Translational Health Reports

Abstract Background: Hyponatremia, a frequent yet potentially life-threatening electrolyte 
imbalance, poses heightened risks in intensive care contexts. This investigation sought to 
explore contributory factors linked to hyponatremia following linezolid administration in 
critically ill (CI) individuals and to formulate a robust predictive framework. 
Methods: A retrospective evaluation was conducted on clinical records and follow-up data 
from 200 CI patients who received linezolid therapy. To isolate key determinants, logistic 
regression modeling was utilized, followed by validation using Receiver Operating 
Characteristic (ROC) curve analysis. A nomogram-based risk assessment tool was then 
constructed, with calibration tested via the Hosmer-Lemeshow goodness-of-fit approach. 
Findings: Adverse reactions were recorded in 23.5% of the cohort. Statistically significant 
disparities (P < 0.05) emerged between CI and non-CI patients across several variables, 
including linezolid serum levels, therapy duration (DOM), baseline sodium values (BSS), 
estimated glomerular filtration rate (eGFR), white blood cell (WBC) count, total bilirubin 
(TBIL), albumin (ALB), and key biomarkers (NGAL, suPAR, Cystatin C), as well as concurrent 
spironolactone usage. The Z-score presented the highest diagnostic efficacy for 
hyponatremia, with a threshold of -3.24. The model demonstrated an 85.5% predictive 
accuracy, and the nomogram—based on multivariate regression and fit assessment—
 exhibited excellent alignment with actual outcomes. 
Interpretation: Independent predictors of hyponatremia included DOM, drug 
concentration, BSS, eGFR, and TBIL. Incorporation of novel biomarker profiles modestly 
improved model precision, suggesting added value in patient risk stratification. The 
developed tool offers promise for early detection and intervention in vulnerable ICU 
populations. 

Abstract  Background: This investigation explored the clinical utility of the Gugging Swallowing 
Screen (GUSS) in identifying swallowing dysfunction following stroke and examined its 
application in designing individualized nutritional interventions. The study also assessed a 
set of physiological markers—brain-derived neurotrophic factor (BDNF), salivary cortisol, 
leptin, and growth differentiation factor-15 (GDF-15)—to determine their relationship with 
dysphagia severity, neural recovery, and clinical prognosis. 
Methods: A cohort of 174 individuals recovering from stroke underwent swallowing 
assessments using both the GUSS protocol and the traditional water swallow test (WST). 
Participants diagnosed with swallowing impairments were randomized into a control group 
(CG), which received standard medical care, and an observation group (OG), which received 
additional GUSS-guided stratified feeding regimens. Comparative analyses focused on 
changes in swallowing ability, emotional well-being, serum and salivary biomarker profiles, 
and occurrence of medical complications. 
Findings: GUSS outperformed WST in sensitivity and responsiveness (P < 0.05), as shown 
by significantly higher effect size (ES) and standardized response mean (SRM). Patients in 
the OG exhibited notably greater improvement in deglutition function and fewer adverse 
outcomes than those in the CG (P < 0.05). Post-treatment nutritional markers—albumin 
(Alb), prealbumin (PA), and transferrin (TNF)—were also more favorable in the OG. BDNF 
and leptin levels showed strong alignment with dysphagia grading, while elevated salivary 
cortisol was associated with stress-related swallowing issues. GDF-15 levels correlated 
significantly with dysphagia-related complications. Moreover, quality of life indicators—
 including mental, physical, and social dimensions—were significantly enhanced in the OG (P 
< 0.05). 
Conclusion: GUSS proves to be a robust tool for early detection of post-stroke swallowing 
disorders and offers added clinical value when used to guide dietary intervention. The 
inclusion of stress, neuroplasticity, and inflammatory biomarkers—particularly salivary 
cortisol and GDF-15—adds depth to severity assessment and supports the development of 
personalized rehabilitation pathways.

Abstract This forward-looking clinical investigation explored the prognostic utility of four distinct 
biomarkers—high-sensitivity cardiac troponin T (hs-cTnT), N-terminal pro b-type 
natriuretic peptide (NT-proBNP), Copeptin, and Mid-regional pro-Adrenomedullin (MR
proADM)—in forecasting significant cardiovascular complications among 120 individuals 
presenting with symptoms suggestive of acute coronary syndrome (ACS) in an emergency 
care setting. Across a 12-month observation window, occurrences of major adverse 
cardiovascular events (MACE)—encompassing myocardial infarction, stroke, and 
cardiovascular mortality—were systematically tracked and correlated with both initial and 
serial biomarker measurements. 
Multivariate analysis using Cox proportional hazards modeling, adjusted for demographic 
and behavioral risk factors such as age, sex, and smoking, revealed a robust association 
between elevated biomarker levels and MACE incidence. Diagnostic accuracy for each 
marker—individually and collectively—was assessed through ROC curve analysis, 
demonstrating favorable area under the curve (AUC) values indicative of strong predictive 
performance. Survival outcomes stratified by median biomarker thresholds were estimated 
using Kaplan-Meier methodology, showing pronounced differences in MACE-free survival 
between high- and low-risk groups. 
The findings affirm the clinical value of hs-cTnT, NT-proBNP, Copeptin, and MR-proADM in 
early cardiovascular risk stratification. Moreover, the integrative use of these markers was 
shown to outperform any single biomarker alone, emphasizing their combined role in 
refining diagnostic precision and guiding therapeutic decisions. These results support 
incorporating such biomarker panels into routine evaluation protocols for patients 
undergoing assessment for suspected ACS.