Baseline Plasma Metabotype Correlates With Direct-Acting Antiviral Therapy Nonresponse for HCV in HIV–HCV Coinfected Patients

Introduction: With the advent of direct-acting antiviral (DAA) therapy for HCV, the cure is achieved at similar rates among HIV–HCV coinfected patients as in HCV mono-infected patients. The present study evaluates host plasma metabolites as putative indicators in predicting the treatment response in baseline HIV–HCV patients.Methods: Non-cirrhotic HIV–HCV (N = 43) coinfected patients were treated with sofosbuvir and daclatasvir for 12 weeks. Plasma metabolite profiling of pre- and post-therapy was analyzed in 20/43 patients. Of the 20 selected, 10 (50%) attained the sustained viral response [(SVR) (responders)] as defined by the absence of HCV RNA at 12 weeks after the treatment, and 10 (50%) did not attain the cure for HCV (nonresponders).Results: A total of 563 features were annotated (metabolomic/spectral databases). Before therapy, 39 metabolites differentiated (FC ±1.5, p < 0.05) nonresponders from responders. Of these, 20 upregulated and 19 downregulated were associated with tryptophan metabolism, nicotinamide metabolism, and others. Post therapy, 62 plasma metabolites (12 upregulated and 50 downregulated, FC±1.5, p < 0.05) differentiated nonresponders from responders and highlighted a significant increase in the steroid and histidine metabolism and significant decrease in tryptophan metabolism and ascorbate and pyruvate metabolism in the nonresponders. Based on random forest and multivariate linear regression analysis, the baseline level of N-acetylspermidine (FC > 2, AUC = 0.940, Bfactor = −0.267) and 2-acetolactate (FC > 2, AUC = 0.880, Bfactor = −0.713) significantly differentiated between nonresponders from responders in HIV–HCV coinfected patients and was able to predict the failure of treatment response.Conclusion: Increased baseline levels of N-acetylspermidine and 2-acetolactate levels are associated with the likeliness of failure to attain the cure for HCV in HIV–HCV coinfected patients.

Real-world effectiveness of liraglutide versus dulaglutide in Japanese patients with type 2 diabetes: a retrospective study

Real-world data comparing the effectiveness of various glucagon-like peptide 1 receptor agonists (GLP-1 RAs) in type 2 diabetes mellitus (T2DM) are limited. We investigated the clinical effectiveness of liraglutide and dulaglutide in Japanese T2DM in a real-world setting. This retrospective study included 179 patients with T2DM who were treated with GLP-1 RA for at least 12 months (liraglutide, n = 97; dulaglutide, n = 82). We used stabilized propensity score-based inverse probability of treatment weighting (IPTW) to reduce selection bias and confounding by observed covariates. Changes in glycated hemoglobin (HbA1c) at the end of the 12-month treatment were evaluated. After adjustment by stabilized propensity score-based IPTW, no significant differences were observed in patient characteristics between the liraglutide and dulaglutide groups. HbA1c was significantly lower at 12 months in both groups (liraglutide, 8.9 to 7.4%; dulaglutide, 8.7 to 7.5%). Multivariate linear regression analysis showed no differences in the extent of changes in HbA1c at 12 months between the two agents. High baseline HbA1c, the addition of GLP-1 RA treatment modality, and in-hospital initiation of GLP-1 RA treatment were identified as significant contributing factors to HbA1c reduction. The effects of liraglutide and dulaglutide on lowering HbA1c levels at 12 months were comparable in a real-world setting.

Factors associated with response to compression-based physical therapy for secondary lower limb lymphedema after gynecologic cancer treatment: a multicenter retrospective study

Background Lower limb lymphedema (LLL) is one of the most refractory and debilitating complications related to gynecological cancer treatment. We investigated factors associated with response to compression-based physical therapy (CPT) for secondary LLL after gynecologic cancer treatment. Methods We performed a multicenter retrospective study using the records of seven medical institutions from 2002 and 2014. Patients who developed LLL after gynecological cancer treatment were included. Limb volumes were calculated from the lengths of the limb circumferences at four points. All participants underwent compression-based physical therapy for LLL. Factors, including MLD, indicative of circumference reductions in LLL were determined. Results In total, 1,034 LLL met the required criteria of for the study. A multivariate linear regression analysis identified age; body mass index (BMI); endometrial cancer; radiotherapy; and initial limb circumference as significant independent prognostic factors related to improvement in LLL. In analysis of covariance for improvement in LLL adjusted by the initial limb circumference and stratified by BMI and radiotherapy, patients with BMI 28 kg/m2 or higher and receiving radiation rarely responded to CPT. Conclusions Improvements in the lower limb circumference correlated with clinical histories and physical characteristics, which may be used as independent prognostic factors for successful CPT for LLL after gynecological cancer treatment.

Relationship Between 18F-fluorodeoxyglucose Uptake on Positron Emission Tomography and Aortic Calcification

IntroductionAlthough 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) has been widely utilized to assess the extent of inflammation, the association between the extent and severity of atherosclerosis and 18F-FDG uptake on PET remains unexamined. The current study aimed to investigate whether aortic calcium (AC) scores were associated with increased aortic uptake of 18F-FDG on PET.MethodsA total of 167 consecutive patients with suspected lung cancer but unproven malignancy who underwent non-contrast-enhanced computed tomography (CT) and 18F-FDG PET/CT were enrolled. The average standardized uptake values in the ascending aorta was used to calculate the target-to-background ratio (Mean TBR). The total (thoracic and abdominal) AC scores were measured on non-contrast-enhanced chest and abdominal CT using the Agatston method, and were categorized into three groups (0, 1–399, and ≥400). The relationship between total AC scores and 18F-FDG uptake in the ascending aorta was assessed using multivariate linear regression analysis. ResultsIn total, 68.26% were male, and a mean age was 67.10±14.70 years. Mean TBR values increased progressively with total AC score 0, 1–399, and ≥400 (1.01±0.07, 1.08±0.09, and 1.11±0.11, respectively; p<0.00001). Multivariate linear regression analysis revealed that increased total AC scores of 1–399 (β=0.06, 95% CI: 0.01–0.11, p=0.02) and ≥400 (β=0.11, 95% CI: 0.06–0.16, p<0.001) were significantly associated with higher Mean TBR. ConclusionsThe current study demonstrated that total AC scores were associated with Mean TBR. Patients with a greater extent and severity of aortic calcifications may possess increased atherosclerotic inflammatory activity as measured by 18F-FDG PET/CT.

Adherence to COVID-19 Preventive Measures among Dental Care Workers in Vietnam: An Online Cross-Sectional Survey

An online cross-sectional survey using a “snowball” sampling method was carried out to assess the adherence to COVID-19 preventive measures among dental care workers (DCWs) during the pandemic. Six questions concerning the COVID-19 preventive guidelines issued by the Vietnam Ministry of Health were used to evaluate DCWs’ adherence to preventive measures at dental care clinics. The quality of life of DCWs was assessed using the WHO-5 questionnaire and was defined as low if the total score was less than 13 points. Factors relating to adherence to COVID-19 prevention measures of DCWs were determined by multivariate linear regression analysis. In total, 514 DCWs completed the questionnaire. A total of 37% DCWs rated their quality of life as low. Regression analysis suggested that older age, a better quality of life, living in an urban area, and training on COVID-19 prevention were associated with better adherence to COVID-19 preventive measures, while being a dentist and lack of personal protective equipment was associated with less adherence to COVID-19 preventive measures. The pandemic had a significant negative impact on the physical and mental health of DCWs. Therefore, specific national guidelines for the prevention and control of the spread of COVID-19 in dental facilities should be issued.

Professional Ethics Relationship with Patient’s Rights Charter Observance among Nurses and Midwives

Introduction: Respect for patients’ rights and observance of professional ethics standards improves medical services that will have an essential role in promoting patients’ health. Objective: This study aimed to determine the relationship between awareness of patient’s rights charter and professional ethics with patient’s rights charter observance. Materials and Methods: This analytical correlational study was performed on 285 staff members (196 nurses and 85 midwives) working in 2 hospitals affiliated to Alborz University of Medical Sciences, Iran, and 2 social security hospitals. They were selected using a stratified random sampling method. The study data were collected using the sociodemographic characteristics questionnaire, awareness and observance of the patient’s rights, and professional ethics charter questionnaires. Descriptive statistics and inferential statistics, including the independent t-test, Pearson correlation, Chi-square tests, and multivariate linear regression, were used for data analysis. Results: The Mean±SD ages of nurses and midwives were 36.2±8.3 and 37.5±7.9 years, respectively. The results also showed an association of professional ethics and awareness of patient’s rights charter with patient’s rights charter observance in both nurses (P=0.0001) and midwives (P=0.0001). Based on multivariate linear regression analysis, there were relationships between gender (B=-0.3; 95%CI; -2.0, 2.0; P=0.000), work experience (B=-0.6; 95%CI; -4.0, 3.0; P=0.000), marital and employment status (B=-3.2; 95%CI; -6.0, -0.0; P=0.045), in nurses and between job position (B=9.5; 95%CI; 5.4, 13.5; P=0.000), interest to work (B=-7.9; 95%CI; -11.5, -4.3; P=0.000), and income status (B=6.3; 95%CI; 3.3, 9.2; P=0.000), in midwives with Observance of the Charter of Patient Rights. Conclusion: It is possible to improve compliance with the charter of patient’s rights and its dimensions by strengthening the knowledge of nurses and midwives in this area and their professional ethics, which results in patient satisfaction in this area.

Evaluation of the B/F Ratio Distribution of Cataract Patients Without Corneal Abnormalities and Its Effect on Ocular Parameters

Purpose: To evaluate the distribution of the posterior-anterior corneal radius ratio (B/F ratio; posterior corneal radius/anterior corneal radius) in patients without corneal abnormalities, and to investigate which parameters affect this ratio. Methods: Five thousand eyes from 5,000 patients who underwent cataract surgery were recruited to this study. We explored the linear relationship between B/F ratio and 13 variables using Principal Component-Multivariate Linear Regression Analysis. Results: The B/F ratio was negatively correlated with the difference between simulated keratometry (SimK) and true net power (TNP), central corneal thickness, spherical aberration (SA), and posterior corneal astigmatism and positively correlated with posterior corneal radius, corneal posterior surface, axial length (AL) and anterior corneal radius. Several variables (central corneal thickness, difference between SimK and TNP and asphericity coefficient (Q-value) of the posterior corneal surface) had the highest loading on the final score. B/F ratio reflects the refractive state and anatomical structure of the cornea: thus, higher B/F ratios were associated with larger posterior corneal surface curvature radius, longer axial length, thinner central corneal thickness, lower high order aberrations of the cornea and SA, and the numerical difference between simK and TNP gradually reduced. In clinical practice, for patients with lower B/F ratio, special care should be taken in the choice of system used for intraocular lens (IOL) measurements.

The Effect of Heat Shocks and Freezing–Thawing Cycles on the Mechanical Properties of Natural Building Stones

The damage to rock masses due to the action of freezing is one of the most important factors in the development of landscapes, the performance of civil structures, and the efficiency of mining operations. In this research paper, the effect has been studied on the physical and mechanical performance of seven different natural building rock samples. The testing program included an experimental study on both dry and saturated intact rock samples and therefore, the effect of saturation on the extent of damage on the tested samples has been discussed as well. Based on the obtained results, freezing–thawing cycles increase the porosity of rock samples and decrease the values of P-wave velocity, uniaxial compressive strength, elastic modulus, and Brazilian tensile strength. Moreover, the behavior of different rock types differs to some extent when exposed to weathering cycles under dry and saturated conditions. A multivariate linear regression analysis was used to predict the changes in the physical and mechanical properties of different rock types. It was been shown that with some cautions, the obtained correlations can be generalized for practical cases and can be used to predict the change of rock physical and mechanical properties during the lifetime of rock engineering projects. Such predictions have a high potential of applicability in quite different types of natural stone applications in cold climates. From the stability of structures created in rock materials to the durability of structures created by different natural stones.

Correlation between FA and ADC, number and length of the periprostatic neurovascular fibers

Purpose: Our aim was to explore the relation between FA and ADC, number and length of the periprostatic neurovascular fibers (PNF) by means of 1.5 T Diffusion Tensor Imaging (DTI) imaging through a multivariate linear regression analysis model. Methods: For this retrospective study, 56 patients (mean age 63.5 years), who underwent 1.5-T prostate MRI, including DTI, were enrolled between October 2014 and December 2018. Multivariate regression analysis was performed to evaluate the statistically significant correlation between FA values (dependent variable) and ADC, the number and the length of PNF (independent variables), if p-value <0.05. A value of 0.5 indicated poor agreement; 0.5–0.75, moderate agreement; 0.75–0.9, good agreement; 0.61–0.80, good agreement; and 0.9–1.00, excellent agreement. Results: The overall fit of the multivariate regression model was excellent, with R2 value of 0.9445 ( R2 adjusted 0.9412; p < 0.0001). Multivariate linear regression analysis showed a statistically significant correlation ( p < 0.05) for all the three independent variables. The r partial value was −0.9612 for ADC values ( p < 0.0001), suggesting a strong negative correlation, 0.4317 for the number of fiber tracts ( p < 0.001), suggesting a moderate positive correlation, and −0.306 for the length of the fiber tracts ( p < 0.05), suggesting a weak negative correlation. Conclusions: Our multivariate linear regression model has demonstrated a statistically significant correlation between FA values of PNF with other DTI parameters, in particular with ADC.

A cross-sectional study on the tea consumption effects of ankle–brachial index

Objectives This thesis aims to explore the relationship between tea consumption and ankle–brachial index (ABI) and further studies the relationship between tea consumption and lower extremity atherosclerosis. Methods This is a cross-sectional, epidemiological survey of 17,373 subjects selected from the staff of Kailuan Group who had come to Kailuan General Hospital for a health examination from January 2016 to December 2017. Tea consumption was obtained by questionnaires. ABI was measured using an automated analyzer. The other data, such as age, gender, body mass index (BMI), and so on, was collected on the same day of the health examination results. The relationship between tea drinking habits and ABI was studied using logistic regression and multivariate linear regression analysis. Results Among the 17,373 analyzed subjects, the difference in age, gender, BMI, heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), uric acid (UA), C-reactive protein (CRP), fasting blood-glucose (Fbg), and ABI was statistically significant in the tea-drinking group and the nontea-drinking group ( p < 0.05). Multiple logistic regression models revealed that tea consumption was a positive predictor for ABI (odds ratio (OR) = 0.782, confidence interval (CI), 0.615–0.994) ( p < 0.05). Multivariate linear regression analysis of the ABI value showed that frequent tea-drinking has a positive correlation with the ABI value ( p < 0.05). Conclusions The higher tea consumption is significantly associated with higher ABI which means less risk for lower extremity atherosclerosis.