Binary Logistic Regression Research Articles

Completion of maternal and child health continuum of care and associated factors in West Gondar Zone, North West Ethiopia, 2023: a community based cross sectional study

BackgroundThe maternal and child health continuum of care integrates services from pre-pregnancy through childhood to enhance maternal and child outcomes. It is crucial for reducing maternal and child mortality by focusing on comprehensive health interventions. Despite its significance, comprehensive studies on the continuum remain limited. This study aimed to assess the completion of the maternal and child health continuum of care and associated factors among mothers with index children aged 12–23 months in the West Gondar Zone, Northwest Ethiopia, in 2023.MethodsA community-based cross-sectional study was conducted from May 1–30, 2023, by interviewing mothers of 12-23-month-old children in West Gondar zone. A simple random sampling method was used to select 1,019 mothers. Data were collected via KoboCollect and analyzed in Stata version 14.0. Binary logistic regression was used to examine associations between independent variables and the continuum of care. Variables with a p value < 0.2 in bi-variable analysis were included in the multivariable model. Finally, adjusted odds ratios (AOR) with 95% confidence intervals (CI) and p values < 0.05 were used to determine statistical significance. The Hosmer and Lemeshow goodness-of-fit test was computed.ResultsThe overall rate of completion of the maternal and child health continuum of care was 6.19% (95% CI: 4.69–7.68). The factors associated were having the first ANC visit before 16 weeks of pregnancy [AOR: 4.25 (CI: 2.14–8.47)], birth preparedness and complication readiness [AOR: 3.02 (CI: 1.41–6.46)], history of modern contraceptive use [AOR: 2.34 (CI: 1.16–4.73)], intended pregnancy [AOR: 3.25 (CI: 1.63–6.48)], receiving maternal services during ANC visits [AOR: 2.69 (CI: 1.07–6.80)], and the health facility being less than an hour away from home [AOR: 2.53 (CI: 1.06–6.03)].ConclusionsThe maternal and child health (MCH) continuum of care in West Gondar was low. Key factors affecting completion included birth preparedness and complication readiness, early ANC initiation, planned pregnancy, family planning use, proximity to health facilities, and maternal health services provided during ANC. Efforts should target these factors and ensure services at each stage of the continuum to stay mothers along the path of the MCH continuum of care.

Mild behavioral impairment in people with mild cognitive impairment: Are the two conditions related?

Mild cognitive impairment (MCI) and mild behavioral impairment (MBI) are both considered potential prodromal stages of dementia, especially Alzheimer's disease. Previous literature has lacked specific information about MBI in individuals with MCI and associations of several aspects of both, MBI and MCI. Our aim was to investigate whether associations exist between aspects of MBI and aspects of cognitive performance in certain dimensions of the Montreal Cognitive Assessment (MoCA). We used baseline data from the double-blind randomized controlled intervention MCI-CCT-study. Current cognitive performance of individuals with MCI was measured with the MoCA. MBI was assessed with the MBI Shortscale (MBI short), which was administered through a self-report interview. Associations were assessed with Pearson correlations. Sensitivity analyses were conducted for gender and cognition. Group differences were examined with independent samples t-tests or Welch test. Significant correlations were considered in binary logistic regressions under control of covariates. There was no significant correlation between the current MoCA and MBI short scores in the total sample or in the gender-related analysis. Using dichotomized cognitive performance, significant correlations between MCI and MBI were revealed for individuals with lower MoCA scores. On the task level, several significant associations were identified between MoCA dimensions and MBI dimensions in the total sample and in the sensitivity analyses, also under control of covariates. Our findings support the hypothesis that with increasing cognitive decline, the association between MCI and MBI becomes stronger. Furthermore, a certain cut-off on the MoCA must be reached to identify a correlation.

Association of dietary inflammatory index with sarcopenia in patients with Metabolic dysfunction-associated fatty liver disease: a cross-sectional study

BackgroundSarcopenia is a common complication of fatty liver, and sarcopenia increases the risk of advanced liver fibrosis in patients with Metabolic dysfunction-associated fatty liver disease (MAFLD). Chronic inflammation is the crucial link between sarcopenia and fatty liver. An anti-inflammatory diet is expected to be an essential measure to prevent sarcopenia in patients with fatty liver, and the dietary inflammatory index (DII) is a crucial tool for assessing the inflammatory potential of diets. However, the relationship between DII and sarcopenia in patients with fatty liver is unclear.ObjectiveThis study investigated the correlation between the dietary inflammatory index (DII) and sarcopenia in patients with Metabolic dysfunction-associated fatty liver disease (MAFLD).MethodsData for this study were obtained from the National Health and Nutrition Examination Survey (NHANES) 2017–2018, with 917 patients with MAFLD participating in the study. Participants were divided into three groups based on DII tertiles: group T1 (n = 305), group T2 (n = 306), and group T3 (n = 306), and binary logistic regression was used to assess the relationship between DII and sarcopenia with stratified analyses based on the weights recommended by the NHANES and multivariate linear regression was used to evaluate the association of DII with total appendicular lean mass.ResultsAfter adjusting for all confounders, DII was significantly and positively associated with the risk of sarcopenia in women [OR: 1.61, 95% CI: (1.226, 2.06), p &amp;lt; 0.001]. The risk of sarcopenia was higher in the T3 group compared to the T1 group [OR: 4.04, 95% CI: (1.66, 9.84), p = 0.002]. DII was negatively associated with appendicular lean mass adjusted for body mass index in both men and women.ConclusionDII was significantly associated with the risk of sarcopenia in female patients with MAFLD, with higher DII scores related to a higher risk of sarcopenia. Higher DII scores related to a higher risk of sarcopenia in men with significant fibrosis.

Association of time in range with cognitive impairment in middle-aged type 2 diabetic patients

ObjectiveThis study investigated the association of Time In Range (TIR) obtained from Blood Glucose Monitoring (BGM) with Cognitive Impairment (CI) inpatients with middle-aged Type 2 Diabetes Mellitus (T2DM) and further explored whether a TIR goal for T2DM in adults with > 70% possess a protective effect on cognitive function.Research design and methodsA total of 274 inpatients with T2DM aged 40–64 years, who underwent seven-point BGM ( pre meals and 120 min post meals and at bedtime) were recruited in this cross-sectional study. TIR was defined as the percentage of blood glucose within the target range of 3.9-10.0mmol/L. Subjects were divided into Normal Cognitive Function (NCF) (n = 160) and CI (n = 114) groups according to the results of the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE). The association of TIR and other glycemic metrics, calculated from seven-point BGM data, with cognitive dysfunction was analyzed.ResultsThe prevalence of CI was 41.6% in patients with middle-aged T2DM (median age 58 years). TIR was lower in CI group than in NCF group (28.6% vs. 42.9%, P = 0.004). The prevalence of CI decreased with ascending tertiles of TIR (p for trend < 0.05). Binary logistic regression analysis showed a significant association between TIR and CI (odds ratio [OR] = 0.84, p < 0.001) after adjusting for confounders (age, education, marital status, age at Diabetes Mellitus (DM) onset, cerebrovascular disease). Further adjustment of Standard Deviation (SD)(OR = 0.84, p = 0.001) or Coefficient of Variation (CV)(OR = 0.83, p < 0.001), TIR was still associated with CI. While a TIR goal of > 70% probably possessed independent protective effect on cognitive function (OR = 0.25, p = 0.001) after controlling for confounders above.ConclusionsTIR obtained from BGM was related to CI in middle-aged T2DM individuals and a TIR goal of > 70% probably possessed a protective effect on cognitive function for middle-aged T2DM .

Provincial distribution and factors associated with self-reported sexually transmitted infections and their symptoms among women in Sierra Leone

BackgroundSexually transmitted infections (STIs) are a significant public health concern worldwide. These infections can have severe consequences for women’s health, including pelvic inflammatory disease, infertility, and increased risk of HIV acquisition. Understanding the prevalence and factors associated with STIs among women in Sierra Leone is crucial to developing effective prevention and treatment strategies. This study investigated the provincial distribution and factors associated with self-reported STIs (SR-STIs) and STI symptoms among women in Sierra Leone.MethodsThe study used data from the 2019 Sierra Leone Demographic and Health Survey, comprising 13,965 women aged 15 to 49 who have ever had sex. Provincial variations in the prevalence of SR-STIs and STI symptoms were presented using a spatial map. A binary logistic regression analysis was performed to assess the factors associated with SR-STIs and STI symptoms among women in Sierra Leone. The results were presented as adjusted odds ratios (aOR) with a 95% confidence interval (CI).ResultsThe overall prevalence of SR-STIs and their symptoms was 21.6% [20.4, 22.9] among women in Sierra Leone. Higher odds of SR-STIs and their symptoms were associated with being aged 25–29 (aOR = 1.35, 95% CI = 1.10,1.66), 30–34 (aOR = 1.38, 95% CI = 1.09,1.74), 35–39 (aOR = 1.39, 95% CI = 1.10, 1.77), having tested for HIV (aOR = 1.16, 95% CI = 1.04, 1.29), and having multiple sexual partners (aOR = 2.25, 95% CI = 1.80, 2.83) compared to those in the reference category. Being in the rich wealth index (aOR = 1.32, 95% CI = 1.11, 1.57), living in the Northern (aOR = 2.43, 95% CI = 2.08, 2.83) and Northwestern province (aOR = 3.28, 95% CI = 2.81, 3.83), and being covered by health insurance (aOR = 3.19, 95% CI = 2.62, 3.88) were associated with higher odds of SR-STIs and their symptoms. Lower odds of SR-STIs and their symptoms were found among women with one (aOR = 0.81, 95% CI = 0.68, 0.96), two (aOR = 0.75, 95% CI = 0.61, 0.93), three (aOR = 0.66, 95% CI = 0.53, 0.83), and four or more children (aOR = 0.62, 95% CI = 0.49, 0.77], those residing in rural areas (aOR = 0.81, 95% CI = 0.69, 0.94), and women living in the Southern province (aOR = 0.67, 95% CI = 0.57, 0.80) compared to those in the reference category.ConclusionThe findings indicate that SR-STIs and their symptoms are prevalent among women in Sierra Leone. Our findings underscore the urgent need for targeted public health interventions to address the SR-STIs and their symptoms among women in Sierra Leone. The increased risk among women aged 25–39, those with multiple sexual partners and those from wealthier backgrounds, suggests that educational programmes focusing on safe sexual practices and STI prevention should be prioritized in urban and affluent areas. Additionally, the lower odds of SR-STIs among women with more children and those in rural regions indicate that family dynamics and geographic factors may offer protective benefits, which could be leveraged in public health messaging. Our findings highlight the importance of tailoring health services and outreach efforts to effectively reach and support vulnerable populations, ultimately aiming to reduce the incidence of SR-STIs.

A comparative study of antenatal depression among urban and rural pregnant women in Gimbi District, Oromia, Ethiopia

BackgroundAntenatal depression (AND) is a form of clinical depression that can be caused by stress and worries that can bring pregnancy to more severe levels. It has negative impacts on women, the family, and the community at large. The comparative study of antenatal depression among rural and urban pregnant women was less studied in Ethiopia and in this study area in particular.ObjectiveThe objective of the study was to compare the prevalence of antenatal depression and its associated factors among pregnant women in Gimbi rural and urban residents in Ethiopia in 2023.MethodsA community-based comparative cross-sectional study design was used from 1 February to 30 March 2023. A systematic random sampling method was used to select study participants. Data were collected using pretested interviewer-administered structured questionnaires. Binary logistic regression analysis was used to identify factors associated with antenatal depression. Variables with a p-value of 0.25 or less in the bi-variable logistic regression model were candidates for a multi-variable logistic regression model.ResultsThe prevalence of antenatal depression was 56 (21.5%), 95% CI: [16.9–25.5] among rural participants and 50 (19.2%) [95%] CI: [14.6–23.8] among urban participants. Having complications during pregnancy (AOR: 4.92, 95% CI: 1.35, 17.88), ever had depression (AOR: 3.20, 95% CI: 1.30, 7.85), consuming alcohol (AOR: 3.78, 95% CI: 1.24, 11.49), and educational status (can read and write) (AOR: 2.14, 95% CI:1.05, 4.67) were factors associated with antenatal depression among urban mothers, while no antenatal care follow-up (AOR: 6.6, 95% CI: 2.63, 16.85), unplanned pregnancy (AOR: 4.51, 95% CI:1.10, 1.86), and having complications during pregnancy (AOR: 2.77, 95% CI: 1.30, 5.92) were factors associated with antenatal depression among rural mothers.ConclusionThe prevalence of antenatal depression among rural mothers was higher than the prevalence of antenatal depression among urban mothers in the Gimbi district. Having complications during pregnancy, ever had depression, consuming alcohol, and educational status were associated factors with antenatal depression among urban mothers; having complications during pregnancy, unplanned pregnancy, and no ANC follow-up were factors associated with antenatal depression among rural mothers. Therefore, quality family planning and ANC services should be provided for the women to reduce unplanned pregnancies and experience complication-free pregnancy periods.

Prediction Models for Elevated Cardiac Biomarkers from Previous Risk Factors and During the COVID-19 Pandemic in Residents of Trujillo City, Peru

Cardiac troponin serum concentration is a marker of myocardial injury, but NT-pro BNP is a marker of myocardial insufficiency. The purpose of this study was to determine binary logistic regression models to verify the possible association of cardiovascular risk indicators, pre-pandemic history, the number of times participants were infected with SARS-CoV-2, and vaccination against these biomarkers. A total of 281 residents of Trujillo city (Peru) participated between September and December 2023. We found a high prevalence of abdominal obesity of 55.2%; glycemia &gt; 100 m/dL in 53%; hypercholesterolemia in 49.8%; low HDL in 71.9%; and LDL &gt; 100 mg/dL in 78.6%. A total of 97.5% were vaccinated against COVID-19, and 92.2% had three or more doses. Also, 2.5% had cTnI &gt; 0.05 ng/mL, and 3.3% had NT-proBNP &gt; 125 pg/mL. The number of COVID-19 infections versus cTnI &gt; 0.05 ng/mL presented an OR = 3.513 (p = 0.003), while for NT-proBNP &gt; 125 pg/mL, the number of comorbidities presented an OR = 2.185 (p = 0.025) and LDL an OR = 0.209 (p = 0.025). A regression model was obtained in which there is an association between a higher number of COVID-19 infections and elevated cTnI values and a model implying an association of the number of comorbidities and LDL with the NT-proBNP level in a direct and inverse manner, respectively. Both models contribute to the prevention of cardiac damage.

Timely initiation of breastfeeding and its associated factors among immediate postpartum mother-newborn pairs in Debre Tabor comprehensive specialized hospital, South Gondar Zone, North West, Ethiopia

BackgroundInitiation of breast feeding within one hour of birth is the easiest and most cost-effective intervention to reduce the risk of neonatal morbidity and mortality. Conducting studies immediately after an hour of birth for the timely initiation of breastfeeding has the significance of initiating breastfeeding and acting immediately. However, there was a paucity of information in the region as well as in the country at large. Therefore, the aim of this study was to assess the magnitude of timely initiation of breastfeeding and its associated factors among immediate postpartum mother-newborn pairs in Debre Tabor comprehensive specialized hospital, northwest Ethiopia, in 2024.MethodAn institutional-based cross-sectional study was conducted from October 25, 2023, to January 25, 2024, at Debre Tabor Comprehensive Specialized Hospital. A total of 478 immediate postpartum mothers were selected at birth using systematic random sampling techniques. Data were collected using chart reviews, interviewer-administered questionnaires, and through observation. Data entry and analysis was performed by Epi-Data version 4.6.02 and Statistical Package for Social Sciences version 25(SPSS) soft war respectively. Descriptive statistics were computed to determine the frequency of variables. After doing a binary logistic regression analysis, a p-value less than 0.25 indicated a potential candidate for multivariable analysis aimed at identifying statistically relevant factors. Both crude and adjusted odds ratios (AOR) were computed, and the levels of significance were declared based on the AOR with a 95% confidence interval (CI) at a p-value < 0.05.ResultsIn this study, the prevalence of timely initiation of breastfeeding was 73.7% with a 95% CI (69.65%, 77.67%). Being multiparous (AOR: 2.25, 95% CI: 1.32, 3.84), receiving counseling immediately after delivery (AOR: 4.19, 95% CI: 2.20, 7.98), receiving support and guidance from health care providers (AOR: 1.95, 95% CI: 1.01, 3.77), having no obstetric complications during and immediately after delivery (AOR: 4.44, 95% CI: 2.34, 8.42), and practicing rooming-in (AOR: 3.65, 95% CI: 2.05, 6.51) were significantly associated variables with timely initiation of breast feeding.ConclusionThe overall timely initiation of breastfeeding in this study was lower than the World Health Organization’s recommendations. Therefore, interventions need to focus on mothers who developed obstetric complications, primiparous mothers, improper rooming-in, a lack of advice immediately after delivery, and the support and guidance of mothers on the timely initiation of breastfeeding to improve the timely initiation of breastfeeding practice.

The influence of complexity, uncertainty, and munificence on long‐term organizational resilience to natural disasters

AbstractThe turbulent conditions of the external environment have placed unprecedented pressure on firms, drawing management scholars' attention to organizational resilience. This research aims to study if complexity, uncertainty, and munificence influence organizational resilience in terms of long‐term firm survival. We performed a binary logistic regression using a database of 1,849 Italian joint‐stock firms between 2014 and 2020, of which 89 received public funds as compensation for damages caused by natural disasters. We found that munificence in the context where firms operate is likely to increase their survival in the long term compared to the peers together with turnover, however, context complexity and uncertainty have not been found significant. The results shed light on the role of the context as an antecedent of organizational resilience.

Impact of protein consumption on sleep problems: Insights from NHANES data

Sleep problems are common and significantly impact health and well-being. Diet, particularly protein intake, may affect sleep, yet the precise relationship remains unclear. This study investigates the association between protein consumption and sleep problems while considering potential confounders and gender differences, using data from the National Health and Nutrition Examination Survey. Our cross-sectional analysis included 18,077 women (51.3%) and 17,175 men (48.7%), averaging 45.9 years (standard deviation = 17.7). Protein consumption was assessed through 24-h dietary recall interviews and sleep problems were assessed through the question: &amp;ldquo;Have you ever told a doctor or other health professional that you have trouble sleeping?&amp;rdquo; Using binary logistic regression models, we found that 24.6% of individuals reported sleep problems. A statistically significant association emerged between protein consumption and the likelihood of experiencing sleep problems across quartiles of protein intake. Specifically, individuals in the highest quartile of protein consumption had the lowest odds of sleep problems compared to those in the lowest quartile, even after adjusting for various demographic and lifestyle factors (P &lt; 0.001). Gender-stratified analysis revealed a persistent association between protein intake and sleep problems, with a stronger effect observed in females (P &lt; 0.002) compared to males (P = 0.337). Overall, our findings suggest that higher protein consumption is independently associated with reduced odds of sleep problems. This underscores the importance of adequate protein intake for promoting better sleep outcomes and highlights potential implications for public health interventions and clinical practice.

Glaucoma medication non-adherence rate and associated barriers among glaucoma patients in Hawassa, Ethiopia

BackgroundThe estimated number peoples aged 40 to 80 years affected with glaucoma were 76.0 million in 2020 and 111.8 in 2040 globally. The estimated number peoples aged 40 to 80 years affected with glaucoma were 76.0 million in 2020 and 111.8 in 2040. This study identified glaucoma medication non-adherence rates and associated barriers among patients with glaucoma attending Hawassa University Comprehensive Specialized Hospital.MethodsA prospective cross-sectional study was conducted on 340 patients diagnosed with glaucoma who were administered ocular hypotensive medication at least for one week before current visit and those who were diagnosed and prescribed the medication, currently presented to the hospital as new attendant. A systematic random sampling technique was used to select study participants. Data was collected using a validated questionnaire by interviewing patients and reviewing their medical charts from May 01 to November 30, 2022. The collected data checked for completeness, entered to SPSS 22. Descriptive and binary logistic regression analysis were done using the software. The findings were presented using tables and Pie-charts. A p-value ≤ 0.05 was used to indicate statistical significance.ResultsAbout 340 patients participated in this study with response rate of 90%. More than half of them (59.4%) were male. Mean age of the study participants was 60.2 ± 3.17SD years. The majority came from rural areas (186 (54.71%). Approximately 62.4% of them were with bilateral glaucoma while 47.10% were at advanced stage at least in one eye. The glaucoma non-adherence rate was 54.71% (95% CI; 50.90–58.50). Forgetfulness (AOR 28.32 (95% CI;14.80–54.16), difficulty with schedule AOR 2.52 (95% CI;1.009–6.29), believing eye drops were not effective AOR 6.35 (95% CI;1.17–34.49) and poor self-efficacy AOR 10.96 (95% CI;1.26–95.57) were barriers significantly associated with non-adherence.Conclusion and recommendationThe nonadherence rate to glaucoma medication among patients with glaucoma attending Hawassa University comprehensive hospital was high (54.71%). Forgetfulness, difficulty with schedule, belief that the drug was not effective and poor self-efficacy were barriers associated with glaucoma medication non-adherence. Health workers better to properly council and inform the patients about the disease nature, goal of treatment, danger of nonadherence to administered medication and mechanism to increase their adherence such as setting reminder.

Parental Acceptance of Fetal Tissue Donation

Human fetal tissue is essential for biomedical research, providing unparalleled insights into human development and disease. To assess changes in parental decisions to donate fetal tissue following termination of pregnancy after the introduction of the Dutch Fetal Biobank (DFB) and to identify factors associated with consent to donate. This cohort study collected data from all individuals assigned female at birth (hereafter referred to as participants) who underwent a termination of pregnancy at the Amsterdam University Medical Center from January 1, 2008, to December 31, 2022. No exclusion criteria were applied. Introduction of the DFB on September 1, 2017, which offers the option to donate fetal tissue after pregnancy termination. Rates of fetal tissue donation before and after DFB introduction and associations between patient characteristics (maternal age, race and ethnicity, socioeconomic status, gestational age, and reason for termination) and consent to donation were assessed using multivariable binary logistic regression modeling. Of a total of 1272 participants (mean [SD] age, 33.0 [5.4] years), 576 (45.3%) were nulliparous. The mean (SD) gestational age at termination was 18 weeks 3 days (26 days), and reasons for termination were primarily because of structural defects (567 participants [44.6%]), with only a small portion (58 participants [4.6%]) terminating for social reasons (eg, unwanted or unplanned pregnancy). Fetal tissue donations increased from 1.2% (8 donations among 663 terminations) before the DFB introduction to 21.7% (132 donations among 609 terminations) after its introduction. This rise was primarily due to a shift from collective cremation to donation, while individual cremation or burial rates remained stable. The consent rate was 30.3% (132 of 436) for participants informed about the donation option. No significant demographic differences were found between participants who consented and those who did not, except for gestational age; consent rates decreased with advanced gestational age (odds ratio per week, 0.88; 95% CI, 0.83-0.94). Higher consent rates were observed for terminations due to social reasons (odds ratio, 3.56; 95% CI, 1.40-9.10). These findings suggest that a substantial proportion of individuals may be willing to donate fetal tissue for biomedical research after pregnancy termination. Integrating donation options in posttermination counseling respects patient autonomy and could ethically increase tissue availability for research. Expanding biobanks and fostering international collaboration is crucial for standardizing practices and ensuring equitable research benefits.

Prevalence of Open Defecation Practice and Associated Factors Poverty and Geography in Palembang Indonesia

Palembang is one of the large cities in Indonesia which has a specific geography. A study was conducted to estimate the prevalence and determine poverty factors associated with open defecation practices.An analytical cross-sectional study was conducted for one year among 397 respondents as a sampling. Prevalence was calculated with 95% confidence intervals and binary logistic regression analysis was performed to determine factors associated with open defecation.32.5 percent of people still practice open defecation which is influenced by poverty and geographical factors. Influence of income ) AOR of 13,891 (Cl 8,345 – 23,123), education AOR of 20,328 (Cl 11,881 – 34,780), clean AOR 6,192 (Cl 3,747 – 10,234), water source AOR of 28,882 (16,403 - 50,854), characteristics of the house AOR of 3,977 (2,555 – 6,191), facilities or the availability of toilets at home AOR of 7,066 (4,167 – 11,983), geographical location of the house towards the river or water AOR of 478.995 (173.112 – 1325.1399), knowledge of open defecation behavior AOR of 3.607 , attitudes AOR of 3.277. Respondents who practice open defecation have low income and education, no water source available from the government, geographical location of the house near a river or swamp, no defecation facilities, lack of knowledge and bad behavior.

Serum albumin as a biomarker of (nutritional status in) sarcopenia.

To explore the possible associations between blood markers including albumin, hemoglobulin, creatinine and 25 OH vitamin D with sarcopenia using the ISarcoPRM algorithm. A total of 2094 community-dwelling males and postmenopausal females (495 males, 1599 females)aged ≥ 50years were recruited and their demographic data along with all comorbidities and laboratory evaluations were noted. Functional measurements were also quantified and the ISarcoPRM algorithm was used for the diagnosis/confirmation of the participants into sarcopenic and non-sarcopenic categories. Sarcopenia was detected in 434 (20.7%) participants and low albumin level in 578 (27.6%) of them. While sarcopenia was detected in 193 (33.4%) of 578 subjects with low albumin levels, and in 241 (15.9%) of 1516 subjects with normal albumin levels (p < 0.001). In the binary logistic regression analysis, among the blood parameters; only albumin levels [OR: 0.932 (95% CI 0.876-0.992) in males (p = 0.026), OR: 0.901 (95% CI 0.862-0.941) in females (p < 0.001)were found to be independently associated with sarcopenia in each gender. After adjusting for sociodemographic and other clinical factors, having low albumin levels(≤ 4.0 g/dL) were independently associated with sarcopenia i.e. 2.368 times (95% CI 1.424-3.939) in males and 2.026 times (95% CI 1.520-2.699) in females (both p < 0.001). Independent of other factors, low albumin level is associated with sarcopenia i.e. at least two times in both genders. Older and obese adults at risk of malnutrition should be screened/diagnosed and treated early for sarcopenia. Prospective studies are needed for better/prompt management of relevant patients who are prone to significant morbidity and mortality.

Burden of acute malnutrition in the conflict-affected urban communities of Tigray, Northern Ethiopia: a cross-sectional study

BackgroundMalnutrition impedes the growth, development, and survival of children. Conflict has severely affected the livelihoods of families and caused an alarming increase in food insecurity, population displacements, and extreme poverty in Tigray. Therefore, this study aimed to assess the prevalence and factors associated with acute malnutrition among 6- to 23-month-old children in the armed conflict-affected urban areas of Tigray.MethodsThe study population were randomly selected children aged 6 to 23 months. A cross-sectional study design was used. Data was collected from July 13 to 28, 2022 in Tigray region, Northern Ethiopia. A systematic random sampling technique was used to select the participants. Sociodemographic, lifestyle, anthropometric, and clinical variables were collected using a structured questionnaire. The data were analyzed using SPSS version 24 and presented using descriptive and analytical statistics. Binary logistic regression was used to identify independent predictors of acute malnutrition. All variables were declared statistically significant at a p-value of < 0.05.ResultsA total of 368 participants aged 6–23 months were included in the study. Half (50.5%) and around three-fourths (72.6%) of the participants were females and 12 to 23 months old children, respectively, with a mean (SD) age of 15.2 (5.1) months. The overall proxy global acute malnutrition rate was 44.3%, with 34.5% and 9.8% being moderate acute malnutrition and severe acute malnutrition, respectively. In the multivariable logistic regression model, three variables (consumption of legumes, maternal nutritional status, and household access to clean water) were identified as significant predictors of proxy global acute malnutrition. Children who didn’t eat legumes (AOR (95%CI): 2.39 (1.44, 3.97)), children of acutely malnourished mothers (AOR (95%CI): 1.60 (1.02, 2.51)), and children from households with insufficient water supply (AOR (95%CI): 1.99 (1.20, 3.31)) were significantly associated with an increased likelihood of acute malnutrition as compared with their counterparts.ConclusionsChildren from the armed conflict areas of Tigray are disproportionally impacted by acute malnutrition. Nearly half of the children were acutely malnourished, with one in ten suffering from the more serious severe acute malnutrition. Hence, urgent action is needed to prevent their permanent mental and physical deterioration and death by improving consumption of high protein foods, nutritional status of mothers, and access to clean water.

Predictors of recurrent ischemic stroke: A retrospective cohort study

Introduction: Cerebrovascular events are one of the most common causes of disability and the third leading cause of death in developed countries. Herein, we aimed to investigate the potential underlying causes of recurrent ischemic stroke. Methods: This study was a retrospective cohort study conducted in Razi Hospital, Tabriz, Iran between March 2018 and September 2020. Patients with the diagnosis of recurrent ischemic stroke during the study period were eligible to be included. Baseline characteristics and data on the recurrence were collected using chart reviews. Also, binary logistic regression was used to examine the factors related to recurrence. Results: Among one hundred participants with a mean age of 68.88 years, 59% were male. Hypertension, diabetes, heart disease, smoking, and hyperlipidemia were identified in 79%, 42%, 24%, 15%, and 15%, respectively. The average recurrence time of stroke was about 2.52 years. According to our findings, a significant relationship between the history of heart diseases and ischemic stroke recurrence was observed (risk ratio: 0.10: 95% confidence interval: 0.03-0.33). Conclusion: We found no significant association between ischemic stroke recurrence and underlying diseases except for heart diseases. Further large-scale observational studies and meta-analyses are recommended to evaluate the possible association.

Attitudes of Health Professionals Toward Digital Health Data Security in Northwest Ethiopia: Cross-Sectional Study.

Digital health is a new health field initiative. Health professionals require security in digital places because cybercriminals target health care professionals. Therefore, millions of medical records have been breached for money. Regarding digital security, there is a gap in studies in limited-resource countries. Therefore, surveying health professionals' attitudes toward digital health data security has a significant purpose for interventions. This study aimed to assess the attitudes of health professionals toward digital health data security and their associated factors in a resource-limited country. A cross-sectional study was conducted to measure health professionals' attitudes toward digital health data security. The sample size was calculated using a single population. A pretest was conducted to measure consistency. Binary logistic regression was used to identify associated factors. For multivariable logistic analysis, a P value ≤.20 was selected using Stata software (version 16; StataCorp LP). Of the total sample, 95% (402/423) of health professionals participated in the study. Of all participants, 63.2% (254/402) were male, and the mean age of the respondents was 34.5 (SD 5.87) years. The proportion of health professionals who had a favorable attitude toward digital health data security at specialized teaching hospitals was 60.9% (95% CI 56.0%-65.6%). Educational status (adjusted odds ratio [AOR] 3.292, 95% CI 1.16-9.34), basic computer skills (AOR 1.807, 95% CI 1.11-2.938), knowledge (AOR 3.238, 95% CI 2.0-5.218), and perceived usefulness (AOR 1.965, 95% CI 1.063-3.632) were factors associated with attitudes toward digital health data security. This study aimed to assess health professionals' attitudes toward digital health data security. Interventions on educational status, basic computer skills, knowledge, and perceived usefulness are important for improving health professionals' attitudes. Improving the attitudes of health professionals related to digital data security is necessary for digitalization in the health care arena.

Perceived social support and symptoms of depression and anxiety in emerging adulthood: A Swedish prospective cohort study.

The transition from adolescence to young adulthood, often referred to as 'emerging adulthood', is a challenging period in life, and mental health problems are common. Although a large number of studies have shown that social support is linked with fewer mental health problems, few longitudinal studies have examined these associations during this life phase. The aim of the current study was to examine the associations between perceived social support from different sources - family, friends and significant other - at age 17-18 and symptoms of depression and anxiety at age 20-21. Data were obtained from the cohort study Futura01 based on a Swedish national sample of adolescents attending grade 9 in 2016/2017. We used survey information from 2019 (age 17-18) and 2022 (age 20-21) and linked registry information (N=2722). Symptoms of depression and anxiety were measured by the Patient Health Questionnaire-4 (PHQ-4) at age 20-21. Perceived social support was measured by the Multidimensional Scale of Perceived Social Support (MSPSS) at age 17-18. Control variables included sociodemographic characteristics and indicators of mental health problems at age 17-18. Binary logistic regressions were performed. When mutually adjusting for all sources of perceived social support, family support at age 17-18 had inverse associations with symptoms of both depression and anxiety at age 20-21. Perceived support from friends was associated with subsequent symptoms of anxiety only. Perceived social support can be a protective factor against mental health problems in emerging adulthood. The family serves a particularly important source of social support.

Incremental and Radical Innovations that Contribute to the Survival of Small Businesses in Environments of Crisis

This paper examines the influence of incremental and radical innovations on the survival capacity of micro and small companies (MSE) in contexts of economic crisis.State of the art on innovation points to a lack of a specific methodology to segregate incremental and radical innovation in MSEs. Identifying such a method allows for action to promote innovation in such more assertive companies, contributing to the survival of companies in the most adverse moments, such as crises.In this sense, a methodology was developed to identify the type and degree of innovation based on the level of innovation in the sector of activity and was applied to a sample of 60 companies in the textile retail sector. The dependent variable was business survival, measured by the continuity or cessation of activity in 2020. The estimate of the probability of survival was carried out using a binary logistic regression model.The dimensions of incremental innovation, which are the most common in the business environment, did not significantly affect survival. The dimensions of radical innovation, which imply deeper and more disruptive changes in the business model, had a positive impact. significant impact on survival in all cases. The most complex actions in the Solutions dimension increased the chances of survival by 42%; improving Processes by 39%; and innovation in the Square by 38%. These findings suggest that small businesses that adopt radical innovations have greater adaptability and resilience to adverse situations.

Challenges in harvesting and utilization of Ziziphus tree fruits in Ethiopia

Ziziphus tree species commonly known as “jujube” are wide sources of nutritious and socio-economically important fruits in arid and semi-arid regions of Asia and Africa. However, understanding of local communities’ engagement in harvesting and utilization of these fruits remains limited consequently undermining sustainable harvesting and broader utilization. Household interviews (HHIs), focus group discussions (FGDs) and key informants’ interviews (KIIs) were used to investigate the level of harvesting and utilization of fruits from different tree species of jujube in Ethiopia. Multiple linear and binary logistic regressions were utilized to investigate factors influencing the annual fruit yield per tree and to discern factors impacting the local community's capacity to grow and sell jujube, respectively. Fruit yield per tree, market involvement and the principal challenges to growing were found to vary among two study sites. Bosset district's yield exceeded Bati's by 0.87 times. Women and children played significant roles in fruit collection, sale and management. Less rainfall reduced annual yield by 33 kg per tree while planting seedlings instead of relying solely on naturally regenerated trees boosted yield by 42 kg per year. With each advancing year in age, older respondents were 0.04 times less likely to sell harvested jujube fruits. The increasing impact of pests, water shortage and cultural influences decreased community interest in growing jujube by factors of 1.15, 1.41 and 2 times, respectively. Suboptimal involvement in jujube cultivation, fruit harvest and market activities was frequently ascribed to inadequate community support, organizational oversight and depressed market prices. These findings highlight the need to enhance awareness, management and market access for jujube fruits to broaden community benefits in Ethiopia.