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Background Different methods are available to assess the healing status of repaired root for medial meniscus posterior root tears (MMPRT) using second-look arthroscopy. However, few studies are comparing them or validating their usefulness. Therefore, it was hypothesized that the semi-quantitative arthroscopic score might correlate more with 1-year clinical outcomes in patients with MMPRT than the qualitative evaluation. Methods Data of 61 patients who underwent MMPRT pullout repair and second-look arthroscopy were retrospectively evaluated. The semi-quantitative arthroscopic scoring system was divided into three evaluation criteria: scores from 0 to 10 points include the width of the bridging tissue, stability of the repaired root, and synovial coverage. The qualitative evaluation was classified into 4 status; complete healing, lax healing, scar tissue healing, and failed healing according to the stability and mobility of the repaired root. Multivariate linear regression analyses were used to identify predictors of 1-year postoperative clinical outcomes, including Knee Injury and Osteoarthritis Outcome, Lysholm, or International Knee Documentation Committee scores. Spearman's correlation analysis was used to analyze the correlation between second-look arthroscopic score/qualitative evaluation and 1-year postoperative clinical outcomes. In addition, the optimal cutoff point of semi-quantitative arthroscopic score was determined by receiver operating characteristic (ROC) curve. The Mann–Whitney U test was used to compare clinical outcomes between patients with semi-quantitative arthroscopic scores ≥8 and scores Results All clinical scores significantly improved at 1 year postoperatively. A good correlation was observed between the semi-quantitative score and clinical scores, but none between qualitative evaluation and clinical scores. The optimal cutoff point of semi-quantitative second-look arthroscopic score was 8 points. Significantly, better clinical outcomes were observed in patients with semi-quantitative scores ≥8 points. Conclusions All 1-year postoperative clinical scores were significantly improved. The semi-quantitative arthroscopic scores correlate more with 1-year clinical outcomes in patients with MMPRT than the qualitative evaluation. Level of evidence IV case series study.

Background Suicide attempted by self-inflicted burns are associated with lower survival rates compared to accident related burns. Objective We investigate the relation between self-inflicted burns (SIB) and survival rates and how this relation is moderated by variables used to predict survival rates in the ABSI score, a widely used measure. Additionally, we compare the predicted survival rates by the ABSI score to the actual rates in our sample for SIB and accident patients. Methods In this prospective multicenter study data from the German Burn Registry are statistically analyzed using two sided t-test and multivariate linear regression models. Results 5330 patients (214 with SIB) met our inclusion criteria. We find a 6.8 percentage points lower survival rate for patients with SIB when we control for patient condition with the five ABSI components as covariates. These higher mortality rates can be explained by the higher rate of therapy restrictions for patients with self-inflicted burns. Additionally, different ABSI modifications can improve the predictive power of the score. Conclusion Patients with SIB have lower survival rates compared to accident patients. Recently proposed modifications of the ABSI score can improve the accuracy of survival rate prediction for SIB.

Person-centred care has the potential to improve the patient experience in the intensive care unit (ICU). However, the relationship between person-centred care perceived by critically ill patients and their ICU experience has yet to be determined.The aim of this study was to investigate the relationship between person-centred care and the ICU experience of critically ill patients.This study was a multicentre, cross-sectional survey involving 19 ICUs of four university hospitals in Busan, Korea. The survey was conducted from June 2019 to July 2020, and 787 patients who had been admitted to the ICU for more than 24 hours participated. We measured person-centred care using the Person-Centered Critical Care Nursing perceived by Patient Questionnaire. Participants' ICU experience was measured by the Korean version of the Intensive Care Experience Questionnaire that consists of four subscales. We analysed the relationship between person-centred care and each area of the ICU experience using multivariate linear regression.Person-centred care was associated with 'awareness of surroundings' (β = 0.29, p lt; .001), 'frightening experiences' (β = -0.31, p lt; .001), and 'satisfaction with care' (β = 0.54, p lt; .001). However, there was no significant association between person-centred care and 'recall of experience'.We observed that person-centred care was positively related to most of the ICU experiences of critically ill patients except for recall of experience. Further studies on developing person-centred nursing interventions are needed.

Fundamento y objetivos En la pandemia provocada por SARS-CoV-2 es importante identificar qué factores de riesgo se asocian a las formas más graves de la enfermedad. El grupo sanguíneo A se ha presentado en diversos estudios como factor de mal pronóstico. El objetivo de este estudio radica en evaluar si los pacientes de grupo sanguíneo A asocian comorbilidades más importantes, medido por el Índice de Charlson, que puedan justificar también su peor evolución clínica. Pacientes y método Estudio prospectivo y consecutivo con 100 pacientes diagnosticados de COVID-19 ingresados en marzo de 2020. Se empleó un modelo de regresión lineal multivariante para evaluar la asociación del grupo sanguíneo A con el Índice de Charlson. Resultados Los pacientes del grupo A presentaron mayor índice de Charlson (p = 0,037), linfopenia (p = 0,039), trombocitopenia (p = 0,014) y mortalidad hospitalaria (p = 0,044). El grupo sanguíneo A demostró ser un factor independiente asociado a dicho índice (B 0,582; IC 95% [0,02-1,14], p = 0,041). Conclusiones El grupo A se asocia de forma independiente a mayor comorbilidad, asociando un incremento de 0,582 puntos en el índice de Charlson con respecto al resto de grupos sanguíneos. Además, asocia una tendencia de menor mortalidad hospitalaria.

The aim of this study was to evaluate the accuracy of navigation-assisted maxillofacial reconstruction and to identify the predictors of the clinical outcomes. A total of 112 patients who underwent navigation-assisted maxillofacial reconstruction with free flaps between 2014 and 2019, performed by a single surgical team, were assessed. Accuracy was evaluated by superimposing the postoperative computed tomography data with the preoperative virtual surgical plan. Predictors of the clinical outcomes affecting the accuracy were identified and analysed. The mean deviation and root mean square (RMS) estimate of the orbital, maxillary, and mandibular reconstructions were 0.88 ± 3.25 mm and 3.38 ± 0.73 mm, 0.77 ± 3.44 mm and 3.69 ± 0.82 mm, and 1.07 ± 4.16 mm and 4.67 ± 3.95 mm, respectively (P < 0.05). There was no significant difference in orbital volume or projection between the preoperative, postoperative, and healthy orbits (P = 0.093 and P = 0.225, respectively). Multivariate linear regression analysis confirmed significant associations between the accuracy of navigation-assisted mandibular reconstruction and preservation of the condyle, type of reconstruction, type of osteosynthesis plate, and number of bony segments. Navigation-assisted midface reconstruction yielded a higher level of accuracy in the final surgical outcome when compared to mandibular reconstruction. Computer-assisted techniques and intraoperative navigation can be an alternative or adjunct to current surgical techniques to improve the final surgical outcome, especially in more complex maxillofacial reconstructions.

Background: Hemoglobin is an essential biomolecule for the transportation of oxygen, therefore, its assessment is also important to be done frequently in numerous clinical practices. Traditional invasive techniques have concomitant shortcomings, such as time delay, the onset of infections, and discomfort, which necessitate a non-invasive hemoglobin estimation solution to get rid of these constraints in health informatics. Currently, various techniques are underway in the allied domain, and scanty products are also feasible in the market. However, due to the low satisfaction rate, invasive solutions are still assumed as the gold standard. Recently introduced technologies effectively evolved as optical spectroscopy and digital photographic concepts on different sensing spots, e.g., fingertip, palpebral conjunctiva, bulbar conjunctiva, and fingernail. Productive sensors develop more than eight wavelengths to compute hemoglobin concentration and four wavelengths to display only Hb-index (trending of hemoglobin) either in disposable adhesive or reusable cliptype sensor’s configuration. Objective: This study aims at an optimistic optical spectroscopic technique to measure hemoglobin concentration and conditional usability of non-invasive blood parameters’ diagnostics at point-ofcare. Methods: Two distinguishable light emitting sources (810 nm and 1300 nm) are utilized at isosbestic points with a single photodetector (800-1700 nm). With this purpose, reusable finger probe assembly is facilitated in transmittance mode based on the newly offered sliding mechanism to block ambient light. Results: Investigation with proposed design presents correlation coefficients between reference hemoglobin and every individual feature, a multivariate linear regression model for highly correlated independent features. Moreover, principal component analytical model with multivariate linear regression offers mean bias of 0.036 and -0.316 g/dL, precision of 0.878 and 0.838 and limits of agreement from -1.685 to 1.758 g/dL and -1.790 to 1.474 g/dL for 18 and 21 principal components, respectively. Conclusion: The encouraging readouts emphasize favorable precision; therefore, it is proposed that the sensing system is amenable to assess hemoglobin in settings with limited resources and strengthening future routes for the point of care applications.

The current study aimed to investigate the effects of school resumption on college students' mental health during the coronavirus disease 2019 (COVID-19) pandemic. We used the Perceived Stress Scale (PSS-10), Patient Health Questionnaire-9 (PHQ-9), and Self-Rating Anxiety Scale (SAS) to assess stress, depression, and anxiety, respectively, between same-age college students returning to school and those not returning to school. Of 1,598 students who completed the baseline survey (S1), 836 students completed a follow-up survey 10 months after school resumption (S2). There were statistically significant differences in stress and mild anxiety between male and female students ( p < 0.01). Comparison of PSS-10, PHQ-9, and SAS scores by perceived impact of COVID-19 showed significant differences (Welch test, p < 0.01). The correlation between PHQ-9 and SAS scores in school resumption and non–school resumption groups was relatively strong (adjusted R2 = 0.49 vs. 0.5). Multivariate linear regression showed that only PSS-10 ( p < 0.01) and SAS ( p < 0.05) scores significantly differed between returning and non-returning students. School resumption was an independent risk factor for PSS-10 and SAS scores. PSS-10, PHQ-9, and SAS scores were significantly higher in S1 than in S2 ( p < 0.01). During the COVID-19 pandemic, stress, anxiety, and depression were prevalent among college students; however, stress and anxiety were generally lower among college students returning to school than among non-returning students. [ Journal of Psychosocial Nursing and Mental Health Services, 60 (5), 19–27.]

Background It has been speculated that women's productivity decreases after maternity leave. In this study, we measured if surgeon clinical productivity decreases after a maternity leave or other types of leave. Methods Data from a large medical center was used to measure surgeon productivity before (pre) and after (post) a leave of absence. Post-to-pre productivity ratios were calculated for each leave based on operative volumes and Relative Value Units (RVUs). Multivariate linear regression analysis was performed for the post/pre productivity ratios, adjusting for surgeon characteristics. Results Fifty leaves of absence, from 30 surgeons, were analyzed. There was no significant difference between post and pre leave productivity for maternity leave or other types of leave. There was also no significant difference when comparing post/pre productivity ratios between maternity leaves versus other types of leave (volume: 0.06, p = 0.52; RVU: 0.08, p = 0.58). Conclusion Surgeons do not significantly reduce clinical productivity after maternity or other types of leaves.

The objective is to evaluate the effect of robot-assisted radical prostatectomy (RARP)-related postoperative complications on the 6-month postoperative health-related quality of life (HRQoL). A total of 1008 patients underwent a RARP with or without pelvic lymph node dissection (PLND) between 2012 and 2020 and were invited to complete questionnaires about HRQoL and functional outcomes (urinary incontinence (UI), erectile dysfunction (ED) and urinary complaints (UC)) before and 6 months after RARP. Patient characteristics and postoperative complications up to 90 days after surgery were prospectively recorded. Associations between complications and HRQoL/functional outcomes were assessed by multivariate linear regression analyses. In total, 528 patients (52.4%) were included in the analyses. Complications occurred in 165/528 (31.3%) patients, of which 30/165 (18.2%) had a Clavien–Dindo ≥ III complication. In multivariate regression analyses, postoperative complications were not significantly associated with postoperative HRQoL, UI and ED (p = 0.73, p = 0.72 and p = 0.95, respectively), but were significantly associated with a minor increase in UC (β = 1.7, p < 0.001). More specifically, infectious and urological complications were significantly associated with an increase in UC (β = 1.9, p < 0.001 and β = 0.9, p = 0.004, respectively). The presence of UTI, in particular, was significantly associated with this minor increase (β = 1.5, p = 0.002). Functional outcomes were all significantly associated with the HRQoL at 6 months postoperatively. No significant associations were found between postoperative complications and HRQoL at 6 months after RARP. However, worse functional outcomes were associated with a worse HRQoL at 6 months postoperatively. In addition, postoperative infectious and urological complications were significantly associated with a minor increase in UC.

Background: Physical activity (PA) has substantial health benefits and is important in combatting chronic diseases, which have been associated with elevated levels of advanced glycation endproducts (AGEs). AGEs play a role in the aging process, and an association between PA and AGEs has been reported. We aimed to investigate the relationship between PA and AGE accumulation in a general population and in a population with chronic diseases.Methods: This large cross-sectional population study used data from adult participants in the LifeLines project, with participant information drawn from the LifeLines database as well data from patients with diabetes mellitus or renal and/or cardiovascular diseases. Tissue AGE accumulation was assessed non-invasively by skin-autofluorescence (SAF) using an AGE reader (DiagnOptics Technologies BV, Groningen, the Netherlands). PA was assessed using the short questionnaire to assess health-enhancing physical activity (SQUASH). Multivariate linear regression analyses were adjusted for age, body mass index, sex, and smoking status.Results: Data from 63,452 participants (general population n = 59,177, chronic disease n = 4275) were analyzed. The general population was significantly younger (43.58 +/- 11.77 years, mean +/- SD) and had significantly lower SAF (1.90 +/- 0.42 arbitrary units (AU)) compared to the population with chronic disease (age: 55.51 +/- 12.07 years; SAF: 2.27 +/- 0.51 AU). In the group with chronic disease, more hours of moderate to vigorous physical activities per week were associated with lower SAF (beta= -0.002, 95% confidence interval (95%CI): -0.002 to -0.001). For the general population, there was no association between hours of moderate to vigorous activity and SAF (beta= 3.2 x 10(-5), 95%CI: 0.000-0.001, p = 0.742). However, there was an association in the general population between total hours of PA per week and SAF (beta= 4.2 x 10(-4), 95%CI: 0.000-0.001, p < 0.001), but this association was not found in the chronic disease population (beta = -3.2 x 10(-4), 95%CI: -0.001 to 0.000, p = 0.347).Conclusion: Our study demonstrates that an inverse relationship exists between PA and AGE accumulation in the population with chronic disease. More hours of moderate to vigorous activity is associated with a significantly decreased SAF. More PA is associated with a lower SAF, even after adjusting for the established predictors (age, body mass index, smoking status, and sex). Our findings could help to promote health and prolong longevity.

Background Levels of inflammatory markers are elevated in patients with psychological disorders. However, anti-psychological drugs have an effect on proinflammatory cytokine production and disturb their relationship. Limited evidence focuses on the inflammatory marker profile of psychological status before treatment. This study aimed to investigate the inflammatory biomarker profiles of psychological treatment-naive individuals. Methods We included 790 psychological treatment-naive individuals from a longitudinal cohort study of Midlife in the United States (MIDUS). Symptoms of depression, anxiety, and stress were assessed by the Center for Epidemiologic Studies Depression Scale (CES-D) subscales, the Social Anxiety Scale (STAI), and Liebowitz Social Anxiety Scale (LSAS), the Perceived Stress Scale (PSS), respectively. Results Spearman correlation analysis showed that a higher CESD total score was correlated with higher CRP (p=0.009), IL-6 (p=0.007), fibrinogen (p=0.036), E-selectin (p=0.018), ICAM-1 (p=0.013), and IL-8 (p=0.05) levels. Multivariate linear regression analysis showed that the CESD total score was positively associated with the levels of IL-6 (p=0.024) after adjustments. Moreover, the perceived stress score (PSS) was negatively associated with the levels of IL-8 (p=0.025). However, these associations were not significant after multiple testing (p=0.088, 0.091, respectively). Limitations The casual relationship cannot be drawn due to the cross-sectional design Conclusion Overall, our results suggested IL-6 and IL-8 might play a important role in the pathogenesis of psychological disorder. Larger and longitude studies are needed to confirm our results.

To date, the accurate prediction of tunnel boring machine (TBM) performance remains a considerable challenge owing to the complex interactions between the TBM and ground. Using evolutionary polynomial regression (EPR) and random forest (RF), this study develops two novel prediction models for TBM performance. Both models can predict the TBM penetration rate and field penetration index as outputs with four input parameters: the uniaxial compressive strength, intact rock brittleness index, distance between planes of weakness, and angle between the tunnel axis and planes of weakness (α). First, the performances of both EPR- and RF-based models are examined by comparison with the conventional numerical regression method (i.e., multivariate linear regression). Subsequently, the performances of the RF- and EPR-based models are further investigated and compared, including the model robustness for unknown datasets, interior relationships between input and output parameters, and variable importance. The results indicate that the RF-based model has greater prediction accuracy, particularly in identifying outliers, whereas the EPR-based model is more convenient to use by field engineers owing to its explicit expression. Both EPR- and RF-based models can accurately identify the relationships between the input and output parameters. This ensures their excellent generalization ability and high prediction accuracy on unknown datasets.

In the context of global warming, forest fires are expected to occur more frequently and intensively, and impose more significant impacts on human society, terrestrial ecosystems, and atmosphere. Most of the existing methods in monitoring large-scale forest fire are based either on satellite visible and infrared observations or weather-based indices. This work explored the advantages of a new satellite microwave-based vegetation index in monitoring forest fire occurrence and fire intensity in Northeastern Asia and Southern China. Specifically, we used satellite observations during 2002–2011 to investigate the correlation at different temporal scales between forest fire properties (fire count, FC; fire radiative power, FRP) and the vegetation water content proxy of the Microwave Emissivity Difference Vegetation Index (EDVI) derived from the Moderate Resolution Imaging Spectroradiometer and the Advanced Microwave Scanning Radiometer-EOS on Aqua satellite. The correlations were compared to that with three weather-based indices including the Fine Fuel Moisture Code, Initial Spread Index and Fire Weather Index (FWI) to determine whether EDVI provides new independent information of forest fires. Finally, EDVI and the weather-based indices FWI were combined to establish multivariate linear regression models to estimate FC and FRP. Results show that: 1) the temporal variations of FC and total FRP are negatively correlated with EDVI using the daily and monthly observations at 1° grid and regional scales; and overall opposite annual cycles and interannual variations between FC (and total FRP) and EDVI are observed in Northeastern Asia and Southern China; 2) compared to the weather-based indices, EDVI shows higher correlation with the temperate forest fire properties in Southern China while shows weaker correlation with the forest fire properties in Northeastern Asia; and a combination of the two kind of indices is found to improve the explained variance for fire properties in both regions; 3) multivariate linear regression models based on EDVI and FWI provide better estimation of FC and FRP compared to the linear regression models based on FWI alone. To our knowledge, this is the first work that comprehensively investigates the potential application of the microwave-based vegetation water content index in forest fire count and fire intensity.

Background/Objectives: The purpose of this study was to investigate the differences in the physical fitness characteristics of Chinese single-handed dinghy and 470 sailors, predict the single-handed dinghy sailors’ physical factors on the performance by equation to guide the training. Methods: The sample of this study consisted of one hundred and sixty-seven Chinese sailors who participated in the 2020 China National Sailing Championships, K Independent Samples Test was used to analyze the differences of different classes sailors, and the performance of Laser and Laser Radial sailors were analyzed by step multivariate linear regression. Results: The results showed that the 470 helmsmen are shorter, lighter and have a lower BMI, 470 crew are similar in height to the single-handed dinghy sailors, but lower in weight and BMI. Laser sailors have better strength and flexibility than the ones of male 470. There is no significant difference in the physical fitness characteristics between the Laser Radial sailors and the female 470 crew, they both had better upper and lower body strength than female 470 helmsmen. The regression equation is possible to explain 65.5% of the performance of the sailors in Laser = 90.963-1.33 × sailing experience-0.461 × bench press-0.018 × cycling peak power out; The regression equation is possible to explain 76.7% of the performance of the sailors in Laser Radial = 27.433-0.391 × sailing experience+0.351 × vertical jump-0.329 × pull-up-0.027 × cycling peak power out. Conclusions: Performance in laser and Laser Radial sailors will be determined by the technique and tactics (sailing experience) as well as physical fitness.

Objective To investigate the relationship between metabolic syndrome (MetS) and lower urinary tract symptoms (LUTS) with functional and anatomic changes of the lower urinary tract with MRI. Materials and Methods The bladder and prostate of 95 subjects (56M, 39F) were segmented on T2-weighted pelvic MRI using Materialize Mimics 3D software. Bladder wall volume (BWV), post-void residual (PVR) and prostate volume (PV) were quantified from the 3D renderings. LUTS were quantified using validated questionnaires administered at the time of MRI. Wilcoxin rank sum, win ratio and chi-square tests were used to correlate symptom scores, BWV, PVR and PV in patients 1) without vs with MetS, 2) with mild (IPSS or UDI-6: 0-7) vs moderate-severe (IPSS: 8-35 or UDI-6: ≥8) and 3) normal vs enlarged prostates (>40cm3). Multivariate linear regression was used to determine predictors for BWV, PVR and PV. Results Men with MetS had increased BWV (66.8 vs 51.1cm3, P = .003), higher PVR (69.1 vs 50.5cc, P= .05) and increased PV (67.2 vs 40.1cm3, P= .01). Women without and with MetS had similar BWV, PVR and LUTS (P= .3-.78). There was no difference in prevalence of MetS, BWV, PVR or PV in men or women with mild vs moderate-severe LUTS (P = .26-.97). Men with enlarged prostates were more likely to have MetS (P = .003). There was no difference in BWV, PVR and LUTS for men with normal vs enlarged prostates (P= .44-.94). In men, BWV was highly correlated with MetS (P = .005) on regression analysis. Conclusion MetS leads to detrusor hypertrophy and may contribute to impaired bladder function, likely related to the effect on the prostate.

Tensor-valued data are becoming increasingly available in economics and this calls for suitable econometric tools. We propose a new dynamic linear model for tensor-valued response variables and covariates that encompasses some well-known econometric models as special cases. Our contribution is manifold. First, we define a tensor autoregressive process (ART), study its properties and derive the associated impulse response function. Second, we exploit the PARAFAC low-rank decomposition for providing a parsimonious parametrization and to incorporate sparsity effects. We also contribute to inference methods for tensors by developing a Bayesian framework which allows for including extra-sample information and for introducing shrinking effects. We apply the ART model to time-varying multilayer networks of international trade and capital stock and study the propagation of shocks across countries, over time and between layers.

Background: Many patients with stable coronary artery disease (CAD) have no visual segmental wall motion abnormalities and a left ventricular (LV) ejection fraction (LVEF) ≥ 50% at rest despite significant coronary artery stenosis. Here, the aim was to determine the impact of percutaneous coronary intervention (PCI) on LV function assessed by enhanced echocardiography in patients with stable CAD with or without diabetes mellitus type 2 and a preserved LVEF. Methods: Sixty-six consecutive patients with CAD and LVEF ≥ 50%, admitted to the hospital for planned coronary angiography, were prospectively assessed. PCI was performed for coronary artery stenosis > 70%. CAD extent was assessed using SYNTAX and EXTENT scores. To assess LV function, LVEF, global longitudinal strain (GLS), and LV peak systolic myocardial velocity (S’) were measured and Tei index was calculated before and 3 months after PCI. Results: Before PCI, LVEF, GLS, and Tei index were significantly worse in diabetic patients. LV functional indices improved significantly after PCI in all patients (p < 0.001). Multivariate linear regression analyses were performed to evaluate the impact of selected factors on LV function after PCI expressed as changes (Δ) of LVEF, GLS, S’, and Tei index. LV function improvement expressed as ΔGLS was associated only with SYNTAX score. Higher SYNTAX scores were related to greater GLS improvement (β = 0.003, 95% confidence interval: 0.0004–0.005; p = 0.02). Conclusions: Percutaneous coronary intervention significantly improved LV function in diabetic and non-diabetic CAD patients with preserved LVEF. Enhanced echocardiography allowed an assessment of subtle changes in LV function.

AIM There is a crucial need for pharmacokinetic (PK) data of oral vinorelbine (VNR) in pediatric population. The aim of this work was to assess the PK profile of orally administered VNR in children with recurrent/progressive primary low-grade glioma (LGG). METHODS A multicentric, open-label, single-arm intervention phase II study was conducted. Patients, aged between 6 and 18 years, with histologically confirmed recurrent or progressive primary LGG or non-documented typical optic pathway tumors, were included. PK parameters were estimated by non-compartmental analysis using Phoenix WinNonlin® software (version 8.0, Certara, Inc.). The Influence of demographic and biological covariates on VNR PK parameters was investigated using a multivariate linear regression analysis. RESULTS PK analysis included 36 patients with a median age (range) of 11 (6-17) years. Estimates of apparent oral clearance (CL/F), apparent volume of distribution (V/F), half-life (t1/2 ) and their between-subject variability (CV%) at 60 mg.m-2 dose level, were 472 L.h-1 (51.8%), 7002 L (57.9%) and 10 h (21.0%), respectively. Negligible accumulation of VNR between C1 and C2 was observed. CL/F and V/F were found to increase with body surface area (BSA) (p = 0.004). Lower area under the concentration-time curve (AUC) levels were observed among children in comparison to adults. CONCLUSION Higher doses may be necessary for children with LGG. BSA showed a significant impact on VNR systemic exposure. We believe that our findings will serve as a basis for further studies to better characterize the concentration-response relationships of VNR among pediatric patients.

Introduction: High prevalence of work-related physical and psychological disorders among dentists has been reported. Only one study explored job satisfaction among Health Insurance Organization dentists, in Alexandria. However, job satisfaction among Ministry of Health and Population (MOHP) dentists has not been examined.Objectives: The objective of this study was to measure the level of job satisfaction among MOHP dentists, in Alexandria and to assess the association of work environment factors as well as personal and practice-related factors to job satisfaction.Material and Methods: This study was a cross sectional analytical survey conducted among dentists working in MOHP facilities, in Alexandria during a six month period from October 2019 to March 2020. A validated questionnaire modified from the Dentists Satisfaction Survey that was previously tested in Saudi Arabia was adopted. The first section was concerned with demographic and practice related data whereas the second section explored work environment factors. Multivariate stepwise linear regression analysis was performed to examine the association between total mean job satisfaction with personal/ practice related characteristics and work environment factors.RESULTS: The level of job satisfaction was neutral (2.91±0.41). Overall job satisfaction (Beta=0.437), monetary satisfaction (Beta=0.328) and personal time (Beta=0.265) reported the most significant associations with job satisfaction according to the multivariate linear regression analysis.CONCLUSIONS: This study revealed that overall job satisfaction, perception of income and personal time showed a significant impact on job satisfaction. The findings of this study would help policy makers to design plans to increase level of job satisfaction among dentists.

INTRODUCTION AND PURPOSE So far, few studies have examined the relationship between dietary patterns and depression in adolescents. The aim of the present study was to determine this relationship in a sample of adolescent Iranian girls. MATERIALS AND METHODS 347 female high school students aged 14-17 years living in Shiraz, Iran participated in this cross-sectional study. General and physical activity questionnaires, 3-d dietary recalls, and Beck Depression Inventory-Second Edition (BDI-II) were completed for all individuals and their anthropometric characteristics were measured. The major dietary patterns were then identified using principal component factor analysis. FINDINGS In total, 2 major dietary patterns were identified. After adjusting for potential confounders in multivariate linear regression analysis, the Western pattern (characterized by high consumption of French fries, hydrogenated fats, mayonnaise, sweets and desserts, high-fat dairy, refined grains, red or processed meats, pickles, organ meats and soft drinks and low consumption of low-fat dairy) was positively (standardized β coefficient: 0.510, P

Objective To evaluate the changes in magnetic resonance imaging-based body composition parameters during follow-ups in patients with Crohn's disease (CD). Methods Between November 1, 2017, and June 30, 2021, patients diagnosed with CD, who underwent two or more magnetic resonance enterography (MRE) scans at our institution were retrospectively reviewed. The baseline and one subsequent follow-up scan for each patient were paired to form longitudinal comparisons. Skeletal muscle, visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) indexes were calculated from tissue areas measured at the third lumbar vertebra level per scan, standardized by dividing the height2 and lumbar height2 (heightL1–L5). We also assessed the correlation between changes in VAT to total adipose tissue ratio (VA/TA index) and CD activity scores (5-point MRE classification) using Spearman’s correlation analysis. A multivariate linear regression model was used to adjust for the follow-up duration and treatment type. Results Overall, 49 patients (with 49 paired scans) were enrolled. VA/TA index changes were negatively correlated with changes in skeletal muscle index (SMI; r = − 0.339, p p p p > 0.05). Changes in total MRE score were negatively correlated with SMI changes (r = − 0.408, p r = 0.479, p Conclusion An increase in SMI and a decrease in VA/TA index could reflect improved nutritional and inflammatory status.

The aim of this prospective longitudinal study was to examine the association between Cesarean section (CS) and child development and behavior. The sample consisted of 256 children who were born at term without serious perinatal pathologies. Their development and behavior was assessed at the age of four using Ages and Stages Questionnaire (ASQ-3), Children’s Behavior Questionnaire and Strength and Difficulties Questionnaire. Multivariate linear regression analyses were conducted to assess the association between CS and child outcomes. CS was associated with better scores in the Problem Solving domain of the ASQ in the whole sample. After stratifying by child sex, the positive association between CS and the Problem Solving domain was significant in boys, while no association was found in girls. Girls were rated less optimally in the Gross Motor domain of the ASQ when born via CS. Mode of birth was not associated with behavioral outcomes. Electronic supplementary material The online version of this article (10.1007/s10578-020-01084-4) contains supplementary material, which is available to authorized users.

Background The goal of this study was to investigate the potential determinants of 18F-NaF uptake in femoral arteries as a marker of arterial calcification in patients with type 2 diabetes and a history of arterial disease. Methods and Results The study consisted of participants of a randomized controlled trial to investigate the effect of vitamin K2 (NCT02839044). In this prespecified analysis, subjects with type 2 diabetes and known arterial disease underwent full body 18F-NaF PET/CT. Target-to-background ratio (TBR) was calculated by dividing the mean SUVmax from both superficial femoral arteries by the SUVmean in the superior vena cava (SVC) and calcium mass was measured on CT. The association between 18F-NaF TBR and cardiovascular risk factors was investigated using uni- and multivariate linear regression corrected for age and sex. In total, 68 patients (mean age: 69 ± 8 years; male: 52) underwent 18F-NaF PET/CT. Higher CT calcium mass, total cholesterol, and HbA1c were associated with higher 18F-NaF TBR after adjusting. Conclusion This study shows that several modifiable cardiovascular risk factors (total cholesterol, triglycerides, HbA1c) are associated with femoral 18F-NaF tracer uptake in patients with type 2 diabetes.

Objective. Rapid changes in the current US health care system, especially in the fields of pharmacy and pharmaceutical sciences, require practicing pharmacists to acquire new knowledge and skills. Despite the growth of opportunities for pharmacists within new spaces such as nanotechnology, informatics, and pharmacogenomics, those without a Doctor of Pharmacy (PharmD) degree could be eliminated from consideration by employers who seek new graduates with more contemporary training and skills. The purpose of this study was to determine what associations exist between student success within a nontraditional Doctor of Pharmacy (NTDP) program and certain demographic factors. Methods. This quantitative longitudinal study was designed to determine which factors predict academic success among NTDP students entering the College of Pharmacy at Howard University. Academic success was measured by cumulative graduating grade point average (GPA). Data from four cohorts of students were used to develop multivariate linear regression models with several predictors including age, region of residence, citizenship status, previous pharmacy work background, and ethnicity. Results. The study sample included 81 students whose mean cumulative GPA was 3.44. A foreign-born African heritage was predictive of a GPA that was significantly higher in comparison to African Americans after adjusting for other factors. Conclusion. Findings showed that international students had a higher cumulative GPA in comparison to African American students in the NTDP program.

PURPOSE Cardiac implantable electronic devices (CIEDs) offer diagnostic information such as device-measured physical activity (PA). Peak oxygen consumption (VO2) measured by cardiopulmonary exercise testing (CPET) is the most objective variable showing exercise capacity. The purpose of this study was to investigate the relationship between these 2 variables. METHODS We retrospectively studied consecutive patients with CIEDs undergoing CPET between April 1, 2018, and January 31, 2021. These patients were divided into 2 groups: patients with peak VO2 ≤ 14 ml/kg/min (low peak VO2 group) and those showing peak VO2 > 14 ml/kg/min (high peak VO2 group). The peak device-measured PA was compared between the 2 groups. The relationship between the peak device-measured PA and peak VO2 was also investigated. RESULTS There were 50 and 51 patients in the low and high peak VO2 groups, respectively. The peak device-measured PA, which was expressed in units of hours/day, was significantly lower in the low peak VO2 group than in the high peak VO2 group (3.06, interquartile range [2.43-4.00] vs. 5.50, interquartile range [4.04-6.70] p 3.87 h/day could predict high peak VO2 (80.4%, sensitivity; 72.0%, specificity). In multivariate linear regression analysis, peak device-measured PA was an independent predictor of peak VO2 (regression coefficient, 0.61; 95% confidence interval, 0.33-0.89; p

Objectives The aims of this study were to determine if there was an increased risk of incident cardiovascular disease (CVD) and diabetes and an increase in arterial stiffness in participants who reported working 41–54 h per week and more than 55 h compared to those who worked 40 h or less over a time interval of 5 years. Methods In a subsample of the population-based prospective Gutenberg Health Study (GHS) study, we examined working participants younger than 65 years at baseline (n = 7241) and after 5 years. To test the association of working time at baseline and incident cardiovascular events and diabetes type II, we estimated hazard ratios (HR) using competing risks models. For a change in the arterial stiffness index (SI) based on assessment using a Pulse Trace PCA2 device, we used multivariate linear regression models. Results The SI increased in those working more than 55 h per week (beta coefficiant = 0.32 m/s (95% CI 0.07–0.58) compared to those working 40 h and less after adjustment for sex, age and SES. Due to small numbers there was no significant association of working hours and clinically manifest cardiovascular events and diabetes type II in the 5-year follow-up time. Conclusions Further studies are needed to confirm the results on working hours and arterial stiffness. Analyses of the 10-year follow-up with more events may clarify the results for incident cardiovascular events and metabolic outcomes.

Bireyin bir bütün olarak yaşam koşullarından hoşnut olması anlamına gelen yaşam memnuniyetinin temel bileşenlerinden biri de, iş kalitesidir. Bu açıdan iş kalitesi, çalışanların kazancı ve iş güvencesinin yanı sıra, yaşam kalitesini etkileyen diğer unsurların bir bileşimini yansıtmaktadır. Özellikle 2008 Küresel Ekonomik Krizi sonrasında iş kalitesine ilişkin endişelerin artması, bazı akademik çevrelerin ve uluslararası örgütlerin iş kalitesine yönelik ilgisini artırmış ve iş kalitesi ölçümüne yönelik çeşitli çalışmalar yapılmıştır. Bu çalışmalardan biri de OECD’nin üç boyut ve dokuz göstergeden oluşan İş Kalitesi Çerçevesi’dir. Bu anlamda, OECD İş Kalitesi Çerçevesi kazanç kalitesi, işgücü piyasası güvencesi ve çalışma ortamının kalitesi olmak üzere üç temel boyutta yapılandırılmıştır. Bu açıdan, bu çalışma temel olarak, OECD ülkelerinin İş Kalitesi Çerçevesi verilerine basit ve çoklu doğrusal regresyon modelleri uygulayarak yaşam memnuniyeti skorları ve iş kalitesi göstergeleri arasındaki ilişkiyi incelemeyi amaçlamaktadır. Basit doğrusal regresyon sonuçları, daha yüksek yaşam memnuniyeti skoruna sahip OECD ülkelerinde, iş kalitesinin daha yüksek olduğunu göstermektedir. Ayrıca çoklu doğrusal regresyon analizi istihdam oranı, kazanç kalitesi, iş otonomisi ve öğrenme fırsatları ile kariyer ilerleme fırsatındaki artışın ülkelerin yaşam memnuniyeti skorlarını farklı derecelerde yükseltebileceği sonucuna ulaşmıştır., One of the basic components of life satisfaction, which means an individual satisfaction with their living conditions as a whole, is job quality. Therefore, job quality reflects a combination of employees’ earnings and job security, as well as other factors affecting their quality of life. Especially after the 2008 Global Economic Crisis, increasing worries on job quality boosted the interest of some academic circles and international organizations on job quality, and various studies were conducted to measure job quality. One of these studies is the OECD’s Job Quality Framework, consisting of three dimensions and nine indicators. Particularly, dimensions of OECD’s Job Quality Framework are structured on earning quality, labor market insecurity, and work environment quality. Therefore, this study aimed to investigate the relationship between life satisfaction scores and job quality indicators by carrying out bivariate and multiple linear regression models to Job Quality Framework data from OECD countries. Bivariate linear regression results revealed that OECD countries with higher life satisfaction scores have a higher job quality. In addition, multivariate linear regression analysis concludes that increased employment rate, earning quality, job autonomy and learning opportunities, and career advancement opportunity may improve life satisfaction scores of countries at varying degrees.

Background Data on the relationship of baseline serum uric acid (SUA) with development of low-density lipoprotein cholesterol (LDL-C) level in patients with first acute myocardial infarction (AMI) are limited. The present study is to evaluate whether elevated SUA predicts the development of LDL-C in the first AMI. Methods This is a retrospective 6-month cohort study of 475 hospitalized Chinese patients who underwent first AMI between January 2015 and December 2019 and were reevaluated half a year later at the Department of Cardiology, the Second Affiliated Hospital of Nanchang University, Jiangxi Province, China. The associations of baseline SUA with the percentage decrease of LDL-C (%) and LDL-C control were analyzed by using logistic regression analyses, multivariate linear regression analyses and the restricted cubic spline. Results Over the 6-month follow-up, baseline SUA was independently and positively associated with the percentage decrease of LDL-C (%) and LDL-C control in a dose response fashion. After multivariable adjustment, per SD increment of baseline SUA (120.58 μmol/L) was associated with 3.96% higher percentage decrease of LDL-C(%). The adjusted OR (95% CI) for LDL-C control was 5.62 (2.05, 15.36) when comparing the highest tertile (SUA ≥ 437.0 μmol/L) to the lowest tertile ( Conclusions Among Chinese patients with first AMI, higher baseline SUA was associated with higher LDL-C deduction percentage (%), and higher rate of LDL-C control in the short-term follow-up, respectively. SUA acquired when AMI occurred was prone to be profitable in predicting the risk stratification of uncontrolled LDL-C and dyslipidemia management.

Background/Aims: This study aimed to assess the association between local and systemic reactogenicity and humoral immunogenicity after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination.Methods: Adverse events were prospectively evaluated using an electronic diary in 135 healthy adults who received a SARS-CoV-2 vaccine (AZD1222, AstraZeneca/Oxford, n = 42; or BNT162b2, Pfizer/BioNTech, n = 93). We semi-quantitatively measured anti-S1 immunoglobulin G (IgG) using an enzyme-linked immunosorbent assay at baseline, 3 weeks after the first dose of AZD1222 or BNT162b2, and 2 weeks after the second dose of BNT162b2. We evaluated the association between the maximum grade of local or systemic adverse events and the anti-S1 IgG optical density using multivariate linear regression with adjustment for age, sex, and use of antipyretics.Results: The median age of the 135 vaccinees was 30 years (36 years in the AZD1222 group and 29 years in the BNT162b2 group) and 25.9% were male (9.5% in the AZD1222 group and 33.3% in the BNT162b2 group). Local and systemic adverse events were generally comparable after the first dose of AZD1222 and the second dose of BNT162b2. The grades of local and systemic adverse events were not significantly associated with anti-S1 IgG levels in the AZD1222 or BNT162b2 group.Conclusions: Local and systemic reactogenicity may not be associated with humoral immunogenicity after SARS-CoV-2 vaccination.

Accurately predicting energy consumption (EC) is a difficult task, owing to its inherent complexity and nonlinearity features. To decrease the complexity of EC predictions, applying a novel three-layer decomposition approach to decompose a complex series into a trend sub-series and several simpler non-trend sub-series. Since the trend sub-series describes the developing tendency that is determined by the primarily influencing factors on EC, it is predicted by multivariate linear regression (MLR). In view of its learning ability of nonlinear mappings and excellent performance in dealing with long term dependency, long short-term memory neural network (LSTM) is applied to predict non-trend sub-series. Then, the final EC prediction is solved by calculating the sum of all these sub-series prediction values. A novel EC forecasting model based on machine learning with three-layer decomposition-ensemble approach is proposed in this study. Compared with traditional decomposition approaches (trend decomposition (TD), wavelet decomposition (WD), empirical mode decomposition (EMD), TD-EMD and TD-WD), the proposed three-layer decomposition approach can improve the prediction performance by combining the advantages of TD, EMD and WD. The proposed forecasting model is validated by empirical studies using the EC data of China and U.S. Finally, this study gives the China’s EC prediction in 2020–2024.

To recognize the role schools play in the acclimatization of refugee children to their new life in the host country, we sought to investigate the psychosocial adjustment of Syrian refugee students enrolled in Lebanese public schools. Psychosocial adjustment involves both the emotional and behavioral wellbeing of children and is measured using the Strength and Difficulties Questionnaire (SDQ). Psychosocial adjustment is also consistently linked to school belonging which, in turn, can be assessed using the Psychological Sense of School Membership (PSSM) scale. The aim of this study is to identify associations between psychosocial adjustment, determined by the SDQ and PSSM scale, and both (1) sociodemographics (age, gender, parental level of education and length of stay in the host country) and (2) classroom environment in Lebanese public schools in the greater Beirut area. A total of 410 Syrian refugee students (222 females) with a mean age of 11.4 years, who arrived in Lebanon between the years 2011 and 2017, were included in the study. The results showed a very weak correlation between older age and psychosocial maladjustment measured using the SDQ (r = .10, p = .04). Additionally, girls had a better psychosocial adjustment than boys (mean PSSM-scale score: 70.7 ± 10.1 Vs. 67.4 ± 11.8, p = .0014). On multivariate linear regression, there was a strong positive correlation between the classroom environment and psychosocial adjustment (p

Objective To examine associations between adverse childhood experiences (ACEs) and teen behavior outcomes and whether the presence of disability moderates this relationship. Methods We conducted a secondary analysis of population-based data from the Fragile Families & Child Wellbeing Study urban birth cohort. Disability status included physical/developmental/behavioral conditions (ages 1–5) using mother-reported child health conditions and cognitive disability (age 9), measured by the Peabody Picture Vocabulary Test (PPVT), an assessment of receptive vocabulary. We investigated whether either disability type moderates the relationship between ACEs occurring between ages 5 to 9 and behavior outcomes at age 15, specifically, standardized scales of caregiver-reported externalizing and youth-reported internalizing and delinquent behaviors. Associations were examined using multivariate linear regression models, including interaction effects of ACEs with low PPVT score and disability conditions to assess for potential moderation. Results Of the 3038 children included, 15% had a cognitive disability and 24% had a disabling health condition. The presence of 2 or more ACEs (compared to none) is associated with more externalizing (by 0.34 standard deviations [SD]), internalizing (0.18 SD), and delinquent (0.18 SD) behaviors. Cognitive disability exacerbates this association for externalizing behaviors and delinquent behaviors while other disabling health conditions do not. Conclusions ACEs were associated with more behavior problems among urban youth. Cognitive disability, but not other disabling health conditions, compounded this association for externalizing and delinquent behaviors, indicating these children may be particularly vulnerable to the effects of trauma and adversity. Targeted assessment and resources for youth with cognitive disability are critical.

OBJECTIVES To investigate the association between diabetes mellitus (DM) and the prevalence and severity of hearing loss in a population of community-dwelling older adults in Singapore. MATERIALS AND METHODS This is a retrospective, cross-sectional study of 1787 adults aged 60-100 who had undergone a comprehensive audiological assessment in a community-based audiology clinic. Data extracted included their age, hearing profile, medical history, and comorbidities collected through verbal interview at the point of audiologic assessment. Multivariate linear regression and multivariate logistic regression were performed to investigate the relationship between DM and hearing loss. RESULTS The prevalence of DM in our studied population is 17.9%. After controlling for age, gender, race, hypertension, and hyperlipidaemia status, DM was found to be independently associated with at least moderate hearing loss (adjusted OR 1.3 [95% CI 1.06-1.59], p = .012). This was especially so in the younger (

PurposeThe purpose of this paper is to show a comparative study of different direction-of-arrival (DOA) estimation techniques, namely, multiple signal classification (MUSIC) algorithm, delay-and-sum (DAS) beamforming, support vector regression (SVR), multivariate linear regression (MLR) and multivariate curvilinear regression (MCR).Design/methodology/approachThe relative delay between the microphone signals is the key attribute for the implementation of any of these techniques. The machine-learning models SVR, MLR and MCR have been trained using correlation coefficient as the feature set. However, MUSIC uses noise subspace of the covariance-matrix of the signals recorded with the microphone, whereas DAS uses the constructive and destructive interference of the microphone signals.FindingsVariations in root mean square angular error (RMSAE) values are plotted using different DOA estimation techniques at different signal-to-noise-ratio (SNR) values as 10, 14, 18, 22 and 26dB. The RMSAE curve for DAS seems to be smooth as compared to PR1, PR2 and RR but it shows a relatively higher RMSAE at higher SNR. As compared to (DAS, PR1, PR2 and RR), SVR has the lowest RMSAE such that the graph is more suppressed towards the bottom.Originality/valueDAS has a smooth curve but has higher RMSAE at higher SNR values. All the techniques show a higher RMSAE at the end-fire, i.e. angles near 90°, but comparatively, MUSIC has the lowest RMSAE near the end-fire, supporting the claim that MUSIC outperforms all other algorithms considered.

To explore the use of wearable sensors for objective measurement of motor impairment in spinocerebellar ataxia (SCA) patients during clinical assessments of gait and balance. In total, 14 patients with genetically confirmed SCA (mean age 61.6 ± 8.6 years) and 4 healthy controls (mean age 49.0 ± 16.4 years) were recruited through the Massachusetts General Hospital (MGH) Ataxia Center. Participants donned seven inertial sensors while performing two independent trials of gait and balance assessments from the Scale for the Assessment and Rating of Ataxia (SARA) and Brief Ataxia Rating Scale (BARS2). Univariate analysis was used to identify sensor-derived metrics from wearable sensors that discriminate motor function between the SCA and control groups. Multivariate linear regression models were used to estimate the subjective in-person SARA/BARS2 ratings. Spearman correlation coefficients were used to evaluate the performance of the model. Stride length variability, stride duration, cadence, stance phase, pelvis sway, and turn duration were different between SCA and controls (p

Objective: This exploratory study aimed to examine associations between executive function and simulated and self-reported driving behavior among young adults with and without a history of prenatal cocaine exposure (PCE).Methods: Young adult drivers with PCE (n = 38) and with no drug exposure (NDE; n = 25) were recruited from an ongoing longitudinal birth cohort study assessing effects of PCE on development (Mean age = 23.7; 60.3% male; 61.9% with a valid U.S. driver's license, 38.1% report independent driving without a license). Participants completed executive function tasks (i.e., the Stop Signal Task and Groton Maze Learning Task) and self-reported driving measures (i.e., Checkpoints Risky Driving Scale (C-RDS)) outside the cab. Average stop signal reaction time(s) measured inhibitory control, number of exploratory errors measured visuo-spatial working memory, and the total C-RDS score measured self-reported risky driving. Participants completed a high-fidelity driving simulation scenario in a miniSim™ ½ cab National Advanced Driving Simulator (NADS) that yielded indicators of driving performance shown in previous research to correlate with inhibitory control (e.g., average speed, standard deviation lane position (SDLP)) and working memory (minimum headway time, lane departures). Multivariate linear regression models tested whether PCE status, licensure status and executive function measures were associated with simulated driving measures or C-RDS, controlling for sex.Results: Multivariate regression models demonstrated inhibitory control, working memory and PCE group status was not significantly associated with driving outcomes. Licensure was significantly associated with total lane departures (β = -0.66, SE = 0.19; p < 0.01) and C-RDS (β = 5.86, SE = 1.4; p ≤ 0.001).Conclusions: This exploratory study suggests that young adults with PCE have similar neurocognitive performance and driving behaviors as their non-drug exposed (NDE) peers. These findings add to the growing literature demonstrating that the effect of PCE on cognitive functions in childhood may not persist to young adulthood. Further research with similar groups of young drivers in a naturalistic driving context (i.e., instrumented vehicles) is needed to more definitively translate and confirm our findings.

Extended redundancy analysis (ERA), a generalized version of redundancy analysis (RA), has been proposed as a useful method for examining interrelationships among multiple sets of variables in multivariate linear regression models. As a limitation of the extant RA or ERA analyses, however, parameters are estimated by aggregating data across all observations even in a case where the study population could consist of several heterogeneous subpopulations. In this paper, we propose a Bayesian mixture extension of ERA to obtain both probabilistic classification of observations into a number of subpopulations and estimation of ERA models within each subpopulation. It specifically estimates the posterior probabilities of observations belonging to different subpopulations, subpopulation-specific residual covariance structures, component weights and regression coefficients in a unified manner. We conduct a simulation study to demonstrate the performance of the proposed method in terms of recovering parameters correctly. We also apply the approach to real data to demonstrate its empirical usefulness.

Introduction: Neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) are recent prognostic biomarkers associated with inflammation. Increased erythropoiesis resistance index (ERI) may predict the risk of all-cause and cardiovascular mortality in hemodialysis (HD) patients. However, the roles of NLR and PLR in erythropoietin (EPO) responsiveness remain unclear in HD patients. This study aims to investigate the relationship between NLR and PLR and EPO responsiveness in maintenance HD patients. Methods: A total of 299 HD patients were included in this survey. Laboratory data and demographic details were collected. EPO responsiveness was evaluated by ERI. Pearson correlation analysis and logistic regressions were conducted to evaluate the factors that may be associated with EPO responsiveness. Results: The EPO responsiveness was positively related to ferritin and negatively related to serum albumin, lymphocytes, and hemoglobin. A multivariate linear regression revealed that only NLR (standardized β = 0.13, p = 0.024) but not PLR (standardized β = 0.107, p = 0.063) was correlated with a higher ERI. Conclusion: A higher NLR level was shown to be a cheaper method to predict worse EPO responsiveness in HD patients.

OBJECTIVES To evaluate the relationship between the creatinine reduction ratio between postoperative days 1 and 2 and post-transplantation clinical outcomes after living donor kidney transplantation. METHODS Clinical data of patients who underwent living donor kidney transplantation at Jichi Medical University Hospital, Tochigi, Japan, between 2006 and 2019 were retrieved. The creatinine reduction ratio between postoperative days 1 and 2 was calculated based on the formula: (Cre1 - Cre2) × 100/Cre1; patients were then classified into either the slow graft function (creatinine reduction ratio between postoperative days 1 and 2 ≤30%) or immediate graft function (creatinine reduction ratio between postoperative days 1 and 2 >30%) group. We carried out the log-rank test and multivariate Cox proportional hazards regression analyses to assess graft survival and rejection-free survival, and the unpaired t-test and multivariate linear regression to assess post-transplantation estimated glomerular filtration rates. Multivariate analyses used age, sex, dialysis duration, ABO compatibility, donor-specific antibody positivity and medically complex living donors as explanatory variables. RESULTS Of the 272 patients, 30 and 242 were in the slow graft function and immediate graft function groups, respectively. Multivariate Cox proportional hazards regression analyses showed a significantly higher incidence of overall and death-censored graft loss in the slow graft function group than the immediate graft function group. The frequency of rejection after 1 week post-transplantation did not differ within the groups. Post-transplantation estimated glomerular filtration rates tended to decline earlier in the slow graft function group than in the immediate graft function group; however, the difference was not statistically significant. CONCLUSIONS The creatinine reduction ratio between postoperative days 1 and 2 could potentially predict long-term outcomes after living donor kidney transplantation. Using the creatinine reduction ratio between postoperative days 1 and 2 and other conventional indicators might allow accurate risk classification and appropriate therapeutic interventions.

We propose two variable selection methods in multivariate linear regression with high-dimensional covariates. The first method uses a multiple correlation coefficient to fast reduce the dimension o...

Aims/Introduction Diabetes mellitus is a major risk factor for the development of cardiovascular diseases. Heart failure with preserved ejection fraction is characterized by left ventricular diastolic dysfunction (LVDD). It has been reported that excess cortisol found in patients with Cushing's syndrome was associated with the development of LVDD. However, the relationship between cortisol concentration and LVDD in patients with diabetes mellitus has not been addressed. Materials and Methods We enrolled 109 patients with diabetes mellitus and 104 patients without diabetes mellitus who had undergone echocardiographic examination at Kyushu University Hospital, Fukuoka, Japan, between November 2016 and March 2019. Left ventricular function was evaluated and the ratio of early diastolic velocity from transmitral inflow to early diastolic velocity (E/eʹ) was used as an index of diastolic function. Plasma cortisol concentrations, glycemic control, lipid profiles, treatment with antidiabetic drugs and other clinical characteristics were evaluated, and their associations with E/eʹ were determined using univariate and multivariate analyses. Results Multivariate linear regression analysis showed that log E/eʹ was positively correlated with age (P = 0.017), log systolic blood pressure (P = 0.004) and cortisol (P = 0.037), and negatively correlated with estimated glomerular filtration rate (P = 0.016) and the use of sodium–glucose cotransporter 2 inhibitors (P = 0.042) in patients with diabetes mellitus. Multivariate analysis showed that cortisol was positively correlated with age (P = 0.016) and glycated hemoglobin (P = 0.011). There was no association between E/eʹ and cortisol in patients without diabetes mellitus. Conclusions Increased cortisol levels might increase the risk of developing LVDD in diabetes mellitus patients.

Background The prevalence of coronary artery disease (CAD) continues to increase among young Chinese adults. Current smoking has been recognized as a major risk factor for premature CAD, and hyperhomocysteinaemia (HHcy) has also been suggested to be associated with CAD progression. However, the combined effect of current smoking and HHcy on the severity of coronary artery stenosis in young adults is still uncertain. Methods We consecutively collected young patients (18–35 years of age), diagnosed with CAD and underwent coronary angiography (CAG) at Anzhen Hospital between January 2013 and May 2020. HHcy was defined as serum homocysteine (Hcy) level > 15 µmol/L. The severity of coronary artery stenosis was evaluated by Gensini Score. The co-effect of current smoking and HHcy on CAD severity as well as the relationship between plasma Hcy, pack-years of smoking and CAD severity were assessed by multivariate linear regression analysis. Results A total of 989 participants (mean age, 33 years; 96.2% male) fulfilling the criteria were enrolled in this study. Patients with both HHcy and current smoking accounted for 39.1% of all the subjects. Multivariate liner analysis indicated both serum Hcy levels (β 0.302; 95% CI 0.141–0.462; P β 0.523; 95% CI 0.265–0.781; P r = 0.116, P = 0.001). Moreover, combination of HHcy and current smoking was suggested to have higher risk for CAD severity (β 17.892; 95% CI 11.314–24.469; P β 7.471; 95% CI 0.009–14.934; P = 0.048) or current smoking (β 7.421; 95% CI 0.608–14.233; P = 0.033) alone. Conclusion Combination of HHcy and smoking is independently associated with the severity of CAD in young patients ≤ 35 years of age.

Wojciech Ta&nacute;ski Department of Internal Medicine, 4th Military Teaching Hospital, Wroclaw, PolandCorrespondence: Wojciech Ta&nacute;skiDepartment of Internal Medicine, 4th Military Teaching Hospital, Weigla 5, Wroclaw, 53-114, PolandEmail wtanski@op.plIntroduction: During the SARS-CoV-2 pandemic, most primary and specialist care outpatient clinics have started to offer their patients teleconsultation appointments as well as electronic prescriptions and referrals. For many patients, it was the only available way to access medical care.Purpose: The aim of the study was to assess the quality of life in rheumatoid arthritis (RA) patients and determine whether loneliness and satisfaction with telemedicine service can affect their perceived QoL during the SARS-CoV-2 pandemic.Material and Methods: One hundred and forty-three RA patients (mean age 45.83± 13.5 years) were included in the study. The De Jong-Gierveld Loneliness Scale (DJGLS), The Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL) and the questionnaire of satisfaction with teleconsultations were used in the study. The following statistical tests were used in the study: Spearman correlation test, multivariate linear regression. A significance level of 0.05 was used in the analysis.Results: The patients presented a moderate level of loneliness (DJGLS; 31.1 points). The mean ASQoL score was 11.49± 4.64. The correlation analysis showed a significant positive relationship between the level of loneliness and QoL – the higher the level of loneliness, the poorer the QoL (rho=0.283; p=0.001). An analysis of the relationship between satisfaction with teleconsultations and perceived QoL showed a statistically significant negative relationship – the higher the level of satisfaction with teleconsultations, the better the QoL (b=− 0.166; p=0.047). The linear multivariate regression analysis showed that the loneliness (rho=0.1; p=0.01) was significant (p< 0.05) independent predictor of QoL.Conclusion: During the SARS-CoV-2 pandemic, RA patients experienced loneliness and their QoL was low. Teleconsultation visits proved to be unsatisfactory and negatively perceived by patients. Higher severity of RA symptoms (weakness, fatigue), being unemployed and loneliness during the blockade are independent determinants of reduced QoL in RA patients.Keywords: e-health, loneliness, SARS-CoV-2, rheumatoid arthritis

Background Relationships between right ventricular (RV) and left ventricular (LV) shape and function may be useful in determining optimal timing for pulmonary valve replacement in patients with repaired tetralogy of Fallot (rTOF). However, these are multivariate and difficult to quantify. We aimed to quantify variations in biventricular shape associated with pulmonary regurgitant volume (PRV) in rTOF using a biventricular atlas. Methods In this cross-sectional retrospective study, a biventricular shape model was customized to cardiovascular magnetic resonance (CMR) images from 88 rTOF patients (median age 16, inter-quartile range 11.8–24.3 years). Morphometric scores quantifying biventricular shape at end-diastole and end-systole were computed using principal component analysis. Multivariate linear regression was used to quantify biventricular shape associations with PRV, corrected for age, sex, height, and weight. Regional associations were confirmed by univariate correlations with distances and angles computed from the models, as well as global systolic strains computed from changes in arc length from end-diastole to end-systole. Results PRV was significantly associated with 5 biventricular morphometric scores, independent of covariates, and accounted for 12.3% of total shape variation (p Conclusion A biventricular atlas of rTOF patients quantified multivariate relationships between left–right ventricular morphometry and wall motion with pulmonary regurgitation. Regional RV dilation, LV reduction, LV septal-lateral flattening and increased RV strain were all associated with increased pulmonary regurgitant volume. Morphometric scores provide simple metrics linking mechanisms for structural and functional alteration with important clinical indices.

Lack of characterization of indoor pollutant concentrations has been identified as a key barrier for exposure and health estimates. In this study, a field campaign was conducted to measure indoor concentrations of PM1, PM2.5, PM10, CO, and NO2 in a mechanically ventilated building. Statistical method using multivariate linear regression (MLR) and machine learning using random forest (RF) were used and compared to quantify variations in observed concentrations and were then used to predict indoor concentrations for selected pollutants. The two methods were consistent in identifying major predictors for each pollutant. Outdoor particles were the single largest predictors found for PM1 and PM2.5, while indoor environment and occupant-related variables were dominant predictors for PM10, CO, and NO2 in the selected mall. Based on MLR models, outdoor PM accounted for 91%, 64%, and 25% of variations in indoor PM1, PM2.5, and PM10 during opening hours. More than 30% of indoor CO variations were related to time-dependent activities. Nearly 50% of the indoor NO2 variations were explained by temperature and relative humidity. Both models are useful in predicting indoor concentrations. In the tenfold cross validation, RF models showed high prediction capability for PM1 (R2 > 0.9) and moderate (R2: 0.5 ~ 0.7) for the other four pollutants in both periods except for PM10 during non-opening hours (R2 = 0.3). MLR models exhibited comparable prediction power for PM1 and PM2.5, but generally lower for PM10 and gases. Availability of parameter information in modern cities facilitates the application of such models on large scale, based on proper validation, for better characterizing of indoor air quality.

To evaluate the effects of metreleptin in distinct subgroups of patients with generalized lipodystrophy (GL) and partial lipodystrophy (PL), using multivariate linear regression modeling to account for the role of patients' baseline usage of concomitant glucose and lipid-lowering medications and other covariates on their outcomes.AAs previously reported, improvement in HbA1c and fasting TG from baseline to 12 months on metreleptin were observed in the overall population (mean change -1.57 percentage points and median change -37.9%, respectively) and subgroups. For both HbA1c and TG, baseline levels were significant predictors of changes after metreleptin. After considering baseline characteristics such as disease type, age, sex, and baseline HbA1c, baseline insulin use was not found to be a significant predictor of HbA1c improvement following metreleptin initiation. Similar results were seen for TG levels, with the use of any lipid-lowering medications at baseline not found to be a significant predictor of reductions in fasting TG levels.Patients treated with metreleptin experienced statistically significant improvement in metabolic markers of glycemic and hypertriglyceridemic control-e.g. HbA1c and triglyceride levels-across various subgroups after controlling for baseline characteristics and concomitant medication usage.

OBJECTIVE To test the hypothesis that higher walking cadence is associated with lower knee loading, while controlling for walking speed, in patients with medial compartment tibiofemoral osteoarthritis (OA). METHODS A total of 691 patients underwent quantitative gait analysis, including 3-dimensional knee moments and temporospatial parameters. Using multivariate linear regression, we tested the association of walking cadence with the knee adduction moment angular impulse (a surrogate measure of medial knee compartment load throughout the stance), while controlling for walking speed. We repeated the analysis while also adjusting for sex, age, body mass index, radiographic OA, knee pain, lateral trunk lean, foot progression angle, and mechanical axis angle, and while replacing the knee adduction moment angular impulse with other surrogate measures of knee loading. RESULTS While controlling for walking speed, we found that a lower cadence was associated with higher knee adduction moment angular impulse (standardized β = -0.396, P < 0.001), suggesting a 0.02% body weight × height × seconds (%BW × Ht × s) decrease in impulse for each step per minute increase in cadence (unstandardized β -0.020 %BW × Ht × s [95% confidence interval -0.027, -0.015]), and remained consistent after adjusting for covariates. A lower cadence was also associated with higher first (standardized β = -0.138, P = 0.010) and second peak knee adduction moment (standardized β = -0.132, P = 0.018), higher peak knee flexion moment (standardized β = -0.128, P = 0.049), and vertical ground reaction force (standardized β = -0.116, P = 0.035) in the adjusted analyses. CONCLUSION When controlling for walking speed, we found that a lower cadence is associated with higher knee loading per step in patients with medial tibiofemoral OA. Future research should investigate the potential beneficial biomechanical and clinical effects of increasing walking cadence in patients with knee OA.

The aim of this paper was to investigate the relationship between countries’ PISA study results from 2018 and a set of indices related to socio-economic inequality, such as the Gini index, human development index, or gender inequality index, along with purely economic variables, such as GDP per capita and government expenditure on education. The study covered 70 countries, consisting of 37 OECD countries and 33 non-OECD countries. Research methods included multivariate linear regression models, k-means clustering, and hierarchical clustering. Our findings revealed that the Gini index was statistically insignificant, indicating income inequality had little effect on students’ PISA performance. On the other hand, the gender inequality index was the single most statistically significant explanatory variable for both OECD and non-OECD countries. Therefore, our recommendation for policymakers is simple: increase students’ PISA performance, thus enhancing countries’ human capital and competitiveness, and focus on decreasing gender disparity and the associated loss of achievement due to gender inequality. Celem tego artykułu było zbadanie związku między wynikami badania PISA przeprowadzonego w poszczególnych krajach w 2018 r. a zestawem wskaźników związanych z nierównościami społeczno-ekonomicznymi, takimi jak indeks Giniego, wskaźnik rozwoju społecznego czy wskaźnik nierówności płci, oraz ze zmiennymi czysto ekonomicznymi, takimi jak PKB per capita i wydatki rządowe na edukację. Badaniem objęto 70 krajów, w tym 37 krajów OECD i 33 kraje spoza OECD. Metody badawcze obejmowały wielowymiarowe modele regresji liniowej, grupowanie k‑średnich i grupowanie hierarchiczne. Wyniki przeprowadzonej analizy wykazały, że wskaźnik Giniego był statystycznie nieistotny, co wskazuje, że nierówności dochodowe miały niewielki wpływ na wyniki uczniów w badaniu PISA. Z drugiej strony, wskaźnik nierówności płci był jedyną najbardziej istotną statystycznie zmienną objaśniającą zarówno dla krajów OECD, jak i spoza OECD. Dlatego nasza rekomendacja dla decydentów jest prosta: należy zwiększyć wyniki uczniów w badaniu PISA, a tym samym osiągnąć poprawę w obszarze kapitału ludzkiego i konkurencyjności krajów, oraz skupić się na zmniejszaniu nierówności płci i związanej z tym utraty osiągnięć edukacyjnych wynikających z nierówności płci.