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Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction. Reports regarding the correlation and effect size of change of the full spectrum of quality of life and disease severity measures applied in-person to patients with atopic dermatitis are scarce. Objectives. To assess quality-of-life with 3 different instruments and to evaluate disease severity indices and to determine their correlation and effect size of change between two measurements. Materials and methods. Patient-level data were obtained through two in-person visits. Sociodemographic information and data related to disease distribution, severity (through the BSA, EASI, SCORAD, POEM, and itching scales), and the impact of atopic dermatitis on quality of life using the DLQI and Skindex-29, and EQ-5D, were assessed. The correlation between change in quality-of-life scores and disease severity scores in addition to the standardized effect size were also evaluated. Results. Only 139 out of 212 patients completed the follow-up visit. BSA highly correlated with SCORAD and EASI, and the lowest correlation was found with POEM. The best correlation of pruritus VAS was found with sleep disturbance. The SCORAD score highly correlated with EASI, and the lowest correlation was found with POEM. The magnitude of the effect at initiation of the study vs follow-up was in average moderate to important. Conclusions. Patients with atopic dermatitis experience a substantial burden on quality of life. Disease activity correlates better with quality-of-life measurements when the disease is less severe after starting therapy. POEM and Skindex-29 seem to be optimal to determine disease severity and quality of life in adults with atopic dermatitis.

BackgroundOne of the most consistent research findings related to race and mental health diseases is the disproportionately high rate of psychotic disorder diagnoses among people of color, specifically people of African descent. It is important to examine if a similar pattern exists among specific psychotic disorders. We aimed to examine the racial/ethnic differences in ambulatory care visits diagnosed with schizophrenia-spectrum disorders (SSDs).MethodsWe analyzed data from the National Ambulatory Medical Care Survey (NAMCS) 2010-2015. The study sample included physician office-based visits by individuals diagnosed with SSDs, including schizophrenia, schizoaffective, and unspecified psychotic disorder (n = 1155). We used descriptive and bivariate analysis by race/ethnicity and three multinomial logistic regression models to test the association between the SSDs and race/ethnicity, adjusting for age, gender, insurance, disposition, medication Rx, and co-morbidity, considering the design and weight.ResultOf the 1155 visits for SSDs, 44.8% had schizophrenia, 37.4% had schizoaffective disorder diagnosis, and 19.0% had unspecified psychosis disorder. We found significant racial disparities in the diagnosis of SSDs. Black patients were overrepresented in all three categories: schizophrenia (24%), schizoaffective disorder (17%), and unspecified psychosis disorder (26%). Also, a notable percentage of Black patients (20%) were referred to another physician in cases of schizophrenia compared to other ethnoracial groups (p

Objective　To investigate the association between urinary thallium （TL） and nonalcoholic fatty liver disease （NAFLD). Methods　Related data were collected from the registered participants aged ≥18 years in National Health and Nutrition Examination Survey from 2017 to 2020， with th exclusion of the individuals with a lack of liver transient elastography data and urinary TL indicators and those with hepatitis B， hepatitis C or significant alcohol consumption. A total of individuals were divided into NAFLD group and non-NAFLD group. Urinary TL level was quantitatively measured using high-performance liquid chromatography-electrospray ionization-tandem mass spectrometry and online solid-phase extraction combined with isotope dilution. The two groups were compared in terms of age， sex， race， marital status， education， family income poverty impact ratio （FMPIR), body mass index（ BMI), smoking， alcohol consumption， diabetes mellitus（ DM), （HL), and urinary TL level. The independent-samples t test or the Wilcoxon rank-sum test was used for comparison of continuous data between two groups， and the chi-square test was used for comparison of categorical data between two groups. Descriptive analysis， multivariable Logistic regression， restricted cubic spline regression analysis， subgroup analysis， and interaction analysis were conducted to investigate the risk association between urinary TL and NAFLD. Results　A total of 2 511 individuals were included， with 1 612 （64.20%） in the NAFLD group and 899 （35.80%） in the non-NAFLD group， and the NAFLD group had a significantly higher urinary TL level than the non-NAFLD group ［0.18 （0.11 — 0.26）μg/L vs 0.16 （0.09 — 0.25）μg/L， Z=−2.76， P= 0.01］. After adjustment for the covariates of age， sex， race， education， marital status， FMPIR， BMI， smoking， alcohol consumption， DM， HTN， and HL， the urinary TL Q4 group had a significant increase in the risk of NAFLD （odds ratio ［OR］= 1.90， 95% confidence interval［ CI］： 1.48 — 2.44， P<0.01). There was a positive dose-response relationship（ P<0.01） and a non-linear relationship （P<0.01） between urinary TL and the risk of NAFLD. A significant interaction was observed between urinary TL and smoking/BMI （P<0.05). For individuals taking ≥100 cigarettes in their lifetime， the risk of NAFLD was increased by 50% for every quartile increase in urinary TL （OR=1.50， 95%CI： 1.24 — 1.80), and for individuals taking<100 cigarettes in their lifetime， the risk of NAFLD was increased by 20% for every quartile increase in urinary TL （OR=1.20， 95%CI： 1.03 — 1.40）； for individuals with a BMI of ≥30 kg/m2， the risk of NAFLD was increased by 30% for every quartile increase in urinary TL （OR=1.30， 95%CI： 1.05 — 1.70), with a statistical significance（ P<0.05). Conclusion　Urinary TL level is significantly associated with the risk of NAFLD.hypertension（ HTN), hyperlipidemia [ABSTRACT FROM AUTHOR]

Background/Aim. Sepsis-associated encephalopathy (SAE) is a severe complication of sepsis, characterized by brain dysfunction and associated with a poor prognosis. SAE has a complex pathogenesis, and its severity is in close association with the levels of various serum factors. The aim of the study was to investigate the correlation of tumor necrosis factor (TNF)-a, monocyte chemoattractant protein (MCP)-1, and neuron-specific enolase (NSE) levels with the severity of SAE and to analyze the prognostic values of the three parameters. Methods. This prospective study enrolled 126 patients treated for SAE from June 2020 to June 2022. The levels of TNF-α, MCP-1, and NSE were measured, and the severity of SAE was evaluated using the Sequential Organ Failure Assessment (SOFA) score. Based on the SOFA score, the patients were assigned to two groups: a group with a bad prognosis and a group with a good prognosis. The correlations of TNF-α, MCP-1, and NSE levels with the severity of SAE were analyzed, and their prognostic values were evaluated during a 28-day follow-up. Results. The mean levels of TNF-α, MCP-1, and NSE and the SOFA score of the 126 patients with SAE were 6.52 ± 1.48 pg/mL, 62.53 ± 18.49 pg/mL, 8.61 ± 2.17 ng/mL, and 10.24 ± 2.86 points, respectively. Pearson's analysis demonstrated significant correlations between TNF-α, MCP-1, and NSE levels and the SOFA score of patients with SAE (r > 0, p < 0.05). Of the 126 patients, 61 (48.4%) had a poor prognosis, while 65 (51.6%) had a good prognosis. Increased serum TNF-α, MCP-1, and NSE levels were risk factors for the poor prognosis of patients with SAE [odds ratio (OR) > 1, p < 0.05]. The areas under the receiver operating characteristic (ROC) curves of serum TNF-α, MCP-1, and NSE levels were all > 0.7, suggesting high predictive values of these parameters. Conclusion. Serum TNF-α, MCP-1, and NSE levels are closely correlated with the severity of SAE and may work as valuable predictors of treatment outcome. [ABSTRACT FROM AUTHOR]

الملخص: أهداف البحث: توجد ندرة في الأبحاث المتعلقة بجودة النوم في متلازمة الألم العضلي الليفي في السياق الهندي. تهدف الدراسة الحالية إلى وصف ملف نوم مرضى متلازمة الفيبروميالجيا الذين يعانون من قلة النوم المقيمين في مدينة بنغالور الحضرية وتحديد العلاقة بين متغيرات قلة النوم والفيبروميالجيا. طريقة البحث: تم تضمين ستة وثمانون مريضا متلازمة الألم العضلي الليفي في الدراسة. تم استخدام مؤشر جودة النوم في بيتسبرغ واستبيان تأثير الألم العضلي الليفي المنقح ، على التوالي، لتقييم متغيرات نمط النوم والفيبروميالجيا. تم استخدام ارتباط رتبة سبيرمان واختبار ''ت'' و أنوفا أحادي الاتجاه للتحليل. النتائج: تم تحديد واحد وتسعين بالمائة من مرضى متلازمة الألم العضلي الليفي على أنهم يعانون من قلة النوم. كان متوسط النتيجة العالمية لمؤشر جودة النوم في بيتسبرغ للمرضى المشمولين هو 12.04 ± 3.5. اختلفت درجة النوم العالمية حسب الجنس وشدة الألم العضلي الليفي. تم العثور على علاقة ذات دلالة إحصائية بين النتيجة العالمية لمؤشر جودة النوم في بيتسبرغ وإجمالي استبيان تأثير الألم العضلي الليفي المنقح والمجالات الفرعية لاستبيان تأثير الألم العضلي الليفي المنقح ومدة متلازمة متلازمة الألم العضلي الليفي. ترتبط النتيجة العالمية لمؤشر جودة النوم في بيتسبرغ أيضا بالألم والاكتئاب والذاكرة والقلق والتوازن والحساسية. الاستنتاجات: ينتشر اضطراب النوم بشكل كبير في مرضى متلازمة الألم العضلي الليفي المقيمين في مدينة بنغالور الحضرية. تميل جودة النوم إلى التدهور عند الإناث مع زيادة شدة متلازمة الألم العضلي الليفي ومدتها ولكنها لم تختلف عبر المتغيرات الديموغرافية الأخرى. ترتبط جودة النوم بشكل كبير بالمتغيرات الجسدية والنفسية. يمكن للدراسات المستقبلية التي تهدف إلى تقييم المتنبئين بسوء النوم أن تعزز النتائج بشكل أكبر. Abstract: Objective: A scarcity of literature exists on sleep quality in fibromyalgia syndrome (FMS) in Indian patients. The current study described the sleep profile of patients with FMS with poor sleep quality residing in urban Bangalore and determined the relationship between poor sleep and fibromyalgia variables. Methods: Eighty-six patients with FMS were included in the study. Pittsburgh Sleep Quality Index (PSQI) and Revised Fibromyalgia Impact Questionnaire (FIQR) were used to evaluate the sleep profile and fibromyalgia variables. Spearman's rank correlation, t-test, and one-way analysis of variance were used for the analyses. Results: Ninety-one percent of patients with FMS were identified as poor sleepers (PSQI >5). The mean PSQI global score of the included patients was 12.04 ± 3.5. The global sleep score varied with sex (p = 0.003) and fibromyalgia severity (p = 0.001). A significant correlation was found between PSQI global score and FIQR total score (r = 0.4, p

Background/Aim. Sepsis-associated encephalopathy (SAE) is a severe complication of sepsis, characterized by brain dysfunction and associated with a poor prognosis. SAE has a complex pathogenesis, and its severity is in close association with the levels of various serum factors. The aim of the study was to investigate the correlation of tumor necrosis factor (TNF)-α, monocyte chemoattractant protein (MCP)-1, and neuron-specific enolase (NSE) levels with the severity of SAE and to analyze the prognostic values of the three parameters. Methods. This prospective study enrolled 126 patients treated for SAE from June 2020 to June 2022. The levels of TNF-α, MCP-1, and NSE were measured, and the severity of SAE was evaluated using the Sequential Organ Failure Assessment (SOFA) score. Based on the SOFA score, the patients were assigned to two groups: a group with a bad prognosis and a group with a good prognosis. The correlations of TNF-α, MCP-1, and NSE levels with the severity of SAE were analyzed, and their prognostic values were evaluated during a 28-day follow-up. Results. The mean levels of TNF-α, MCP-1, and NSE and the SOFA score of the 126 patients with SAE were 6.52 ± 1.48 pg/mL, 62.53 ± 18.49 pg/mL, 8.61 ± 2.17 ng/mL, and 10.24 ± 2.86 points, respectively. Pearson’s analysis demonstrated significant correlations be-tween TNF-α, MCP-1, and NSE levels and the SOFA score of patients with SAE (r > 0, p < 0.05). Of the 126 patients, 61 (48.4%) had a poor prognosis, while 65 (51.6%) had a good prognosis. Increased serum TNF-α, MCP-1, and NSE levels were risk factors for the poor prognosis of patients with SAE [odds ratio (OR) > 1, p < 0.05]. The areas under the receiver operating characteristic (ROC) curves of serum TNF-α, MCP-1, and NSE levels were all > 0.7, suggesting high predictive values of these parameters. Conclusion. Serum TNF-α, MCP-1, and NSE levels are closely correlated with the severity of SAE and may work as valuable predictors of treatment outcome.

Yu-Yun Zhang,1 Wei Li,2 Yu Sheng,1 Qun Wang,3,&ast; Fang Zhao,4,&ast; Ying Wei4 1School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China; 2Department of Endocrinology, Peking Union Medical College Hospital, Beijing, People’s Republic of China; 3Endocrinology and Metabolism Department, Peking University Third Hospital, Beijing, People’s Republic of China; 4Department of Endocrinology, China-Japan Friendship Hospital, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Yu Sheng, School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 33 Badachu Road, Shijingshan District, Beijing, People’s Republic of China, Tel +86 138 1069 1298, Email shengyupumc2020@163.comPurpose: To address the prevalence of diabetes distress (DD) and its correlators in adults with type 2 diabetes.Patients and Methods: During 2021 and 2022, we conducted a cross-sectional study in three Class A tertiary comprehensive hospitals in China, and received 947 participants who completed a printed survey covering DD, demographic, diabetic, physiological, and psychosocial factors. We used Jonckheere-Terpstra, chi-square, and Fisher’s exact tests to assess intergroup differences between different levels of DD. We used ordinal logistic regression analysis to analyze correlators of DD further.Results: The prevalence of DD was 34.64%. In univariate analysis, those with lower satisfaction with financial status, longer durations of diabetes, more complications, higher glycemia, more severe insomnia, treatment by medications only, poorer lifestyle interventions, fewer self-care activities, more types and frequencies of insulin injections, and spending more money and time on treatment were susceptible to DD. Type D personality, negative illness perceptions, negative coping styles, and psychological effects of major life events were related to higher DD. Hope, self-efficacy, positive coping styles, and social support can reduce DD. In ordinal logistic regression analysis, hypoglycemic episode (β=− 1.118, p=0.019, “have hypoglycemic” as reference) and Brief Illness Perception Questionnaire (β=0.090, p< 0.001) were significant positive correlators for DD, while diet intervention (β=0.803, p=0.022, “have diet intervention” as reference), money spent on diabetes treatment (β

Copyright of Journal of Taibah University Medical Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: Intra‐articular corticosteroid injections (IACIs) can reduce osteoarthritis‐related pain, with differing levels of response across patient groups. This systematic review investigates what is known about the positive and negative predictors of outcomes in patients with osteoarthritis who undergo IACIs. Methods: We systematically searched the Medline, Embase, and Cochrane databases to May 2023 for studies that evaluated patients undergoing IACIs for osteoarthritis and reported on predictors of outcomes in these patients. Results: Eight studies were included. Two were placebo‐controlled trials, six were observational studies. Due to the heterogeneity of outcomes and variables between the studies, it was not possible to pool the results for formal meta‐analysis. Higher baseline pain, older age, higher BMI, lower range of movement, higher Kellgren‐Lawrence radiographic score, joint effusion, and aspiration were shown to be predictors of a positive response to IACIs in some of the included studies. However, other studies showed no difference in response with these variables, or a negative correlation with response. Sex, smoking, mental health status, hypertension/ischaemic heart disease, diabetes mellitus, duration of symptoms, and socioeconomic status did not demonstrate any correlation with the prediction of positive or negative outcomes after IACIs. Conclusion: Several patient features have been identified as positive predictors of outcomes following IACIs. However, this systematic review has identified inconsistent and variable findings across the existing literature. Further research with standardization of IACI administration and outcome measures is required to facilitate further analysis of the reliability and significance of predictive factors for response to IACIs. [ABSTRACT FROM AUTHOR]

Copyright of Salud Uninorte is the property of Fundacion Universidad del Norte and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To explore the association between arch morphology and sprint performance in children, utilizing arch volume and arch index to assess arch development, and comparing and analyzing its relationship with athletic capability. Methods A total of 640 primary and secondary school students (324 boys and 316 girls) aged between 7 to 15 years were recruited from Chongqing Municipality. Foot arch index and arch volume were measured by "Foot Secret 3D Foot Plantar Scanner". Performance of 50-meter sprint was assessed. The participants were stratified into 6 groups based upon gender and age: boys aged 7-9 years (n=93), girls aged 7-9 years (n=103), boys aged 10-12 years (n=116), girls aged 10-12 years (n=112), boys aged 13-15 years (n=115) and girls aged 13-15 years (n=101). The correlations between arch index, arch volume and athletic performance were examined. Results In the age group of 7-9 years, the comparisons of both the left and right foot's weight-bearing arch index and the non-weight-bearing arch index between boys and girls showed no statistical significance (P>0.05). However, except for the comparisons of the left foot's weight-bearing arch volume and non-weight-bearing arch volume in the 7-9 year-old girls group, which showed no statistical significance (P>0.05), the following comparisons indicated a weak correlation with the 50-meter sprint performance and were statistically significant(P>0.05): the left foot's weight-bearing arch volume, the left foot's non-weight-bearing arch volume, the right foot's weight-bearing arch volume, and the right foot's non-weight-bearing arch volume in the 7-9 year-old boys group (r=-0.301, r=-0.294, r=-0. 295, r=-0.207), and the right foot's weight-bearing arch volume and non-weight-bearing arch volume in the 7-9 year-old girls group (r=-0.279, r=-0.278). In the 10-12 years age group, the comparisons of the right foot's arch index-both weight-bearing and non-weight-bearing-with the 50-meter sprint performance in the 10-12 year-old girls group showed a weak correlation (r=0.250, r=0.243) and were statistically significant (P < 0.05). However, the comparisons of the left foot's weight-bearing arch index, the left foot's non-weight-bearing arch index, the right foot's weight-bearing arch index, and the right foot's non-weight-bearing arch index in both the 10-12 year-old boys and girls groups showed no statistical significance (P>0.05). Moreover, except for the left foot's weight-bearing arch volume and non-weight-bearing arch volume in the 10-12 year-old girls group, which showed no statistical significance (P>0.05), the following comparisons indicated a weak correlation with the 50-meter sprint performance and were statistically significant: the left foot's weight-bearing arch volume, the left foot's non-weight-bearing arch volume, the right foot's weight-bearing arch volume, and the right foot's non-weight-bearing arch volume in the 10-12 year-old boys group (r=-0.273, r=-0.224, r=-0.236, r=-0.273), and the right foot's weight-bearing arch volume and non-weight-bearing arch volume in the 10-12 year-old girls group (r=-0.224, r=-0.211). In the 13-15 years age group, the comparisons of the left and right foot's arch index-both weight-bearing and non-weight-bearing-in the 13-15 year-old boys and girls groups with the 50-meter sprint performance showed no statistical significance (P>0.05). However, except for the non-weight-bearing arch volumes of the left and right feet in the 13-15 year-old girls group, which showed a weak correlation with the 50-meter sprint performance (r=-0.233, r=-0.225) and were statistically significant (P < 0.05), the comparisons of the left foot's weight-bearing arch volume, the left foot's non-weight-bearing arch volume, the right foot's weight-bearing arch volume, and the right foot's non-weight-bearing arch volume in the 13-15 year-old boys group, as well as the left foot's weight-bearing arch volume and the right foot's weight-bearing arch volume in the 13-15 year-old girls group, showed no statistical significance (P>0.05). Conclusions As a three-dimensional parameter, arch volume not only accurately depicts the development of foot arch but also serves as a reliable indicator for assessing motor capabilities in children. [ABSTRACT FROM AUTHOR]

BackgroundSocial determinants of health (SDH) greatly influence outcomes during the first year of treatment in rheumatoid arthritis, a disease similar to polyarticular juvenile idiopathic arthritis (pJIA). We investigated the correlation of community poverty level and other SDH with the persistence of moderate to severe disease activity and functional disability over the first year of treatment in pJIA patients enrolled in the Childhood Arthritis and Rheumatology Research Alliance Registry.MethodsIn this cohort study, unadjusted and adjusted generalized linear mixed effects models analyzed the effect of community poverty and other SDH on disease activity, using the clinical Juvenile Arthritis Disease Activity Score-10, and disability, using the Child Health Assessment Questionnaire, measured at baseline, 6, and 12 months.ResultsOne thousand six hundred eighty-four patients were identified. High community poverty (≥20% living below the federal poverty level) was associated with increased odds of functional disability (OR 1.82, 95% CI 1.28-2.60) but was not statistically significant after adjustment (aOR 1.23, 95% CI 0.81-1.86) and was not associated with increased disease activity. Non-white race/ethnicity was associated with higher disease activity (aOR 2.48, 95% CI: 1.41-4.36). Lower self-reported household income was associated with higher disease activity and persistent functional disability. Public insurance (aOR 1.56, 95% CI 1.06-2.29) and low family education (aOR 1.89, 95% CI 1.14-3.12) was associated with persistent functional disability.ConclusionHigh community poverty level was associated with persistent functional disability in unadjusted analysis but not with persistent moderate to high disease activity. Race/ethnicity and other SDH were associated with persistent disease activity and functional disability.

BackgroundPhotoplethysmography (PPG) is a low-cost and easy-to-implement method to measure vital signs, including heart rate (HR) and pulse rate variability (PRV) which widely used as a substitute of heart rate variability (HRV). The method is used in various wearable devices. For example, Samsung smartwatches are PPG-based open-source wristbands used in remote well-being monitoring and fitness applications. However, PPG is highly susceptible to motion artifacts and environmental noise. A validation study is required to investigate the accuracy of PPG-based wearable devices in free-living conditions.ObjectiveWe evaluate the accuracy of PPG signals-collected by the Samsung Gear Sport smartwatch in free-living conditions-in terms of HR and time-domain and frequency-domain HRV parameters against a medical-grade chest electrocardiogram (ECG) monitor.MethodsWe conducted 24-hours monitoring using a Samsung Gear Sport smartwatch and a Shimmer3 ECG device. The monitoring included 28 participants (14 male and 14 female), where they engaged in their daily routines. We evaluated HR and HRV parameters during the sleep and awake time. The parameters extracted from the smartwatch were compared against the ECG reference. For the comparison, we employed the Pearson correlation coefficient, Bland-Altman plot, and linear regression methods.ResultsWe found a significantly high positive correlation between the smartwatch's and Shimmer ECG's HR, time-domain HRV, LF, and HF and a significant moderate positive correlation between the smartwatch's and shimmer ECG's LF/HF during sleep time. The mean biases of HR, time-domain HRV, and LF/HF were low, while the biases of LF and HF were moderate during sleep. The regression analysis showed low error variances of HR, AVNN, and pNN50, moderate error variances of SDNN, RMSSD, LF, and HF, and high error variances of LF/HF during sleep. During the awake time, there was a significantly high positive correlation of AVNN and a moderate positive correlation of HR, while the other parameters indicated significantly low positive correlations. RMSSD and SDNN showed low mean biases, and the other parameters had moderate mean biases. In addition, AVNN had moderate error variance while the other parameters indicated high error variances.ConclusionThe Samsung smartwatch provides acceptable HR, time-domain HRV, LF, and HF parameters during sleep time. In contrast, during the awake time, AVNN and HR show satisfactory accuracy, and the other HRV parameters have high errors.

ObjectiveTo investigate the relationship between hypotension and neurologic outcome in adults with return of spontaneous circulation after out-of-hospital cardiac arrest.MethodsBlood pressure and medication data were extracted from adult patients who had ROSC after OHCA in Alameda County and matched with neurologic outcome using the CARES database from January 1, 2018 through July 1, 2019. We used univariate logistic regression with p ≤ 0.2 followed by multivariate logistic regression and reported an odds ratio with 95% confidence intervals.ResultsAmong the 781 adult patients who had ROSC after OHCA, 107 (13.7%) were noted to be hypotensive and 61 (57% of the hypotensive group) received vasopressors. Patients with a final prehospital blood pressure recording of

PurposeNeratinib plus capecitabine (N+C) demonstrated significant progression-free survival (PFS) benefit in NALA (NCT01808573), a randomized phase III trial comparing N+C with lapatinib + capecitabine (L+C) in 621 patients with HER2-positive (HER2+) metastatic breast cancer (MBC) who had received ≥2 prior HER2-directed regimens in the metastatic setting. We evaluated correlations between exploratory biomarkers and PFS.Patients and methodsSomatic mutations were evaluated by next-generation sequencing on primary or metastatic samples. HER2 protein expression was evaluated by central IHC, H-score, and VeraTag/HERmark. p95 expression (truncated HER2) was measured by VeraTag. HRs were estimated using unstratified Cox proportional hazards models.ResultsFour hundred and twenty samples had successful sequencing: 34.0% had PIK3CA mutations and 5.5% had HER2 (ERBB2) mutations. In the combined patient populations, PIK3CA mutations trended toward shorter PFS [wild-type vs. mutant, HR = 0.81; 95% confidence interval (CI), 0.64-1.03], whereas HER2 mutations trended toward longer PFS [HR = 1.69 (95% CI, 0.97-3.29)]. Higher HER2 protein expression was associated with longer PFS [IHC 3+ vs. 2+, HR = 0.67 (0.54-0.82); H-score ≥240 versus

BackgroundWith the rapid development of artificial intelligence, prediction of warfarin dose via machine learning has received more and more attention. Since the dose prediction involve both linear and nonlinear problems, traditional machine learning algorithms are ineffective to solve such problems at one time.ObjectiveBased on the characteristics of clinical data of Chinese warfarin patients, an improved stacking ensemble learning can achieve higher prediction accuracy.MethodsInformation of 641 patients from southern China who had reached a steady state on warfarin was collected, including demographic information, medical history, genotype, and co-medication status. The dataset was randomly divided into a training set (90%) and a test set (10%). The predictive capability is evaluated on a new test set generated by stacking ensemble learning. Additional factors associated with warfarin dose were discovered by feature selection methods.ResultsA newly proposed heuristic-stacking ensemble learning performs better than traditional-stacking ensemble learning in key metrics such as accuracy of ideal dose (73.44%, 71.88%), mean absolute errors (0.11 mg/day, 0.13 mg/day), root mean square errors (0.18 mg/day, 0.20 mg/day) and R2 (0.87, 0.82).ConclusionsThe developed heuristic-stacking ensemble learning can satisfactorily predict warfarin dose with high accuracy. A relationship between hypertension, a history of severe preoperative embolism, and warfarin dose is found, which provides a useful reference for the warfarin dose administration in the future.

BackgroundPostpartum depression (PPD) is among the most common postpartum complications. Its prevalence is associated with strong regional variability. Women in rural areas of China have a high risk of PPD. The aim of this study was to investigate the PPD status of women in rural South China and explore the effects of modifiable lifestyle behaviors during pregnancy on their PPD status, thereby providing a scientific basis for the prevention and intervention of PPD in rural China.MethodsA cohort study was conducted on 261 women from four maternal health institutions situated in rural areas of Guangdong Province and the Guangxi Zhuang Autonomous Region from October 2021 to December 2022. The questionnaires were administered to these women to obtain data about sociodemographic characteristics, health literacy, physical activity during pregnancy, and sleep and dietary status during pregnancy, as well as depression status on the 42nd day after delivery. The lifestyle behaviors during pregnancy and the PPD status of the study population were analyzed. Multiple linear regression models were used to determine the correlation between lifestyle behaviors and PPD status. Path analysis was performed to explore the interaction between various lifestyle behaviors.ResultsA total of 14.6% of women had a PPD status. Women who continued to work during pregnancy had an Edinburgh Postpartum Depression Scale (EPDS) score of 1.386 points higher than that of women who did not (В = 1.386, β = 0.141, p = 0.029). For every 1-point increase in the infant feeding-related knowledge score and pregnancy diet diversity score, the EPDS score decreased by 0.188 and 0.484 points, respectively, and for every 1-point increase in the Pittsburgh sleep quality index score, the EPDS score increased by 0.288 points. Age was related to infant feeding-related knowledge (indirect path coefficient = 0.023). During pregnancy, sedentary time was correlated with sleep quality (indirect path coefficient = 0.031) and employment status (indirect path coefficient = 0.043).ConclusionEmployment status, infant feeding-related knowledge, sleep quality, and diet diversity during pregnancy directly influenced the PPD status, while age and sedentary time during pregnancy indirectly influenced the PPD status. Promoting healthy lifestyle behaviors, including reducing sedentary time, improving sleep quality, and increasing dietary diversity, may be effective in reducing PPD occurrence.

The objective if this study was to determine the relation that exists between the predominant tendency of the learning style, according to the Felder-Silverman model, and partial and final academic performance of the students attending the subject Morphology and Function I. A transversal study was carried out among 231 college students who joined the Faculties of Health and Education during the first term of 2019. They received the Index of Learning Styles Questionnaire and it was correlated with the mark of the theoretical test n°1, the practical evaluation n° 1 and the final average of the course. Results showed that 53.4 % of the total numbers of students assessed are visual, for these pupils the Spearman correlation coefficient was -0.378 for the theoretical test (p<0.001), -0.467 for the practical evaluation (p<0.001) and -0.500 for the final average (p<0.001). Visual students have higher average marks in the theoretical test and the final average contrasted with the active ones (p<0.05). We concluded that the predominant tendency is the visual style. For these students there is an inverted and statistically significant correlation with the academic performance. Besides, they show significantly higher average marks than the other tendencies. [ABSTRACT FROM AUTHOR]

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Background: Stress is an inevitable and important part of being a medical student. Present study explores perceived stress among undergraduate medical students and the correlation of stress with learning strategies and academic performance. Method: This descriptive cross-sectional study was carried out at Medical College Kolkata, India. The target population was undergraduate medical students from phase II and III. Participants’ learning strategies was measured using the modified Approaches to Learning Medicine (mALM) questionnaire. The stress level of the students was determined by Perceived stress Scale (PSS 10). Academic performance was measured in terms of percentages scored in the last MBBS examination. Data were analysed using SPSS version 21. Frequencies and percentages were calculated for categorical variables and measures of central tendency and dispersion was calculated for continuous variables. Differences of mean were tested by independent samples t-test. Correlation was tested by Pearson correlation test. Results: There were 136 students enrolled in the study; and 129 (94.8%) students scored above 60% in their last MBBS examination. Mean PSS score of the participants was 19.4± 4.17. One hundred and twenty-three (90.4%) students were found to have moderate stress. Deep learning approach was significantly more for MBBS Phase III students (p=0.003). However, perceived stress had no significant correlation with either learning strategy (p=0.916) or academic performance of students (p=0.309). Conclusion: Perceived stress was found to be high among undergraduate medical students in the present study. However, any particular learning style or academic performance was not found to be associated with stress. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to investigate the association between ankle torque and performance-based tests, self-reported pain, and physical function in patients with knee osteoarthritis (OA). Patients and methods: The cross-sectional study was conducted with 39 individuals (24 females, 15 males; mean age: 57.3±6.2 years; range, 40 to 65 years) with knee OA between January 2014 and July 2015. Ankle torque was determined using an isokinetic dynamometer. The 40-m fast-paced walk test and a stair climb test were used to assess functional performance. Self-reported pain and physical function were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Pearson's correlation coefficients were calculated to test correlations between the dependent variables (40-m fast-paced walk test, stair climb test, WOMAC pain and physical function domains, sex, age, body mass index, and radiologic evidence of OA) and the independent variables (mean plantar flexor torque and dorsiflexor peak torque). A multiple linear regression analysis was applied to quantify the association between the dependent and independent variables. Results: Dorsiflexor and plantar flexor peak torques in the concentric and eccentric modes were negatively correlated with the 40-m fast-paced walk and stair climb tests (r=-0.33 to -0.51, p=0.05). A negative correlation was found between concentric plantar flexor torque and the WOMAC physical function score (r=-0.35, p=0.03). No correlation was found between ankle torques and the WOMAC pain score (p>0.05). The multiple linear regression analysis showed that the eccentric plantar flexor and dorsiflexor torques were significantly associated with the stair climb test (β=-0.001, 95% confidence interval [CI]: -0.001 to 0.000, p=0.03, and β=-0.002, 95% CI: -0.004 to 0.000, p=0.05, respectively). No significant associations were found between concentric plantar flexor and dorsiflexor torques and the stair climb test (p>0.05). No significant associations were found between the ankle torques and the 40-m fast-paced walk test and WOMAC physical function (p>0.05). Conclusion: Ankle torque plays an important role in functional performance. Thus, ankle torque deficit, especially eccentric plantar flexor and dorsiflexor torques, may exert a negative influence on stair climbing performance in patients with knee osteoarthritis. [ABSTRACT FROM AUTHOR]

Objective To explore the correlation between preoperative inflammation parameters and severity of acute appendicitis (AA) in children. Methods From January 2017 to April 2021, 149 hospitalized AA children undergoing laparoscopic appendectomy were recruited as research subjects. According to the postoperative pathological results, they were assigned into two groups of uncomplicated appendicitis (n=28) and complicated appendicitis (n=121). The latter group included 85 cases of purulent appendicitis and 36 cases of gangrene appendicitis. Univariate analysis was performed for comparing the inter-group differences of baseline profiles and preoperative inflammatory parameters. Binary Logistic regression analysis was performed for determining the independent risk factors of complicated appendicitis. Finally receiver operating characteristic (ROC) curve was plotted for evaluating the diagnostic value of inflammatory parameters for complicated appendicitis. Results In the preoperative uncomplicated appendicitis group and complicated appendicitis group, The number and proportion of fever cases or not was respectively[8 cases (28.6%) and 20 cases (71.4%)]vs.[66 cases (54.5%) and 55 cases (45.5%)], white blood cell count (WBC) (10.95±5.50)vs.(15.81±5.12)×109/L, neutrophil count percentage (NEUT%) (67.49±16.97)vs.(82.84±7.99)%, C-reactive protein (CRP) was (17.77±26.06) vs.(83.84±68.47)mg/L, CRP/ALB (albumin, ALB) were (0.61±1.13) vs.(1.97±1.78), prealbumin (PAB) (189.61±50.91)vs.(152.93±57.92)mg/L, and all above these difference was significant statistical (P<0.05). Preoperative NEUT% (OR=1.096, 95%CI: 1.027~1.170) and CRP(OR=1.045, 95%CI: 1.006~1.085) were independent risk factors for complicated appendicitis (P<0.05). The areas under the curve of NRUT% and CRP were 0.801 and 0.839, respectively (P<0.05). The critical preoperative NEUT% and CRP values for complex appendicitis were 77.75% and 28.27 mg/L respectively. The critical CRP value of 28.27mg/L was converted into a binary variable, and the calculated relative risk was 1.659 (95%CI: 1.321-2.083). Conclusion Preoperative levels of NEUT% and CRP are valuable for predicting complicated appendicitis in children. When NEUT%≥77.75% or CRP≥28.27 mg/L occurs preoperatively, preoperative diagnosis of complicated appendicitis is more likely in AA children. Surgery should be promptly performed. [ABSTRACT FROM AUTHOR]

ContextIn preclinical studies, high androgen levels during pregnancy are associated with low birth weight and rapid postnatal weight gain in the offspring. However, human data linking prenatal androgens with birth weight and early life weight gain in the offspring are scarce.DesignWe evaluated 516 mother-child pairs enrolled in the New England birth cohorts of the Collaborative Perinatal Project (1959-1966). We assayed androgen bioactivity in maternal sera during third-trimester using a receptor-mediated luciferase expression bioassay. Age and sex-specific BMI Z-scores (BMIz), defined using established standards, were assessed at birth, 4 months, 1 year, 4 years, and 7 years. We used linear mixed models to evaluate the relation of maternal androgens with childhood BMIz overall and by sex. We examined the association of maternal androgens with fetal growth restriction. The association of weight trajectories with maternal androgens was examined using multinomial logistic regression.ResultsHigher maternal androgen levels associated with lower BMIz at birth (β = - 0.39, 95% CI: - 0.73, - 0.06); this relation was sex-dependent, such that maternal androgens significantly associated with BMIz at birth in girls alone (β = - 0.72, 95% CI: - 1.40, - 0.04). The relation of maternal androgens with fetal growth restriction revealed dose threshold effects that differed by sex. There was no significant association between maternal androgens and weight trajectory overall. However, we found a significant sex interaction (p = 0.01); higher maternal androgen levels associated with accelerated catch-up growth in boys (aOR = 2.14, 95% CI: 1.14, 4.03).ConclusionOur findings provide evidence that maternal androgens may have differential effects on the programming of intrauterine growth and postnatal weight gain depending on fetal sex.

BackgroundThe large-scale social distancing efforts to reduce SARS-CoV-2 transmission have dramatically changed human behaviors associated with traumatic injuries. Trauma centers have reported decreases in trauma volume, paralleled by changes in injury mechanisms. We aimed to quantify changes in trauma epidemiology at an urban Level I trauma center in a county that instituted one of the earliest shelter-in-place orders to inform trauma care during future pandemic responses.MethodsA single-center interrupted time-series analysis was performed to identify associations of shelter-in-place with trauma volume, injury mechanisms, and patient demographics in San Francisco, California. To control for short-term trends in trauma epidemiology, weekly level data were analyzed 6 months before shelter-in-place. To control for long-term trends, monthly level data were analyzed 5 years before shelter-in-place.ResultsTrauma volume decreased by 50% in the week following shelter-in-place (p < 0.01), followed by a linear increase each successive week (p < 0.01). Despite this, trauma volume for each month (March-June 2020) remained lower compared with corresponding months for all previous 5 years (2015-2019). Pediatric trauma volume showed similar trends with initial decreases (p = 0.02) followed by steady increases (p = 0.05). Reductions in trauma volumes were due entirely to changes in nonviolent injury mechanisms, while violence-related injury mechanisms remained unchanged (p < 0.01).ConclusionAlthough the shelter-in-place order was associated with an overall decline in trauma volume, violence-related injuries persisted. Delineating and addressing underlying factors driving persistent violence-related injuries during shelter-in-place orders should be a focus of public health efforts in preparation for future pandemic responses.Level of evidenceEpidemiological study, level III.

BackgroundReduced cortical sensorimotor inhibition is associated with mobility and cognitive impairments in people with Parkinson's disease (PD) and older adults (OAs). However, there is a lack of clarity regarding the relationships among sensorimotor, cognitive, and mobility impairments. The purpose of this study was to determine how cortical sensorimotor inhibition relates to impairments in mobility and cognition in people with PD and OAs.MethodCortical sensorimotor inhibition was characterized with short-latency afferent inhibition (SAI) in 81 people with PD and 69 OAs. Six inertial sensors recorded single- and dual-task gait and postural sway characteristics during a 2-minute walk and a 1-minute quiet stance. Cognition was assessed across the memory, visuospatial, executive function, attention, and language domains.ResultsSAI was significantly impaired in the PD compared to the OA group. The PD group preformed significantly worse across all gait and postural sway tasks. In PD, SAI significantly correlated with single-task foot strike angle and stride length variability, sway area, and jerkiness of sway in the coronal and sagittal planes. In OAs, SAI significantly related to single-task gait speed and stride length, dual-task stride length, and immediate recall (memory domain). No relationship among mobility, cognition, and SAI was observed.ConclusionsImpaired SAI related to slower gait in OA and to increased gait variability and postural sway in people with PD, all of which have been shown to be related to increased fall risk.

Background There are numerous patients with diabetes complicated with heart failure. Dapagliflozin is a new hypoglycemic drug that has been used for heart failure according to guideline recommendation, however, its mechanism of improving heart function has not been fully defined. Objective To study the effects of dapagliflozin on the expression of plasma miRNA-423-5p and cardiac function in patients with type 2 diabetes mellitus (T2DM) and chronic heart failure (CHF) . Methods Fifty patients with T2DM complicated with CHF admitted to the 960th Hospital of PLA from April 1 to November 30, 2021 were enrolled and randomly divided into dapagliflozin group (n=25) and control group (n=25) . Both groups received the same treatment for six months except that dapagliflozin group received dapagliflozin 10 mg/d per day, and the control group received other hypoglycemic drugs. They were compared to healthy physical examinees with normal cardiac function (healthy group, n=25) . Basic data of the patients were collected through the electronic medical record system, including age, sex, smoking history, hypertension, blood pressure level, body mass index (BMI) , blood lipid, blood glucose, creatinine (Cr) , amino-terminal pro-B-type natriuretic peptide precursor (NT-proBNP) , alanine aminotransferase (ALT) , aspartate aminotransferase (AST) , NYHA class, results of cardiac color ultrasound and drug combination. Blood samples were collected for the detection of miRNA-423-5p. A six-month follow-up was given to the patients with the time of first administration of dapagliflozin after inclusion as the starting point, during which patients' cardiac function indices and miRNA-423-5p were measured and collected at the end of four weeks of treatment, and their cardiac function indices, blood pressure level, ALT, AST, and Cr were measured at six months of treatment. Pearson correlation analysis or Spearman rank correlation analysis was used to analyze the correlation between miRNA-423-5p expression level and cardiac function indices of the patients. Results After 6 months of intervention, left ventricular ejection fraction (LVEF) , stroke output (SV) and left ventricular short-axis shortening rate (LVFS) in daglizin group were higher than those in control group, while left ventricular end-diastolic diameter (LVEDD) was lower than those in control group (P

Background: The International Classification of Functioning, Disability and Health (ICF) model, created by the World Health Organization, provides a theoretical framework that can be applied in the diagnosis and treatment of various disorders. Objects: Our research purposed to ascertain the relationship between structure/function, activity, and participation domain variables of the ICF and pain, pain-associated disability, activities of daily living (ADL), and quality of life in patients with chronic low back pain (LBP). Methods: Two-hundred patients with chronic LBP (mean age: 35.5 ± 8.8 years, females, n = 40) were recruited from hospital and community settings. We evaluated the body structure/ function domain variable using the Numeric Pain Rating Scale (NPRS) and Roland–Morris disability (RMD) questionnaire. To evaluate the activity domain variable, we used the Oswestry Disability Index (ODI) and Quebec Back Pain Disability Scale (QBDS). For clinical outcome measures, we used Short-form 12 (SF-12). Pearson’s correlation coefficient was used to ascertain the relationships among the variables (p < 0.05). All the participants with LBP received 30 minutes of conventional physical therapy 3 days/week for 4 weeks. Results: There were significant correlations between the body structure/function domain (NPRS and RMD questionnaire), activity domain (ODI and QBDS), and participation domain variables (SF-12), rending from pre-intervention (r = –0.723 to 0.783) and postintervention (r = –0.742 to 0.757, p < 0.05). Conclusion: The identification of a significant difference between these domain variables point to important relationships between pain, disability, performance of ADL, and quality in participants with LBP.

Abstract Background The assessment of gastric content and volume using bedside ultrasound (US) has become a useful tool in emergency departments, anesthesiology departments and inpatient wards, as it provides a rapid and dynamic assessment of the gastric content of patients, which, allows making decisions regarding the risk of regurgitation or the need to adjust the strategy used to induce general anesthesia in patients with a full stomach. This assessment consists of two evaluations: a qualitative one, in which the status of the antrum, in terms of gastric content, is classified into three categories (empty, liquid content and full), and a quantitative one, where gastric volume is estimated. The objective of this study was to estimate the intra-observer and inter-observer agreement in ultrasound assessment of gastric content and volume in critically ill patients receiving enteral nutrition. Results A total of 41 patients were included and each examiner performed 64 gastric US (n = 128). Participants’ average age was 56.5 years (SD ± 12.6) and 63.4% were men. Regarding the qualitative evaluation of the antrum, in supine position both examiners classified the gastric content as grade 0 in 1 gastric US (1.5%), grade 1 in 4 gastric US (6.2%) and grade 2 in 59 (92.1%). Regarding intra-observer variability in the measurement of the area of the antrum, Lin's concordance correlation coefficient (CCC), the difference of means between measurements and the 95% limits of agreement of Bland and Altman values were 0.95 (95% CI 0.940–0.977), − 0.47 cm2 (SD ± 1.64) and − 3.70 cm2 to 2.75 cm2, respectively, in EC1, and 0.94 (95% CI 0.922–0.973), − 0.18 cm2 (SD ± 2.18) and − 4.47 cm2 to 4.09 cm2 in EC2. Concerning to inter-observer variability (EC1 vs EC2) in the measurement of the area of the antrum and of gastric volume, the following CCC, mean difference between measurements and 95% limits of agreement of Bland and Altman values were obtained: measurement of the area of the antrum: 0.84 (95% CI 0.778–0.911), − 0.86 cm2 (SD ± 3.38) and − 7.50 cm2 to 5.78 cm2; gastric volume measurement: 0.84 (95% CI 0.782–0.913), − 12.3 mL (SD ± 49.2) and − 108.8 mL to 84.0 mL. Conclusions The assessment of gastric content and volume using bedside US in critically ill patients on mechanical ventilation and receiving enteral nutrition showed a good intra and inter-rater reliability. Most of the patients included in the study had a high risk of pulmonary aspiration, since, according to the results of the gastric US evaluation, they had gastric volumes > 1.5 mL/kg.

Background/objectivesChronic kidney disease (CKD) is associated with frailty. Fibroblast growth factor 23 (FGF23) is elevated in CKD and associated with frailty among non-CKD older adults and individuals with human immunodeficiency virus. Whether FGF23 is associated with frailty and falls in CKD is unknown.DesignCross-sectional and longitudinal observational study.SettingSystolic Blood Pressure Intervention Trial (SPRINT), a randomized trial evaluating standard (systolic blood pressure [SBP]

BackgroundCystatin C is a well-validated marker of glomerular filtration rate in chronic kidney disease. Higher plasma concentrations of cystatin C are associated with worse clinical outcomes in heterogenous populations of critically ill patients and may be superior to creatinine in identifying kidney injury in critically ill patients. We hypothesized that elevated levels of plasma cystatin C in patients with acute respiratory distress syndrome (ARDS) would be associated with mortality risk.MethodsIn a retrospective study, cystatin C was measured by nephelometry on plasma obtained at enrollment from 919 patients in the Fluid and Catheter Treatment Trial. Multivariable logistic regression was performed testing the association between quartiles of cystatin C and 60-day mortality. Analyses were stratified by acute kidney injury (AKI) status identified in the first 7 days after enrollment by Kidney Disease: Improving Global Outcomes (KDIGO) criteria.ResultsCystatin C was significantly higher among those patients who died compared to those who survived to 60 days [1.2 (0.9-1.9) mg/L vs. 0.8 (0.6-1.2) mg/L, p

Background: Stress is an inevitable and important part of being a medical student. Present study explores perceived stress among undergraduate medical students and the correlation of stress with learning strategies and academic performance.Method: This descriptive cross-sectional study was carried out at Medical College Kolkata, India. The target population was undergraduate medical students from phase II and III. Participants’ learning strategies was measured using the modified Approaches to Learning Medicine (mALM) questionnaire. The stress level of the students was determined by Perceived stress Scale (PSS 10). Academic performance was measured in terms of percentages scored in the last MBBS examination. Data were analysed using SPSS version 21. Frequencies and percentages were calculated for categorical variables and measures of central tendency and dispersion was calculated for continuous variables. Differences of mean were tested by independent samples t-test. Correlation was tested by Pearson correlation test.Results: There were 136 students enrolled in the study; and 129 (94.8%) students scored above 60% in their last MBBS examination. Mean PSS score of the participants was 19.4± 4.17. One hundred and twenty-three (90.4%) students were found to have moderate stress. Deep learning approach was significantly more for MBBS Phase III students (p=0.003). However, perceived stress had no significant correlation with either learning strategy (p=0.916) or academic performance of students (p=0.309).Conclusion: Perceived stress was found to be high among undergraduate medical students in the present study. However, any particular learning style or academic performance was not found to be associated with stress.

Objective To explore the influencing factors for the results of ASQ-3 age and developmental process questionnaire in children with nonsyndromic craniosynostosis ( NSC) after surgery. Methods The relevant clinical data were retrospectively reviewed for 68 hospitalized NSC children from June 2016 to June 2022. ASQ-3 questionnaire was employed for assessing the five capability domains of communication, gross motor, fine motor, problem-solving and personal-social after craniosuture reconstruction skull remodeling. Operative age, gender, disease type, assessment age, postoperative fever, educational level of parents and major caregivers and questionnaire assessments were collected. The influencing factors of ASQ-3 questionnaire were examined. Results The results of 68 ASQ-3 questionnaire were evaluated. The detection rates of poor capability in communication, gross motor, fine motor, problem-solving and individual-social domains were 23. 5% ( 16/68), 35. 3% (24/68),32. 4% (22/68), 35. 3% (24/68) and 26. 5% (18/68) respectively. And 39 children ( 39/ 68,57. 4%) had normal development and 29 children ( 29/68, 42. 6%) poor development. Inter-group differences existed in assessment age, postoperative fever or not and paternal and primary caregiver education ( P < 0. 05). Multi-factorial Logistic regression analysis indicated that higher assessment age (OR= 0. 896, 95% CI: 0. 843 -0. 953) and postoperative fever ( OR =0. 173, 95% C/:0. 029 -0. 645) were the protective factors of normal postoperative development according to the results of ASQ-3 ( P < 0. 05). Conclusion NSC children undergoing craniosuture reconstruction and skull remodeling have varying degrees of poor capability in five functional domains based upon ASQ-3 questionnaire. Higher assessment age and postoperative fever are the protective factors of normal postoperative development. [ABSTRACT FROM AUTHOR]

Determining the walking ability of post-stroke patients is crucial for the design of rehabilitation programs and the correct functional information to give to patients and their caregivers at their return home after a neurorehabilitation program. We aimed to assess the convergent validity of three different walking tests: the Functional Ambulation Category (FAC) test, the 10-m walking test (10MeWT) and the 6-minute walking test (6MWT). Eighty walking participants with stroke (34 F, age 64.54 ± 13.02 years) were classified according to the FAC score. Gait speed evaluation was performed with 10MeWT and 6MWT. The cut-off values for FAC and walking tests were calculated using a receiver-operating characteristic (ROC) curve. Area under the curve (AUC) and Youden's index were used to find the cut-off value. Statistical differences were found in all FAC subgroups with respect to walking speed on short and long distances, and in the Rivermead Mobility Index and Barthel Index. Mid-level precision (AUC > 0.7; p < 0.05) was detected in the walking speed with respect to FAC score (III vs. IV and IV vs. V). The confusion matrix and the accuracy analysis showed that the most sensitive test was the 10MeWT, with cut-off values of 0.59 m/s and 1.02 m/s. Walking speed cut-offs of 0.59 and 1.02 m/s were assessed with the 10MeWT and can be used in FAC classification in patients with subacute stroke between the subgroups able to walk with supervision and independently on uniform and non-uniform surfaces. Moreover, the overlapping walking speed registered with the two tests, the 10MeWT showed a better accuracy to drive FAC classification. [ABSTRACT FROM AUTHOR]

The process of platelet aggregation is often influenced by several factors including sex and age. A literature review confirmed the existence of sex-related differences in platelet aggregation. Although 68 out of 78 papers found such differences, there are still some controversies regarding these differences, which can be due to multiple factors (age, trigger, concomitant disease, sample handling, etc.). These outcomes are discussed in line with novel results obtained from a local study, in which blood samples from a total of 53 overall healthy women and men with ages ranging from 20 to 66 years were collected. Aggregation was induced with seven different triggers (ristocetin, thrombin receptor activating peptide 6 [TRAP-6], arachidonic acid [AA], platelet-activating factor 16 [PAF-16], ADP, collagen, or thromboxane A 2 analog U-46619) ex vivo. In addition, three FDA-approved antiplatelet drugs (vorapaxar, ticagrelor, or acetylsalicylic acid [ASA]) were also tested. In general, women had higher aggregation responses to some agonists (ADP, TRAP), as well as lower benefit from inhibitors (ASA, vorapaxar). The aggregatory responses to AA and TRAP decreased with age in both sexes, while responses to ADP, U-46619, and PAF were affected by age only in women. In conclusion, more studies are needed to decipher the biological importance of sex-related differences in platelet aggregation in part to enable personalized antiplatelet treatment. [ABSTRACT FROM AUTHOR]

PurposeWe evaluated and identified baseline factors associated with change in health related quality of life among patients with interstitial cystitis/bladder pain syndrome and chronic prostatitis/chronic pelvic pain syndrome.Materials and methodsA total of 191 men and 233 women with interstitial cystitis/bladder pain syndrome or chronic prostatitis/chronic pelvic pain syndrome (collectively referred to as urologic chronic pelvic pain syndrome) were followed for 12 months with bimonthly completion of the Short Form 12 to assess general mental and physical health related quality of life, and with biweekly assessment of condition specific health related quality of life using the Genitourinary Pain Index. A functional clustering algorithm was used to classify participants as improved, stable or worsened for each health related quality of life measure. Ordinal logistic regression was used to determine baseline factors associated with change.ResultsPhysical health related quality of life improved in 22% of the participants, mental health related quality of life improved in 25% and condition specific health related quality of life improved in 47%. Better baseline physical health related quality of life, older age and the presence of nonurological symptoms were associated with lower likelihood of improvement in physical health related quality of life. Better baseline mental health related quality of life, female sex, and greater baseline depression and stress were associated with a lower likelihood of improvement in mental health related quality of life. Better baseline condition specific health related quality of life and more severe baseline urologic chronic pelvic pain syndrome pain symptoms were associated with a lower likelihood of improvement in condition specific health related quality of life.ConclusionsWhile several nonurologic chronic pelvic pain syndrome factors influenced the trajectory of general health related quality of life over time, only condition specific baseline health related quality of life and urologic chronic pelvic pain syndrome symptoms were associated with urologic chronic pelvic pain syndrome specific health related quality of life change. Significant differences in how urologic chronic pelvic pain syndrome impacts various aspects of health related quality of life suggest a multidisciplinary approach to assessment and treatment of these patients.

This cross-sectional study assesses the association between blood donation and willingness to register as an organ donor among California high school students.

Uromodulin is released into serum (sUMOD) and urine (uUMOD) exclusively by renal tubular cells. Both sUMOD and uUMOD are correlated with estimated glomerular filtration rate (eGFR), and associated with mortality and cardiovascular disease (CVD). However, no study to our knowledge has measured both sUMOD and uUMOD in the same population, thus the relationship of sUMOD with uUMOD with one another, and their respective correlates have not been evaluated simultaneously. We evaluated the correlations of sUMOD, uUMOD with eGFR in a random sub-cohort (n = 933) of the Cardiovascular Health Study and their associations with demographic and laboratory parameters and CVD risk factors using multi-variable linear regression analysis. The mean age of the cohort was 78 years, 40% were male and 15% were Black. The mean sUMOD level was 127 ng/mL, uUMOD was 30 500 ng/mL and eGFR was 63 mL/min/1.73 m2 . Correlation between sUMOD and uUMOD, adjusted for eGFR was moderate (r = 0.27 [95% confidence interval = 0.21-0.33]). The correlation of eGFR with sUMOD (r = 0.44 [0.39-0.49]) was stronger than with uUMOD (r = 0.21 [0.15-0.27]). In multi-variable analysis adjusting sUMOD for uUMOD and vice versa, sUMOD was independently associated with eGFR (β = 1.3 [1.1-1.6]), log2 C-reactive protein (β = -4.2 [-6.8 to -1.6]) and male sex (β = -13.6 [-22.7 to -4.5]). In contrast, male sex was associated with higher uUMOD (β = 3700 [400-7000]), while diabetes (β = -6400 [-10 600 to -2100]) and hypertension (-4300 [-7500 to -1100]) were associated with lower uUMOD levels. We conclude that sUMOD is more strongly associated with eGFR compared with uUMOD. Correlates of sUMOD and uUMOD differ substantially, suggesting that apical and basolateral secretion may be differentially regulated.

ObjectiveTo determine whether maternal cardiovascular disease (CVD) risk factors predict preterm birth.DesignCase control.SettingCalifornia hospitals.Participants868 mothers with linked demographic information and biospecimens who delivered singleton births from July 2009 to December 2010.MethodsLogistic regression analysis was employed to calculate odds ratios for the associations between maternal CVD risk factors before and during pregnancy (including diabetes, hypertensive disorders and cholesterol levels) and preterm birth outcomes.Primary outcomePreterm delivery status.ResultsAdjusting for the other maternal CVD risk factors of interest, all categories of hypertension led to increased odds of preterm birth, with the strongest magnitude observed in the pre-eclampsia group (adjusted OR (aOR), 13.49; 95% CI 6.01 to 30.27 for preterm birth; aOR, 10.62; 95% CI 4.58 to 24.60 for late preterm birth; aOR, 17.98; 95% CI 7.55 to 42.82 for early preterm birth) and chronic hypertension alone for early preterm birth (aOR, 4.58; 95% CI 1.40 to 15.05). Diabetes (types 1 and 2 and gestational) was also associated with threefold increased risk for preterm birth (aOR, 3.06; 95% CI 1.12 to 8.41). A significant and linear dose response was found between total and low-density lipoprotein (LDL) cholesterol and aORs for late and early preterm birth, with increasing cholesterol values associated with increased risk (likelihood χ2 differences of 8.422 and 8.019 for total cholesterol for late and early, and 9.169 and 10.896 for LDL for late and early, respectively). Receiver operating characteristic curves using these risk factors to predict late and early preterm birth produced C statistics of 0.601 and 0.686.ConclusionTraditional CVD risk factors are significantly associated with an increased risk of preterm birth; these findings reinforce the clinical importance of integrating obstetric and cardiovascular risk assessment across the healthcare continuum in women.

BackgroundThe relationship between 25-hydroxyvitamin D (25-OH-vitamin D) and COPD outcomes remains unclear. Using the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS), we determined associations among baseline 25-OH-vitamin D and cross-sectional and longitudinal lung function and COPD exacerbations.MethodsSerum 25-OH-vitamin D level was measured in stored samples from 1,609 SPIROMICS participants with COPD. 25-OH-vitamin D levels were modeled continuously and dichotomized as deficient (< 20 ng/mL) vs not deficient (≥ 20 ng/mL). Outcomes of interest included % predicted FEV1 (current and 1-year longitudinal decline) and COPD exacerbations (separately any and severe, occurring in prior year and first year of follow-up).ResultsVitamin D deficiency was present in 21% of the cohort and was more prevalent in the younger, active smokers, and blacks. Vitamin D deficiency was independently associated with lower % predicted FEV1 (by 4.11%) at enrollment (95% CI, -6.90% to -1.34% predicted FEV1; P = .004), 1.27% predicted greater rate of FEV1 decline after 1 year (95% CI, -2.32% to -0.22% predicted/y; P = .02), and higher odds of any COPD exacerbation in the prior year (OR, 1.32; 95% CI, 1.00-1.74; P = .049). Each 10-ng/mL decrease in 25-OH-vitamin D was associated with lower baseline lung function (-1.04% predicted; 95% CI, -1.96% to -0.12% predicted; P = .03) and increased odds of any exacerbation in the year before enrollment (OR, 1.11; 95% CI, 1.01-1.22; P = .04).ConclusionsVitamin D deficiency is associated with worse cross-sectional and longitudinal lung function and increased odds of prior COPD exacerbations. These findings identify 25-OH-vitamin D levels as a potentially useful marker of adverse COPD-related outcomes.

OBJECTIVE. The purpose of this study is to describe postoperative MRI findings after femoroacetabular impingement surgery in correlation with pain changes and surgical findings. SUBJECTS AND METHODS. We prospectively enrolled 42 patients (43 hips) who were scheduled for FAI surgery. Pre- and postoperative MR images were obtained using a 3-T MRI system. Changes in pain scores were assessed using the hip dysfunction and osteoarthritis outcome score. MR images were evaluated for the presence of acetabuloplasty or femoroplasty, presence of chondral and labral repair surgery, bone marrow edema, subchondral cysts, chondral defects, labral tears, capsular defects, and effusion. The optimal orientation to detect these changes was noted. Imaging findings were compared with pain score changes using linear regression analysis. Sensitivity and specificity were assessed using surgical correlation as the reference standard. RESULTS. Increased acetabular bony débridement length was associated with decreased improvement in pain scores (coefficient, -2.07; 95% CI, -3.53 to -0.62; p = 0.008), whereas other imaging findings were not significantly different. Femoroplasty and capsular alterations were best detected on oblique axial sequences; acetabuloplasty and cartilage and labral repair were best seen on sagittal sequences. MRI showed excellent sensitivity (100%) and specificity (100%) for detecting labral repair and excellent sensitivity for detecting femoroplasty (98%). Sensitivity and specificity were lower for detecting acetabuloplasty (83% and 80%, respectively) and chondral repair (75% and 54%, respectively). CONCLUSION. Arthroscopic acetabuloplasty showed a greater association with postoperative pain than did other aspects of surgical correction for femoroacetabular impingement. Femoroplasty and labral repair were reliably diagnosed on 3-T MRI; however, limitations were found in the evaluation of acetabular chondral repair.

BackgroundMortality in patients with end-stage renal disease (ESRD) on maintenance hemodialysis (MHD) remains exceptionally high. While traditional risk factors such as obesity are paradoxically associated with better survival, nontraditional risk factors including cachexia increase the likelihood of poor outcomes. There is accumulating evidence that the endocannabinoid (ECB) system plays a major role in energy preservation and storage, factors which can prevent the deleterious effects of cachexia. Hence, in this study, we evaluated the association of circulating ECB levels with mortality in MHD patients.MethodsSerum concentrations of anandamide (AEA) and 2-arachidonoyl-sn-glycerol (2-AG), major ECB ligands, were measured in MHD patients. Their correlation with various clinical/laboratory indices and association with 12-month all-cause mortality were examined.ResultsSerum 2-AG levels positively correlated with body mass index, serum triglycerides and body anthropometric measures. Meanwhile, serum AEA levels correlated positively with serum interleukin-6, and negatively with serum very low-density lipoprotein levels. While increased serum 2-AG levels were associated with reduced risk of all-cause mortality (hazard ratio [HR] 0.52, 95% CI 0.28-0.98), there was no clear association between serum AEA levels and mortality (HR 0.91, 95% CI 0.48-1.72).ConclusionsIn MHD patients, the circulating levels of ECB ligand, 2-AG, may play an important role in determining body mass and risk of mortality. These observations were unique to 2-AG as similar findings were not obtained with serum AEA. Future studies need to investigate the mechanisms responsible for these associations and examine the modulation of the ECB system as a potential target for therapy in ESRD.

Abstract Background It has been shown that stimulation of innate immunity may provide temporary protection against a variety of infectious diseases. Malaria has been shown to induce a robust innate immune response. This study was conducted to test the hypothesis that if the cumulative number of cases diagnosed with COVID-19 per 100,000 population was correlated with the prevalence of malaria in African countries where both malaria and COVID-19 were prevalent. Methods In this ecological study, the cumulative incidence of COVID-19 and the prevalence of malaria were compared in 53 African countries. A negative binomial regression analysis with the cumulative incidence of COVID-19 as the dependent variable, and the human development index (HDI) and the prevalence of malaria, as independent variables, were used. Results The mean cumulative incidence of COVID-19 was 522 cases per 100,000. Each 0.1 unit increase in HDI was associated with 2.4-fold (95% confidence interval 1.8–3.1) increase in the cumulative incidence of COVID-19. Prevalence of malaria was also independently associated with the cumulative incidence; each 10% increase in the prevalence was associated with 28% (10–41%) decrease in the cumulative incidence of COVID-19. Conclusions Malaria might protect people against SARS-CoV-2 through the stimulation of innate immunity. Stimulation of the innate immune system could be the first line of defense in the pandemic preparedness arsenal.

Background/Aim. The decreased mouth opening (MO) is a key factor in diagnosing most oral health-related issues. The aim of the study was to assess the magnitude of the maximum mouth opening (MMO) and its correlation with the facial types of children in the southern part of Saudi Arabia. Methods. A cross-sectional study was conducted in a group of 555 children ranging from 2 to 12 years of age. The MMO was measured as the distance between the incisal edge of maxillary and mandibular central incisors in the midline using the digital Vernier caliper. Three readings of MMO value were obtained, and the average mean of these readings was taken as the final MMO value. Based on the calculated facial index (FI), five facial types were determined in the study subjects: hypereuryprosopic (very broad face, FI range ≤ 79.9); euryprosopic (broad face, FI range 80– 84.9); mesoprosopic (round face, FI range 85–89.9); leptoprosopic (long face, FI range 90–94.9); hyperleptoprosopic (very l ong f ace, F I range ≥ 95). Subjects were categorized and compared accordingly. The facial profile, height, weight, and body mass index (BMI) of each subject were recorded as well. The data hence obtained was subjected to statistical analysis using SPSS (version 19.0, SPSS Incorporated, Chicago, IL, USA). Results. The overall mean value ± standard deviation of MMO for all the subjects in the study was 47.3 ± 8.7 mm. The mean value of MMO in hyperleptoprosopic children (FI range ≥ 95.0) was significantly higher than in other children. The mean difference value of MO in mesoprosopic (FI range 85.0–89.9) children was significantly lower than in leptoprosopic (FI range 90.0– 94.9) and hyperleptoprosopic (FI range ≥ 95.0) children. The mean difference value of MO of the leptoprosopic (FI range 90.0–94.9) type was significantly lower than that of the hyperleptoprosopic type (FI range ≥ 95.0). Conclusion. Based on the analyzed results, it was found that the MMO correlates with different facial types and facial profiles among the studied population.

BACKGROUND: In accordance with the requirements of the IAEA basic safety standards and the International Commission on Radiation Protection, comparing the radiation dose for patients undergoing computed tomography (CT) in diagnostic and treatment clinics with national or international DRLs is important for controlling medical radiation doses. The search for ways to improve DRLs calculations determines the relevance of such studies. AIM: To analyze the dependence of effective doses (EDs) in CT of different body parts on patients weight and to calculate the standard ED for the patient (70 and 80 kg). MATERIALS AND METHODS: CT acquisition protocols in 209 patients were single phase (SP) CT, while 114 patients underwent multi-phase (MP) CT. ED was calculated according to the normalized coefficients for each body area. The values of standard ED was calculated by data approximation using linear function of ED relatively body weight for each type CT scanner and body area scanned. RESULTS: The increase in ED following a CT examination was proportional to the body weight of patients. For SP and MP CT scans, the standard EDs were calculated according to all body areas. The mean ED, median ED, and DRLs (mSv) in these groups was slightly higher than standard ED (mSv) if the criterion was 70 kg and were close to standard ED if the criterion was 80 kg. These values give a basis for improving the guidelines concerning the recommended limits of radiation doses for CT in individual patients according to indications and body parts studied. CONCLUSIONS: In the study, a methodology for assessing and comparing the dose of CT-radiation at two hospitals in the two CT scanners, considering weight of a standard patient, is described. Our results show that the calculation and analysis of the standard ED of CT-examining areas of the body instead of mean ED and median ED help to compare the radiation exposure in different medical facilities more properly. Given the recent sharp increase in the number of CT studies, not exceeding the standard ED for patients with CT will reduce the long-term consequences in the form of oncological pathology among the population.

Objective Ankle fractures are often combined with syndesmotic instability, requiring reduction and stabilization. However, the optimal level for syndesmotic screw positioning remains unclear. This study aims to evaluate the effect of different syndesmotic screw insertion levels on postoperative clinical outcomes and determine whether an optimal level exists. Methods This retrospective study included data from 43 adult patients with acute closed ankle fractures combined with intraoperative evidence of unstable syndesmotic injuries who underwent open reduction internal fixation from January 1, 2017 to March 1, 2018 according to the inclusion and exclusion criteria. All 43 patients were divided into three groups based on the syndesmotic screw placement level: trans‐syndesmotic group: screw level of 2–3 cm; inferior‐syndesmotic group: screw level 3 cm. Clinical outcomes were measured at the final follow‐up, including the American Orthopedic Foot and Ankle Society (AOFAS) ankle‐hindfoot score, Olerud–Molander Ankle Score (OMAS), short‐form 36‐item questionnaire (SF‐36), visual analogue scale (VAS) score and restrictions in ankle range of motion (ROM). The relationships between screw placement level and clinical outcomes were analyzed with the Kruskal–Wallis H‐test and Spearman correlation analysis. Results The median follow‐up duration was 15 months (range, 10–22 months). No patients developed fracture nonunion or malunion or experienced hardware failure. The outcome scoring systems showed an overall score for the entire group of 94.91 points for the AOFAS ankle‐hindfoot score, 83.14 for the OMAS, 96.65 for the SF‐36, 1.77 for the VAS, 9.14° for the restrictions in dorsiflexion, and 1.30° for the restrictions in plantarflexion. There were no significant differences among three groups in clinical outcomes (P > 0.05). Neither the AOFAS score nor OMAS had significant correlations with screw insertion level (P = 0.825 and P = 0.585, respectively). No postoperative arthritis or widening of the tibiofibular space was observed at the final follow‐up. Conclusion Different syndesmotic screw placement levels appear not to affect the clinical outcomes of ankle fractures with syndesmotic instability. No optimal level was observed in this study. Our findings suggest other clinically acceptable options apart from syndesmotic screw placement 2–3 cm above the ankle.

BackgroundAlthough homelessness and opioid overdose are major public health issues in the U.S., evidence is limited as to whether homelessness is associated with an increased risk of opioid overdose.ObjectiveTo compare opioid-related outcomes between homeless versus housed individuals in low-income communities.Design, setting, and participantsCross-sectional analysis of individuals who had at least one ED visit or hospitalization in four states (Florida, Maryland, Massachusetts, and New York) in 2014.MeasurementsRisk of opioid overdose and opioid-related ED visits/hospital admissions were compared between homeless versus low-income housed individuals, adjusting for patient characteristics and hospital-specific fixed effects (effectively comparing homeless versus low-income housed individuals treated at the same hospital). We also examined whether risk of opioid-related outcomes varied by patients' sex and race/ethnicity.ResultsA total of 96,099 homeless and 2,869,230 low-income housed individuals were analyzed. Homeless individuals had significantly higher risk of opioid overdose (adjusted risk, 1.8% for homeless vs. 0.3% for low-income housed individuals; adjusted risk difference [aRD], +1.5%; 95%CI, +1.0% to +2.0%; p

Background Colorectal cancer is a common tumor, and surgery is still one of the main treatment methods. Nowadays the research on surgical treatment of colorectal cancer is very mature, but that of predicting the possibilities of postoperative complications from preoperative and intraoperative status is scarce. Objective To investigate the predictive value of POSSUM system and aCCI index in postoperative complications after radical resection of colorectal cancer. Methods Retrospective analysis was performed on the clinical data of 118 patients performed colorectal cancer operation in the First Hospital of Hebei Medical University from June 2016 to September 2020. They were divided into complication group (n=42) and non-complication group (n=76) according to the incidence of postoperative complications. Spearman rank correlation was used to explore the relationship between postoperative complications after radical resection of colorectal cancer and clinical indicators. ROC curve was used to evaluate the predictive value of POSSUM system and aCCI index. Results R1, R2, aCCI levels and blood loss in the complication group were higher than those in the non-complication group, while Z and preoperative Hb levels were lower than those in the non-complication group (P

Background We investigated how quiz activities can improve summative assessment outcomes by analyzing the relationship between them. Methods We used 217 first-year medical students’ medical informatics data from 3 consecutive years. We analyzed summative assessment outcomes between quiz completion and incompletion groups, one-time and multiple-time quiz learning groups, and three combined comparisons between subgroups of quiz learning activity frequencies: 1 versus 2, 3, 4, and 6 (group 1), 1 and 2 versus 3, 4, and 6 (group 2), and 1, 2, and 3 versus 4 and 6 (group 3). We then analyzed correlations between the final quiz scores and summative assessment outcomes. Results The summative assessment means for students who completed quizzes and those who did not were 87.16±8.73 and 83.22±8.31, respectively (p=0.001). The means for the one-time and multiple-time quiz learning groups were 86.54±8.94 and 88.71±8.10, respectively (p=0.223). The means for combined subgroups were not significantly different between groups (p>0.05), although a statistically significant increasing trend was found from groups 1 to 3 (0.223>0.203>0.075 using the t-test and 0.225>0.150>0.067 using the Mann-Whitney test, respectively). Summative assessment scores were not significantly correlated with quiz scores (r=0.115, p=0.213). Conclusions Quizzes helped students who used self-directed learning obtain better summative assessment outcomes. Formative quizzes presumably did not provide students with direct knowledge, but showed them their weak points and motivated them to work on areas where their knowledge was insufficient.

Background: The assessment of gastric content and volume using bedside ultrasound (US) has become a useful tool in emergency departments, anesthesiology departments and inpatient wards, as it provides a rapid and dynamic assessment of the gastric content of patients, which, allows making decisions regarding the risk of regurgitation or the need to adjust the strategy used to induce general anesthesia in patients with a full stomach. This assessment consists of two evaluations: a qualitative one, in which the status of the antrum, in terms of gastric content, is classified into three categories (empty, liquid content and full), and a quantitative one, where gastric volume is estimated. The objective of this study was to estimate the intra-observer and inter-observer agreement in ultrasound assessment of gastric content and volume in critically ill patients receiving enteral nutrition. Results: A total of 41 patients were included and each examiner performed 64 gastric US (n = 128). Participants' average age was 56.5 years (SD ± 12.6) and 63.4% were men. Regarding the qualitative evaluation of the antrum, in supine position both examiners classified the gastric content as grade 0 in 1 gastric US (1.5%), grade 1 in 4 gastric US (6.2%) and grade 2 in 59 (92.1%). Regarding intra-observer variability in the measurement of the area of the antrum, Lin's concordance correlation coefficient (CCC), the difference of means between measurements and the 95% limits of agreement of Bland and Altman values were 0.95 (95% CI 0.940–0.977), − 0.47 cm2 (SD ± 1.64) and − 3.70 cm2 to 2.75 cm2, respectively, in EC1, and 0.94 (95% CI 0.922–0.973), − 0.18 cm2 (SD ± 2.18) and − 4.47 cm2 to 4.09 cm2 in EC2. Concerning to inter-observer variability (EC1 vs EC2) in the measurement of the area of the antrum and of gastric volume, the following CCC, mean difference between measurements and 95% limits of agreement of Bland and Altman values were obtained: measurement of the area of the antrum: 0.84 (95% CI 0.778–0.911), − 0.86 cm2 (SD ± 3.38) and − 7.50 cm2 to 5.78 cm2; gastric volume measurement: 0.84 (95% CI 0.782–0.913), − 12.3 mL (SD ± 49.2) and − 108.8 mL to 84.0 mL. Conclusions: The assessment of gastric content and volume using bedside US in critically ill patients on mechanical ventilation and receiving enteral nutrition showed a good intra and inter-rater reliability. Most of the patients included in the study had a high risk of pulmonary aspiration, since, according to the results of the gastric US evaluation, they had gastric volumes > 1.5 mL/kg. [ABSTRACT FROM AUTHOR]