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Effect of carbon black exposure on respiratory function and symptoms.

Carbon black is a widely used pigment and filler. Some, but not all, previous studies have suggested an effect of long-term exposure upon the lungs. Carbon black production facility employees (1755) participated in the third round of the industry-wide medical surveillance testing. They were employed in 22 North American plants. Spirometry and a systematically administered questionnaire were included in the year 2000 round of the industry-wide medical surveillance program. Industrial hygiene data from an industry-wide survey in 2000-2001, as well as all available exposure assessment data collected since 1979, were integrated with process questionnaires and exposure rating questionnaires completed by plant personnel. Analyses included multiple linear regression and categorical data analyses. Multiple regression analyses showed statistically significant, consistent relationships between cumulative exposure and small reductions in forced expiratory volume in 1 second (FEV1) but not with other spirometry parameters. The estimated slopes were -2 mL FEV1 per mg-year/m3 of cumulative 'total' dust exposure and -0.7 mL FEV1 per mg-year/m3 of cumulative exposure for the inhalable fraction. In addition, heavy cumulative exposures were associated with a small increase in chronic bronchitis in nonsmokers. Recent exposures, typically much lower than in the past, were not demonstrated to be associated with these effects. Consistent with good occupational hygiene practice for any contaminant, workplace exposures to carbon black should be controlled to lowest practical levels.

Adult↗

[Relationship between methicillin resistant Staphylococcus aureus from inpatients and parenteral antibiotics].

We examined the relationship between clinical isolates from inpatients, mainly methicillin resistance Staphylococcus aureus (MRSA), and usage of parenteral antibiotics in Yamagata University Hospital and comparison of the relationship of the previous decade and the present. The first period was from 1988 to 1990 in a row, and the second period was from 1998 to 2000 in a row. In the first period, third generation cephems were used much and usage of antibiotics was shifted from latamoxef to flomoxef. Isolations of MRSA were decreased. In the second period, the third generation cephems decreased, cefazolin and the forth generation cephems increased. And also decrease in usage of penicillins was observed. Isolations of MRSA were increased. For further examination of these relation, we studied by statistical analysis the number of MRSA patients and usage of antibiotics per month in the second period. MRSA patients showed positive correlation with cephems and carbapenems, negative correlation with penicillins. In major antibiotics MRSA patients showed positive correlation with cefazolin, negative correlation with piperacillin. In multiple linear regression analysis, MRSA patients calculated multiple regression model including cefazolin. In conclusion, it was suggested that cefazolin related with MRSA. It has been estimated that cefazolin were administered before the appearance of MRSA. It is a possibility that cefazolin related with the appearance or fixation of MRSA.

Anti-Bacterial Agents↗

Bronchial responsiveness and five-year FEV1 decline: a study in miners and nonminers.

Increased nonspecific bronchial responsiveness (NSBR) may be a risk factor for the development of chronic airflow obstruction. We evaluated this hypothesis in a cohort of 378 underground coal miners and working nonminers. Methacholine testing was performed at the beginning and end of a 5-yr study period. Spirometry was repeated at 6-mo intervals and individual 5-yr FEV1 slopes were calculated by linear regression. Relationships between FEV1 slopes and NSBR were examined using multiple linear regression models, controlling for FEV1 level, smoking, and mining. Increasing NSBR at the initial survey was associated with a somewhat greater rate of subsequent FEV1 decline. Methacholine responders at the final survey had a considerably increased rate of decline during the previous years. Responsiveness status changed over the 5 yr in 22% of the subjects. Both the development and persistence of increased NSBR were strongly associated with higher rates of FEV1 decline. In contrast, FEV1 declines were not accelerated among workers with increased NSBR that reverted to normal. Smoking and mining were both independently associated with FEV1 declines, but did not substantially modify the effect of NSBR. Due to its variability over time, NSBR testing predicts lung function decline only in some individuals, and its value as a prognostic test for chronic airway disorders is limited. Because improvement in bronchial hyperresponsiveness was associated with a reduction in the rate of FEV1 loss, interventions directed at preventing or reducing nonspecific airway hyperresponsiveness should be investigated.

Adult↗

Comparison of methods for calculating serum osmolality: multivariate linear regression analysis.

BACKGROUND: There are several methods for calculating serum osmolality, and their accordance with measured osmolality is the subject of controversy. METHODS: The concentrations of sodium, potassium, glucose, blood urea nitrogen (BUN) and osmolalities of 210 serum samples were measured. Two empirical equations were deduced for the calculation of serum osmolality by regression analysis of the data. To choose the best equation, chemical concentrations were also used to calculate osmolalities according to our formulas and 16 different equations were taken from the literature and compared with the measured osmolalities. Correlation and linear regression analyses were performed using Excel and SPSS software. RESULTS: Multiple linear regression analysis showed that serum concentrations of sodium (beta = 0.778, p< or = 0.000), BUN (beta = 0.315, p < or = 0.000), glucose (beta = 0.0.089, p < or = 0.007) and potassium (beta = 0.109, p < or = 0.008) are strong predictors of serum osmolality. The data were also analyzed by manual linear regression to yield the equations: osmolality = 1.897[Na + ]+glucose+BUN+13.5, and osmolality = 1.90[Na+ + K+]+glucose+BUN+5.0. The osmotic coefficient for sodium and potassium solutes was deduced to be 0.949 from the slope of the curves of measured osmolality vs. [Na+] and [Na+ + K+], respectively. The inclusion of a BUN value in the equation for osmolality increased the correlation coefficient by approximately 450% and decreased the SD of difference by approximately 35% (p < or = 0.002). Inclusion of the osmotic coefficient for sodium solutes caused an underestimation of measured osmolality and positive osmolal gap unless an appropriate coefficient, constant value and/or the potassium value were included in the equation. The agreement was not improved when molal chemical concentrations were used instead of molar values. The formula presented by Dorwart and Chalmers gave inferior results to those obtained with our formulas. CONCLUSIONS: Our data suggest use of the Worthley et al. formula Osm = 2[Na +]+glucose+BUN for rapid mental calculation and the formulas of Bhagat et al. or ours for calculation of serum osmolality by equipment linked to a computer.

Blood Glucose↗

A mathematical analysis of various factors involved in transmission of bancroftian filariasis in Pondicherry.

The variation of clumping factor in microfilaraemia among different age groups was observed in Pondicherry for 1981 and 1986. The clumping factor was minimum in the age group 0-5 yr and it was maximum in 16-20 yr group in 1981 and 21-25 yr in 1986. The variation in clumping factor resembled the changes in microfilaria (mf) rate. Multiple linear regression analysis showed that the multiple correlation between mf rate and the other parameters i.e., median microfilarial density (MFD50), clumping factor in human population, and, infection rate and infectivity rate in vector population was highly significant. The relationship between filariometric indices in human host and vector population may provide the basis on which a mathematical model on transmission of filariasis could be developed.

Adolescent↗

Polysomnography vs self-reported measures in patients with sleep apnea.

BACKGROUND: While obstructive sleep apnea syndrome is defined by both polysomnographic (PSG) abnormalities and symptoms, severity is quantified primarily by the apnea-hypopnea index (AHI) alone. OBJECTIVE: To determine the correlation between standard PSG indices (AHI and others) and self-reported sleepiness, mental health status, and general health in patients with sleep apnea. DESIGN: Cross-sectional study. SETTING: University-affiliated outpatient sleep laboratory. PATIENTS: Ninety-six consecutive patients with PSG-confirmed sleep apnea (AHI >or=5). MEASUREMENTS: Patients completed a questionnaire that included the Epworth Sleepiness Scale, Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) mental health domain, and self-rated health on the evening of diagnostic PSG. Spearman correlation coefficients were computed. This sample had 85% power to detect a correlation of 0.3 or greater. The associations between PSG indices and self-reported measures were further assessed with multivariable regression techniques, adjusting for age, sex, body mass index, comorbidity, and PSG type. RESULTS: The PSG parameters correlated poorly with self-reported measures (15 correlations; range of magnitude, 0.004-0.24; mean, 0.09). AHI was not associated with self-reported sleepiness or general health, and it was associated with the SF-36 Health Status mental health domain only on multiple linear regression (P =.04) but not on multiple logistic regression (adjusted odds ratio, 1.02; 95% confidence interval, 1.00-1.04; P =.09). CONCLUSIONS: In general, PSG measures, and AHI in particular, correlated poorly with self-reported measures in a clinical sleep laboratory sample. After adjustment for potentially confounding variables, weak associations were found between some PSG indices and selected self-reported measures. These findings suggest that sleep apnea disease burden should be quantified with both physiologic and subjective measures.

Adolescent↗

The transfer between instruments of a reflectance near-infrared assay for paracetamol in intact tablets.

This study compares several correction methods to facilitate the transfer of a validated near-infrared (NIR) assay for paracetamol in intact tablets between two reflectance NIR instruments of the same type. Transfer was defined as the ability to accurately predict the true assay value of a sample measured on a NIR system using an assay developed on a different system, and was assessed using a comprehensive set of statistical tests. Direct electronic transfer of the calibration models, representing the NIR assay, was not possible as a result of a definite residual spectrum between instruments. The use of a correction method based on the standardisation of the material used to record the reference spectrum also proved ineffective. Two methods investigated did succeed, the first employed a response surface calculated between the reflectance values of a set of six certified photometric standards measured on both instruments, with all full range partial least square (PLS) regression models subsequently transferred. The next was correction of the spectra from the second instrument utilising the residual spectrum between the mean sample of the validation set measured on both instruments. Through this approach all PLS regression models and also a single multiple linear regression (MLR) model were transferred. As an outcome of this study guidelines are suggested for the transfer of NIR assays along with the criteria deemed necessary to conclusively prove transfer and justify any correction method utilised. The significant criteria were determined to be the paired t-test with both the UV reference assay data and the original NIR assay data, and comparison of the coefficient of multiple determinations.

Acetaminophen↗

Non protein bound iron concentrations in amniotic fluid.

OBJECTIVES: To investigate whether amniotic fluid concentrations of non protein bound iron (NPBI) vary with growth in healthy fetuses and also offer a reference curve in the second trimester of pregnancy. DESIGN AND METHODS: Amniotic fluid concentrations of NPBI were measured by HPLC in 118 women with physiological singleton pregnancies, who underwent amniocentesis for fetal karyotype between weeks 15 and 18 of gestation. RESULTS: NPBI increased progressively from weeks 14--15 to weeks 15--16, peaking at 17--18 weeks of gestation. NPBI values regressed positively with gestational age (GA). Multiple linear regression analysis between NPBI, as dependent variable, and various fetal parameters, as independent variables, showed a statistically significant regression coefficient with GA, bi-parietal diameter and transverse cerebellar diameter. CONCLUSIONS: The present data constitutes the first quantification of NPBI concentrations in amniotic fluid under physiological conditions. Correlations with GA and ultrasound fetal biometry suggest that NPBI may play a role in fetal growth.

Adult↗

Negative association between erythrocyte reduced glutathione concentration and diabetic complications.

1. Multiple logistic regression analysis of biochemical and clinical variables in diabetic patients was performed to identify those associated with the presence of diabetic complications (retinopathy, neuropathy and nephropathy). 2. The presence of diabetic complications correlated positively with duration of diabetes and patients age and negatively with the concentration of reduced glutathione in erythrocytes. Individually, retinopathy, neuropathy and nephropathy correlated with duration of diabetes, but retinopathy also correlated positively with haemoglobin A1C in diabetic patients. In insulin-dependent patients, the concentration of methylglyoxal was also in the logistic model for retinopathy and diabetic complications, but the logistic regression coefficient was not significant. 3. Multiple linear regression analysis indicated that erythrocyte reduced glutathione concentration correlated negatively with D-lactate concentration and positively with duration of diabetes in insulin-dependent patients and correlated negatively with glucose concentration in non-insulin-dependent diabetic patients. 4. In non-diabetic subjects, erythrocyte glyoxalase I activity correlated positively with methylglyoxal concentration. There was no similar correlation in diabetic patients. In insulin-dependent patients, methylglyoxal concentration correlated positively with duration of diabetes. 5. Glyoxal and methylglyoxal are detoxified by the glyoxalase system with reduced glutathione as co-factor. The concentration of reduced glutathione may be decreased by oxidative stress and by decreased in situ glutathione reductase activity in diabetes mellitus. A reduced concentration of reduced glutathione may predispose diabetic patients to oxidative damage and to alpha-oxoaldehydemediated glycation by decreasing the in situ glyoxalase I activity. Recent studies of vascular endothelial cells in vitro have suggested that alpha-oxoaldehydes detoxified by glyoxalase I are the major precursors of advanced glycation end products implicated in the development of diabetic complications. The role of these factors in the development of diabetic complications and the prospective prevention of diabetic complications by supplementation of reduced glutathione and/or alpha-oxoaldehyde-scavenging agents now deserve investigation.

Adult↗

The relationship between socioeconomic factors and gang violence in the City of Los Angeles.

OBJECTIVE: To investigate the relationship between community-level socioeconomic factors and the incidence of gang-related homicide in the city of Los Angeles. METHODS: An ecological group-level analysis was conducted to correlate the 5-year incidence rates (from 1988 through 1992) of gang-related homicide with community-level socioeconomic statistics for the 18 geographically distinct Los Angeles Police Department divisions. Eight socioeconomic factors were examined: (1) log mean per capita income, (2) proportion employed, (3) proportion high school graduates, (4) proportion single-parent families, (5) proportion male, (6) proportion younger than 20 years of age, (7) proportion African American, and (8) proportion Hispanic. Pearson correlation coefficients were calculated for the interrelationships among the study variables and gang-related homicide. Adjusted regression estimates were calculated from a multiple linear regression model. RESULTS: The overall 5-year gang-related homicide rate for the city was 48.8 per 100,000, with a range of 5.2 to 173.5 per 100,000 among the different Los Angeles Police Department divisions. Pearson correlation coefficients revealed that the strongest negative correlations with gang-related homicide were log mean per capita income and proportion employed, and the strongest positive correlations were proportion single-parent families and proportion younger than 20 years of age. With mutual adjustment of all variables, only log mean per capita income and proportion employed were significantly associated with gang-related homicide. CONCLUSION: At the community level, gang-related homicide in Los Angeles is most closely associated with lower income and unemployment. These relationships may provide important insights into the causes of gang formation and gang violence.

Adolescent↗

Physical fitness and endothelial function (nitric oxide synthesis) are independent determinants of insulin-stimulated blood flow in normal subjects.

Insulin induces vasodilation via stimulation of nitric oxide (NO) synthesis. This action of insulin exhibits considerable interindividual variation. We determined whether the response of blood flow to endothelium-dependent vasoactive agents correlates with that to insulin or whether other factors, such as physical fitness, limb muscularity, or vasodilatory capacity, better explain variations in insulin-stimulated blood flow. Direct measurements of the forearm blood flow response to three 2-h sequential doses of insulin (1, 2, and 5 mU/ kg.min), endothelium-dependent (acetylcholine and NG-monomethyl-L-arginine) and endothelium-independent (sodium nitroprusside) vasoactive agents, and ischemia (reactive hyperemic forearm blood flow) were performed in 22 normal subjects (age, 24 +/- 1 yr; body mass index, 22.2 +/- 0.6 kg/m2; maximal aerobic power, 40 +/- 2 mL/kg.min). The highest insulin dose increased blood flow by 111 +/- 17%. The fraction of basal blood flow inhibited by NG-monomethyl-L-arginine (NO synthesis-dependent flow) varied from 6-47%. Maximal aerobic power (r = 0.52; P < 0.02), the percentage of forearm muscle (r = 0.50; P < 0.02), and the NO synthesis-dependent flow (r = 0.42; P < 0.05), but not reactive hyperemic, acetylcholine-stimulated, or sodium nitroprusside-stimulated flow, were significantly correlated with insulin-stimulated (5 mU/kg.min) blood flow. In multiple linear regression analysis, 52% of the variation (multiple R = 0.72; P < 0.001) in insulin-stimulated blood flow was explained by NO synthesis-dependent flow (P < 0.005) and the percentage of forearm muscle (P < 0.005). We conclude that endothelial function (NO synthesis-dependent basal blood flow) and forearm muscularity are independent determinants of insulin-stimulated blood flow.

Adult↗

The importance of subterranean mosquito habitat to arbovirus vector control strategies in north Queensland, Australia.

In north Queensland, 14 localities were surveyed for mosquito larvae (third and fourth instar) during summer/autumn and winter from 1996 to 1999. Absolute population numbers in subterranean habitats, mainly service manholes and pits (97%) but also some wells, septic tanks, storm drains, and sumps, were expressed as a proportion of total numbers in these sites plus surface sites within a 100-m radius. When correction factors were applied to subterranean samples, the 472,477 larvae mainly of Aedes tremulus (Theobald) group, Aedes notoscriptus (Skuse), and Aedes aegypti (L.) comprised 78% of the total population. In relation to the proportion of the overall immature mosquito population from subterranean habitats (propsub), linear regression coefficients for minimum temperature, relative humidity, and Mesocyclops copepod prevalence were significant for winter data; but for summer, only relative humidity was significant. Linear regression coefficients for Mesocyclops prevalence approached significance (P = 0.061) in summer. When multiple linear regression was used to model propsub, 68% of the variation was accounted for by relative humidity and the prevalence of Mesocyclops. In the drier and cooler towns, increased use of subterranean sites during winter was caused by reduced availability of surface oviposition sites because of the dry season. In the wetter coastal towns, no such restrictions applied and ambient conditions remained more equitable all year round. Mesocyclops were surprisingly common, particularly in these coastal towns. Release of known numbers of Mesocyclops indicated that 3-sweep netting in service manholes was sensitive down to densities of one Mesocyclops per 10 liters, and overall recovery varied from 1 to 4%. In relation to control, service manholes represent a stable habitat for mosquito (7% positive overall) and Mesocyclops populations. If they remained wet, service manholes positive for mosquito immatures or Mesocyclops during summer/autumn had 96% and 85% chance, respectively, of being positive the following winter. Even allowing for the effect of drying, a mosquito-positive manhole had a 79% chance of remaining positive the following winter. In view of the importance of these sites as refuges from adverse ambient conditions, it is proposed that a winter control strategy using Mesocyclops presents a cost-effective control option to reduce the recolonization of surface sites when conditions become more suitable.

Aedes↗

The relationship between surgeon and hospital volume and outcomes for shoulder arthroplasty.

BACKGROUND: As far as we know, no previous study has determined the relationship between volume and outcomes for shoulder arthroplasty. We hypothesized that surgeons and hospitals with higher caseloads of total shoulder arthroplasties and hemiarthroplasties have better outcomes as measured by decreased mortality rate, shorter length of stay in the hospital, reduced postoperative complications, and routine disposition of patients on discharge. METHODS: Data on patients undergoing shoulder arthroplasty were extracted from the Nationwide Inpatient Sample databases for the years 1988 through 2000. Logistic regression with generalized estimating equations and multiple linear regression models were used to estimate the adjusted association between surgeon and hospital volume and outcomes for total shoulder arthroplasty and hemiarthroplasty after adjusting for comorbidity, age, race, household income, and sex. RESULTS: The mortality rates for patients who had a total shoulder arthroplasty performed by surgeons who did fewer than two procedures per year (0.36%) or who did between two and fewer than four procedures per year (0.32%) were higher than those for patients who had a total shoulder arthroplasty performed by surgeons who did four procedures or more per year (0.20%). The risk-adjusted rate of postoperative complications after hemiarthroplasty was significantly higher for patients managed by surgeons who performed fewer than two procedures per year (1.68%) than for those managed by surgeons with a volume of five procedures or more per year (0.97%). The possibility of postoperative complications when total shoulder arthroplasty was performed in hospitals with a volume of fewer than five procedures (1.44%) or in those with a volume of five to ten procedures per year (1.45%) was significantly higher than that in hospitals where ten procedures or more were performed every year (0.64%). The mean lengths of stay in the hospital after total shoulder arthroplasty and hemiarthroplasty were significantly longer when the operations were performed by surgeons who did fewer than two procedures per year or when they were done in hospitals with a volume of fewer than five procedures per year or with a volume of five to fewer than ten procedures per year than when they were done in hospitals or by surgeons in the highest volume category (p < 0.001). CONCLUSIONS: Patients who have a total shoulder arthroplasty or hemiarthroplasty performed by a high-volume surgeon or in a high-volume hospital are more likely to have a better outcome. LEVEL OF EVIDENCE: Therapeutic study, Level III-2 (retrospective cohort study). See Instructions to Authors for a complete description of levels of evidence.

Aged↗

[Studies on quantitative structure-retention relationships for sulfides on stationary phases of different polarities].

Multiple linear regression (MLR) based on forward stepwise multiple regression techniques was used for predicting gas chromatographic retention index of sulfides after calculating their quantum-chemical parameters. The correlative quantitative model between the retention index (IR) of sulfides on four stationary phases of different polarities and their quantum chemical parameters was built. The results proved the strong predictive power of the models. The root-mean-square error (RMS) of the regression equation was less than 4%.

English Abstract↗

Spirometric reference values in school children from Dalmatia.

Data on spirometric reference values in children are based on small, selected populations. We performed spirometric testing (forced vital capacity (FVC); forced expiratory volume in one second (FEV1); forced mid-expiratory flow rate (FEF25-75%)) in 2,500 healthy nonsmoking school children (1,250 boys and 1,250 girls) in the region of Dalmatia, Croatia. Significantly higher FVC and FEV1 values were noted in boys. Standing and sitting heights correlated significantly with FVC and FEV1 in boys and girls. Regression equations were derived, utilizing the multiple linear regression analysis, for FVC, FEV1 and FEF25-75% related to five (sex, age, weight, standing and sitting heights) or three (sex, age and standing height) variables. The reference spirometric values in the Dalmatian school boys were in close agreement with Knudson et al., while the values in girls were closest to those of Knudson et al. and Cotes et al. It is suggested that for calculation of ventilatory reference values in boys and girls the age and the standing height should be used.

Adolescent↗

[Factors associated with the incidence of hospital readmission].

BACKGROUND: To identify factors associated with hospital readmission, especially those potentially avoidable. This information could be useful to reduce the incidence of hospital readmissions. METHODS: A paired (1:1) case-control study nested into the cohort of first admissions at the Granada University Hospital, Spain, in 1990. All patients readmitted at the hospital within 3 years after release from the index-admission by the same diagnostic or complications of it comprised the case group. For each case, a control patient was matched for both primary diagnosis on admission and index-admission date. Information on risk factors associated with hospital readmission was obtained retrospectively from medical records. The relation between these risk factors and readmission was estimated from odds ratio both crude and adjusted using conditional logistic regression analysis. For the readmitted subsample, multiple linear regression models were applied to identify factors associated to the length of time between the index episode and the first readmission. RESULTS: Variables with consistent positive associations with readmission include male sex (odds ratio = 2.86, 95% confidence interval = 1.37-5.88), widowed or single status (2.66, 10.7-6.59) and severity at index admission (3.20, 1.57-6.51). Factors related to quality of health care did not influence readmission risk. CONCLUSIONS: Factors depending of the patient seem to be the most important variables associated to the incidence of hospital readmission.

APACHE↗

Multi-locus allelic architecture underlying natural variation in leaf rolling in japonica rice.

Leaf rolling is a key component of rice canopy architecture that affects light interception, microclimate formation, and planting density. The contribution of naturally occurring allelic variation to quantitative variation in leaf rolling within cultivated rice remains poorly understood, while extreme leaf rolling caused by loss-of-function mutations often results in detrimental pleiotropic effects. Herein, we examined how multi-locus allelic variation contributes to natural variation in leaf rolling within japonica rice. Leaf rolling was quantified based on the leaf rolling index (LRI) using a panel of 201 japonica accessions. The phenotype was transformed using the Yeo-Johnson method to reduce strong right skewness and improve the distributional properties of the data, thereby facilitating subsequent regression modeling. Haplotype analyses were performed for previously reported leaf rolling-associated genes and genome-wide association study (GWAS) lead loci, leading to the identification of five loci exhibiting substantial haplotype-dependent phenotypic variation. Phenotypically defined allelic groups represented these loci were subsequently evaluated using multiple linear regression (MLR), with the first two principal components derived from genome-wide SNP data included as covariates to account for population structure. The final MLR model identified four loci (qALR1, OsYABBY1, OsSLL2, and OsSRL10) as the independent contributors to leaf rolling variation, collectively explaining 21% of the variance in the transformed phenotype after accounting for population structure. Model diagnostics and ten-fold cross-validation supported the statistical validity of the framework and indicated stable model performance across validation folds. Analysis of multi-locus allelic combinations showed 13 distinct configurations that clustered into three phenotypically differentiated groups. This reflected the cumulative dosage of high-leaf rolling alleles. Thus, the natural variation in leaf rolling in japonica rice is governed by the additive effects of multiple moderate-impact loci. The multi-locus allelic framework established here provides a statistically sound and biologically interpretable basis for dissecting polygenic canopy traits and practical guidance for developing genetic materials aimed at optimizing rice plant architecture.

cross-validation↗

Contributions of weekly mean blood glucose values to hemoglobin A1c in insulin-treated type 2 diabetes: the Diabetes Outcomes in Veterans Study (DOVES).

BACKGROUND: Daily self-monitored blood glucose testing is recommended for patients with insulin-treated type 2 diabetes. However, most patients do not test frequently enough for optimal glycemic control. Less frequent testing may be sufficient for assessing glycemic control among stable patients as well as improving patient compliance. The study objective was to evaluate the weekly contribution of glucose readings to hemoglobin (Hb)A1c during an 8-week period of intensified self-monitored blood glucose testing. METHODS: The authors randomly selected stable, insulin-treated subjects with type 2 diabetes. Subjects monitored their blood glucose four times daily for 8 weeks; the authors then downloaded glucose meters and measured an HbA1c. Mean blood glucose values were calculated for each of the 8 weeks. Multiple linear regression analyses examined the contribution of these mean values to the HbA1c. RESULTS: A total of 182 subjects completed the monitoring protocol; mean HbA1c was 7.63 +/- 1.42%, mean glucose was 9.78 +/- 2.27 mmol/L, the regression correlation was 0.77, P < 0.001. A fitted multiple linear model using all 8 weekly mean blood glucose values showed large variation in their independent contributions to the HbA1c. Mean blood glucose values from consecutive weeks were highly correlated and did not provide independent information about glycemic control. Stepwise regression showed that the mean blood glucose values from weeks 4, 6, and 8 significantly and equally influenced HbA1c. CONCLUSIONS: Glycemic control can be efficiently assessed by reviewing at least 5 weeks' worth of monitoring results, focusing on alternate weeks and giving less weight to more remote readings.

Aged↗