Logistic Regression Adjustment Research Articles

Predicting acute kidney injury and future cardiac events using urinary liver-type fatty acid-binding protein in patients with acute myocardial infarction

Abstract Background Urinary liver-type fatty acid-binding protein (L-FABP) has been known as a candidate biomarker for early detection of acute kidney injury (AKI). It has also been suggested to have an effective predictive value for cardiovascular mortality in patients. Therefore, this study aimed to examine the ability of urinary L-FABP in predicting AKI and future cardiovascular events in patients with acute myocardial infarction (AMI). Methods We evaluated consecutive 258 patients with AMI. Urinary L-FABP was measured at admission and a 2-year follow-up was performed. AKI was defined as an increase of >0.3 mg/dl in serum creatinine level within 2 days after emergency percutaneous coronary intervention. The composite endpoint was cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Results AKI was detected in 20 patients (7.8%). Patients with AKI had significantly higher urinary L-FABP levels (68.0 μg/gCr vs 3.1 μg/gCr, p<0.001) compared to those with non-AKI. Receiver operating characteristic analysis showed urinary L-FABP levels exhibited 85.7% sensitivity and 96.0% specificity, at a cutoff value of 29.7 μg/gCr. We used propensity score analyses to balance measurable confounders between patients with and without AKI, including age, left ventricular ejection fraction, an inflammation marker, renal function, and albuminuria. In logistic regression adjustment with the propensity score, urinary L-FABP level of >29.7 μg/gCr was an independent predictor of AKI (p=0.001). Furthermore, high urinary L-FABP (>29.7 μg/gCr) on admission correlated with an increased risk of the composite endpoints during 2-year follow-up in the Kaplan–Meier analysis (p<0.001). Conclusions Urinary L-FABP level may be a useful biomarker for predicting not only the onset of AKI but also adverse cardiovascular events in patients with AMI. Funding Acknowledgement Type of funding sources: None.

Association of Environmental tobacco smoke exposure with depression among non-smoking adults

BackgroundDepression is a psychological dysfunction that impairs health and quality of life. However, whether environmental tobacco smoke exposure (ETSE) is associated with depression is poorly understood. This study was designed to evaluate the association of ETSE with depression among non-smoking adults in the United States.MethodUsing the 2015–2016 United States National Health and Nutrition Examination Survey (NHANES), we identified 2623 adults (females – 64.2%, males – 35.8%) who had never smoked and applied multivariable adjusted-logistic regression to determine the adjusted odds ratio (aOR) and 95% confidence interval (CI) at P < 0.05 for the association of ETSE with depression adjusting for relevant confounders.ResultsMean age of respondents was 46.5 ± 17.9 years, 23.5% reported ETSE, and 4.7% reported depression. Also, aORs for the association of ETSE with depression were 1.992 (1.987, 1.997) among females and 0.674 (0.670, 0.677) among males. When we examined the association by age groups, the aORs were 1.792 (1.787, 1.796) among young adults (< 60 years) and 1.146 (1.140, 1.152) among older adults (≥60 years).ConclusionsWe found that ETSE was associated with higher odds of depression among females but not among males.

Secondhand smoke exposure and dyslipidemia among non-smoking adults in the United States.

Dyslipidemia is a major public health challenge worldwide and whether secondhand smoke exposure (SHSE) is associated with dyslipidemia is yet to be understood. This study evaluated the relationship between SHSE and odds of dyslipidemia among adults in the United States. We identified 3064 adults who had never smoked in the 2015-2016 National Health and Nutrition Examination Survey and estimated the odds ratio and 95% confidence interval for the relationship between SHSE and odds of dyslipidemia using a multivariable adjusted-logistic regression at a two-sided p<0.05. Overall, the mean age of respondents was 46.4±18.0years, 59.6% had dyslipidemia and 36.2% had SHSE. The odds of dyslipidemia among individuals with SHSE were 1.148 (1.147, 1.149) in the overall sample, 1.214 (1.214, 1.215) among women and 1.165 (1.163, 1.167) among men. The odds trended similarly independent of age groups: 1.130 (1.129, 1.131) for young adults (<60years) and 1.304 (1.300, 1.308) for old adults (≥60years). SHSE was associated with higher odds of dyslipidemia with higher odds among women and old adults. Primary intervention(s) targeted at reducing SHSE may show benefits in reducing the odds of dyslipidemia, and longitudinal studies would be necessary to clarify the association between SHSE and dyslipidemia.

Use of Calcium Channel Blockers and Risk of Active Tuberculosis Disease: A Population-Based Analysis.

Calcium channel blockers (CCBs) are known to reduce the availability of iron-an important mineral for intracellular pathogens. Nonetheless, whether the use of CCBs modifies the risk of active tuberculosis in the clinical setting remains unclear. To determine whether CCBs may modify the risk of active tuberculosis disease, we conducted a nested case-control study using the National Health Insurance Research Database of Taiwan between January 1999 and December 2011. Conditional logistic regression and disease risk score adjustment were used to calculate the risk of active tuberculosis disease associated with CCB use. Subgroup analyses investigated the effect of different types of CCBs and potential effect modification in different subpopulations. A total of 8164 new active tuberculosis cases and 816 400 controls were examined. Use of CCBs was associated with a 32% decrease in the risk of active tuberculosis (relative risk [RR], 0.68 [95% CI, 0.58-0.78]) after adjustment with disease risk score. Compared with nonuse of CCBs, the use of dihydropyridine CCBs was associated with a lower risk of tuberculosis (RR, 0.63 [95% CI, 0.53-0.79]) than nondihydropyridine CCBs (RR, 0.73 [95% CI, 0.57-0.94]). In contrast, use of β-blockers (RR, 0.99 [95% CI, 0.83-1.12]) or loop diuretics (RR, 0.88 [95% CI, 0.62-1.26]) was not associated with lower risk of tuberculosis. In subgroup analyses, the risk of tuberculosis associated with the use of CCBs was similar among patients with heart failure or cerebrovascular diseases. Our study confirms that use of dihydropyridine CCBs decreases the risk of active tuberculosis.

11 Impact of the coronavirus pandemic lockdown on obstetric outcomes

It has been suggested that lockdown during the COVID-19 pandemic decreased prematurity rates. We investigated the impact of lockdown on obstetric outcomes. We performed a cohort study on women who gave birth at three maternity hospitals in metropolitan Melbourne, Australia, between Jan 1st, 2019 and Sept 16th, 2020. Data were extracted from the common birth registry of the three maternities. The second lockdown started July 8th, 2020 and required people to stay at home, with limited exemptions. We performed interrupted time-series analysis to compare the monthly rates of preterm birth before 34 weeks prior to and after July 2020. We also compared the group of women who delivered between July and September 2020 to the group of women who delivered during the same period in 2019. A total 15,394 women gave birth. Interrupted time-series analysis demonstrated a significantly lower monthly rate of deliveries before 34 weeks of gestational age after July 2020 (Figure 1; p = 0.001). There were 2,207 deliveries between July to Sept. 2019 and 1,870 deliveries between July to Sept. 2020. Baseline characteristics were comparable, except for a significantly difference in twins (1.5% in 2020 versus 2.6% in 2019, p = 0.012). After excluding women with pregnancies complicated by major fetal abnormalities or stillbirth, the risk of preterm delivery before 34 weeks was much lower in patients who delivered between July and September 2020 (2.1% versus 3.3%, RR 0.64, 95% CI 0.44 to 0.94, p = 0.022) (Table 1). Similar patterns were observed for iatrogenic and spontaneous preterm birth at different gestational ages. The effect persisted after logistic regression adjustment for multiple pregnancies (adjusted OR 0.65, 95% CI 0.46 to 0.96, p = 0.028). The decrease in prematurity was not at the cost of an increase in stillbirth or undetected small for gestational age neonates. Strict lockdown has a strong impact on iatrogenic and spontaneous prematurity rates. While returning to normal, which aspects of lockdown contributed to this unprecedented effect should be evaluated.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Understanding the genetic architecture of the metabolically unhealthy normal weight and metabolically healthy obese phenotypes in a Korean population

Understanding the mechanisms underlying the metabolically unhealthy normal weight (MUHNW) and metabolically healthy obese (MHO) phenotypes is important for developing strategies to prevent cardiometabolic diseases. Here, we conducted genome-wide association studies (GWASs) to identify the MUHNW and MHO genetic indices. The study dataset comprised genome-wide single-nucleotide polymorphism genotypes and epidemiological data from 49,915 subjects categorised into four phenotypes—metabolically healthy normal weight (MHNW), MUHNW, MHO, and metabolically unhealthy obese (MUHO). We conducted two GWASs using logistic regression analyses and adjustments for confounding variables (model 1: MHNW versus MUHNW and model 2: MHO versus MUHO). GCKR, ABCB11, CDKAL1, LPL, CDKN2B, NT5C2, APOA5, CETP, and APOC1 were associated with metabolically unhealthy phenotypes among normal weight individuals (model 1). LPL, APOA5, and CETP were associated with metabolically unhealthy phenotypes among obese individuals (model 2). The genes common to both models are related to lipid metabolism (LPL, APOA5, and CETP), and those associated with model 1 are related to insulin or glucose metabolism (GCKR, CDKAL1, and CDKN2B). This study reveals the genetic architecture of the MUHNW and MHO phenotypes in a Korean population-based cohort. These findings could help identify individuals at a high metabolic risk in normal weight and obese populations and provide potential novel targets for the management of metabolically unhealthy phenotypes.

Association between admission blood fibrinogen-to-albumin ratio and clinical outcomes after acute lacunar stroke.

Aim: We aimed to investigate the influence of admission fibrinogen-to-albumin ratio (FAR) on 3-month outcomes after acute lacunar stroke. Materials & methods: Consecutive patients with acute lacunar stroke were included and classified into two groups according to an optimized FAR cut-off value determined by receiver operating characteristic curve analysis. Results: Compared with those with low FAR (<0.077), patients from the high FAR group (≥0.077) had significantly higher risk for 3-month disability and the composite outcome of death/disability. After logistic regression adjustment, high FAR was still significantly associated with 3-month disability and death/disability. Conclusion: FAR ≥0.077 on admission might be an independent predictor of disability and death/disability at 3months after lacunar stroke, which needs to be verified in future studies.

Passive smoking exposure and the risk of hypertension among non-smoking adults: the 2015\u20132016 NHANES data

BackgroundHypertension is a major public health problem and a prominent risk factor for cardiovascular diseases. However, whether passive smoking exposure (PSE) is associated with the risk of hypertension is scarcely understood. This study assessed the association between PSE and the risk of hypertension among adults (≥18 years) in the United States of America.MethodsThree thousand and sixty-seven adults were identified from the 2015–2016 National Health and Nutrition Examination Survey and the association between PSE and hypertension (adjusting for relevant confounders) was examined using multivariable adjusted-logistic regression analysis at P < 0.05.ResultsMean age of respondents was 46.5 ± 17.9 years. Overall, 23.7% of respondents reported PSE and 32.6% were hypertensives (of which only 14.3% were aware of their hypertensive state) Also, adjusted odds of hypertension for participants with PSE was 1.038 (1.037, 1.040), P < 0.0001, in the overall population. Also, PSE aggravated odds of hypertension among young adults – < 60 years (aOR: 1.095, 95CI%: 1.094 to 1.097), P < 0.0001, and old adults – ≥60 years (aOR: 1.110, 95% CI: 1.108 to 1.113), P < 0.0001. Similarly, PSE was associated with increased odds of hypertension among women (aOR: 1.240, 95% CI: 1.238 to 1.242), P < 0.0001 but not among men (aOR: 0.755, 95% CI: 0.754 to 0.757), P < 0.0001.ConclusionsPSE was independently associated with the risk of hypertension particularly among women, young and old adults. A multi-ethnic longitudinal cohort may help ascertain causality and provide more evidence for appropriate interventions.

Control of volunteer corn with rates of post-emergent ACCase inhibitors applied at different phenological stages

The occurrence of volunteer corn (Zea maysL.) has been common in Brazilian crops due to the adoption of a succession of soybean (Glycine max(L.) Merrill) and corn resistant to glyphosate. The aim of this work was to evaluate the control of volunteer corn using different rates of acetyl-CoAcarboxylase (ACCase) inhibitors herbicides at different phenological stages. The experiment was carried out in a greenhouse in a completely randomized design. The experiment was organized in a factorial scheme (3x7x2) with three herbicides (clethodim, quizalofop-P-tefuryl and clethodim + quizalofop-P-ethyl) applied atseven rates [0; 25; 50; 100; 200; 400 and 800 mL of commercial product (C.P.) ha-1], andat two corn phenological stages (V3 and V6). Visual control (%) assessments were carried out at 14, 21 and 28 days after application of treatments (DAT) and shoot dry mass (SDM) at 28 DAT. The data were submitted to analysis of variance and to complementary analysis by logistic regression adjustment. For allherbicides, the control of volunteer corn was greater at V3 stage, requiring lower rates compared to V6. Complete visual control of volunteer corn plants at V3 was obtained with rates of 25 mL C.P. ha-1for all herbicides evaluated, corresponding to 6, 3 and 6 + 3 g a.i. ha-1of clethodim, quizalofop-P-tefuryl and clethodim + quizalofop-P-ethyl, respectively. For V6 application, 400 mL C.P. ha-1of clethodim (equivalent to 96 g a.i. ha-1) and 100 mL C.P. ha-1of quizalofop-P-tefuryl (equivalent to 12 g a.i. ha-1) and clethodim + quizalofop-P-ethyl (equivalent to 24 + 12 g a.i. ha-1) were necessary to achieve 100% of plant mortality. Thus, the efficiency of clethodim was more dependent on the stage of application compared to others herbicides, requiring higher rates to achieve complete control of volunteer corn at V6.

Prevalence and risk factors of prolonged corrected QT interval in general Chinese population

BackgroundCorrected QT (QTc) interval has been correlated with total and CVD mortality. Although much is known about the relation between prolonged QTc interval and clinical outcome, there is no information on the prevalence and specific risk factors of QTc prolongation in general Chinese population. We evaluated the prevalence of prolonged QTc interval and its risk factors in general Chinese population, aiming to fill in the gaps in the literature and provide evidence for potential CVD risk prediction and disease burden estimate in community.MethodsA population-based survey was conducted on 11,209 participants over the age of 35 in rural areas of Liaoning Province from 2012 to 2013. Twelve-lead ECGs and automatic analysis were performed on all participants. Logistic regression adjustments were made by using the Bazett’s formula to correlate specific risk factors with prolonged QTc intervals (> 440 ms) for potential confounders.ResultsThe overall prevalence of prolonged QTc interval was 31.6%. The prevalence increased significantly with age (24.1% among those aged 35–44 years; 28.3%, 45–54 years; 35.2%, 55–64 years; 43.4%, ≥65 years, P < 0.001). Participants with a history of CVD had a higher prevalence of QTc prolongation (40.7% vs. 30.0%). In the fully adjusted logistic regress model, older age, abdominal obesity, hypertension, diabetes, hypokalemia and any medicine used in the past two weeks were associated independently with increased risk for prolonged QTc interval (All P < 0.05). We found no significant differences between general obesity, hypocalcemia and hypomagnesemia with prolongation of QTc interval. Female sex showed opposite results after applying clinical diagnostic criteria, and high physical activity could reduce the risk of prolonged QTc interval.ConclusionsThe prevalence of prolonged QTc interval was relatively high in general Chinese population and listed relevant factors, which would help identify patients at risk in pre-clinical prevention and provide evidence for estimating potential CVD burden and making management strategies in community.

Prevalence and Cardiovascular Health Impact of Family History of Premature Heart Disease in the United States: Analysis of the National Health and Nutrition Examination Survey, 2007-2014.

BackgroundBecause family history is a known risk factor for heart disease, it is important to characterize its public health impact in terms of population prevalence of family history of heart disease, the burden of heart disease attributable to family history, and whether family history interacts with modifiable risk factors for heart disease.Methods and ResultsWe used population data from NHANES (the National Health and Nutrition Examination Survey [2007–2014]) to measure the association of self‐reported family history of premature heart disease (FHPHD) with cardiovascular disease (n=19 253) and to examine the association between cardiovascular health metrics and FHPHD (n=16 248). Using logistic regression and multivariable adjustment, family history odds ratios were 5.91 (95% CI, 3.34–10.44) for ages 20 to 39, 3.02 (95% CI, 2.41–3.79) for ages 40 to 59, and 1.87 (95% CI, 1.54–2.28) for age ≥60 for cardiovascular disease. The prevalence of cardiovascular disease for the population with a FHPHD (15.72%; 95% CI, 13.81–17.64) was more than double the prevalence of cardiovascular disease for those without a family history (6.25%; 95% CI, 5.82–6.69). Compared with participants with optimum cardiovascular health, the prevalence ratio for FHPHD was 1.98 (95% CI, 1.40–2.79) for those with inadequate cardiovascular health.ConclusionsMillions of people who are at high risk of having cardiovascular disease could be identified using FHPHD. FHPHD can become an important component of public health campaigns that address modifiable risk factors that plan to reduce the overall risk of heart disease.

Health-Predictive Social-Environmental Stressors and Social Buffers Are Place Based: A Multilevel Example From San Bernardino Communities.

Significant evidence demonstrates the powerful effects social determinants have on health-related perceptions, behaviors, and health outcomes. However, these factors are often studied out of context, despite the acknowledgement that social determinants of health are place based. This research aimed to demonstrate that health-related perceptions are dependent on where one lives. Via a community-based participatory study, participants were randomly selected from 3 residential regions varying distances from a freight railyard (nearest n = 300, middle n = 338, farthest n = 327), all mostly low-income, predominately Latino areas. Interview-administered surveys with adults were collected by bilingual trained community members (87% response) in English/Spanish. Adjusted-logistic regression models assessed residential region as a predictor of stressors (perceptions of community safety, community noise disturbance, health care access, food insecurity) and buffers (3 neighborhood cohesion variables), after adjusting for household income, race/ethnicity, gender, and age. Each region experienced a unique amalgam of stressors and buffers. In general, the region closest to the railyard experienced more stressors (odds ratio [OR] = 1.58; 95% CI 1.12-2.20) and less buffers (OR = 0.69; 95% CI 0.49-0.96) than the region furthest from the railyard. More than half of participants in each region reported 2 or more stressors and 2 or more buffers. In this seemingly homogenous study population, place remained important in spite of traditionally used socioeconomic factors, such as household income and race/ethnicity. Social determinants of health should be studied with regard to their environmental context, which will require interdisciplinary collaboration to improve multilevel research methods. Including the study of social buffers will also promote sustainable, positive change to reduce health disparities.

The contribution of family history to the burden of diagnosed diabetes, undiagnosed diabetes, and prediabetes in the United States: analysis of the National Health and Nutrition Examination Survey, 2009–2014

PurposeGiven the importance of family history in the early detection and prevention of type 2 diabetes, we quantified the public health impact of reported family health history on diagnosed diabetes (DD), undiagnosed diabetes (UD), and prediabetes (PD) in the United States. MethodsWe used population data from the National Health and Nutrition Examination Survey 2009–2014 to measure the association of reported family history of diabetes with DD, UD, and PD. ResultsUsing polytomous logistic regression and multivariable adjustment, family history prevalence ratios were 4.27 (confidence interval (CI): 3.57, 5.12) for DD, 2.03 (CI: 1.56, 2.63) for UD, and 1.26 (CI: 1.09, 1.44) for PD. In the United States, we estimate that 10.1 million DD cases, 1.4 million UD cases, and 3.9 million PD cases can be attributed to having a family history of diabetes. ConclusionThese findings confirm that family history of diabetes has a major public health impact on diabetes in the United States. In spite of the recent interest and focus on genomics and precision medicine, family health history continues to be an integral component of public health campaigns to identify persons at high risk for developing type 2 diabetes and early detection of diabetes to prevent or delay complications.

Returning to school after a terror attack: a longitudinal study of school functioning and health in terror-exposed youth

Terrorist attacks and mass shootings often involve youth. Knowledge is needed on how this may impact their health and functioning. This study investigates perceived academic performance and school wellbeing in 237 terror-exposed survivors of the Utøya youth camp attack according to their sociodemographic characteristics, health and mental health service (MHS) utilization. Semi-structured interviews were conducted after 4–5 and 14–15 months. The year following the attack, 143 (61%) survivors reported impaired academic performance and 66 (29%) impaired school wellbeing. Female survivors more often reported impaired performance. Non-Norwegian origin, being financially disadvantaged and less social support were associated with impaired wellbeing. Sleep problems, posttraumatic stress, anxiety/depression, somatic symptoms, and lower life satisfaction were associated with both impaired performance and impaired wellbeing. Survivors who had received MHS were more likely to report impaired or improved academic performance and school wellbeing. Higher age and posttraumatic stress reactions were associated with impaired academic performance after multivariate logistic regression adjustments for gender, somatic symptoms and social support. When additionally adjusting for impaired school wellbeing, age and impaired wellbeing were associated with impaired performance. Only posttraumatic stress reactions were associated with impaired wellbeing after similar adjustments. Non-Norwegian origin and being financially disadvantaged were not significantly associated with impaired wellbeing after adjusting for posttraumatic stress reactions, age and gender. Our findings demonstrate how a terrorist attack can considerably deteriorate young survivors’ performance and wellbeing at school, which is associated with poorer health. Consequently, it is important to provide appropriate school support, and coordinate MHS with follow-up at school.

Plasma lipid peroxidation biomarkers for early and non-invasive Alzheimer Disease detection

IntroductionAlzheimer Disease (AD) standard diagnosis is based on evaluations and biomarkers that are non-specific, expensive, or requires invasive sampling. Therefore, an early, and non-invasive diagnosis is required. As regards molecular mechanisms, recent research has shown that lipid peroxidation plays an important role. MethodsWell-defined participants groups were recruited. Lipid peroxidation compounds were determined in plasma using a validated analytical method. Statistical studies consisted of an elastic-net-penalized logistic regression adjustment. ResultsThe regression model fitted to the data included six variables (lipid peroxidation biomarkers) as potential predictors of early AD. This model achieved an apparent area under the receiver operating characteristics (AUC-ROCs) of 0.883 and a bootstrap-validated AUC-ROC of 0.817. Calibration of the model showed very low deviations from real probabilities. ConclusionA satisfactory early diagnostic model has been obtained from plasma levels of 6 lipid peroxidation compounds, indicating the individual probability of suffering from early AD.

Residential mobility and childhood leukemia

AimsStudies of environmental exposures and childhood leukemia studies do not usually account for residential mobility. Yet, in addition to being a potential risk factor, mobility can induce selection bias, confounding, or measurement error in such studies. Using data collected for California Powerline Study (CAPS), we attempt to disentangle the effect of mobility. MethodsWe analyzed data from a population-based case-control study of childhood leukemia using cases who were born in California and diagnosed between 1988 and 2008 and birth certificate controls. We used stratified logistic regression, case-only analysis, and propensity-score adjustments to assess predictors of residential mobility between birth and diagnosis, and account for potential confounding due to residential mobility. ResultsChildren who moved tended to be older, lived in housing other than single-family homes, had younger mothers and fewer siblings, and were of lower socioeconomic status. Odds ratios for leukemia among non-movers living <50 meters (m) from a 200+ kilovolt line (OR: 1.62; 95% CI: 0.72–3.65) and for calculated fields ≥ 0.4 microTesla (OR: 1.71; 95% CI: 0.65–4.52) were slightly higher than previously reported overall results. Adjustments for propensity scores based on all variables predictive of mobility, including dwelling type, increased odds ratios for leukemia to 2.61 (95% CI: 1.76–3.86) for living < 50 m from a 200 + kilovolt line and to 1.98 (1.11–3.52) for calculated fields. Individual or propensity-score adjustments for all variables, except dwelling type, did not materially change the estimates of power line exposures on childhood leukemia. ConclusionThe residential mobility of childhood leukemia cases varied by several sociodemographic characteristics, but not by the distance to the nearest power line or calculated magnetic fields. Mobility appears to be an unlikely explanation for the associations observed between power lines exposure and childhood leukemia.

Development of Vaccine Preferences among Parents of Newborns

Objective Vaccine hesitancy and refusal and the resulting outbreaks of vaccine-preventable diseases continue to be an issue today. Most of contemporary research on these issues has focused on underlying characteristics of non-vaccinators and ambivalent parents; however, few studies have looked into how or when vaccine preferences develop. In this study, we sought to explore when parental preferences for vaccines develop in relation to a pregnancy. We also examined self-reported influences on vaccine decision making. Methods We recruited and administered a short survey to parents at the North Carolina Women's Hospital in Chapel Hill, NC, following the birth of their child from February to April 2015. Results A total of 166 parents (55%) completed the entire survey. Seventy-two percent of surveyed parents reported deciding on their vaccine preferences for their newborn before conception. Parents who were older, Caucasian, married, and had attained higher levels of education were significantly more likely to develop preconception vaccine preferences. The presence of partner conversations in the past and the desire for more information on vaccines were also significant predictors of preconception vaccine preference development. After logistic regression adjustment, only education level and past vaccine conversations remained significant. The most common influences for vaccine decision making were family, friends, and medical staff and organizations. Conclusion Our study documents that a majority of parents establish vaccine decision making and preferences before conception. Notable influences from friends, family, and medical sources are part of the process. These findings suggest that vaccine information and interventions currently are given too late in the vaccine preference decision-making process.

Dietary patterns, central obesity and serum lipids concentration in Mexican adults.

Introduction: dietary patterns (DP) analyse the relationship between consumption of foods or nutrients and disease or health outcomes. High prevalence of obesity in adults in Mexico is associated with factors such as high consumption of certain food groups and nutrients. However, few studies have been conducted to explore associations between dietary patterns and obesity in apparently healthy adults. Objective: to identify major dietary patterns (DP) associated with central-obesity (CO) and lipid concentrations in healthy adults. Methods: longitudinal study including usual dietary intakes derived from multiple 24-hour-recalls. Waist-circumference (WC) and biochemical measurements were obtained by standardized procedures and DP by principal component analysis. Adjusted-logistic regression was used to examine associations between DP, CO and serum-lipid concentrations. Results: three DP were identified: healthy-DP, risky-DP and empty-DP. Participants in the healthy-DP were more likely to have lower risk for central-obesity according to WC criteria (OR = 0.31, CI = 0.12, 0.82), p = 0.017, but also had the highest risk for elevated LDL-cholesterol (OR = 2.98, CI = 1.16, 7.66), p = 0.030. There was no significant association between risky and empty DP with obesity or overweight by body mass index (BMI), central-obesity by WC or serum lipid abnormalities. Conclusions: the healthy-DP is associated with lower risk for CO, with higher risk for elevated LDL-cholesterol. It is necessary to develop longitudinal studies of foods and nutritional analysis of the diet to clarify these associations, to promote the reduction of modifiable risk factors.

Biceps ultrasound: Correlation with tendinitis arthroscopy

Introduction To assess correlations between new sonographic features at different biceps tendon levels compared to tendinitis arthroscopy. Material and methods A total of 47 patients in our Upper Limb Orthopedic Surgery Department were prospectively included over a 5-month period. Arthroscopy was performed to assess the macroscopic appearance of the horizontal intra-articular portion of the tendon. The horizontal part of the biceps tendon was divided into 3 parts in order to assess inflammation by grade. The tendon was considered inflammatory in case of grade 2 and 3. Biceps tendon criteria were analyzed at five ultrasound levels, i.e. area, tendon flattening ratio, presence of fluid, Doppler inflammation assessment and intra-tendon ROI on a dynamic film to assess the maximum, minimum signal and heterogeneity. Results No significant correlations were found between arthroscopy-detected inflammation and the surface. On the dynamic film, the maximum tendon signal was significantly lower when the biceps tendon was classified by the surgeon as inflammatory ( p = 0.030), and remained significant after logistic regression adjustment for age and gender ( p = 0.048). The 114 threshold resulted in the best differentiation, with 91% sensitivity, 48% specificity, 86% NPV and 61% PPV. Discussion The maximum biceps tendon signal measured on a dynamic film made when tilting the probe was significantly lower when the tendon was detected as inflammatory via arthroscopy. None of the other quantitative or qualitative measurements had any correlation. Level of evidence IV.

HUBUNGAN LARANGAN MEROKOK DI RUMAH DENGAN KEBERHASILAN BERHENTI MEROKOK

The Global Adult Tobacco Survey (GATS) in 2011 indicated that despite the intention of tobacco user to cease smoking, only a few people that succeed to stop the smoking habit. This research aimed to investigate correlation between smoking bans at home and smoking cessation. The GATS design was a cross-sectional study. Resident ≥ 15 y.o as the target population and as much as 8.305 respondents were recruited by stratified multistage cluster sampling (4 stages) and only 1.376 respondent who had tried to quit smoking were chosen as the sample and being analyzed. The dependent variable was the achievement of smoking cessation. The descriptive statistic was reported in weighted proportions. Logistic regression analysis and adjustment for confounders were applicated. Smoking bans at home increased the odds of smoking cessation achievement by 200 % (OR: 2,0; 95%CI 1,1-3,4) compared to the inexistence of such rule at home. As a conclusion, smoking bans at home was able to increase the smoking cessation achievement in the stop smoking program.