Multinomial Logistic Regression Analysis Research Articles

Latent profile analysis of resilience and its influencing factors in patients with lung cancer undergoing chemotherapy

ObjectiveThis study aims to analyze the classification characteristics of resilience in patients with lung cancer undergoing chemotherapy using latent profile analysis and explore the influencing factors and their relationship with medical coping strategies. MethodsA questionnaire survey was conducted on 265 patients with lung cancer undergoing chemotherapy at a tertiary Grade-A hospital in Guangzhou from November 2023 to March 2024, using the General Information Questionnaire, Resilience Scale Specific to Cancer (RS-SC), Lung Cancer Chemotherapy Symptom Cluster Assessment Questionnaire, and Medical Coping Modes Questionnaire (MCMQ). Latent profile analysis was performed using Mplus 8.3 to identify resilience classifications, estimate influencing factors, and evaluate their impact on medical coping strategy selection. ResultsA total of 259 valid questionnaires were collected, with an effective response rate of 97.74%. Patients were categorized into three groups based on resilience levels: low-resilience group (20.46%), mid-resilience group (40.52%), and high-resilience group (38.97%). Multinomial logistic regression analysis revealed that education level, family per capita monthly income, and gastrointestinal and emotional symptom cluster scores were significant influencing factors for different resilience classifications (P < 0.05). Statistically significant differences were found in the scores for the confrontation and resignation dimensions of medical coping strategies across different latent profiles (P < 0.01). ConclusionsResilience in patients with lung cancer undergoing chemotherapy is heterogeneous, presenting in three distinct categories. Medical staff should provide tailored interventions based on the characteristics and influencing factors of each patient profile to enhance resilience and coping strategies.

Elevated risk of pre-diabetes and diabetes in people with past history of COVID-19 in northeastern Nigeria

BackgroundAn increased risk of diabetes mellitus (DM) after COVID-19 has been reported in the United States, Europe, and Asia. The burden of COVID-related DM has yet to be described in Africa, where the overall risk of DM has been increasing rapidly. Our objective was to compare the prevalence of pre-DM and DM in Nigerian individuals with a history of COVID-19 to individuals without known COVID-19 infection.MethodsWe undertook a retrospective cohort study with 256 individuals with a past medical history of COVID-19 with no history of pre-DM or DM and 256 individuals without a history of COVID-19 or pre-DM/DM. Participants were categorized as pre-DM (fasting capillary glucose 100–125 mg/dL) or DM (fasting capillary glucose ≥ 126 mg/dL). We employed univariate and multivariable logistic regression to identify key predictors and adjust for confounders related to hyperglycaemia risk factors. Additionally, we used multinomial logistic regression to analyze the relationship between COVID-19 history and diabetes status, distinguishing between normal, pre-diabetic, and diabetic glucose levels. All models were adjusted for age, gender, hypertension, physical activity, central adiposity, and family history of DM.ResultsCompared to the control group, those with a history of COVID-19 had a similar median age (38 vs. 40 years, p = 0.84), had a higher proportion of men (63% vs. 49%), and had a lower prevalence of central adiposity (waist: hip ratio ≥ 0.90 for males and WHR ≥ 0.85 for females) (48% vs. 56.3%, p = 0.06). Of the 256 with a history of COVID-19, 44 (17%) required in-patient care. The median (interquartile range) time interval between COVID-19 diagnosis and the glycaemic assessment was 19 (IQR: 14, 24) months. Pre-DM prevalence was 27% in the post-COVID-19 group and 4% in the control group, whereas the prevalence of DM was 7% in the post-COVID-19 group and 2% in the control group. After multivariable adjustment, the odds of pre-DM were 8.12 (95% confidence interval (CI): 3.98, 16.58; p < 0.001) higher, and the odds of DM were 3.97 (95% CI: 1.16, 13.63) higher in those with a history of COVID-19 compared to controls. In the adjusted multinomial logistic regression analysis, individuals with a history of COVID-19 exhibited significantly elevated risks for pre-diabetes (RRR = 7.55, 95% CI: 3.76–15.17) and diabetes (RRR = 3.44, 95% CI: 1.01–11.71) compared to those without COVID-19.ConclusionPrevious COVID-19 was found to be a risk factor for prevalent pre-diabetes and diabetes mellitus in Nigeria. More intensive screening for DM in those with a history of COVID-19 should be considered.

Storage of firearms in vehicles: findings from a sample of firearm owners in nine U.S. states

BackgroundIn recent years, there has been a growing number of thefts of firearms stored in vehicles. Despite this trend, there is limited research on firearm storage patterns in vehicles in the United States. This study investigates these storage patterns and evaluates the relationship between the surge in firearm purchases after March 2020 and the practice of storing firearms in vehicles.MethodsFirearm storage practices were classified into four categories: (a) no vehicle storage, (b) locked vehicle storage only, (c) unlocked vehicle storage only, and (d) both locked and unlocked vehicle storage. Multinomial logistic regression analyses were conducted to determine the association between vehicle firearm storage practices and the main independent variable (firearm purchases since March 2020), adjusting for covariates.ResultsThose who purchased a firearm since March 2020 were significantly more likely to store at least one firearm in a vehicle unlocked only (RRR = 2.41, 95% CI 1.45–3.99) or both locked and unlocked (RRR = 2.57, 95% CI .180–3.67) compared to the reference category of no vehicle storage.ConclusionIndividuals who purchased a firearm after March 2020 were more likely to report storing a firearm in a vehicle. Given the limited research on patterns of firearm storage in vehicles, these findings provide novel evidence suggesting that firearm purchases following the March 2020 firearm purchasing surge may have fomented behaviors that increased the likelihood of firearm storage in automobiles. Moving forward, there is a need for additional quantitative and qualitative research that can better understand patterns and motivations of firearm storage in vehicles.

Addiction Therapeutic Communities in Saudi Arabia: An Evaluation of the Resident Retention Rates and Their Correlation With the Type of Drug Used.

Long-term retention is a reliable, well-studied factor associated with enhanced outcomes in addiction therapeutic communities (ATCs). The aim of this study was to estimate resident retention rates of ATCs in Saudi Arabia at three and six months, completion of therapy, and early dropout, and investigate their correlation with the type of drug used and other social variables. This was a cohort retrospective study and data of all residents admitted to all Saudi ATCs since their establishment in 2000 through September 2014 were collected from their files. There were five Saudi ATCs during the study period. The date of admission, discharge date, socio-demographics, and drug use were reported. Retention rates at three and six months and dropouts in the first week were calculated, and the correlation with the type of drug used was studied using multinomial binary logistic regression analysis. Out of a total of 2050 files, 2003 were suitable for analysis. All residents were male adults. The retention rate for three and six months was 45% and 28%, respectively, and 8.3% dropped out in the first week. The median duration of stay was 77 days. Unemployment and being a student were associated with the completion of treatment. The type of drug used showed no significant correlation with retention rates or dropouts. Three-month retention, treatment completion, and dropout within the first week were reasonable, comparable, and consistent with reported rates worldwide. These rates can be considered an indicator of successful Saudi ATC programs. The type of drug used does not make a difference in retention and dropout rates in the present study, which is in line with the ATC management system that does not view the type of drug as a main treatment outcome modifier.

Trajectories of cognitive function development and predictive factors in disabled middle-aged and older adults.

To explore the trajectories of cognitive function development and predictive factors in disabled middle-aged and older adults. Utilizing data from 983 disabled middle-aged and older adults in the China Health and Retirement Longitudinal Study (CHARLS) from 2013 to 2020, latent growth mixture models were constructed to analyze the categories of cognitive function development trajectories and their predictive factors. The cognitive function trajectories of the disabled middle-aged and older adults were classified into three categories: rapid decline (32.6%), Slow decline (36.1%), and Stable (31.2%). Multinomial logistic regression analysis identified age, gender, residence, education, marital status, household income, sleep duration, depression, hearing ability, and social participation as predictors of these trajectories. There is heterogeneity in the cognitive function development trajectories among disabled middle-aged and older adults. Healthcare professionals can implement targeted health management based on the characteristics of different groups to prevent the deterioration of cognitive function in this population.

Correlation of the Upper Nasolabial Angle With Skeletal Patterns and Nasal Morphology in Indian Adults: An Observational Study.

The upper nasolabial angle (UNLA) is an important determinant in clinical diagnosis and treatment planning. Therefore, the primary objective of this study was to assess the correlation between various skeletal parameters and nasal morphology in an Indian cohort, particularly UNLA. The secondary objectives were to evaluate sex differences in nasal morphology, optimal cut-off values of the UNLA for skeletal malocclusions, and differences in nasal morphology in different skeletal malocclusions. This retrospective study used 162 pre-treatment lateral cephalometric records of patients with skeletal Class I, Class II, and Class III relationships. Group 1 consisted of 68 skeletal Class I patients (ANB angle of 2-40), Group 2 consisted of 68 skeletal Class II patients (ANB angle > 40), and Group 3 consisted of 26 skeletal Class III patients (ANB angle of less than 20). Each group was further subdivided according to the growth pattern into low (horizontal), average, and high (vertical) growers. The angle between the sella-nasion plane and mandibular plane (SN-GoGn angle) was used to further divide the groups according to their growth pattern into a horizontal growth pattern (SN-GoGn angle < 280), an average growth pattern (SN-GoGn angle of 28-360), and a vertical growth pattern (SN-GoGn angle > 360). The study sample was also divided into males and females to assess gender differences. Spearman's correlation coefficient, multinomial logistic regression analysis, Mann-Whitney U test, and Kruskal-Wallis tests were used. Receiver operating characteristic curves were used to obtain the optimal cut-off values for UNLA. The UNLA showed a positive correlation with the sagittal position of the maxilla and a negative correlation with the sagittal position of the mandible and palatal plane (PP) inclination angle. Statistically significant sex differences were observed in nasal length, nasal depth, and lower anterior facial height. The optimal cut-off values for the UNLA angle in the class II skeletal pattern were ≥ 200, 16-200 for skeletal class I, and ≤ 160 for skeletal class III patients. None of the skeletal and nasal parameters were reliable predictors of the skeletal pattern type. The present study showed that the UNLA increased in the skeletal class II pattern with the downward inclination of the PP. Patients with skeletal class III malocclusion had an upward-canted nasal tip.

Uncovering gene expression signatures and diagnostic – Biomarkers in hepatocellular carcinoma through multinomial logistic regression analysis

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer death worldwide, and classifying the developmental stages of HCC can help with early prognosis and treatment. This study aimed to investigate diagnostic and prognostic molecular signatures underlying the progression of HCC, including tumor initiation and growth, and to classify its developmental stages based on gene expression levels. We integrated data from two cancer systems, including 78 patients with Edmondson-Steiner (ES) grade and 417 patients with TNM stage cancer. Functional profiling was performed using identified signatures. Using a multinomial logistic regression model (MLR), we classified controls, early-stage HCC, and advanced-stage HCC. The model was validated in three independent cohorts comprising 45 patients (neoplastic stage), 394 patients (ES grade), and 466 patients (TNM stage). Multivariate Cox regression was employed for HCC prognosis prediction. We identified 35 genes with gradual upregulation or downregulation in both ES grade and TNM stage patients during HCC progression. These genes are involved in cell division, chromosome segregation, and mitotic cytokinesis, promoting tumor cell proliferation through the mitotic cell cycle. The MLR model accurately differentiated controls, early-stage HCC, and advanced-stage HCC across multiple cancer systems, which was further validated in various independent cohorts. Survival analysis revealed a subset of five genes from TNM stage (HR: 3.27, p < 0.0001) and three genes from ES grade (HR: 7.56, p < 0.0001) that showed significant association with HCC prognosis. The identified molecular signature not only initiates tumorigenesis but also promotes HCC development. It has the potential to improve clinical diagnosis, prognosis, and therapeutic interventions for HCC. This study enhances our understanding of HCC progression and provides valuable insights for precision medicine approaches.

Predictors of outcomes in conservative management of high-grade renal trauma

BackgroundManagement of high-grade renal trauma is debatable, with the recent evidence embracing a conservative approach in the management of even grade 5 renal injuries. The study aimed to analyze the clinical profile of patients with high-grade renal trauma, assessing their management strategies, outcomes, complications, and need for ancillary procedures.MethodsA retrospective analysis of prospectively maintained data was performed involving blunt abdominal trauma patients with high-grade renal injuries (Grade 4 and 5) presenting to our hospital from January 2018 to December 2022. Patient data analyzed included demographics, clinical presentation, injury characteristics, complications, ancillary procedures, and mortality rates. All patients underwent renal functional assessment using an isotope renogram scan at the 3-month follow-up. Data collected were entered into a database and subjected to descriptive analysis using Jamovi version 2.3.28.ResultsThe study included 45 patients with a mean age of 29 years and a male-to-female ratio of 41:4. Most patients (n = 42) were managed conservatively. Thirty-eight patients had grade 4 injuries, and seven had grade 5 injuries. Twenty-six patients suffered renal parenchymal injuries alone, three patients had renal vascular injuries alone, and 16 patients had both parenchymal and vascular injuries. Grade 5 renal injury (p < 0.001), vascular high-grade injury (p < 0.001), angioembolization (p < 0.001), and blood transfusions (p = 0.021) were significantly associated with the incidence of poorly functioning kidney in high-grade renal trauma patients managed conservatively. Multinomial logistic regression analysis revealed angioembolization (p < 0.001), poorly functioning kidney post-trauma (p < 0.001), and blood transfusions (p < 0.001) were significantly associated with high-grade renal vascular injuries compared to high-grade renal parenchymal injuries.ConclusionConservative management is advisable for high-grade renal trauma in hemodynamically stable patients. High-grade vascular injuries are more severe than parenchymal injuries and correlate with poorer renal functional outcomes. Grade 5 renal injury, predominantly vascular high-grade injury, and the requirement for angioembolization and blood transfusions serve as significant predictors of poorly functioning kidneys post-trauma. Urologists should consider these predictors when counseling patients regarding potential outcomes following conservative management of high-grade renal trauma.

Predictors of inadequate gestational weight gain according to iom recommendations and intergrowth-21st standards: the araraquara cohort study

BackgroundGestational weight gain (GWG) is a critical factor for maternal and fetal health.ObjectiveTo identify maternal predictors of inadequate GWG according to the 2009 Institute of Medicine (IOM) recommendations and Intergrowth-21st standards.MethodsA prospective epidemiological cohort study conducted from 2017 to 2023 in southeastern Brazil assessed 1,557 women at three different stages of pregnancy (≤ 18, 20–26, and 30–36 weeks of gestation) and at delivery. Sociodemographic, obstetric, lifestyle, nutritional, and maternal morbidity characteristics were collected, along with biochemical parameters.ResultsAmong the participants, 38.7% had GWG above IOM recommendations, while 67.5% had GWG above the Intergrowth-21st standards. Multinomial logistic regression analysis showed that women with pre-pregnancy obesity and women with the highest body fat percentage had, respectively, a 95% (OR = 1.95; 95% CI: 1.08–3.51) and 1% (OR = 1.01; 95% CI: 1.01–1.05) higher chance of GWG above IOM recommendations. Pregnant women in the lowest tertile of height, smokers, number of previous pregnancies, and women living in crowded homes had, respectively, a 57% (OR = 0.57; 95% CI: 0.41–0.80), 36% (OR = 0.64; 95% CI: 0.37–0.86), 35% (OR = 0.65; 95% CI: 0.43–0.97), and 14% (OR = 0.86; 95% CI: 0.59–0.86) lower chance of GWG above IOM recommendations. Women with diabetes were 2.53 times more likely (OR = 2.53; 95% CI: 1.32–4.83) to have GWG below IOM recommendations. Using the Intergrowth-21st standards, women with the highest body fat percentage had a 12% (OR = 1.12; 95% CI: 1.02–1.24) higher chance of GWG above the 90th percentile. Pregnant women in the lowest tertile of height were 2.82 times more likely (OR = 2.82; 95% CI: 1.08–8.13) and women with the lowest hemoglobin concentrations had a 41% lower chance (OR = 0.59; 95% CI: 0.39–0.88) of having GWG below the 10th percentile. While both guidelines identified body fat percentage and pre-pregnancy obesity as significant predictors of excessive GWG, the Intergrowth-21st standards captured a higher percentage of women exceeding GWG limits.ConclusionThe findings underscore the importance of comparing two instruments for assessing the adequacy of GWG. The IOM and Intergrowth-21st standards provide complementary insights, which can help implement targeted interventions for specific groups of women based on their nutritional and socioeconomic status, lifestyle, and obstetric factors to prevent pregnancy-related complications.

Karakteristik Pekerjaan Utama terhadap Sektor Informal dan Sektor Formal di Provinsi Gorontalo

This study aims to analyze (i) the magnitude of the influence of working hours on labor income (ii) the magnitude of the influence of employment status on labor (iii) the magnitude of the influence of training on labor income (iv) the magnitude of the influence of training/courses on data Labor income used in this research is secondary data sourced from the Central Statistics Agency obtained from the National Labor Force Survey. This research uses Multinomial Logistic Regression Analysis. The results of this research show that the influence of main work with indicators of working hours, employment status, training certificates, and training/courses has a positive and significant influence on the income of workers in the informal and formal sectors, meaning that every 1 percent increase in main workers can increase the income of workers in the informal and formal sectors. Formal in Gorontalo Province.

The Impact of Sacubitril/Valsartan on Heart Failure Patient with Reduced Left Ventricular Ejection Fraction: Single Center Retrospective Study in Saudi Arabia.

Sacubitril/valsartan (S/V) is used in managing heart failure with reduced ejection fraction (HFrEF), reducing morbidity and mortality while improving symptoms and prognosis. This study aims to evaluate the effectiveness of S/V in patients with reduced left ventricular ejection fraction (LVEF) and its safety. This retrospective cohort study included adult patients aged ≥18 years diagnosed with HFrEF, receiving S/V, and followed up at a tertiary hospital in Riyadh. Primary outcomes included improvements in LVEF on echocardiography and the number of hospitalizations due to acute decompensated heart failure (ADHF). Secondary outcomes assessed the safety profile of S/V. Multinomial logistic regression analysis was performed with statistical significance set at P < 0.05. . The study included 107 patients: 80 with LVEF < 30% and 27 with LVEF 30-40%. Six-month follow-up, LVEF improvement was categorized into three groups: no improvement, LVEF increased by 1 to <10 points, and LVEF increased by ≥10 points. The LVEF was similar across groups (P = 0.59). Although hospitalizations due to ADHF were not significantly different between groups, they numerically decreased after initiating S/V (P = 0.1). S/V was generally well tolerated. This study suggests no significant benefit from S/V regarding LVEF improvement. It is recommended that heart failure clinics assess and titrate S/V to the maximum tolerated dose.

Impact of Financial Risk Tolerance on Reinvestment Intention and Investor’s Financial Well-Being: A Narcissistic Personality and Perceived Financial Transparency Approach

This study investigates the impact of monetary gamble tolerance on investment intentions among people, emphasizing the job of monetary information and personality traits. Utilizing a sample of 284 money students, we employed multinomial logistic regression analysis to explore what monetary information means for risk tolerance and investment choices. Our discoveries uncover that people characterized by elevated degrees of extraversion, suitability, openness to experience, and conscientiousness are more disposed to invest, with monetary gamble tolerance significantly mediating these relationships. Specifically, monetary gamble tolerance completely mediates the connection between neuroticism and long haul investment intentions, highlighting the psychological elements of investment conduct. Additionally, monetary information arose as a significant factor impacting short-term and long haul investment intentions, though it showed limited moderating effects between risk tolerance and investment purpose. These insights highlight the importance of improving monetary literacy and understanding personality traits to foster more educated investment choices. The implications of this research extend to monetary supervisors, institutions, and policymakers, emphasizing the need to promote monetary information and chance tolerance as pivotal components in empowering people to take part in investment activities.

Comparison of Serum Vitamin D Levels in Obese Subjects with and without Type 2 Diabetes Mellitus.

Although observational studies have reported a correlation between vitamin D deficiency and type 2 diabetes mellitus (T2DM), epidemiological evidence on the risk of obese subjects suffering T2DM due to a vitamin D deficiency is limited. Therefore, we investigated the correlation between T2DM and serum vitamin D, lipids, blood pressure, insulin indexes in an obese population. A total of 1440 participants including 450 healthy controls and 990 obese subjects, 470 without T2DM and 520 with T2DM. Serum vitamin D levels were measured, and the association between low levels and T2DM in obese subjects was examined using multinomial and linear regression analyses. Of the participants, 35% had deficient or insufficient vitamin D levels (ie, <20 ng/mL). Compared with healthy controls, obese subjects, particularly those with T2DM had lower vitamin D levels. Multinomial logistic regression analysis showed that obese subjects with T2DM had a gradually increasing risk for desirable (RO = 1.41, 95% CI 1.06-1.93, P = 0.027), insufficient (RO = 1.83, 95% CI 1.27-2.84, P < 0.001), or deficient ((RO = 2.14, 95% CI 1.15-3.75, P = 0.014) vitamin D levels. In obese subjects with T2DM, vitamin D levels correlated inversely with the risk indicators for diabetes, such as the levels of HbA1c (β = -0.16, P = 0.002), fasting insulin (Fins; β = -0.31, P = 0.008), and HOMA-IR (β = -0.19, P < 0.001). In obese subjects without T2DM, vitamin D was associated negatively with the risk of having T2DM at five-year follow-up (relative risk = 0.93, 95% CI 0.79-0.97, P = 0.037). This study demonstrates that low vitamin D levels correlate with the presence of T2DM in the obese population. This finding indicates that hypovitaminosis D may be a potential biological vulnerability factor for the development of T2DM in obese subjects.

Trajectories and influencing factors of psychological resilience among Chinese patients with maintenance hemodialysis

ObjectiveTo identify distinct trajectories of psychological resilience among Chinese patients with maintenance hemodialysis, explore influencing factors and inform the formulation of corresponding interventions. MethodsThis was a multi-center longitudinal study with a 6-month follow-up. With convenience sampling, a total of 231 patients with maintenance hemodialysis were recruited between September 2020 and July 2021. Patients’ characteristics, including sociodemographic information, social support and family resilience was collected through structured questionnaires as potential baseline influencing factors of psychological resilience trajectories. Psychological resilience was evaluated using the 25-item Chinese version of the Conner and Davidson resilience scale. Latent class growth modeling was conducted to identify homogeneous subgroups with distinct trajectories of psychological resilience. Univariable and multinomial logistic regression analysis were used to examine whether baseline influencing factors were associated with trajectories in patients with maintenance hemodialysis. ResultsFive distinct psychological resilience trajectory groups were identified: declining group (n = 20, 8.7 %), rising group (n = 17, 7.4 %), moderate-stable group (n = 128, 55.4 %), high-stable group (n = 7, 3.0 %) and low-stable group (n = 59, 25.5 %). High-stable group and moderate-stable group were combined into the well-psychological resilience group for multinomial logistic regression analysis. The multinomial logistic regression analysis showed that influencing factors associated with trajectories of psychological resilience were age, religion, monthly household income per capita, and baseline family resilience. ConclusionsThe results highlight the heterogeneity in the development of psychological resilience among Chinese patients with maintenance hemodialysis. There is a need for healthcare professionals to screen for trajectories of psychological resilience in Chinese maintenance hemodialysis patients and prepare individual mental healthcare interventions.

The Impact of Household Debt on Domestic Violence (DV) Against Children in Indonesia

Financial difficulties within a household could contribute to cases of domestic violence (DV). This study investigates the correlation between household debt and occurrences of domestic violence towards children in Indonesia. The study employs a quantitative methodology, notably utilising multinomial logistic regression analysis. Evidence suggests that households with several forms of debt are more prone to exhibiting both psychological and physical domestic violence against children, in contrast to households without domestic violence. This association maintains its significance even after taking into account control variables, such as the age of the spouse, the level of education of the head of home, the spouse's level of education, the size of the household, the perception of domestic violence, the schooling status of the children, and the age of the children are statistically associated with psychological, physical, and both types of domestic violence against children. Policymakers should assess household loan repayment capacity to limit lending to those at risk of financial struggle, while the government should implement parental education programs to raise awareness of child abuse and encourage non-violent parenting techniques.

Impact of lumbar spine pathology on asymmetrical hallux valgus in a population-based cohort study

This study aims to investigate the influence of lumbar spine disorders on the development of asymmetric hallux valgus (HV). Data from the fifth survey of the Osteoarthritis/Osteoporosis Against Disability (ROAD) study, a nationwide prospective study in Japan, were analyzed. HV severity was categorized into 4 grades based on the radiographic HV angle, and asymmetric HV was defined as having at least one HV on either side, with a difference of two or more severity grades between the left and right. Controls were matched from both the Normal group (without HV on both sides) and the Symmetric group (HV on at least one side with a difference of one or less severity grades). Univariate analysis assessed lumbar conditions, and multinomial logistic regression analysis explored the association between lumbar spine disorders and asymmetric HV. Among 1997 participants, 27 had asymmetric HV. Univariate analysis revealed a higher incidence of L5 spondylolisthesis and scoliosis in the Asymmetric group. Multinomial logistic regression analysis revealed that scoliosis independently increased the likelihood of asymmetrical HV (Odds ratio [OR] = 3.586, 95%Confidence interval [CI] 1.111–11.582), but showed no significant impact on symmetrical HV (OR 0.910, 95% CI 0.355–2.334). Asymmetric HV is rare but may be associated with lumbar spine disorders, particularly scoliosis.

Clinical Practice Ability and Related Factors Among Senior Undergraduate Nursing Students Post-Clinical Internship: A Latent Profile Analysis

The shortage of nurses and inadequate clinical practice abilities among senior undergraduate nursing students has raised significant concerns globally. The discrepancy between nursing education and practical skill requirements in hospitals is the primary contributor to this issue. Objectives: This study aimed to (1) explore potential classifications for assessing the clinical practice abilities of senior undergraduate nursing students in clinical practice, (2) identify distinct subgroups based on their clinical practice abilities, and (3) analyze the factors influencing these subgroups. Design: This was a cross-sectional study using latent profile analysis. Participants: A total of 336 fourth-year nursing students who had recently completed clinical practice were included in this study. Methods: Data were collected using a structured questionnaire that included sociodemographic factors, the Nursing Professional Attitude Questionnaire (NPAQ), and the Environmental Assessment Scale for Nursing Clinical Practice. The Clinical Ability Scale for Undergraduate Nursing Students (CCSUNS) measures clinical practice abilities. Latent profile analysis was used to identify subgroups of students based on their clinical practice abilities. Multinomial logistic regression analysis was used to analyze the factors influencing these subgroups. Results: Three profiles of clinical practice ability were identified: (1) "low level - guidance dependent" (51.79%), (2) "intermediate - response improvement" (33.85%), and (3) "high level - autonomous decision-making" (16.37%). Key influencing factors included gender, academic performance, professional nursing attitude, and the clinical practice environment. Conclusions: More than half of the senior nursing students demonstrated poor clinical practice abilities. Enhancing the clinical practice environment, increasing practical opportunities, fostering professional attitudes, and addressing gender equality are critical for improving clinical practice abilities. Future multicenter longitudinal studies are recommended to explore changes in clinical practice abilities over time and across different stages of clinical practice.

Unveiling the hidden link: fungi and HPV in cervical lesions.

Cervical cancer, primarily driven by high-risk human papillomavirus (HR-HPV) infection, ranks as the second most common cancer globally. Understanding combined infections' role, including Cervical fungi, is crucial in cervical carcinogenesis. This study aims to explore the potential correlation between HR-HPV, cervical fungi, and cervical cancer, while adjusting for various factors. The study population comprised patients undergoing colposcopy and conization due to abnormal cervical screening results. Clinical data including age, gravidity, HPV (human papillomavirus) genotypes, cervical pathology, and p16/Ki67 expression were extracted. Cervical TCT (ThinPrep Pap Test) and HPV testing are utilized for screening cervical lesions, with fungal presence suggested by TCT results. 5,528 participants were included in this study. Statistical analyses investigated associations between HPV/fungi co-infection and cervical lesions, employing multinomial logistic regression and interaction analysis. Co-infection with fungi and HPV may decrease the risk of cervical lesions compared to HPV infection alone. In the co-infection group, compared with HPV infection alone, the risk of low-grade squamous intraepithelial lesions (LSIL) was reduced by 27% (OR = 0.73, 95% CI: 0.59-0.90), the risk of high-grade squamous intraepithelial lesions (HSIL) was reduced by 35% (OR = 0.65, 95% CI: 0.51-0.82), and the risk of cervical cancer was reduced by 43% (OR = 0.57, 95% CI: 0.35-0.92). The interaction analysis revealed a negative interaction between fungal and HPV infections in the development of cervical cancer (RERI = -6.25, AP = -0.79, SI = 0.52), HSIL (RERI = -19.15, AP = -0.37, SI = 0.72) and LSIL (RERI = -1.87, AP = -0.33, SI = 0.71), suggesting a sub-additive effect, where the combined effect of the two infections was less than the sum of their individual effects. This indicates that fungal infection may attenuate the promoting effect of HPV on cervical lesions. In exploring the potential mechanism, we found that the co-infection group had significantly lower p16 positivity (54.6%) compared to the HPV-only group (60.2%) (p = 0.004), while there was no statistically significant difference in Ki67 positivity. This study unveils the intricate relationship between cervical fungi and HPV in cervical lesions. Co-infection with fungi and HPV against cervical lesions compared to HPV infection alone, indicating a novel clinical interaction. Lower p16 positivity in co-infection hints at a protective mechanism, urging further exploration.

Product Characteristics and Emotions to Bridge the Intention-Behavior Gap in Green Food Purchasing

Promoting environmentally friendly behaviors is a pivotal strategy in addressing the climate crisis. The food industry’s impact on pollution and resource consumption underscores the importance of fostering eco-sustainable food consumption, which can significantly benefit the environment. However, despite the global surge in green purchase intentions, a noticeable discrepancy persists between these intentions and actual purchasing behavior. This study aimed to investigate the influence of various factors on the likelihood of purchasing green food. An online survey was administered to Italian adult consumers (n = 832, 66% female, aged 18–84 years), collecting sociodemographic data and assessing emotions related to green purchases, perceptions of green food characteristics, intention to buy green food, and frequency of green food purchases. Through cluster analysis, three distinct consumer categories emerged: Coherent Buyers (individuals willing to buy green food and actively doing so), Coherent Non-Buyers (individuals who have no intention to buy green food and do not buy it), and Non-Buyers with Favorable Intentions (individuals expressing willingness to buy green food but not following through with purchases). Results from multinomial logistic regression analysis revealed that several factors influenced the likelihood of being categorized in the other two categories, as opposed to the Coherent Buyers one. These factors included younger age, a lower sense of pride associated with purchasing green products, and considering healthiness, natural content, and eco-sustainability of food less important and familiarity of green food more important. These findings provide valuable insights for marketers and policymakers, facilitating efforts to bridge the gap between green food intentions and behaviors and promote a shift toward a more eco-sustainable dietary pattern.

Risk and Protective Factors for Driving Under the Influence of Alcohol, Marijuana, and Both Substances in a Population-Based Sample of High School Students

Using results from the 2017 Nevada Youth Risk Behavior Survey, this research aims to understand factors associated with driving under the influence of alcohol (DUIA), marijuana (DUIM), and both alcohol and marijuana (DUIB) among students who reported they drove and used alcohol and/or marijuana recently. DUIM was the most prevalent behavior (16.4%), followed by DUIB (9.3%) and DUIA (4.9%). Weighted multinomial logistic regression analysis showed more risk and protective factors were associated with DUIB than DUIM and DUIA. To decrease motor vehicle crashes among adolescents, interventions should address modifiable factors for driving under the influence of both alcohol and marijuana.