable health disadvantages and poorer quality of life. Australia has a rapidly increasing multicultural population, officially referred to as Culturally and Linguistically Diverse (CALD) people. This paper explores similarities and differences in the carer profile and physical and mental health of CALD and non-CALD family carers. A cross-sectional anonymous survey was conducted of self-reported family carers aged 18 years and older. Identical paper and online survey modes were provided to enable choice. Key variables included demographic and carer profile, diagnosed chronic physical health conditions, and validated scales such as CESD-12 and MOS-SF12, including derivative composite Physical and Mental Component Summary (PCS and MCS, respectively) scores. The sample comprised 649 participants (CALD = 347, non-CALD = 302). The analyses included univariate, bivariate, and multivariable linear regression analyses for three outcome variables: PCS, MCS, and CESD-12. CALD carers were comparatively younger and married, and 54% had university-level education (29% in the gfvnon-CALD group). Women were primary carers in both groups (67.4% versus 72.2%). The weekly care hours were higher for non-CALD carers. Both groups had below population-referenced scores for mean PCS and MCS values. For CESD-12, non-CALD respondents had higher scores (17.5 vs. 11.2, p < 0.022). Regression analyses showed significant differences for demographic, carer, and physical health variables across the three outcome variables. Women have a higher domestic workload, which, when combined with high care hours, adversely impacts physical and mental health. The need for improved and culturally aligned care support systems is required.

Assessing Anxiety and Satisfaction Levels among Dental Students during Online Learning amid the COVID-19 Pandemic: A Cross-Sectional Study

Introduction: The COVID-19 pandemic led to widespread adoption of online learning. In April 2020, the Higher Education Commission (HEC) of Pakistan released policy guidance on online readiness with three levels: basic, effective, and exemplary. However, concerns about the quality and readiness for online curriculum delivery in Pakistan persisted. This study assesses the anxiety and satisfaction levels of undergraduate dental students with online classes during the pandemic. Methods: An analytical cross-sectional study was conducted between June and July 2020. Data were collected via email from undergraduate dental students of a private dental college using convenience sampling, after three months of online teaching. Two tools were used: a student satisfaction questionnaire adapted from Bolliger and Halupa’s study, and a student anxiety questionnaire. Frequencies, percentages, means, and standard deviations were calculated for satisfaction and anxiety scores. Univariate and multiple linear regression analyses were performed to assess factors associated with student satisfaction. Results: Out of 300 eligible participants, 237 responded (79% response rate). Most participants (53.16% female, 59.07% hostellers) had no prior experience with online learning (85.65%). The mean anxiety score was 54.87 (SD=9.6), and the mean satisfaction score was 58.63 (SD=16.66). Male students showed less satisfaction than females, though not statistically significant. Second-year students had significantly higher satisfaction scores than third- and fourth-year students. Conclusion: Most students had no prior experience with online learning, resulting in increased anxiety and poor satisfaction with the modality during the COVID-19 pandemic.

A clinical study on the optimal placement depth for peripherally inserted central catheter through the great saphenous vein in preterm infants

To investigate the correlation between optimal placement depth (OPD) and physical measurement parameters in preterm infants receiving placement of peripherally inserted central catheter (PICC) through the great saphenous vein (GSV), and to establish a predictive formula for OPD during the placement of PICC through the GSV. A retrospective analysis was performed for the preterm infants who received the placement of PICC through the GSV in the Neonatal Intensive Care Unit of the Third Xiangya Hospital of Central South University from December 2022 to February 2024. According to the site of puncture [GSV of the knee joint (KJ) or the ankle joint (AJ)], they were divided into a GSV-KJ placement group (n=38) and a GSV-AJ placement group (n=33). The infants were measured in terms of body weight (BW), body length, the length of the upper and lower parts of the body, head circumference, and abdominal circumference at the time of placement. The Pearson correlation analysis was used to investigate the correlation between the above variables and OPD. A predictive formula was established for OPD in the placement of PICC via the GSV in preterm infants, and the predicted residual between the predicted depth and the ideal OPD was compared between the conventional predictive formula and the new predictive formula. The Pearson correlation analysis showed that PICC OPD was significantly positively correlated with BW, body length, the length of the upper and lower parts of the body, head circumference, and abdominal circumference in both the GSV-KJ placement group and GSV-AJ placement group (P<0.05), with the highest degree of correlation between OPD and BW. The univariate linear regression analysis showed a linear relationship between PICC OPD and BW in both groups. The predictive formulas for OPD were as follows: GSV-KJ PICC OPD (cm) = 13.1 + 2.7 × BW (kg) and GSV-AJ PICC OPD (cm) = 13.4 + 6.0 × BW (kg), and the new predictive formulas had a significantly lower predicted residual than the conventional predictive formula (P<0.05). OPD for PICC through the GSV is positively correlated with BW, and the prediction results of the new predictive formula based on BW are closer to the ideal OPD.

Associations between birth characteristics, pubertal timing and adult height.

This study investigated the association between gestational age and birth size with pubertal timing, measured as peak height velocity, and adult height. This retrospective, population-based study was conducted in Sweden in 2023. A sub-group of the 1974 and 1990 GrowUp Gothenburg cohorts was used (n = 4700, 50% males). The subgroup consisted of healthy individuals with Nordic ethnicity, known parental heights and measured adult heights. Data on birth characteristics (gestational age, birth length, birth weight) were collected. Pubertal timing was assessed as age at peak height velocity. Univariable linear regression analysis and bivariate correlations were conducted to answer the research questions. Gestational age was not associated with age at peak height velocity or adult height. Birth length and weight could explain 12% and 8% (p ≤ 0.001) respectively of attained adult height. However, birth length and birth weight could only explain the variation in age at peak height velocity to a small degree. This study showed that gestational age is not associated with age at peak height velocity or adult height. A positive relationship was found between birth size, particularly birth length, and adult height. No strong associations were found between birth size and age at peak height velocity.

Predictors of attitudes towards postgraduate education of nurses: A descriptive and correlational study.

This study was conducted to identify the determinants of the attitudes of postgraduate nurses towards postgraduate education. Postgraduate education in nursing contributes to many individual and professional gains. For this reason, nurses' attitudes towards postgraduate education are gaining importance. This descriptive and correlational study was conducted with 201 nurses continuing their postgraduate education in Türkiye between 01 December 2022 and 30 August 2023. The data were obtained online via Google Forms. The data was collected using the 'Descriptive Characteristic form' and 'Scale of Attitude towards Postgraduate Education'. Univariate and multiple linear regression analyses were used to evaluate the data. The mean age of the nurses was 28.96 ± 4.85, and most of them were continuing their master's education (65.7%). Years of the employment were negatively and the quality of postgraduate education was positively related to attitudes toward postgraduate education (p < 0.05). According to the results of the multiple linear regression analysis, the quality of the postgraduate education had a significant positive effect on attitudes towards postgraduate education (β = 0.262, p < 0.001). Years of employment and quality of education were related to attitudes towards postgraduate education. As the quality of education increases, nurses' attitudes towards postgraduate education increase positively. Different qualitative and quantitative studies need to be conducted on the attitudes of postgraduate nurses toward postgraduate education and the factors affecting them in Türkiye. Plans should be made to positively affect nurses' attitudes towards postgraduate education, and their professional and individual development should be supported.