Multiple Logistic Regression Analysis Research Articles

High-Titer Rheumatoid Factor is Associated with Worse Clinical Outcomes and Higher Needs for Advanced Therapies in Rheumatoid Arthritis Under Real-Life Conditions.

Rheumatoid factor (RF) plays an important role in rheumatoid arthritis (RA) pathophysiology, yet the differential effects of varying RF titers remain understudied. We evaluated associations between different RF titers and clinical outcomes in long-standing RA. This multicenter, cross-sectional study included adults meeting ACR/EULAR (2010) criteria for RA. Circulating RF titers and clinical-epidemiological characteristics were evaluated. Bivariate (Student's t and chi-squared tests) tests and multiple logistic and linear regression analyses were conducted. We included 1097 participants; 78.7% had positive RF, with high titers (≥ 3 × the upper limit of normality) in 56.2%. Negative vs. low-positive RF groups performed similarly concerning all clinical outcomes, being subsequently aggregated as "non-high" RF group. High RF titers (compared to "non-high") were associated with tobacco use (odds ratio, OR [95% confidence interval, CI]: 2.04 [1.35, 3.08]; p < 0.001), multiraciality (OR [95% CI] 1.31 [1.03, 1.67]; p = 0.028, compared to White race), and higher body mass index (mean difference [95% CI] 0.69 [0.05, 1.33] kg/m2; p = 0.033). In multivariate analyses, high-titer RF was independently associated with higher disease activity (Clinical Disease Activity Index, CDAI: β = 2.44 [0.89, 3.99], p = 0.002), worse functional capacity (Health Assessment Questionnaire Disability Index, HAQ-DI: β = 0.112 [0.018, 0.205], p = 0.020); extra-articular manifestations (OR 1.48 [1.09, 2.00], p = 0.011); increased corticosteroid (OR 1.53 [1.19, 1.96], p = 0.001) and biological disease-modifying antirheumatic drugs (bDMARD) use (OR 1.41 [1.08, 1.84], p = 0.011). High RF titers in long-standing RA were associated with worse disease activity, lower physical functionality, increased extra-articular manifestations, and higher usage of corticosteroids and bDMARDs. Comparing high vs. non-high RF titers (rather than positive vs. negative RF) seems more useful for evaluating the clinical effects of RF in RA. This approach should be considered in future studies of RF.

Effect of changes in skin properties due to diabetes mellitus on the titration period of transdermal fentanyl: single-center retrospective study and diabetic animal model study

BackgroundIn the dose titration of transdermal fentanyl to prevent unrelieved pain, it is important to consider not only dose adjustment, but also the titration period, which is influenced by the time required to reach the steady state. Many patients with cancer pain experience comorbidities that might affect the skin properties and influence transdermal absorption. We hypothesized that skin changes due to diabetes mellitus (DM) would affect the titration period of transdermal fentanyl. We conducted a retrospective study and diabetic animal model study to test this hypothesis.MethodsIn the retrospective study, the titration period was defined in terms of “dose change” and “number of rescue opioids” in patients initiated on transdermal fentanyl. Multiple logistic regression analysis was performed to analyze the relation between the titration period and comorbidities, including DM. In the diabetic animal model study, intercellular lipids of stratum corneum (SC) were analyzed in Goto-Kakizaki (GK) rats, a model of DM, and the pharmacokinetics of intravenously or transdermally administered fentanyl was examined.ResultsIn the retrospective study, the titration period ranged from 5 to 39 days (n = 387), and the patients taking a longer period (6 days or more) was significantly related to in patients with unspecified DM: AOR (95% confidence interval), 0.438 (0.217–0.884). In the diabetic animal model study, the ceramides (CERs) content in the SC was decreased by approximately 30% in GK rats compared to Wistar rats. The absorption rate constant (ka) of fentanyl administered transdermally was increased approximately 1.4-fold in GK rats, though there was no difference in transdermal bioavailability (F) or systemic clearance (CLtot).ConclusionOur results suggest that the steady state of transdermally administered fentanyl is reached sooner in cancer patients with DM as a comorbidity. Earlier pain assessment and dose adjustment may be possible in these patients.

Skeletal Muscle Mass Loss and Physical Function in Young to Middle-Aged Adult Patients With Diabetes: Cross-Sectional Observational Study.

Recently, it has been reported that older adults with type 2 diabetes mellitus (T2DM) have lower skeletal muscle mass than healthy individuals. Although skeletal muscle mass in older adults with diabetes is occasionally reported, similar reports on young to middle-aged adults are limited. This study aims to assess the prevalence of skeletal muscle loss in young to middle-aged adults with diabetes, examine the relationship between skeletal muscle loss and physical function in these patients, and examine whether there are differences in these characteristics between men and women. This cross-sectional, observational study included patients younger than 65 years with T2DM who were admitted to our hospital between 2014 and 2022 for educational admission for glycemic control and requested rehabilitation by the Department of Metabolic Medicine. The control group consisted of patients who received rehabilitation during their hospitalization at our hospital and did not have diabetes. The main parameters included skeletal muscle mass, muscle strength, physical function, and activities of daily living. The prevalence of skeletal muscle mass loss in this study was 18.2% (10/55) in men and 7.7% (4/52) in women. The skeletal muscle mass index (SMI) was 7.7 (SD 0.8) and 8.4 (SD 0.5) for men in the T2DM and control groups, respectively, and 7.0 (SD 0.9) and 6.8 (SD 0.7) for women in the T2DM and control groups, respectively. Therefore, compared with the nondiabetes group, a significant difference was observed in men but not in women (men: P<.001, women: P=.35). Nonetheless, the diabetes group exhibited significantly lower physical functions, such as a walking speed of 1.3 (SD 0.2) m/s and 1.2 (SD 0.43) m/s for men and women in the T2DM group and 1.6 (SD 0.2) m/s and 1.5 (SD 0.1) m/s for men and women in the control group, respectively (men: P<.001, women: P<.001). One-leg standing time was measured as 30.7 (SD 26.9) seconds and 29.4 (SD 25.5) seconds for men and women in the T2DM group, compared with 100.5 (SD 30.6) seconds and 82.5 (SD 39.8) seconds for men and women in the control group, respectively, with the T2DM group's times being significantly lower (men: P<.001, women: P<.001). Univariate logistic regression analysis showed that SMI was significantly associated with age, BMI, and peripheral neuropathy (all P≤.002). Multiple logistic regression analysis showed that BMI exhibited the strongest association (odds ratio 1.15, 95% CI 1.07-1.23; P<.001), and peripheral neuropathy was also significantly associated with SMI (P=.009). Patients with diabetes, even those who are not older adults, face an elevated rate of skeletal muscle mass loss, muscle weakness, and a decline in physical function; moreover, they are susceptible to dynapenia and presarcopenia. Therefore, early intervention focusing on muscle evaluation and exercise is crucial.

Association between Porphyromonas gingivalis in subgingival plaque and coronary artery disease: A case-control study.

Periodontitis is a chronic inflammatory disease of the supporting tissue surrounding the teeth. The disease is caused by specific bacteria, such as Porphyromonas gingivalis, which lead to the destruction of periodontal ligaments and alveolar bone. The study aimed to evaluate the relationship between the prevalence of P. gingivalis in subgingival plaque and coronary artery disease (CAD). Fifty patients with CAD and 50 healthy controls (non-CAD) participated in this case-control study. The periodontal health in the groups was evaluated through the assessment of the pocket depth (PD), clinical attachment loss (CAL) and bleeding on probing (BoP). The presence of P. gingivalis in subgingival plaque samples was determined through real-time polymerase chain reaction (RT-PCR). The data was analyzed using the χ2 test and the Mann-Whitney U test. The mean PD was 3.30 ±1.55 mm and 3.56 ±0.97 mm in CAD patients and non-CAD subjects, respectively (p = 0.028). No significant differences were observed in the CAL (p = 0.858) and BoP (p = 1.000) between the groups. The RT-PCR results revealed the presence of P. gingivalis 16S rDNA in 32% and 22% of the subgingival plaque of patients with CAD and non-CAD, respectively, with a mean concentration of 7.7 × 106. No statistically significant association was observed between the prevalence of P. gingivalis and CAD (p = 0.260). The results of the multiple logistic regression analysis showed an association between CAD and male sex (p = 0.004, odds ratio (OR): 4.163), as well as age (p = 0.011, OR: 1.067). The findings of this study indicated that there is no statistically significant correlation between the prevalence of P. gingivalis in subgingival plaque and CAD.

Prevalence of Myopia and Pseudomyopia and Their Risk Factors in Medical and Nursing Students at Navamindradhiraj University

Objective: To study the prevalence of myopia and pseudomyopia and their factors in medical and nursing students. Materials and Methods: The present study was a cross-sectional study that comprised 250 students at Navamindradhiraj University, Thailand. The authors did the eye examination, including pre-cycloplegic and post-cycloplegic autorefraction, then analyzed the data using crude analysis, simple logistic regression analysis, and Multiple logistic regression analysis with SPSS. Furthermore, the authors recorded the data, such as demographics, ocular history, and the amount of time spent using various devices with a screen and paper reading. Results: The prevalence of myopia and pseudomyopia were 50% and 13.6%, respectively. Myopia risk factors were older age, male gender, sleeping more than six hours and time spent using a tablet (p&lt;0.05). Students with increasing age each year had a 1.70-fold increase in myopia (adjusted OR 1.79, 95% CI 1.38 to 2.31, p&lt;0.001). Besides, students with a history of using artificial tears were 2.91 times more likely to have myopia than students without a history of using artificial tears. Risk factors of pseudomyopia were sleeping time less than six hours and time spent reading paper books (p&lt;0.05). The outdoor activity was not associated with myopia and pseudomyopia. Conclusion: The present study provides information regarding the risk factors of myopia and pseudomyopia. In addition, the present study shows that outdoor activity could not function as a protective factor against myopia. Keywords: Myopia; Pseudomyopia; Medical student; Nursing student

License to drive vehicles: Legal aspects and clinical variables in Brazilian patients with epilepsy.

To evaluate the license to drive a vehicle in patients with epilepsy according to Brazilian legislation and to relate it to demographic and clinical variables. The license-to-drive vehicle rate was related to the demographic and clinical data of 305 patients with epilepsy. The mean age was 49.2years, with 176 females, the mean education was six years, and structural epilepsy occurred in 203 patients. The license to drive vehicles occurred in 35 (11.5%) patients. In the multiple logistic regression analysis, with stepwise variable selection criteria, it was observed that the variables that together best predict the possession of a driving license are education (p-value=0.012; OR = 1.15 (1.03, 1.29)), sex (p-value=0.001; OR = 4.05 (1.80, 9.68)), marital status (p-value=0.022; OR = 2.67 (1.18, 6.41)), neurological examination (p-value=0.029; OR = 3.62 (1.25, 13.22)) and number of antiseizure medication (ASM) in use (p-value=0.019; OR = 3.04 (1.26, 8.28)). The license did not comply with Brazilian legislation in 21 (60%) patients. In nine patients, the practice violated the law due to the type of vehicle, and in 12 patients, due to the maintenance of seizures in the last year. Patients with non-legal aspects of the license were older, had less education, were male, and had a spouse. In patients with epilepsy, the rate of license to drive vehicles was low, and it was associated with higher schooling, males, having a spouse, having no alterations in the neurological examination, and the use of a single ASM. The non-compliance with current legislation was high, suggesting a lack of information or denial of the disease.

Factors Affecting Visual Inspection Examination of Acetic Acid (IVA) in Couples of Childbearing Age in the Working Area of UPT. Puskesmas Mandala Medan Year 2024

Visual Inspection of Acetic Acid (IVA) is an early detection of cervical cancer, the decline in IVA Test examinations in 2022 is from 154 people to 61 people in January to June 2023, where in half a year in 2023 the achievement of IVA Test examinations does not reach 50% of IVA examinations Test in 2022. The aim of the research is to analyze the factors that influence the visual inspection of acetic acid (VIA) in couples of childbearing age in the work area of UPT.Puskesmas Mandala Medan in 2023. This research is a combination of quantitative and qualitative research. The population was 259 people and the sample was 972 people. Quantitative data analysis using the chi-square test and multiple logistic regression and qualitative data analysis. The results of this study show that 38 people did not carry out IVA examinations with the chi-square test results showing the variables age, education, employment, knowledge, attitudes, culture and husband's support. The results of the multiple logistic regression test show that the knowledge variable has the most influence on visual inspection of acetic acid in women of childbearing age. The conclusion of this research is that there is an influence of age, education, work, knowledge, attitudes, culture and husband's support with visual inspection of acetic acid (IVA) on couples of childbearing age in the working area of UPT. Mandala Health Center Medan in 2023. It is recommended that UPT Mandala Health Center increase participation in providing training to health workers and be able to promote the VIA examination program and should involve husbands so that they can be enthusiastic in the VIA examination program and it is better for door to door health workers in providing VIA education

Association Between Obesity and Intra-Abdominal Solid Organ Damage in Patients with Blunt Abdominal Trauma: A Cross-Sectional Study.

Background/Objectives: The global prevalence of obesity continues to rise. However, whether obesity affects the degree of intra-abdominal solid organ damage following blunt trauma remains unclear. This study aimed to investigate the correlation between obesity and intra-abdominal solid organ damage. Methods: This cross-sectional study was conducted at a regional trauma center in the Republic of Korea from January 2018 to December 2022 and included 582 patients aged 18-98 years with blunt abdominal trauma. Patients were categorized into four groups-underweight, normal weight, overweight, and obesity-based on their body mass index (BMI). Odds ratios (ORs), beta coefficients, and 95% confidence intervals (CIs) for intra-abdominal organ damage were calculated across BMI categories using multiple logistic regression analysis after adjusting for the confounding variables. Results: The obesity group exhibited a significant decrease in the prevalence of liver injury (OR: 0.553, CI: 0.316 to 0.966) and a reduction in liver injury severity (β: -0.214, CI: -0.391 to -0.037) compared with the normal-weight group after adjusting for the confounding factors. However, no significant association was observed between the BMI and injuries to other solid organs, such as the spleen, pancreas, and kidneys. Additionally, the younger obesity group (participants aged < 45 years) exhibited a significant negative association with both liver injury and injury grade. However, the older obesity group (participants aged > 65 years) exhibited a statistically significant association only with the liver injury grade compared with the normal-weight group. Conclusions: Obesity can serve as a predictive factor for the presence and severity of liver damage caused by blunt abdominal trauma.

Demographic, socioeconomic and dietary factors are associated with double burden of malnutrition among indigenous communities in Sarawak

Introduction: Double burden of malnutrition (DBM), encompassing both overnutrition and undernutrition, is a growing global public health issue. Indigenous people are one of the marginalised populations experiencing DBM at varying severity. This study aimed to identify factors contributing to DBM in indigenous households in Sarawak. Methods: This cross-sectional study utilised multistage random sampling to include 286 indigenous households from six administrative divisions in Sarawak. Mothers aged 20–49 years who had at least one child aged 2–12 years were recruited. Trained interviewers obtained information on demographic and socioeconomic characteristics, food security, and dietary intake via a two-day, 24-hour dietary recall. Height and weight measurements followed World Health Organization protocols. DBM household was identified as having an overnourished (overweight/ obese) mother with an undernourished (underweight/stunting/wasting) child within the same household. Simple and multiple binary logistic regression analyses were performed. Results: Prevalence of DBM among the indigenous communities in Sarawak was 25.2%. Households with an overweight/obese mother and a stunted child was 12.9%, wasted child (11.9%), and underweight child (9.4%). Households with younger mothers, a household size of &gt;4 persons, and higher income per capita (relative to sample population) were significantly more likely to have DBM. Conversely, households with higher monthly non-food expenditure and greater fish and seafood intake scores in children were significantly less likely to have DBM. Conclusion: DBM is prevalent among Sarawak’s indigenous communities, affecting 25.2% of households. Further research and targeted interventions are needed to address socioeconomic and dietary factors in these populations.

Use of thymidine kinase 1 autoantibody, thymidine kinase antigen, extracellular protein kinase A autoantibody, and C-reactive protein for early detection of malignant tumors in dogs.

Although the importance of early diagnosis of malignant tumors is a major concern, an easily accessible in-house method has not been established. To investigate the most optimal model by combining thymidine kinase 1 (TK1) autoantibody, extracellular protein kinase A (ECPKA) autoantibody, TK1 antigen, C-reactive protein (CRP), age, breed, and sex. Serum samples from 1702 dogs were collected from local animal hospitals and referral animal medical centers in Korea. TK1 autoantibody, ECPKA autoantibody, and CRP were measured using LFIA methods in serum samples of dog to design a new neoplastic index (NI) for early detection of malignant tumors in dogs. AUC of TK1 autoantibody model with TK1 antigen, CRP, age, and breed in multiple logistic regression analysis was 0.966 (TK1 autoantibody, P = .0005; TK1 antigen, P = .0003), and when the cutoff value was 0.417, the specificity was 87.1%, and sensitivity was 96.4%. Regression coefficients were 24.4, 20.5, 24.8, 10.6, respectively in TK1 autoantibody, TK1 antigen, CRP, and age, and the effect by breed (regression coefficient 2.1, 3.0) was the lowest. The same multiple logistic regression analysis on dogs with lymphoma, and AUC of TK1 autoantibody model was 0.981 (all P < .0001, TK1 antigen P = .09), when the cutoff value was 0.352, the specificity was 92.9%, and sensitivity was 93.7%. The NI including TK1 autoantibody could be useful in the screening test for both lymphoma and other tumors.

Observational prospective study to determine the association and diagnostic utility of salivary nitrites levels in periodontitis.

There has been found that patients with chronic periodontitis showed higher salivary concentrations of reactive nitrogen species (RNS) than healthy subjects. However, only a study from elderly Koreans has reported that high salivary RNS concentrations are associated independently with periodontitis. Thus, the objective of this study was to determine whether salivary nitrites concentrations are associated with periodontitis controlling risk factors in other populations (such as European population). This was a prospective and observational study carried out in a Dental Clinic including European subjects without periodontitis (including subjects with periodontal health or with localized gingivitis in <30% sites) or with periodontitis (thus, with loss of periodontal tissue). The levels of nitrite in saliva were assessed using the Griess method. A multivariate regression analysis was performed to determine that variables were associated independently with periodontitis. To determine the association between salivary malondialdehyde levels and severity of periodontitis was used Spearman's rho correlation coefficient. A receiver operating characteristic analysis with salivary nitrites levels and periodontitis diagnostic was performed. Subjects with periodontitis (n=54) in comparison to subjects without periodontitis (n=30) had higher salivary nitrites levels (p=0.003), higher rate of arterial hypertension history (p=0.02) and were older age (p<0.001). Nevertheless, differences between subject with and without periodontitis in other variables were not found. A positive correlation was found between salivary nitrites levels and periodontitis severity (rho=0.23; p=0.04). Multiple logistic regression analysis showed that elevated salivary nitrites levels > 209 nmol/mL were associated with periodontitis controlling for arterial hypertension history and age (OR=10.212; 95% CI=2.665-39.128; p=0.001) and controlling for diabetes mellitus and smoker (OR=8.793; 95% CI=3.038-24.450; p<0.001). The area under the curve for periodontitis diagnostic by salivary nitrites levels was of 69% (95% CI=58%-79%; p<0.001). The selected point of salivary nitrites levels > 209 nmol/mL for periodontitis diagnostic had 72% of sensitivity (58%-84%), 77% of specificity (58%-90%), 3.1 of p ositive likelihood ratio (1.6-6.1), 0.4 of negative likelihood ratio (0.2-0.6), 85% of positive predictive value (74%-92%) and 61% of negative predictive value (49%-71%). Salivary nitrites concentrations could be associated independently with periodontitis, could be associated with periodontitis severity and could help in periodontitis diagnosis in a European population according to the results of this preliminary study.

Predicting independent walking ability using the Simplified Stroke Rehabilitation Assessment of Movement, Berg Balance Scale, and Barthel Index for Activities of Daily Living in individuals post-stroke: an observational preliminary study

IntroductionThe purpose of this study was to determine cut scores to predict independent ambulation for the Simplified Stroke Rehabilitation Assessment of Movement (S-STREAM), Berg Balance Scale (BBS), Barthel Index (BI) for Activities of Daily Living for patients with time after stroke up to 1 year. The study’s second goal was to establish statistical dependence between the tests the S-STREAM, BBS, BI, and the Functional Ambulation Category (FAC).MethodsCohort observational retrospective pilot study by design. Twenty-four people who suffered a stroke within the past year were enrolled in the study. The FAC was used to classify patients into independent walking and non-walking groups (scores 0–2 are non-walking patients, scores 4–5 are independent walking patients). Receiver operating characteristic (ROC) curve analysis was performed for the S-STREAM, BBS, BI selected according to the multiple logistic regression analysis with dichotomy on groups independent walking patients and not.ResultsROC analysis of scores at admission were used to determine cut scores for the independent waking ability for each of the listed measures. The cut score for S-STREAM was 19 points, for BBS was 27 points and for BI was 65 points. Based on this analysis it appears there is sufficient evidence to conclude a significant linear relationship between all tests the S-STREAM, BBS, BI, and FAC.ConclusionsIn patients who were ambulators, less than one year post stroke, this pilot study established a cut score for standardized assessment tools S-STREAM, BBS, BI for Activities of Daily Living.

Association between NF-E2-related factor 2 polymorphism and age-related hearing loss in the general Japanese population from the Iwaki health promotion project

Background Single-nucleotide polymorphisms (SNPs) of the NF-E2-related factor 2 (NRF2) gene might be associated with several diseases. In the animal models, NRF2 has been reported to be associated with the age-related hearing loss (ARHL). However, the effect of NRF2 SNPs on ARHL in the general population has not been reported. Objectives This study aimed to evaluate the effect of NRF2 SNP-617 on ARHL in the general Japanese population. Methods This study included participants from the Iwaki Health Promotion Project. The genotypes of NRF2 SNP-617 were determined via whole-genome sequencing, and the hearing level of the CC homozygote + CA heterozygote carrier group was compared with that of the AA homozygote carrier group. Results Among the 306 CC+CA and 31 AA group male subjects, 22 (7.2%) and six (19.4%), respectively, had hearing loss, with a significant difference. Multiple logistic regression analysis showed that the risk of hearing loss in the male subjects was significantly higher in the AA group than that in the CC+CA group (p = .031, odds ratio = 3.437, 95% confidence interval = 1.116–10.580). Conclusion The genotypes of NRF2 SNP-617 AA carriers were significantly associated with the development of ARHL among the males aged 30–59 years.

Association between modified dietary inflammation index score and lumbar vertebrae bone mineral density in patients with hypertension: data from NHANES—a population-based study

BackgroundThe modified Dietary Inflammation Index Score (M-DIS) is a scoring system used to quantify the inflammatory effects of nutrients and foods. Inflammation may affect Bone Mineral Density (BMD) and increase the risk of osteoporosis and fractures. The purpose of this study was to utilize data from the National Health and Nutrition Examination Survey (NHANES) to evaluate the relationship between M-DIS and lumbar vertebrae BMD in patients with hypertension.MethodsData from 2007 to 2008, 2009–2010, 2013–2014 and 2017–2018 NHANES cycles were collected for secondary analysis. Information provided by NHANES participants included complete dietary intake interviews and BMD measurements. M-DIS was calculated based on dietary intake interviews. Dual energy X-ray absorptiometry (DXA) was used to evaluate the average BMD of lumbar vertebrae (L1–L4). As an indicator of bone health, weighted multiple logistic regression and restricted spline analysis were utilized to study the relationship between M-DIS and lumbar vertebrae BMD in American patients with hypertension.ResultsA total of 3864 participants aged ≥ 20 years with complete data were included in this study. The proportion of osteopenia in the lumbar spine was 7.2%. After adjusting for confounding factors, negative correlations were observed between the BMD of each vertebral and its average BMD with M-DIS. In Model 3, the relationship between mean lumbar BMD and M-DIS was β = − 0.0103 (95% CI − 0.0160 to − 0.0046, P < 0.001). Notably, L1 showed a particularly significant negative correlation with β = − 0.0120 (95% CI − 0.0172 to − 0.0067, P < 0.001), while the proportion of osteopenia was highest in the L3 vertebra, accounting for 8.3%. Higher M-DIS was positively correlated with the incidence of osteopenia (OR 0.595, 95% CI 0.371–0.965, P = 0.041). Further analyses revealed that in hypertensive patients, elevated M-DIS in women was associated with lower lumbar BMD (P for nonlinearity = 0.093), while this trend was not significant in hypertensive men.ConclusionsThe results of this study suggest that a higher M-DIS (pro-inflammatory diet) is significantly associated with BMD in females with hypertension. These results indicate that female with hypertension who prefer a pro-inflammatory diet may be at an increased risk of osteopenia, highlighting the necessity for tailored dietary recommendations.

Differences in suicide acceptability by farming-related occupation, demographic, and religiosity factors, general social survey 2000–2022

Introduction Suicide acceptability beliefs must be considered when evaluating interventions to prevent suicide, as such beliefs can reveal cultural sanctions associated with suicide and suicidal behaviors and thoughts. Compared to the general US population, farmers/ranchers have an elevated suicide rate, requiring culturally competent interventions. This analysis investigated whether farmers and workers in agricultural-related industries differ from the general U.S. population in suicide acceptability levels. Methods Cross-sectional General Social Survey (GSS) data were combined from years 2000 to 2022. Four yes/no items assessing whether respondents thought an individual should be able to decide to end their life amid four negative life scenarios were used to define suicide acceptability or endorsement. U.S. Census Bureau industry and occupational codes were used to delineate occupations. Age, sex, race, ethnicity, educational level, survey administration year, and religiosity level were covariates for multiple logistic regression analyses. Among 18,191 respondents to the GSS, 167 people worked in farming/ranching roles, including 74 farmers/ranch operators and 93 farm/ranch workers. Results In unadjusted models, individuals in farm-related occupations had a lower prevalence than the general US adult population of sanctioning suicide if facing an incurable disease. Yet, suicide endorsement beliefs showed no statistically significant differences between farmers/ranchers and the general population after demographic factors were included in the model. Age, sex, race, ethnicity, and education were significant predictors of suicide acceptability, p &lt; 0.01. The prevalence of farmer/ranch operators identifying as very or moderately religious was significantly higher than that of farm/ranch workers and the general population, p &lt; 0.05. The sample identifying as non-religious had higher odds of sanctioning suicide when faced with an incurable disease (aOR 5.980, 95%CI 5.235–6.829), bankruptcy (aOR 3.281, 95%CI 2.791–3.857), having dishonored their family (aOR 3.215, 95%CI 2.732–3.784), or becoming tired of living (aOR 3.660, 95%CI 3.209–4.175). Conclusion The present results showed that farmers’/ranchers’ acceptability of suicide was not distinct from the general US population in multivariable models. However, given their disproportionately high suicide rate, they require customized outreach and interventions. Further research may elucidate how religiosity, demographic factors, and beliefs about suicide and religion impact interventions to prevent suicide for individuals working in farming/ranching.

The appearance of scalp high-frequency oscillations is associated with poor seizure control in pediatric epilepsy patients.

Epilepsy treatment with anti-seizure medications (ASMs) is based on careful assessment of the balance between the likelihood of further seizures and the risk of side effects of treatment. However, there is currently no established biomarker to ascertain seizure control status with ASMs. High-frequency oscillations (HFOs), transient bursts of EEG activity with frequencies beyond 80 Hz, are a new and promising noninvasive epilepsy biomarker. We compared the risk of scalp HFO appearance between pediatric patients with good and poor seizure control by treatment with ASMs. A total of 72 epilepsy patients (aged 0-18 years, 39 males) with good and poor seizure control with ASMs participated in this study. We applied a validated automated detector to determine HFO and spike. We calculated the odds ratios (ORs) for scalp HFO and spike appearance according to seizure control status by multiple logistic regression analysis. Scalp HFO was seen more commonly and with a significantly higher detection rate in patients with poor seizure control as compared with patients with good seizure control for both ripple and fast ripple. These significant associations were found for both focal and generalized epilepsy. The ORs for scalp HFO appearance adjusted for confounding factors were significantly higher in patients with poor seizure control compared to those with good seizure control (ripple: OR [95% CI] = 11.91 [2.21-64.30], p = 0.004; fast ripple: 4.98 [1.03-24.09], p = 0.046). There were no significant associations between spike appearance and seizure control status. We found an increased risk of scalp HFO appearance in patients with poor seizure control. The results of this study support that scalp HFO is associated with patients having frequent seizures after treatment in both ripple and fast ripple. This study analyzed scalp high-frequency oscillations and spikes in pediatric patients with various types of epilepsy who were being treated using ASMs. The results showed that an increased risk of scalp HFO appearance was observed in patients with poor seizure control compared to those with good seizure control. These findings were observed in both the ripple (80-250 Hz) and fast ripple (250-500 Hz) bands. The scalp HFO is associated with patients having frequent seizures after treatment in both ripple and fast ripple.

Personalized diet order compliance is associated with an improved functional independence measure (FIM) score in elderly patients: An eight-week follow-up study in a convalescent hospital.

It is important to establish the relationship between appropriate nutritional intake and improvements in activities of daily living (ADLs) in elderly hospitalized patients. This prospective observational study aimed to investigate diet order compliance (DOC) during 8 weeks of hospitalization and calculate the odds of improved functional independence measure (FIM) scores for high- and low-DOC groups using covariate-adjusted models in geriatric convalescent hospitals. The study subjects were elderly inpatients (>65 years old) with degenerative disease who consumed prescribed oral meals (Functional Oral Intake Scale (FOIS) = 6/7) and who did not receive physical/occupational therapy. The personalized diet order was prescript, and the DOC was calculated using dietitian-monitored daily intake data. The 73 patients were divided into a low-DOC group (< 84.0%, n = 35) and a high-DOC group (≥ 84.0%, n = 38) on the basis of the median DOC (84.0%, average for 8 weeks). Twenty (52.6%) high-DOC patients and nine (25.7%) low-DOC patients experienced motor-FIM improvements (P = 0.017). After 8 weeks, the change in motor-FIM in the high-DOC group (1.6±0.3) was greater than that in the low-DOC group (0.3±0.1; P = 0.001). According to the baseline and nutrition-intake-adjusted model of multiple logistic regression analysis, in the high-DOC group, the motor-FIM improvement OR was 5.102 (95% CI: 1.100-16.233, P = 0.036), and the total-FIM improvement OR was 5.273 (95% CI: 1.102-25.238, P = 0.037). High compliance with individualized nutritional prescriptions can increase FIM scores in clinical settings. Thus, comprehensive approaches to increase dietary compliance are needed for elderly long-term care patients.

Plain radiograph evaluation of concurrent filling of tibial peg holes with bone in cementless total knee arthroplasty

PurposeThis study aimed to evaluate the effectiveness of a novel technique for securing the tibial component in cementless total knee arthroplasty (TKA) by utilizing resected cancellous bone to fill the peg holes. It was hypothesized that this method would reduce the incidence of radiolucent lines (RLLs) on plain radiographs. To test this hypothesis, a retrospective comparison of plain radiographs from patients who underwent the bone-filling technique (bone filling group) versus those who did not receive this treatment (conventional group) was conducted. MethodsParticipants were 151 patients (213 joints) who underwent TKA with the NexGen trabecular metal (TM) modular tibia (Zimmer Biomet) from 2011 to 2016 [bone filling group, 54 patients (69 joints); conventional group, 100 patients (144 joints); 3 patients had 1 joint in each group]. Clinical evaluations, plain radiographs, and operative time were compared between groups. ResultsThe mean follow-up period was 5 years and 5 months. Knee Society Scores and Knee Society Functional Scores did not differ significantly between groups; however, the bone filling group had a significantly lower incidence of RLLs (p ​< ​0.05) and significantly more longitudinal trabecular thickening below the pegs (p ​< ​0.05). Multiple logistic regression analysis with the presence/absence of RLLs as the dependent variable revealed a significant effect of bone filling (odds ratio ​= ​2.820, 95% confidence interval 1.033–7.700; p ​< ​0.05). ConclusionConcurrent peg hole bone filling significantly reduces the incidence of RLLs and significantly increases longitudinal trabecular thickening below the pegs during TKA with the NexGen TM modular tibial component.

The Independent Association Between Changes in Physical Activity Participation Time and Dyslipidemia Risk

Background and AimThis study aimed to examine the independent association between changes in participation time across different types of physical activities and dyslipidemia. Methods and ResultsThe study utilized data from a large-scale cohort survey of Koreans, comprising a total of 2,543 participants recruited during 2011-2012 and 2013-2014. Physical activity participation times by type were assessed using validated questionnaires, and changes in these participation times over two years were categorized into four groups(Consistently Inactive, Formerly Active, Newly Active, and Consistently Active). Dyslipidemia was classified according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Multiple logistic regression analysis was used to calculate odds ratios (OR) and 95% confidence intervals (CI) to assess the association between changes in physical activity participation times and dyslipidemia. The analysis revealed that, when adjusting for sex and age, the Consistently Active group had a 40% lower odds ratio (OR=0.60, 95% CI=0.45, 0.81) of dyslipidemia compared to the Consistently Inactive group. Similar results were observed after adjusting for various confounding factors. Also, being newly active(OR=0.75, 95% CI=0.58, 0.97) or consistently active(OR=0.63, 95% CI=0.41, 0.97) in moderate-intensity physical activity, as well as being consistently active(OR=0.76, 95% CI=0.61, 0.95), in walking, independently reduced the risk of dyslipidemia after adjusting for various confounding variables. ConclusionsMaintaining a high level of physical activity was associated with a reduced risk of dyslipidemia. Therefore, national recommendations should focus on sustaining and increasing physical activity levels to manage dyslipidemia effectively.

Effects of parental migration on children’s schooling: a cross-sectional study of internal labour migrants in Delhi, India

ABSTRACT This paper reports how children’s educational prospects are affected when parent(s) migrate for livelihood. A cross-sectional study was conducted in the National Capital Territory of Delhi, India. Six thousand one hundred sixty-eight migrant households from 189 slums and slum-like areas across Delhi were selected following cluster-random sampling. Socio-demographic details of all household members were collected from an adult family member. Analysis of descriptive statistics and multiple logistic regression were carried out. There were 5,698 children aged 6–14 years in these households. 23.8% of children of migrants (6–14 years) lost the opportunity to attend school. Migration status, ethnicity, residence, per capita income, and parental education were associated with children’s schooling. The study concludes that the children of poor migrants have low levels of schooling at the destination compared to the children of migrants living in their native place.