Bivariate Analysis Research Articles

Age differences in cannabis-related perceptions, knowledge, and sources of information among adults in the post-legalization era in Quebec, Canada.

Individuals access and perceive information about cannabis differently according to age groups. This study compared differences in beliefs and knowledge regarding cannabis, and exposure to information, advertisement, and prevention messages among emerging (18-24 years old), prime-age (25-44), middle-age (45-64), and old-age adults (65 and over). Participants (n=2,001) completed online questionnaires regarding their sociodemographic characteristics, mental health perception, cannabis use, sources of cannabis information, and exposure to advertisement and prevention messages. Bivariate analyses allowed the detection of differences among the age groups. Emerging adults exhibited more positive attitudes regarding cannabis and were more knowledgeable regarding cannabis facts than their older counterparts. Online media constituted the principal source of information for the overall sample. Health resources were the most trusted information source for all age groups, but only one-fifth of the sample consulted them. A higher proportion of emerging adults were exposed to cannabis advertisements and prevention messages. Old-age adults were more likely to be reached through traditional media. As perceptions and beliefs about cannabis, information access, and exposure to advertisement or prevention messages vary across age groups, effective prevention and education should be tailored accordingly. Health resources and scientific literature about cannabis should become more accessible and understandable to the general population.

Building RECOVERY: development of the registry of eating disorders and their co-morbidities OVER time in youth

BackgroundEating disorder (ED) research is limited by the lack of longitudinal cohort studies, particularly those in adolescents, and the lack of inclusion of multiple perspectives and diagnoses. The objective of this study was to describe the development of a longitudinal cohort of adolescents/young adults representing varied ED diagnoses and including perspectives of parents and multi-disciplinary clinicians in addition to those of patients.MethodsPatients of an outpatient ED program who were age 10–27 years, along with their parents and clinicians, were recruited to participate in a longitudinal web-based study. Using univariate, bivariate, and multivariate analyses, we assessed rates of participation among different groups (i.e., parents, patients, different clinical disciplines) as well as factors related to attrition.Results71% of patients, 75% of parents, 56% of adolescent medicine providers, 20% of primary care physicians, 83% of dietitians, and 80% of mental health clinicians invited agreed to participate. At 12 months, 32% of patient participants had not completed their on-line surveys. Attrition rates were higher for parents (55%) and clinicians (45% of nutritionists, 55% of primary care physicians, 51% of Adolescent/Young Adult providers, and 64% of mental health providers) at 12 months.ConclusionsA longitudinal registry of patients with EDs is feasible and efficient when using web-based surveys. However, clinician participation is particularly hard to secure and maintain.

Peripheral neuropathy and associated factors among children living with HIV on antiretroviral therapy in Gamo zone, Southern Ethiopia: an institution-based cross-sectional study

BackgroundPeripheral neuropathy (PN) is a common neurological complication of HIV (Human Immunodeficiency Virus) that can significantly affect patients’ quality of life. In Ethiopia, children living with HIV are at an increased risk of developing peripheral neuropathy due to comorbidities such as anemia, tuberculosis, malnutrition, and poor socio-economic status. Our study aims to evaluate the prevalence of peripheral neuropathy among children living with HIV in Ethiopia using a simple clinical screening tool.MethodsA health institution-based cross-sectional study was conducted among 148 children aged 5 to 18 years living with HIV who are receiving treatment at the antiretroviral therapy (ART) clinic of the randomly selected public health institutions in the Gamo zone. An interview and neurologic examination were conducted. A binary logistic regression model was used to identify factors associated with the outcome variable. Variables with p-value < 0.25 in the bi-variable logistic regression analysis were entered and checked for association in a multivariable logistic regression model. The level of statistical significance was declared at the p-value < 0.05.ResultIn this study, 148 children participated, making a response rate of 97.5%. The mean ± standard deviation (SD) age of the respondents was 15.03 ± 2.99 years, and 81(54.7%) were male. The magnitude of PN was 20.9% (31/148). Children in the age category of 15–18 (adjusted odds ratio (AOR) = 1.88, 95%CI; 1.24–4.60), low BMI for age (AOR = 1.66, 95%CI; 1.12–4.15), last exposure to isoniazid within 1 year (AOR = 2.31, 95%CI; 1.12–8.53). Longer duration of HIV illness (AOR = 2.17, 95%CI; 1.54–4.64), and past tuberculosis (TB) treatment (AOR = 2.11, 95%CI; 1.08–7.48) were significantly associated factors with peripheral neuropathy.ConclusionOur analysis revealed that being in the age category of 15–18 years, low BMI for age, Isoniazid exposure, longer Duration of HIV illness, and past TB treatment were significantly associated with peripheral neuropathy in children living with HIV. These disease-related factors may contribute to the development and progression of peripheral neuropathy in this population.Clinical trial numberNot applicable.

The Relationship Of Compliance With Posyandu Visits And Accuracy Of MP-ASI Portions With Stunted Incidents In Yosowilangun Village, Manyar District

The prevalence of stunting is still increasing, including in Indonesia. The prevalence of stunting in 2022 in East Java province is 19.2%, while stunting in Gresik Regency in 2022 is 10.7% (Ministry of Health, 2022). However, at the end of 2023 there was a spike in stunting cases in Gresik which caused the percentage of stunted toddlers to rise. The aim of the research was to determine the relationship between compliance with Posyandu visits and accuracy of MP-ASI portions with short incidents (Stunted) in Yosowilangun Village, Manyar District. The research design method used is cross-sectional and the sampling method uses Proportioned Random Sampling. This research population involved mothers who had children aged 6-24 months who were registered at the Yosowilangun Village Posyandu. The sampling technique is Simple Random Sampling. The sample size was 112 toddlers. The results of the bivariate analysis between compliance with posyandu visits and appropriate portions of MP-ASI administration and the incidence of stunting were obtained (p = 0.000). Based on the data above, it can be concluded that compliance with Posyandu visits and the correct portion of MP-ASI delivery are significantly related to the incidence of stunting in Yosowilangun village.

Addressing disparity in attitudes and utilization of family planning among married couples in the pastoralist community of Fentale District, Eastern Ethiopia.

Despite progress in national reproductive health programs, pastoralist regions like Fentale District in Eastern Ethiopia face challenges with low contraceptive coverage, attributed to insufficient positive attitudes and uptake among couples. This cross-sectional study was conducted from October 1 to December 25, 2021, in Fentale District, Eastern Ethiopia. It involved 1,496 couples selected using multistage sampling. Data were entered into EPI Data and analyzed with SPSS (v23.0) and STATA (v14.0), employing descriptive statistics, bivariate analysis, and binary logistic regression to identify predictors of contraceptive attitudes and use. The study's response rate was 93.8%, with 1,404 pastoralist couples participating, equally split between women and men. A nomadic-pastoralist lifestyle was common (64.6%), and family planning discussions were rare (93.2%). Gender disparities in contraceptive attitudes and use were evident. Contraception use was reported by 27.4%, with women (41.2%) outnumbering men (13.5%). Women showed more positive attitudes towards contraception (87.9% vs. 31.9% for men). Only 33% had favorable attitudes towards different contraceptive methods, with women more likely to be positive. Modern contraception use was low (18.2%), with women (34.8%) predominating over men (1.7%). Among users, women had a more favorable attitude (78.5% vs. 6.6% for men). Health extension workers were key information providers. Predictors of contraceptive attitudes and use included sex, education, occupation, electronic device ownership, migration frequency, treatment preferences, and family planning discussions. The limited positive attitude towards and use of family planning in Fentale District may stem from unfavorable attitudes, low adoption, and couple disparities. Key factors include gender, education, occupation, electronic device ownership, migration, treatment preferences, and family planning discussions. Targeted educational campaigns for men are needed to address these issues and reduce the gender gap in contraceptive attitudes and use.

Sex differences in symptoms following the administration of BNT162b2 mRNA COVID-19 vaccine in children below 5 years of age in Germany (CoVacU5): a retrospective cohort study

BackgroundSex differences exist not only in the efficacy but also in adverse event rates of many vaccines. Here we compared the safety of BNT162b2 vaccine administered off-label in female and male children younger than 5 years in Germany.MethodsThis is a retrospective cohort study, in which we performed a post-hoc analysis of a dataset collected through an authentication-based survey of individuals having registered children aged 0-<5 years for vaccination against SARS-CoV-2 in six private practices and/or two lay person-initiated vaccination campaigns. We analyzed the safety profiles of the first 3 doses of 3–10 µg BNT162b2. Primary outcome was comparison in frequencies of 4 common post-vaccination symptom categories such as local, general, musculoskeletal symptoms and fever. Data were analyzed according to sex in bivariate analyses and regression models adjusting for age, weight, and dosage. Interaction between sex and BNT162b2 dosage was assessed. An active-comparator analysis was applied to compare post-vaccination symptoms after BNT162b2 versus non-SARS-CoV-2 vaccines.ResultsThe dataset for the present analysis consisted of 7801 participants including 3842 females (49%) and 3977 males (51%) with an age of 3 years (median, interquartile: 2 years). Among individuals receiving 3 µg BNT162b2, no sex differences were noted, but after a first dose of 5–10 µg BNT162b2, local injection-site symptoms were more prevalent in girls compared to boys. In logistic regression, female sex was associated with higher odds of local symptoms, odds ratio (OR) of 1.33 (95% confidence interval [CI]: 1.15–1.55, p < 0.05) and general symptoms with OR 1.21 (95% CI: 1.01–1.44, p < 0.05). Following non-BNT162b2 childhood vaccinations, female sex was associated with a lower odds of post-vaccination musculoskeletal symptoms (OR: 0.29, 95% CI: 0.11–0.82, p < 0.05). An active comparator analysis between BNT162b2 and non-SARS-CoV-2 vaccinations revealed that female sex positively influenced the association between BNT162b2 vaccine type and musculoskeletal symptoms.ConclusionsSex differences exist in post-vaccination symptoms after BNT162b2 administration even in young children. These are of importance for the conception of approval studies, for post-vaccination monitoring and for future vaccination strategies (German Clinical Trials Register ID: DRKS00028759).

Effectiveness of Deep Breathing Relaxation on Anxiety Due to Hospitalization in Preschool Age Children

Hospitalization in preschool children causes them to lose control over their environment, resulting in psychological and physical distress, characterized by panic, phobia, obsessive, compulsive, and generalized anxiety disorders. Objective: This study aims to analyze the effectiveness of Deep Breathing Relaxation. on hospitalization anxiety. Method: This study is a quantitative study with a quasi-experimental design of two groups pre and posttest. The sample of this study was preschool children who underwent hospitalization as many as 32 children. This study used the Preschool Anxiety Scale (PAS) instrument which is of international standard with proven validity (r=0.68) and reliability (0.87). The bivariate data analysis used the Wilcoxon test for the intervention group, the Paired T Test for the control group, and Man Whitney test for comparison of intervention group with control, and N-Gain test to see the effectiveness of the intervention. Result: The results of the study showed that hospitalization anxiety in children before Deep Breathing Relaxation averaged 65.75 with the lowest score of 32 and the highest 79 (SD: 13.394). After the intervention, the children's anxiety score decreased, namely an average score of 53.69, the lowest score of 27 and the highest 66 (SD: 12.877). There was a significant difference between the intervention group and the control group with a p value of 0.038 (&lt;0.05), but the N-Gain results showed that the intervention was in the ineffective category (N-Gain: 20.46%).

Methodology and development of a machine learning probability calculator: Data heterogeneity limits ability to predict recurrence after arthroscopic Bankart repair.

The aim of this study was to develop and train a machine learning (ML) algorithm to create a clinical decision support tool (i.e., ML-driven probability calculator) to be used in clinical practice to estimate recurrence rates following an arthroscopic Bankart repair (ABR). Data from 14 previously published studies were collected. Inclusion criteria were (1) patients treated with ABR without remplissage for traumatic anterior shoulder instability and (2) a minimum of 2 years follow-up. Risk factors associated with recurrence were identified using bivariate logistic regression analysis. Subsequently, four ML algorithms were developed and internally validated. The predictive performance was assessed using discrimination, calibration and the Brier score. In total, 5591 patients underwent ABR with a recurrence rate of 15.4% (n = 862). Age <35 years, participation in contact and collision sports, bony Bankart lesions and full-thickness rotator cuff tears increased the risk of recurrence (all p < 0.05). A single shoulder dislocation (compared to multiple dislocations) lowered the risk of recurrence (p < 0.05). Due to the unavailability of certain variables in some patients, a portion of the patient data had to be excluded before pooling the data set to create the algorithm. A total of 797 patients were included providing information on risk factors associated with recurrence. The discrimination (area under the receiver operating curve) ranged between 0.54 and 0.57 for prediction of recurrence. ML was not able to predict the recurrence following ABR with the current available predictors. Despite a global coordinated effort, the heterogeneity of clinical data limited the predictive capabilities of the algorithm, emphasizing the need for standardized data collection methods in future studies. Level IV, retrospective cohort study.

Effects of Pelvic Rocking and Deep Breathing Relaxation Exercises on the Progression of the Active Phase of the First Stage of Labor

Prolonged labor or undeveloped labor is one of the complications in childbirth. Where prolonged labor is labor that lasts more than 24 hours in primi and more than 18 hours in multi. The purpose of this research is for the Influence of Pelvic Rocking Exercise and Slow Deep Breathing Relaxation on the Progress of the First Stage of Labor among mothers giving birth in Indonesia in 2024. Research methods This is a pre experimental quantitative research with a group compilation statistical design. The data analysis used is univariate and bivariate analysis using the Mann Whitney hypothesis test, which is a non-parametric test that measures differences equivalent to the independent T test in parametric measurements. The p-value result was 0.000. This shows that there is a significant influence of pelvic rocking exercise and slow deep breathing relaxation on the progress of the first stage of labor in 2024. This pelvic rocking exercise and slow deep breathing relaxation intervention can be applied by the birthing mother so that the mother can give birth safely, comfortably and in a quicker time than without intervention.

The Influence of Complementary Feeding on Appetite and Growth Development in Children Aged 7-12 Months

Complementary feeding (MP-ASI) is crucial for meeting the nutritional needs of infants aged 7-12 months, influencing their appetite and growth. Objective: This study evaluates the effects of MP-ASI on the appetite and growth of infants aged 7-12 months in 2024. A pre-post test design with 194 respondents assessed the impact of different types of MP-ASI on appetite and growth. All respondents received the same type of MP-ASI. Data were analyzed using univariate and bivariate analyses with SPSS. There was no statistically significant relationship between the type of MP-ASI given and weight gain. However, varieties such as spinach and eggs, and chayote and eggs, showed higher compliance with recommended nutritional standards (KPSP), indicating that MP-ASI type significantly influences adherence to these standards. Diverse MP-ASI positively affects the appetite and growth of infants aged 7-12 months. The study underscores the importance of MP-ASI variety and quality in child nutrition programs. Increasing parental education on the importance of MP-ASI variety is recommended to support optimal developmental potential in children.

Axial tics in Tourette syndrome and chronic tic disorders.

Tics are the hallmark of Tourette syndrome (TS) and chronic tic disorders (CTD). Although typically involving the face, especially at onset, tics may involve any muscle under voluntary control, including axial muscles of the neck (causing head movements), shoulders and trunk (thorax and abdomen). We aimed to characterize these tics and provide a clinical frame for their associations and complications. We reviewed video recordings and clinical history of 196 patients with TS or CTD according to DSM-5. Any axial tic was identified in 75% of patients. Tic distribution were head (n = 113, 57.6%), shoulder (n = 91, 46.4%), and trunk (n = 63, 32.2%). There were no differences in sex, age at onset or at evaluation between patients with and without axial tics. The most common axial tics by anatomical distribution were head turning, bilateral synchronous shoulder elevation and trunk jerks; however, tic phenomenology was quite variable. A greater severity of tics (P = 0.018) was associated with axial tics in the multivariate regression analysis. Head/neck tics associated with simple phonic tics (P = 0.002); whereas shoulder and trunk tics associated with complex motor tics (P < 0.05) in a bivariate analysis. Neck pain, breathing interference, sleep limitation and radiculopathy, secondary to axial tics were complications observed in a proportion of these cases. Axial tics are commonly observed in patients with TS/CTD with variable phenomenology. They associate with greater tic severity, phonic tics and complex motor tics. They may result in neck pain, breathing interference, sleeping problems and cervical spine injuries.

Nutritional Status and Cardiometabolic Markers to Determine Athlete’s Achievement: A Cross-Sectional Study

The health, physiological, and nutritional status of an athlete is a top priority in achieving success and career sustainability. Information about an athlete's health, such as blood biochemistry, anthropometry, and adequate nutritional intake, might indicate their ability to perform exceptionally well in different levels of competition. Objective: This research objective is to examine the correlation between athletes' sports achievements in Bandung and their anthropometric traits, nutritional status, and blood biochemical indicators. Methods: This study utilised a cross-sectional design and incidental data collection techniques. Participants: The study comprised 84 athletes from 27 different sports who received achievement allowances from KONI Bandung City. Instruments: n this study, we employed reliable and validated techniques to assess anthropometrics, body composition, somatotype, blood biochemistry, nutritional intake adequacy, and energy adequacy. Data analysis: Both the bivariate and multivariate analyses used logistic regression. Results: The findings of the analysis indicate a significant relationship between athlete performance and two variables: blood pressure (p=0.026) and dietary diversity (p=0.048). The findings from the multivariate analysis revealed a significant relationship between blood pressure and dietary variety, which influences the achievement of athletes. The calculation of the odds ratio (OR) revealed that among all the variables examined, the athlete's blood pressure exhibited strongest correlation with their performance. Conclusion: Blood pressure is a physiological measurement that can serve as an indicator of cardiac function and overall well-being. As a result, it is critical to regularly assess the physical well-being of athletes in Bandung to ensure their consistent optimal performance.

Depression, Anxiety, and Coping Strategies Among Farmworkers Exposed to Substance Use at Work

ABSTRACT Objective Migrant farmworkers are at an increased risk of experiencing high levels of stress, depression, anxiety, and problematic substance use. Farmworker behavioral health is a predominant concern for agricultural health and safety efforts. While substance use has been found to be a visible part of the work environment among farming populations, there is scarce information about how farmworkers who are exposed to substance use at work are impacted. Methods This exploratory assessment investigated the association between substance use exposure at work and migrant farmworkers’ (N = 58) symptoms of depression, anxiety, and coping strategies used. Univariate, bivariate, and regression analyses were conducted to examine data from a survey administered to migrant farmworkers in Southern California’s Riverside and Imperial Valley counties. Results Exposure to substance use at work was significantly associated with farmworkers reporting more severe symptoms of anxiety (p = .018). We also found that anxiety among farmworkers was significantly related to their experiences of sexual harassment (p = .026), being called names or insulted (p = .05), feeling unsafe (p = .005), having an increased work burden (p = .001), and caring for a colleague (p = .001). Furthermore, as exposure to substance use at work increased, farmworkers reported more severe symptoms of depression (F (1,45) = 7.90, p = .007) and anxiety (F (1,45) = 16.743, p = .001). To cope, the farmworkers in our sample reported using emotion-focused coping strategies most often. Conclusions Substance use exposure at work can affect migrant farmworker health and safety. Addressing and supporting the behavioral health of the entire farming community is warranted.

Dietary diversity and associated factors among pregnant women attending antenatal care at public hospitals in North Shewa, Oromia, Ethiopia, 2023.

Adequate consumption of diversified food during pregnancy enables adequate intake of 11 important micronutrients. Pregnant women who consume an inadequate amount of diversified food during pregnancy are at a higher risk of delivering preterm babies, stillbirth, low birth weight, and small for gestational age newborns. This study aimed to assess dietary diversity (DD) and associated factors among pregnant women attending antenatal care (ANC) at public hospitals in North Shewa, Oromia, Ethiopia, 2023. An institution-based cross-sectional study was conducted on 400 pregnant women attending antenatal care. The study participants were selected using a systematic random sampling method. A pre-tested, structured, and interviewer-administered questionnaire was used to collect information about dietary diversity. The questionnaire was adapted from a validated and modified individual dietary diversity guideline, as recommended by the Food and Agriculture Organization (FAO) of the United Nations. The household food security level was determined using a standard set of questions derived from the Household Food Insecurity Access Scale (HFIAS) measurement guide. The data were entered into EpiData version 4.6 software and exported to Statistical Package for the Social Sciences (SPSS) version 24 for analysis. The results from the bivariate analysis of p < 0.25 were moved to the multivariable logistics regression analysis model. Any statistical test with a p < 0.05 at a 95% confidence interval (CI) was considered statistically significant. The study revealed that 55.4% of the pregnant women had adequate dietary diversity. Being an urban dweller [adjusted odds ratios (AOR = 2.4. 95% CI: 1.1, 5.18)], being a housewife (AOR = 3.44, 95% CI: 1.37, 8.68), being employed (AOR = 3.69, 95% CI: 1.12, 12.16), being a merchant (AOR = 3.43, 95% CI: 1.15, 10.24), being a daily laborer (AOR = 3.66, 95% CI: 1.0, 13.45), having a low average monthly household income of <500 Ethiopian birr (ETB) (AOR = 0.25, 95% CI: 0.07, 0.83), practicing home gardening (AOR = 2.5, 95% CI: 1.39, 4.5), meal frequency being three or more times per day (AOR = 2.9, 95% CI: 1.64, 5.09), and receiving dietary counseling during antenatal care (AOR = 3.56, 95% CI: 2.0, 6.35) were factors associated with the dietary diversity of the pregnant women. This study found that 55.4% of the pregnant women had adequate dietary diversity. Place of residence, women's occupation, average monthly household income, practicing home gardening, meal frequency per day, and receiving dietary counseling during antenatal care were strong predictors of adequate dietary diversity among pregnant women. Therefore, attention should be paid to pregnant women's diet by healthcare providers during antenatal care.

A framework integrating affinity propagation algorithm and spatial bivariate analysis for enhanced identification and localisation of soil heavy metals pollution sources.

The accurate identification of pollutant sources and their spatial distribution is crucial for mitigating soil heavy metals (SHMs) pollution. However, the receptor model struggles to effectively categorize pollutant sources and pinpoint their locations and dispersion trends. We propose a novel comprehensive framework that combines a receptor model, random forest (RF), affinity propagation (AP) algorithm, and bivariate local indicator of spatial association (BLISA), to optimize the traditional approach for tracing SHMs sources in industrial regions. We apportioned SHMs sources using a receptor model combined with RF, while BLISA combined with AP methods were employed to accurately locate the source areas and identify their dispersion tendencies. The results revealed that SHMs originated from mixed sources of equipment manufacturing agglomeration and agricultural activities (59.0%), geological background (30.5%), and emissions from heavily-polluting industries (10.5%). The pollution sources of soil Cd and Pb were located near specific industries, showing characteristics of multi-site concurrent pollution diffusion influenced by their proximity to industrial sites. The spatial distribution of Cr, Cu, and Zn sources was concentrated in high-density urban industrial areas, transitioning from point to nonpoint sources, with diffusion patterns influenced by the spatial agglomeration effect of industries. Our enhanced framework accurately identifies the location of SHMs sources and their dispersion tendencies, thereby improving regional soil pollution management.

Contributions to forearm desaturation during transient ischemia in healthy adult males and females across the lifespan.

This study investigated skeletal muscle tissue oxygenation (StO2) desaturation in males and females across the adult lifespan. One-hundred-two individuals (51 females) of 41 young, 34 midlife, and 27 older adults completed a vascular occlusion test with near-infrared spectroscopy (NIRS+VOT). This included five minutes of arterial occlusion, inducing transient ischemia in the forearm flexor muscle group while recording StO2. The magnitude of desaturation (StO2mag) was quantified as the difference between baseline StO2 and the minimum StO2 value observed during ischemia. The rate of desaturation was also examined. Forearm adipose tissue thickness (ATT), forearm lean mass, and handgrip muscular strength were measured. A p ≤ 0.05 was considered significant. Two-way between factor ANOVAs indicated that males exhibited significantly (p<0.001) less ATT than females (collapsed across age) and that forearm lean mass (p<0.001) and muscular strength (p<0.001) decreased across the lifespan independent of sex. Bivariate analyses revealed significant (p<0.05) associations for sex, age, ATT, forearm lean mass, and muscular strength with the desaturation metrics. The ATT values demonstrated the strongest relations with StO2mag and desaturation rate (r = -0.620 and 0.618). Using a model comparison approach, ATT plus age offered the best predictive power for StO2mag and desaturation rate (R2 = 0.456 and 0.438) such that the inclusion of sex did not improve the models. These findings suggested differences in desaturation were primarily explained by variations in ATT and, to a lesser extent, age, but biological sex had no meaningful effect. Future studies must determine what other factors influence desaturation during ischemia.

Flavored Tobacco User Characteristics in U.S. young Adults: Wave 5 of the Population Assessment of Tobacco and Health Study

Introduction: Flavorings are one of the major appealing factors of current tobacco products, especially for young adults. They constantly evolve, and new flavorings are introduced to the market every year, but little is known about user profiles of flavored tobacco products (FTPs). Methods: We analyzed young adult (ages 18–24) tobacco product users (N = 4,707) from Wave 5 of the Population Assessment of Tobacco and Health Study. We applied bivariate analyses to compare individuals who use FTP and non-FTPs by different flavor types (i.e., menthol/mint, fruit, candy/sweets, and tobacco). Parameter estimates were weighted by applying the sample and replicate weights for the complex study design to produce population-representative estimates. Results: Sixty percent of the current combustible tobacco users and 90% of electronic nicotine delivery systems (ENDS) users were FTP users. FTP users were more likely to be multiple product users than non-FTP users. Being non-Hispanic White, drinking alcohol in the past year, experiencing internalizing problems in the past month, and having tobacco dependence were associated with FTP use. Flavored ENDS users had different sociodemographic characteristics by flavor types but did not differ significantly in vaping-related behaviors (e.g., frequency). Also, preferred flavors differed among tobacco user groups (i.e., ENDS, hookah, and cigars). Conclusions: FTPs appear to be gaining popularity among young adults and tend to show co-use with multiple tobacco products and other substances. Future studies are warranted to monitor the risk factors of young adult FTP use, especially in the context of flavor ban on ENDS products.

Nursing Students' Perception of the Clinical Learning Environment: A Longitudinal, Cohort Study.

The clinical learning environment (CLE) plays a vital role in students' learning in clinical settings. However, to our knowledge, no longitudinal cohort studies have been published on how CLE influences nursing students' learning during clinical placements. This study investigated a cohort of nursing students' perceptions of CLE during their first and third-year clinical placements. The clinical learning environment inventory (CLEI) questionnaire was used in this study. In 2021, a convenience sample of 450 first-year nursing students was invited to complete the CLEI questionnaire. In 2023, the same cohort of students in their third year of study were invited to complete the questionnaire. Personalization, satisfaction, and task orientation had higher mean scores than the other CLEI subscales. The lowest mean scores were found for the teaching innovation and individualization subscales. Multiple regression and bivariate correlation analyses revealed task orientation as the strongest predictor of student satisfaction with the CLE. Nursing students in Singapore have a moderately positive satisfaction with their CLE. Clinical instructors should design innovative lesson plans to improve the student experience and learning in the CLE.

Logistics Technology Adoption and Delivery Performance of Shipping Companies in South-West Nigeria

This study explored logistics technology adoption and delivery performance of shipping companies in South-West Nigeria. The study used a positivist research philosophy and correlational design to analyse data from 65 shipping companies in South-West Nigeria, with 20 managers selected purposefully and a structured questionnaire used as the primary instrument. The data collected were analysed using descriptive statistics while the Pearson Product Moment Correlation Coefficient (PPMCC) was used to test the formulated hypotheses. SPSS software program version 24 was used to perform the bivariate analysis. The findings revealed that Artificial intelligence adoption has a significant relationship with on-time delivery of shipping companies. The study showed a significant correlation between the adoption of Artificial intelligence, transportation technology, and warehouse automation, as well as the on-time delivery of shipping companies. The study concluded and recommended that adopting logistics technology can significantly enhance the delivery performance of shipping companies in South-West Nigeria.

Preoperative Mental Health Disorders Affect Opioid Consumption and Perioperative Complications After Total Shoulder Arthroplasty.

Limited evidence exists regarding the influence of mental health disorders (MHDs) on opioid use and complications after total shoulder arthroplasty (TSA). We aimed to identify the prevalence of common MHDs among patients undergoing anatomic TSA (aTSA) and reverse TSA (rTSA). The Premier Healthcare Database was queried for patients undergoing primary aTSA and rTSA from 2016 to 2020. International Classification of Diseases, Tenth Revision, diagnosis codes were used to identify MHDs. Primary outcomes included the prevalence of MHDs, perioperative opioid consumption, and 90-day risk of postoperative complications, revision, and readmission. Bivariate and multivariate regression analyses were performed to assess 90-day risk of primary endpoints while controlling for potential confounders. Statistical significance was defined as P<.05. From 2016 to 2020, 49,997 of 144,725 (34.55%) patients undergoing primary TSA had at least one diagnosed MHD. The most prevalent were depression (17.03%), anxiety (16.75%), and substance use disorder (10.20%). Patients with a MHD had higher mean hospital costs ($75,984±$43,129 vs $73,316±$39,046, P<.0001), longer mean length of stay (1.95±2.25 days vs 1.61±1.51 days, P<.0001), and higher mean total postoperative opioid use (72.00±231.55 morphine milligram equivalents [MMEs] vs 59.32±127.31 MMEs, P<.0001). Periprosthetic fractures (odds ratio, 1.20; P=.041), dislocation (odds ratio, 1.12; P=.042), and 90-day readmission rates (odds ratio, 1.26; P<.001) were significantly higher among patients with a MHD. This study found that MHDs are associated with significantly increased perioperative opioid consumption, medical and surgical complication rates, and risk of readmission after TSA. Recognition and optimization of MHDs is critical to minimizing complications and opioid consumption after TSA. [Orthopedics. 202x;4x(x):xx-xx.].