Rangsit University

This study proposes a binary logistic regression (BLR) framework with outlier and cutoff adjustments for predicting the Dermatology Life Quality Index (DLQI) in stress-affected psoriasis patients. Data from 149 patients, with DLQI as a binary response and eight predictive features, were analyzed. Cooks distance and M-estimators were applied to address outliers, and alternative cutoff thresholds, including the proportional method and Youdens index, were employed to improve classification accuracy. Adopting Cook's distance and Youden's index, the modified BLR model outperformed others. Subsequently, age, comorbidity and stress were identified as significant features and their odd ratios (OR) are 0.9228, 3.8425 and 1.1448, respectively. Cooks distance demonstrated superior performance, yielding the lowest Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) values, the highest Cox and Snell R-squared (R-CS(2)) and Nagelkerke's R-squared (R-N(2)), and improved classification metrics. Youdens index further optimized sensitivity and specificity. Models incorporating these adjustments exhibited robust predictive capabilities, enhancing DLQI classification. These findings highlight the importance of addressing outliers and selecting appropriate cutoff thresholds in BLR modeling, offering valuable insights for improving clinical assessments and treatment strategies for psoriasis patients affected by stress.

The aim of this research was to assess the effects of different adhesive surface treatment protocols using universal adhesives on the shear bond strength (SBS) between a Vita Enamic and resin composite, as well as to analyze the associated failure modes. Eighty Vita Enamic ceramics were prepared, thermocycled, and randomly allocated into eight experimental groups following silane coupling agent pretreatment and adhesive system: Single Bond 2 (SB), silane + SB, Scotchbond Universal Plus (SBP), silane + SBP, Beautibond Xtreme (BEX), silane + BEX, Tetric N-Bond Universal (TUB), and silane + TUB. All specimens were etched with 9% hydrofluoric acid prior to adhesive application. Resin composites were bonded to the treated surfaces and subjected to SBS analysis using a universal testing device. Failure modes were performed under a stereomicroscope. Data were statistically determined using one-way ANOVA and Tukey's post hoc test (alpha = 0.05). Statistically significant differences in SBS were indicated among the groups (p < 0.05). In the result, the SB (13.96 +/- 2.34 MPa) and TUB (12.39 +/- 2.91 MPa) groups exhibited the lowest SBS values and exclusively adhesive failure modes. Groups treated with silane and/or silane-containing universal adhesives (Sl + SB; 18.42 +/- 3.11 MPa, SBP; 19.01 +/- 2.62 MPa, BEX; 19.20 +/- 2.96 MPa and Sl + TUB; 18.16 +/- 2.82 MPa) demonstrated significantly higher SBS. The highest SBS values were achieved in the silane + SBP (24.53 +/- 2.66 MPa) and silane + BEX (25.12 +/- 2.74 MPa) groups, which were statistically comparable to each other and superior to all other groups. These groups also showed increased proportions of mixed and cohesive failures, indicating improved interfacial integrity. In conclusion, the SBS between Vita Enamic and the resin composite was significantly influenced by surface pretreatment and adhesive composition. Hydrofluoric acid etching combined with silane coupling agent pretreatment and silane coupling agent-containing universal adhesives provided the highest bond strength, supporting a multimodal strategy for the reliable repair of Vita Enamic restorations.

Out-of-hospital cardiac arrest is a major public health concern in Thailand. Despite the wider availability of automated external defibrillators, bystander use remains low. Understanding the factors predicting community volunteers' intention to perform cardiopulmonary resuscitation and to use it is essential for improving emergency response capacity. This cross-sectional study aimed to analyze factors predicting the intention to perform cardiopulmonary resuscitation and to use automated external defibrillators among community volunteers in an urban district in Bangkok, Thailand. Purposive sampling, a non-probability sampling method, was employed to recruit 120 community volunteers. Data were collected between April and May 2024 using structured questionnaires comprising six sections: the Participant Characteristics, the CPR and AEDs Knowledge Test, the Attitudes towards CPR and AEDs Assessment, the Subjective Norms for CPR and AEDs Assessment, the Perceived Behavioral Control for CPR and AEDs Assessment, and Intention to Perform CPR and Use AEDs Assessment. Data were analyzed using multivariate logistic regression. Results revealed that 72.5% of participants reported a high intention to perform cardiopulmonary resuscitation and to use automated external defibrillators, while 90% had no prior experience performing these procedures. Atitude towards cardiopulmonary resuscitation and automated external defibrillators, and subjective norms were statistically significant predictors of intention. The logistic regression model correctly classified 74.2% of intention outcomes. The findings highlight the importance of enhancing volunteers' positive attitudes and strengthening community social support. Nurses can enhance readiness and confidence in performing cardiopulmonary resuscitation and using automated external defibrillators among community volunteers.

QuestionWhat is the association between oral semaglutide and recognized cardiovascular risk factors vs placebo in the SOUL randomized clinical trial?FindingsIn this post hoc secondary analysis of the SOUL randomized clinical trial, oral semaglutide was associated with sustained improvements in multiple cardiovascular risk factors in high-risk participants with type 2 diabetes and atherosclerotic cardiovascular disease and/or chronic kidney disease receiving standard of care.MeaningThese risk factor benefits may contribute to the overall benefit of oral semaglutide on outcomes for major adverse cardiovascular events, providing supporting evidence for the use of oral semaglutide in cardiovascular risk reduction. ImportanceIndividuals with type 2 diabetes (T2D) are at high risk of atherosclerotic cardiovascular disease (ASCVD). In the SOUL randomized clinical trial, once-daily oral semaglutide reduced risk of major adverse cardiovascular (CV) events by 14% vs placebo in people with T2D and ASCVD and/or chronic kidney disease (CKD) receiving standard of care (SoC); however, whether oral semaglutide modifies recognized CV risk factors in the long term is unclear.ObjectiveTo investigate whether treatment with oral semaglutide was associated with changes in ASCVD risk factors vs placebo.Design, Setting, and ParticipantsThis secondary analysis comprises post hoc intention-to-treat analyses of the SOUL (A Heart Disease Study of Semaglutide in Patients With Type 2 Diabetes) double-blind multicenter randomized clinical trial (randomization 1:1 to oral semaglutide or placebo) among adults with T2D and ASCVD and/or CKD receiving SoC. Participants underwent randomization from June 2019 to March 2021, with a mean (SD) of 47.5 (10.9) months of follow-up, and data were analyzed from February to December 2025.Intervention(s)Participants were treated with either once-daily oral semaglutide (maximum dose, 14 mg) or placebo, in addition to standard care.Main Outcomes and MeasuresThe primary outcome was the association of oral semaglutide vs placebo with glycated hemoglobin (HbA1c), body weight, and blood pressure (BP) using estimated treatment differences (ETDs) and with high-sensitivity C-reactive protein (hsCRP) and lipid plasma levels using estimated treatment ratios (ETRs).ResultsOf 9650 randomized participants (mean [SD] age, 66.1 (7.6) years; 2790 female participants [28.9%]), 9495 participants (98.4%) completed the trial. Early (13 weeks) improvements in HbA1c (-0.87 percentage points), body weight (-2.54%), systolic BP (SBP, -3.84 mm Hg), pulse pressure (-3.81 mm Hg), hsCRP (-18.08%), total cholesterol (TC, -7.00%), non-high-density lipoprotein cholesterol (non-HDL-C, -8.02%), HDL-C (-4.49%), and triglycerides (-8.15%) were observed with oral semaglutide vs placebo and sustained over the trial duration. Body weight reductions were gradual across both groups. At week 156, in favor of oral semaglutide were ETDs for HbA1c (-0.47 percentage points; 95% CI, -0.52 to -0.42), body weight (-3.26 percentage points; 95% CI, -3.55 to -2.98), SBP (-1.83 mm Hg; 95% CI, -2.47 to -1.18), and pulse pressure (-2.17 mm Hg; 95% CI, -2.72 to -1.61) and ETRs for hsCRP (0.77; 95% CI, 0.74-0.81), TC (0.99; 95% CI, 0.98-1.00), non-HDL-C (0.98; 95% CI, 0.97-0.99), HDL-C (1.01; 95% CI, 1.01-1.02), and triglycerides (0.94; 95% CI, 0.93-0.96). No significant treatment differences were observed for low-density lipoprotein cholesterol or diastolic BP.Conclusions and RelevanceIn this post hoc secondary analysis of the SOUL randomized clinical trial, oral semaglutide was associated with early and sustained improvements vs placebo in multiple ASCVD risk factors in high-risk participants with T2D and ASCVD and/or CKD, incremental to SoC.Trial RegistrationClinicalTrials.gov Identifier: NCT03914326 This post hoc secondary analysis of the SOUL randomized clinical trial investigates whether treatment with oral semaglutide was associated with changes in atherosclerotic cardiovascular disease risk factors vs placebo among participants with type 2 diabetes.

Diabetic macular edema (DME) significantly contributes to visual impairment in diabetic patients. Treatment responses to intravitreal therapies vary, highlighting the need for patient stratification to predict therapeutic benefits and enable personalized strategies. To our knowledge, this study is the first to explore pre-treatment stratification for predicting DME treatment responses. To advance this research, we organized the 2nd Asia-Pacific Tele-Ophthalmology Society (APTOS) Big Data Competition in 2021. The competition focused on improving predictive accuracy for anti-VEGF therapy responses using ophthalmic OCT images. We provided a dataset containing tens of thousands of OCT images from 2,000 patients with labels across four sub-tasks. This paper details the competition's structure, dataset, leading methods, and evaluation metrics. The competition attracted strong scientific community participation, with 170 teams initially registering and 41 reaching the final round. The top-performing team achieved an AUC of 80.06%, highlighting the potential of AI in personalized DME treatment and clinical decision-making.