Binomial Family Research Articles

Are Sexual Assaults Related to Functional Somatic Disorders? A Cross-Sectional Study.

An increasing number of sexual assaults (SAs) are being reported. This study investigated associations between SA and FSD, conceptualized as bodily distress syndrome (BDS), and five functional somatic syndromes (FSSs): chronic widespread pain (CWP), irritable bowel (IB), chronic fatigue (CF), multiple chemical sensitivity (MCS), and whiplash-associated disorder (WAD). Participants (n = 7493) from the population-based cohort Danish Study of Functional Disorders (DanFunD) completed questionnaires on FSD, emotional distress, SA, and sociodemographics. Risk ratios (RRs) for each FSD and emotional distress were calculated in nine models with SA as the primary exposure using generalized linear models with binomial family and log link and were adjusted for other potential risk factors. The results showed that SA was associated with single-organ FSD (RR = 1.51; 95% CI = 1.22-1.87), multi-organ FSD (RR = 3.51; 95% CI = 1.89-6.49), CWP (RR = 1.28; 95% CI = 0.83-1.98), IB (RR = 2.00; 95% CI = 1.30-3.07), CF (RR = 1.81; 95% CI = 1.42-2.32), WAD (RR = 2.62; 95% CI = 1.37-5.03), MCS (RR = 3.04; 95% CI = 1.79-5.17), emotional distress (RR = 1.75; 95% CI = 1.21-2.54), and health anxiety (RR = 1.65; 95% CI = 1.10-2.46). Overall, SA victims experienced significantly more somatic symptoms than individuals not exposed to SA. Adjusting for physical and emotional abuse did not change the observed associations. Our results suggest a large impact of SA on the overall somatic and mental health of SA victims. Due to the cross-sectional study design, further studies are required.

Risk factors associated with hemorrhagic cerebrovascular accident: A cross-sectional study in patients from a hospital in Peru.

In Peru, cardiovascular accidents (CVA) cause around 15% of premature death, with an increase in CVA due to the prevalence of risk factors for CVA in the Peruvian population. Hemorrhagic CVA presents higher mortality compared to ischemic. This research aimed to identify the risk factors associated with hemorrhagic CVA. We carried out a retrospective cross-sectional study using the medical records of patients with a diagnosis of CVA treated at the Regional Hospital of Ica during the years 2018 and 2019. Independent variables included age, sex, type 2 diabetes, dyslipidemia, hypertension, smoking, obesity, and intracranial carotid artery calcification. To identify factors associated with an increased probability for hemorrhagic CVA compared to ischemic CVA, a generalized linear model with logit link and binomial family, obtaining the odds ratio (OR) and its 95% confidence interval (CI). we evaluated the data from 132 patients. Of them, 46 (34.85%) had hemorrhagic CVA. Only systolic blood pressure (OR: 1.04; 95% CI: 1.02-1.06) and hypertension (OR: 0.29; 95% CI: 0.10-0.89) were significantly associated with hemorrhagic CVA compared to ischemic CVA. Hypertension is associated with hemorrhagic CVA compared to ischemic CVA. These results are consistent with the literature.

Prevalence and persistence of cost-related medication non-adherence before and during the COVID-19 pandemic among medicare patients at high risk of hospitalization.

To study cost-related medication non-adherence (CRN) for a 30-month period before and during the COVID-19 pandemic using a sample of Medicare patients at high risk of hospitalization. A novel data set of quarterly surveys of CRN was used to evaluate CRN before and during the COVID-19 pandemic. Generalized Estimating Equation (GEE) analyses were conducted to evaluate the adjusted coefficients of change in CRN behaviors controlling for socio-demographic and health characteristics. Six hundred seventy-seven Medicare beneficiaries at high risk of hospitalization who were alive on January 1, 2020 and followed up through quarterly surveys on CRN for 30 months before and during the COVID-19 pandemic. Two metrics of prevalence and persistence of CRN and their adjusted coefficients in GEE with binomial family distribution and log link function controlling for socio-demographic and health characteristics. A total of 5,990 quarterly surveys were completed by the 677 patients during the 30-month study period. Among the 677 patients, 250 (37%) were men, 591 (87%) were African American, and 288 (42%) were Medicare-Medicaid dual eligible. The unadjusted prevalence of CRN before and during the COVID-19 pandemic was 31.1% and 25.7% respectively (p = 0.02 by Chi-squared test), and persistent CRN rates were 12.1% and 9.7% respectively (p = 0.17 by Chi-squared test). The adjusted odds ratio of CRN prevalence during the pandemic compared to the pre-pandemic level was 0.75 (p<0.01), and 0.74 (p = 0.03) for persistent CRN in GEE estimations. There are coherent evidence of a reversal of CRN rates during the COVID-19 pandemic among this high-need, high-cost resource utilization Medicare population. Patients' CRN behaviors may be responsive to exogenous impacts, and the behaviors changed in the same direction with similar magnitude in terms of prevalence (the extensive margin) and persistence (the intensive margin). More research is needed to advance the understanding of the driving forces behind patients' behavioral changes and to identify factors that may be informative for reducing CRN in the long run.

Healthcare Market-Level and Hospital-Level Disparities in Access to and Utilization of High-Quality Hip and Knee Replacement Hospitals Among Medicare Beneficiaries.

This study aimed to determine whether healthcare markets with higher social vulnerability have lower access to high-quality hip and knee replacement hospitals and whether hospitals that serve a higher percentage of low-income patients are less likely to be designated as high-quality. This cross-sectional study used 2021 Centers for Medicare and Medicaid Services outcome measures and 2022 Joint Commission (JC) process-of-care measures to identify hospitals performing high-quality hip and knee replacement. A total of 2,682 hospitals and 304 healthcare markets were included. For the market-level analysis, we assessed the association of social vulnerability with the presence of a high-quality hip and knee replacement center. For the hospital-level analysis, we assessed the association of disproportionate share hospital (DSH) percentage with each high-quality designation. Healthcare markets were approximated by hospital referral regions. All associations were assessed with fractional regressions using generalized linear models with binomial family and logit links. We found that healthcare markets in the most vulnerable quartile were less likely to have a hip and knee replacement hospital that did better than the national average (odds ratio [OR] 0.22, P = 0.02) but not more or less likely to have a hospital certified as advanced by JC (OR 0.41, P = 0.16). We found that hip and knee replacement hospitals in the highest DSH quartile were less likely to be designated by the Centers for Medicare and Medicaid Services as better than the national average (OR 0.18, P = 0.001) but not more or less likely to be certified as advanced by JC (OR 1.40, P = 0.28). Geographic distribution of high-quality hospitals may contribute to socioeconomic disparities in patients' access to and utilization of high-quality hip and knee replacement. Equal access to and utilization of hospitals with high-quality surgical processes does not necessarily indicate equitable access to and utilization of hospitals with high-quality outcomes. Level III.

Musculoskeletal pain in health professionals at the end of their studies and 1 year after entry into the profession: a multi-center longitudinal questionnaire study from Switzerland

BackgroundMusculoskeletal pain, especially back pain, is common among health care professionals (HP). For prevention purposes, it is important to know whether HP develop their symptoms before or after entering the health care workforce. Cross-sectional studies among HP cannot answer this question. This follow-up study measures the prevalence and individual course of musculoskeletal pain among full-time HP students at the end of their studies and one year after entering the health care workforce.MethodSelf-reported one-year prevalence for low back pain, neck/shoulder pain, pain in arms/hands, and pain in legs/feet was collected at two timepoints from 1046 participating HP using an online questionnaire. Participants were asked whether their musculoskeletal pain was related to study or work conditions. Generalized estimating equation (GEE) models of the binomial family with log link were used to estimate adjusted prevalence and corresponding normal based 95% confidence intervals were derived using the bootstrap method with 1000 replications.ResultsThe prevalence of low back pain as well as neck and shoulder pain was very high at baseline and follow-up in all full-time students and later HP. Prevalence for pain in arms/hands, legs/feet was low and there were significant differences between the professions. HP clearly associated their low back pain and neck/shoulder pain with study and work conditions; HP strongly associated pain in arms/hands, legs/feet only with work conditions.ConclusionMany HP suffer from back/neck/shoulder pain already as students before starting their professional career. The prevention of back/neck/shoulder pain must be part of the education of all health professions at universities. As an example of best practice, universities should incorporate ergonomic measures and exercises into the daily routine of training health professionals. The effects of physically demanding professional tasks on the upper and lower extremities need to be investigated in further studies to take preventive measures.

Congenital malformations and preeclampsia associated with integrase inhibitor use in pregnancy: A single-center analysis.

Antiretroviral therapy (ART) decreases perinatal HIV transmission, but concerns exist regarding maternal and infant safety. We compared the incidence of congenital malformations and other adverse outcomes in pregnancies exposed to integrase inhibitor (INSTI) versus non-INSTI ART. Single-site review of all pregnancies among women living with HIV between 2008 and 2018. We used binomial family generalized estimating equations to model the relationship of congenital anomalies and pregnancy outcomes with exposure to INSTI or dolutegravir (DTG) versus non-INSTI ART. Among 257 pregnancies, 77 women received ≥1 INSTI (54 DTG, 14 elvitegravir, 15 raltegravir), 167 received non-INSTI, and 3 had missing data. Fifty congenital anomalies were identified in 36 infants. Infants with first-trimester DTG or any first-trimester INSTI exposure had higher odds of congenital anomalies than infants with first-trimester non-INSTI exposure (OR = 2.55; 95%CI = 1.07-6.10; OR = 2.61; 95%CI = 1.15-5.94, respectively). Infants with INSTI exposure after the second trimester had no increased odds of anomalies. Women with INSTI exposure had higher odds of preeclampsia (OR = 4.73; 95%CI = 1.70-13.19). Among women who received INSTI, grade ≥3 laboratory abnormalities were noted in 2.6% while receiving the INSTI and 3.9% while not receiving the INSTI, versus 16.2% in women who received non-INSTI. There was no association between INSTI exposure and other pregnancy outcomes. In our cohort, first-trimester INSTI exposure was associated with increased rates of congenital anomalies and use of INSTI during pregnancy was associated with preeclampsia. These findings underscore the need for continued monitoring of the safety of INSTI in pregnancy.

Site-Specific Analysis of the Incidence Rate of Enterotoxigenic Escherichia coli Infection Elucidates an Association with Childhood Stunting, Wasting, and Being Underweight: A Secondary Analysis of the MAL-ED Birth Cohort.

Asymptomatic infection by fecal enteropathogens is a major contributor to childhood malnutrition. Here, we investigated the incidence rate of asymptomatic infection by enterotoxigenic Escherichia coli (ETEC) and assessed its association with childhood stunting, wasting, and being underweight among children under 2 years of age. The Malnutrition and Enteric Disease birth cohort study included 1,715 children who were followed from birth to 24 months of age from eight distinct geographic locations including Bangladesh, Brazil, India, Peru, Tanzania, Pakistan, Nepal, and South Africa. The TaqMan array card assay was used to determine the presence of ETEC in the nondiarrheal stool samples collected from these children. Poisson regression was used to estimate the incidence rate, and multiple generalized estimating equations with binomial family, logit link function, and exchangeable correlation were used to analyze the association between asymptomatic ETEC infection and anthropometric indicators such as stunting, wasting, and being underweight. The site-specific incidence rates of asymptomatic ETEC infections per 100 child-months were also higher at the study locations in Tanzania (54.81 [95% CI: 52.64, 57.07]) and Bangladesh (46.75 [95% CI: 44.75, 48.83]). In the Bangladesh, India, and Tanzania sites, the composite indicator of anthropometric failure was significantly associated with asymptomatic ETEC infection. Furthermore, a significant association between asymptomatic heat-stable toxin ETEC infections and childhood stunting, wasting, and being underweight was found in only the Bangladesh and Tanzania sites.

COGNITIVE IMPAIRMENT AND CARDIOVASCULAR RISK FACTORS: FINDINGS FROM THE PURE-COLOMBIA COHORT

Objective: To estimate the prevalence of cognitive impairment and its association with cardiovascular risk factors in the cohort population of the Prospective Urban and Rural Epidemiological Study (PURE) for the fifteenth year of follow-up in some departments of Colombia. Design and method: Cross-sectional study nested in the PURE cohort in participants with Mini-Cog test for cognitive screening, with a cut-off point of &lt; = 2 points to screen cognitive impairment. We evaluate behavioral cardiovascular factors such as smoking, pathological history such as arterial hypertension, and measurements of blood pressure, weight, height, waist/hip ratio, glucose, triglycerides, cholesterol, hdl, ldl, and creatinine. We stimate The prevalence ratios for cognitive impairment using a generalized linear model with binomial family and link log. Results: In 707 participants whose mean age is 64.9 (SD 9.2) years, 66.8% are women, we found that 26.8% with indicators of cognitive impairment, with complete difficulty for the clock sub-test in 24.5% and 3.9% on the memory subtest. A higher prevalence of cognitive impairment was found among hypertensives compared to non-hypertensives (63.7% vs. 41.8%, Prevalence Ratio = 1.51, 95% CI 1.17; 1.93, p = &lt;0.001). In addition, systolic blood pressure was 9 mmHg, higher in participants with cognitive impairment (median 138mmHg vs 129mmHg, p = 0.0001) Also, the proportion of people with deterioration was higher in those who had a cholesterol greater than 200mg/dL (PR = 1.38 95% CI = 1.11;1.72 p = 0.004) and with an increase in the waist-hip ratio (PR = 3.27 95% CI = 1.21; 8.8 p = 0.019) the above adjusted for age, sex and educational level. Conclusions: More than a quarter of the participants in the PURE cohort presented indicators of cognitive impairment, its prevalence was significantly higher in hypertensive patients, in people with high cholesterol and with a significantly higher waist/hip ratio, which indicates the importance of preventing and controlling the Cardiovascular risk factors in older adults with cognitive alterations.

A latent class analysis of the socio-demographic factors and associations with mental and behavioral disorders among Australian children and adolescents.

Previous studies have shown a relationship between socio-demographic variables and the mental health of children and adolescents. However, no research has been found on a model-based cluster analysis of socio-demographic characteristics with mental health. This study aimed to identify the cluster of the items representing the socio-demographic characteristics of Australian children and adolescents aged 11-17 years by using latent class analysis (LCA) and examining the associations with their mental health. Children and adolescents aged 11-17 years (n = 3152) were considered from the 2013-2014 Young Minds Matter: The Second Australian Child and Adolescent Survey of Mental Health and Wellbeing. LCA was performed based on relevant socio-demographic factors from three levels. Due to the high prevalence of mental and behavioral disorders, the generalized linear model with log-link binomial family (log-binomial regression model) was used to examine the associations between identified classes, and the mental and behavioral disorders of children and adolescents. This study identified five classes based on various model selection criteria. Classes 1 and 4 presented the vulnerable class carrying the characteristics of "lowest socio-economic status and non-intact family structure" and "good socio-economic status and non-intact family structure" respectively. By contrast, class 5 indicated the most privileged class carrying the characteristics of "highest socio-economic status and intact family structure". Results from the log-binomial regression model (unadjusted and adjusted models) showed that children and adolescents belonging to classes 1 and 4 were about 1.60 and 1.35 times more prevalent to be suffering from mental and behavioral disorders compared to their class 5 counterparts (95% CI of PR [prevalence ratio]: 1.41-1.82 for class 1; 95% CI of PR [prevalence ratio]: 1.16-1.57 for class 4). Although children and adolescents from class 4 belong to a socio-economically advantaged group and shared the lowest class membership (only 12.7%), the class had a greater prevalence (44.1%) of mental and behavioral disorders than did class 2 ("worst education and occupational attainment and intact family structure") (35.2%) and class 3 ("average socio-economic status and intact family structure") (32.9%). Among the five latent classes, children and adolescents from classes 1 and 4 have a higher risk of developing mental and behavioral disorders. The findings suggest that health promotion and prevention as well as combating poverty are needed to improve mental health in particular among children and adolescents living in non-intact families and in families with a low socio-economic status.

Factors influencing the habitat selection of Mugger crocodile (Crocodylus palustris) and its conservation threats in the Rapti River of Chitwan National Park, Nepal

Mugger crocodiles (hereafter called muggers) are the apex predator and keystone species in slow flowing freshwater ecosystem. They play an important role in its functioning by distributing nutrients and increasing primary productivity. Muggers have a sympatric distribution with gharials in the Rapti and Narayani River of Chitwan National Park, but more research and conservation attention has been focused on gharials in Nepal. The inadequate availability of information on the occupied habitats of muggers restrict their evidence-based conservation and management. Therefore, we investigated the ecological factors affecting the habitat selection of muggers and its conservation threats in the Rapti River. We conducted a preliminary survey, followed by a detailed habitat survey, conducted in February and March 2022. During the detailed habitat survey, the pre-defined habitat characteristics were recorded at each station spaced at 500 m intervals along the river as well as the locations where muggers were sighted. We used a generalized linear model (glm) under the binomial family with a logit link function to analyze the factors influencing the habitat selection of muggers. The dependent variable was the presence or absence of muggers at sampling points and the independent variables included: river bank aspect, river width, mid-river depth, river bank substrate type, river bank slope, water current, invasive alien plant species, and anthropogenic disturbances. In addition, a relative whole-site ranking method was employed to determine the most prevalent threats to the mugger. During the survey period, we recorded a total of 46 mugger individuals, 71.8% were observed basking and 28.2% were observed submerged in the river. The highest percentage of muggers (39.1%) was observed on the sandy river bank, followed by the grass and forest bank (19.5%), and clay and sandy bank (15%), respectively. Only the river banks with moderate (15–25°) and moderately steep (25–35°) slopes were found to be the significant factors influencing the occurrence of muggers. Fishing and extraction of river materials, and disposal of garbage and solid waste were ranked as the most prevalent conservation threats. For the long-term conservation of muggers in the Rapti River, effective habitat management plans and strategies are required to control illegal anthropogenic activities such as fishing, sand mining, and boulder quarrying. Research on spatio‐temporal partitioning between mugger and gharials is recommended to understand how resources are shared by the species.

MP02-09 THE IMPACT OF RACE AND SOCIOECONOMIC STATUS ON RENAL TRAUMA CARE: A POPULATION BASED RETROSPECTIVE COHORT STUDY

You have accessJournal of UrologyCME1 Apr 2023MP02-09 THE IMPACT OF RACE AND SOCIOECONOMIC STATUS ON RENAL TRAUMA CARE: A POPULATION BASED RETROSPECTIVE COHORT STUDY Rano Matta, Kevin Hebert, Joemy Ramsay, Niraj Paudel, Benjamin McCormick, Joshua Horns, and Jeremy Myers Rano MattaRano Matta More articles by this author , Kevin HebertKevin Hebert More articles by this author , Joemy RamsayJoemy Ramsay More articles by this author , Niraj PaudelNiraj Paudel More articles by this author , Benjamin McCormickBenjamin McCormick More articles by this author , Joshua HornsJoshua Horns More articles by this author , and Jeremy MyersJeremy Myers More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003213.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To understand the association of race, ethnicity, and payer status with the treatment setting and treatment choices during hospital care for patients with renal trauma. We hypothesize that race, ethnicity, and payer status influence triage, management, and outcomes after renal trauma. METHODS: The National Trauma Databank (NTDB) from 2007-2016 was used to conduct a retrospective cohort study of adult patients with blunt or penetrating renal trauma, without any other significant extra-renal injury (abbreviated injury scale ≥3 in other areas). The primary outcome was under triage, defined as receiving definitive care at NTDB hospitals without state level designation or ACS level I or II verification. Definitive care was defined as treatment and release from emergency department [ED], admission to hospital, or death in ED. Secondary outcomes were procedures for renal hemorrhage (nephrectomy, partial nephrectomy, angioembolization, renorrhapy), total hospital length of stay, discharge disposition from hospital, and mortality. Outcomes of interest were analyzed by racial/ethnic minorities relative to Non-Hispanic Whites using generalized estimating equations models to allow for correlation at the facility level. GEE models with a binomial family and logit link and GEE models with Gaussian family and identity link were used to generate effect estimates for binary and continuous outcomes, respectively. Robust standard errors were used. Models were adjusted for injury year, age, sex, insurance, facility level, academic facility, facility patient mix, injury type, injury severity score, shock, blood transfusion, revised trauma score, and predefined comorbidities. RESULTS: We identified 28,894 patients with isolated renal trauma. Of these, 39% (n=11,328) were identified with a race/ethnicity other than non-Hispanic white, and 35% (n= 10,139) were uninsured. Among the cohort, 7% (n=1,908) were under triaged, 11% received a renal procedure, and 3% died. There was no significant association between race or ethnicity and under triage (non-white vs. non-Hispanic white; OR=0.98; 95% CI 0.96, 1.01), renal procedures (OR=1.06; 95% CI 0.94, 1.19), or discharge disposition (Rehab/Nursing facility vs. Home; OR=0.93; 95% CI 0.81, 1.06). However, non-white patients had a shorter length of hospital stay (OR 0.48; 95% CI 0.21, 0.76) and an increased risk of mortality (OR=1.25; 95% CI 1.03, 1.53). There was no association between insurance status and under triage. Patients with public insurance had an increased risk of renal procedures (OR 1.22; 95% CI 1.06, 1.40). Patients without insurance had increased odds of discharge to home (vs. rehab or nursing facility; OR 0.48; 95% CI 0.39, 0.59), shorter length of hospital stay (OR 0.40; 95% CI 0.29, 0.55), and an increased odds of mortality (OR 2.31; 95% CI 1.75, 3.01). CONCLUSIONS: There was no difference in under triage of patients with isolated renal trauma based on race/ethnicity and insurance status. Despite adjusting for hospital and patient level demographics, injury, and physiology, we found noteworthy differences based on race/ethnicity and insurance status in the rate of renal procedures, hospital length of stay, discharge disposition, and mortality. Further research is needed to identify root causes of these disparities. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e14 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rano Matta More articles by this author Kevin Hebert More articles by this author Joemy Ramsay More articles by this author Niraj Paudel More articles by this author Benjamin McCormick More articles by this author Joshua Horns More articles by this author Jeremy Myers More articles by this author Expand All Advertisement PDF downloadLoading ...

Multi-site comparison of clonal arrangements for tropical and subtropical hybrids of Eucalyptus

The definition of the ideal eucalyptus clonal arrangement directly affects the forest industrial chain, quality of products, and stand yield. The impact of eucalyptus in mono- versus multiclonal stands on plantation production and sustainability has been frequently discussed by primary stakeholders within the pulp industry, but few studies have examined this topic through direct comparison. In this study, we evaluated the differences in genotype ranking and yield of Eucalyptus spp. and clones displayed in mono- and multiclonal arrangements. In this context, the objectives addressed were: (i) to estimate genetic parameters in multi-environment and site-by-site analyses; (ii) to predict genotypic values of clones and the effects of species in mono- and multiclonal experiments, and (iii) to compare the similarity between the ranks of clones and species in the two types of clonal stands. The study was conducted in 2018 at four different sites of the CMPC Celulose Riograndense company, located in the state of Rio Grande do Sul, Brazil. Mono- and multiclonal arrangements were tested at each site, involving 33 eucalyptus clones belonging to 10 species and hybrids. Multiple-tree-plot (MTP) and single-tree-plot (STP) experiments were used to simulate monoclonal stands and multiclonal or composite stands, respectively. In each experiment, a randomized block design was set with three repetitions, 16 plants per plot for MTP, and 24 repetitions and one plant per plot for STP. Traits monitored were diameter at breast height (DBH), total height (H), tree volume (VOL), mean annual volume increment (MAI), and survival (SUV). Data were analyzed using mixed model approaches, considering a normal distribution for growth traits and a binomial family for survival. There was a strong genotype × site interaction for all traits, indicating that edaphoclimatic conditions must be considered for the successful establishment of clonal composites of differing genotypes. There was high similarity in the classification of clones in both mono- and multiclonal experiments, with genetic correlation values above 0.90. The performance of clones differed in mono- and multiclonal experiments, which correlated with their competition behavior toward each other (aggressive, suppressed, or homeostatic). Thus, clonal composites can be recommended based on clonal competition and genetic heterogeneity to maximize the yield of the stand and safeguard the plantations from biotic and abiotic disturbances. This study allowed us to identify the differences between the two types of commercial stands and provide direction for future research regarding the performance of Eucalyptus spp. in differing clonal arrangements. Novel information about competition categories for different eucalyptus tropical and subtropical species were provided.

The WEST Study: A Retrospective and Multicentric Study on the Impact of Steroid Therapy in West Nile Encephalitis.

The use of steroid therapy in potentially life-threatening neuroinvasive forms of West Nile infection (WNND) is controversial. The aim of this study is to assess the efficacy of steroid therapy in reducing intrahospital mortality, length of stay, and neurological sequelae at discharge. This was a multicenter, retrospective, observational study conducted in 5 hospitals in Northern Italy, headed by the Fondazione IRCSS Policlinico San Matteo (Pavia). We extracted all patient data with WNND diagnoses, comparing patients who received steroid treatment with patients who did not receive steroid treatment between January 2014 and January 2022. Comparisons between the 2 groups were performed using chi-square tests for categorical variables and Mann-Whitney tests for non-normal continuous data, and a generalized linear model for the binomial family was carried out. Data from 65 WNND patients were extracted. Among these patients, 33 (50.7%) received steroid therapy at any point during their hospitalization. Receiving steroid therapy did not significantly reduce intrahospital mortality (odds ratio [OR], 1.70; 95% CI, 0.3-13.8; P = .89) or neurological sequelae at discharge (OR, 0.53; 95% CI, 0.16-1.76; P = .47). Steroid treatment is currently used on a single-case basis in severe WNND. More prospective data are needed to demonstrate a protective effect on mortality and neurological sequelae.

Prevalence and factors associated with anemia among children under five years of age in Rombo district, Kilimanjaro region, Northern Tanzania.

Background: Anemia is a severe public health problem affecting more than half of children under five years of age in low-, middle- and high-income countries. The study aimed to determine the prevalence and factors associated with anemia among children under five years of age in northern Tanzania. Methods: This community-based cross-sectional study was conducted in Rombo district, Kilimanjaro region, northern Tanzania, in April 2016. Multistage sampling technique was used to select a total of 602 consenting mothers and their children aged 6-59 months and interviewed using a questionnaire. Data were analyzed using Stata version 15.1. We used generalized linear models (binomial family and logit link function) with a robust variance estimator to determine factors associated with anemia. Results: Prevalence of anemia was 37.9%, and it was significantly higher among children aged 6-23 months (48.3%) compared to those aged 24-59 months (28.5%). There were no significant differences in anemia prevalence by sex of the child. Adjusted for other factors, children aged 6-23 months had over two times higher odds of being anemic (OR=2.47, 95% CI 1.73, 3.53, p<0.001) compared to those aged 24-59 months. No significant association was found between maternal and nutritional characteristics with anemia among children in this study. Conclusion: Prevalence of anemia was lower than the national and regional estimates, and it still constitutes a significant public health problem, especially among children aged 6-23 months. The study recommends iron supplementation, food fortification, dietary diversification, and management of childhood illnesses interventions for mothers and children under two years.

No decrease in perseverance and performance on cognitive tasks in Danish cohort of hormonal contraceptive users.

Cognitive consequences of hormonal contraceptives (HCs) are largely underexplored, despite the popularity of use. This study investigates the association between perseverance during cognitively challenging tasks and the use of HCs among Danish women. We hypothesised that women using HCs show decreased perseverance across tasks compared to their naturally cycling counterparts. We further hypothesised that HC using women would show decreased performance as a measure of accuracy (i.e. more incorrect answers) compared to naturally cycling women. The study used a cross-sectional repeated measures design, consisting of a Danish version of the Anagram Persistence Task and the Hagen Matrices Test, followed by an extensive survey documenting menstrual and HC history for each participant. The study was conducted online. Data processing was conducted on data from 129 participants. The former hypothesis was analysed through multilevel regression with a nested random effects structure on log-transformed data. The latter hypothesis was analysed through a multilevel generalised linear model with a nested random effects structure using the binomial family. No support was found for either of the hypotheses.

On a Karhunen-Loève expansion based on Krawtchouk polynomials with application to Bahadur optimality for the binomial location family

In this paper we extend to the discrete case a Karhunen-Lo?ve expansion already known for continuous families of classical orthogonal polynomials. This expansion involves Krawtchouk polynomials. It provides us with the orthogonal decomposition of the covariance function of a weighted discrete Brownian bridge process. We introduce a discrete Cram?r-von Mises statistic associated with this covariance function. We show that this statistic satisfies a property of Bahadur local optimality for a statistical test in the location family for binomial distributions. Our statistic and the goodness-of-fit problem we deal with can be seen as a discrete version of a problem stated by Y. Nikitin about the statistic of de Wet and Venter. Our proofs make use of the formulas valid for all classical orthogonal families of polynomials, so that the way most of our results can be extended to Meixner, Hahn, and Charlier polynomials and the associated distributions is clearly outlined.

Factors associated with prolonged hospitalization of patients with corona virus disease (COVID-19) in Uganda: a retrospective cohort study

IntroductionIdentification of factors predicting prolonged hospitalization of patients with coronavirus disease (COVID-19) guides the planning, care and flow of patients in the COVID-19 Treatment Units (CTUs). We determined the length of hospital stay and factors associated with prolonged hospitalization among patients with COVID-19 at six CTUs in Uganda.MethodsWe conducted a retrospective cohort study of patients admitted with COVID-19 between January and December 2021 in six CTUs in Uganda. We conducted generalized linear regression models of the binomial family with a log link and robust variance estimation to estimate risk ratios of selected exposure variables and prolonged hospitalization (defined as a hospital stay for 14 days or more). We also conducted negative binomial regression models with robust variance to estimate the rate ratios between selected exposures and hospitalization duration.ResultsData from 968 participants were analyzed. The median length of hospitalization was 5 (range: 1–89) days. A total of 136/968 (14.1%: 95% confidence interval (CI): 11.9–16.4%) patients had prolonged hospitalization. Hospitalization in a public facility (adjusted risk ratio (ARR) = 2.49, 95% CI: 1.65–3.76), critical COVID-19 severity scores (ARR = 3.24: 95% CI: 1.01–10.42), and malaria co-infection (adjusted incident rate ratio (AIRR) = 0.67: 95% CI: 0.55–0.83) were associated with prolonged hospitalization.ConclusionOne out of seven COVID-19 patients had prolonged hospitalization. Healthcare providers in public health facilities should watch out for unnecessary hospitalization. We encourage screening for possible co-morbidities such as malaria among patients admitted for COVID-19.

Prevalence and Predictors of Somatization in Peruvian Undergraduate Students during the COVID-19 Pandemic.

The COVID-19 pandemic had a strong impact on mental health. Multiple studies report the alarming prevalence of depression, anxiety, and stress-related conditions due to the lockdown measures. Nevertheless, somatization has been an overlooked topic in current literature despite its strong relationship with most mental health conditions. The aim of this study was to describe the prevalence of somatic symptoms and their associated factors in a sample of 3218 undergraduate students from Lima, Peru. A cross-sectional design was carried out. The prevalence of somatic symptoms was measured with the PHQ-15. As predictors of somatic symptom severity, we included psychopathological (depression, anxiety, and stress), psychological (perceived social support, resilience, satisfaction with life, and academic self-efficacy), and sociodemographic (e.g., age, sex, employment status, relationship status, daily hours of sleep) variables. A generalized linear model from a binomial family and a logit link function were applied based on a Factor Score Regression approach, with half of the sample presenting moderate-to-severe somatic symptoms. Anxiety was the strongest predictor of somatic symptom severity, followed by academic self-efficacy. Significant differences were found regarding sex, relationship status, daily hours of sleep and COVID-19 risk-related variables. In conclusion, interventions on reducing anxiety and promoting academic self-efficacy may have a stronger impact on somatic symptom severity and should focus on more vulnerable specific demographic groups such as females.

Schools' Participation in the Community Eligibility Provision Affects Students' Receipt of Emergency Benefits during the COVID-19 Pandemic.

Pandemic Electronic Benefits Transfer (P-EBT) benefits were intended for families of school children who lost access to free or reduced-price school meals (FRPMs) during the COVID-19 pandemic-related school closures. In high-poverty communities, all students from schools participating in the Community Eligibility Provision (CEP) were automatically eligible for P-EBT benefits; in non-CEP schools, only students already participating in FRPMs-for which their parents submitted an individual application-were eligible for P-EBT benefits. Using publicly available data from 105 K-12 public schools located in 4 sizeable low-income New Jersey (NJ) cities, this study investigated the association between school CEP participation status and the reach of P-EBT benefits for eligible students. A generalized linear model with a logit link, a binomial family, and robust standard errors was used. Across all levels of FRPM eligibility based on students' household income, as expected, almost all students from CEP schools received P-EBT benefits; significantly fewer received P-EBT benefits if they attended non-CEP schools, even when they were eligible for FRPMs. Our findings show that without changes to the qualification process for CEP, large numbers of eligible children will not receive the intended health benefits of federal meals programs or similar emergency relief initiatives. Expanding CEP eligibility and simplifying the process through which schools qualify would likely improve the uptake of federal meals programs and emergency interventions, and more effectively achieve their intent.

Sharp local minimax rates for goodness-of-fit testing in multivariate binomial and Poisson families and in multinomials

We consider the identity testing problem – or goodness-of-fit testing problem – in multivariate binomial families, multivariate Poisson families and multinomial distributions. Given a known distribution $p$ and $n$ i.i.d. samples drawn from an unknown distribution $q$, we investigate how large $\rho>0$ should be to distinguish, with high probability, the case $p=q$ from the case $d(p,q) \geq \rho$ , where $d$ denotes a specific distance over probability distributions. We answer this question in the case of a family of different distances: $d(p,q) = |p-q|\_t$ for $t \in \[1,2]$, where $|\cdot|\_t$ is the entrywise $\ell\_t$ norm. Besides being locally minimax-optimal – i.e. characterizing the detection threshold in dependence of the known matrix $p$ – our tests have simple expressions and are easily implementable.