Cross-sectional Analysis Research Articles

Is Scotland Walking in the Right Direction? A Cross-Sectional Analysis of Trends in Walking by Socioeconomic Status.

Walking is a key target behavior for promoting population health. This paper charts the 30-year history of walking policy in Scotland. We assess whether population walking levels among adults in Scotland have changed in recent years and identify the characteristics of those least likely to report any walking. We pooled 9years (2012-2019 and 2021) of data from adult (≥16y) respondents of the Scottish Health Survey (n = 41,470). The outcomes of interest were the percentage reporting (1)any walking and (2)any walking with an average pace that is of at least moderate intensity. We also investigated the contribution of walking to total nonoccupational moderate to vigorous physical activity. We used linear and logistic regressions to test linear trends over time and to identify inequalities by age, sex, and the Scottish Index of Multiple Deprivation quintile. There was an increase in all measures of walking over the period 2012-2021; for example, the percentage reporting any walking increased by 7 percentage points (81.4%-88.4%). Inequalities still exist by age, sex, and the Scottish Index of Multiple Deprivation but have not grown over time. Inequalities by sex and age are most pronounced in the least affluent Scottish Index of Multiple Deprivation quintiles; less affluent older women are least likely to report any walking. Scotland appears to be walking in the right direction. Surveillance data support a positive trend after decades of policy and promotion efforts. The policies do not appear to be exacerbating existing inequalities, but narrowing them will require more concentrated efforts.

Contemporary insights on corporate guidance: A discussion of call, Hribar Skinner, and Volant (2024)

Guidance is an important and long-studied topic in the accounting literature. Call, Hribar, Skinner, and Volant (this issue) survey managers who provide guidance and those that do not to generate insights on the costs and benefits of providing guidance. For managers who do provide guidance, perceptions regarding guidance characteristics are elicited. Firm responses are connected to archival data sources, enabling cross-sectional analysis of survey responses and facilitating comparison of self-reported guidance with common guidance proxies in the archival literature. I discuss key insights from the survey, considering the limitations inherent in the survey method. I also clarify what is meant by the term guidance, how it differs from other forward-looking information and how researchers operationalize the guidance construct. I conclude by offering six research questions for future consideration based on the survey evidence.

Lifestyle Clusters of Diet Quality, Sleep, and Screen Time and Associations with Weight Status in Children from Madrid City: ENPIMAD Study.

Childhood overweight and obesity is a global concern and has increased in Spain over the last decades. Combinations of lifestyle behaviors (i.e., diet, sleep, and sedentarism) are highly related to weight status. Therefore, this study aimed to identify lifestyle patterns among children from Madrid City, and analyze associations with the prevalence of overweight, obesity, and abdominal obesity, considering socio-economic factors. A cross-sectional analysis was conducted on 4545 children from the ENPIMAD study with data on diet, sleep, anthropometric, and socio-economic variables. K-means cluster analysis was used to identify lifestyle clusters, and logistic regressions were used to examine the associations between socio-economic indicators and cluster membership, and between clusters and weight status. Findings show three lifestyle clusters (healthy, mixed, and unhealthy), with boys and older children more represented in the unhealthy cluster. Food insecurity and low socio-economic status were associated with unhealthier clusters in boys and girls. Children in unhealthier clusters were more likely to have obesity and abdominal obesity. However, these associations disappeared in girls after controlling for food insecurity. These results provide insight into the combination of behaviors and socio-economic factors associated with childhood obesity that may aid in the design of future interventions.

A Comprehensive Cross-sectional Analysis of Prevalence of Congenital Color Vision Deficiency among Patients

A Comprehensive Cross-sectional Analysis of Prevalence of Congenital Color Vision Deficiency among Patients

Comparative analysis of microstructural, compositional, and grazing incidence characteristics of oxide scale on 316L steel: SLM vs. wrought conditions

The aim of this research is to compare the oxidation behavior and characteristics of oxide scale of 316L steel produced by two methods: selective laser melting (SLM) and conventional casting and forming (wrought). To this end, the initial composition and microstructure of samples produced by those methods were first studied. Thermogravimetric analysis (TGA) and long-term isothermal oxidation tests were carried out on the samples and the oxidation kinetics were compared. The oxidized samples were then examined by scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDS) and grazing incidence X-ray diffraction (GIXRD). The results indicated that in the temperature range of 600 °C–900 °C, the oxidation resistance of the SLM alloy is lower than that of the wrought alloy, especially at 800 °C. This is attributed to the combined effect of: i) smaller grain size due to the rapid solidification in the SLM alloy that increases the paths of oxygen penetration, ii) lower presence of chromium and manganese elements in the oxide layer and iii) preferential growth of iron oxide in the form of hillocks on the surface. Surface and cross-section analysis of the oxide layers show that iron oxide is dominant on the surface of the SLM sample at temperatures of 600 °C and 800 °C, and at 800 °C its extended hilly growth leads to significant spallation of the oxide scale and an exponential increase in the oxidation rate. However, at 900 °C, with the formation of a continuous oxide layer containing Fe2MnO4 and CrMnO4, the oxidation rate significantly decreases in both alloys.

Association between non-alcoholic fatty liver disease and the risk of pulmonary nodules in patients with intestinal polyps.

Associations between metabolic risk factors and lung cancer remain elusive, and evidence on the linkage between non-alcoholic fatty liver disease (NAFLD) and pulmonary nodules is limited. This study sought to examine the independent association between NAFLD and the risk of pulmonary nodules. Cross-sectional analyses of 1,119 patients with intestinal polyps hospitalized at the Department of Gastroenterology, Minhang District Central Hospital of Shanghai, China, were conducted. NAFLD was diagnosed based on hepatic ultrasonography or computed tomography (CT) findings of hepatic steatosis, with exclusion criteria ensuring patients had no history of significant alcohol consumption, viral infections, or hepatic autoimmune diseases. The currently accepted definition of a pulmonary nodule is a solid or sub-solid shadow ≤3 cm in diameter that appears as a solid or semi-solid pattern on a chest CT scan (our specific treatment is pulmonary nodule size: 5 mm to 3 cm). Adjusted 95% confidence intervals (CIs) and odds ratios (ORs) for NAFLD and the clinical features connected with pulmonary nodule risk were determined using a multivariable logistic regression analysis. Among the 979 intestinal polyp patients, the prevalence rates of NAFLD and pulmonary nodules were 25.9% and 32.8%, respectively. Patients with pulmonary nodules exhibited higher rates of NAFLD (31.5% vs. 23.3%, P=0.006) and obesity (41.4% vs. 32.5%, P=0.006) compared to those without pulmonary nodules. After removing all the possible confounding variables, the adjusted ORs for NAFLD, an older age, smoking, and obesity were 1.370 (95% CI: 1.006-1.867, P=0.04), 1.022 (95% CI: 1.010-1.033), 1.599 (95% CI: 1.033-2.475), and 1.410 (95% CI: 1.057-1.880), respectively (all P values <0.05). NAFLD showed a significant association with an increased risk of pulmonary nodules. NAFLD was independently linked to an increased incidence of pulmonary nodules in intestinal polyp patients, which emphasizes the importance of screening and managing these conditions in lung cancer prevention.

The Association between the Planetary Health Diet with a Regular Consumption of Breakfast and a Well-Balanced Diet: A Cross-Sectional Analysis Involving Japanese Male Engineering Students at a University in Hyogo Prefecture

Few young Japanese adults regularly consume a well-balanced diet composed of staples, main courses, and sides. We hypothesised that adopting the recommended planetary health diet with regular breakfast consumption would promote well-balanced diets among young Japanese male undergraduates. This study aimed to examine the structural association between the planetary health diet with regular breakfast consumption and a well-balanced diet intake. This cross-sectional study included 142 male engineering undergraduates who completed a 2022 online questionnaire via Google Forms at a public university in Hyogo Prefecture. The planetary health diet comprises the consumption of the recommended eight items. A covariance structure analysis was performed in a hypothetical model with factors (regular breakfast consumption and eight items) potentially associated with the intake of a well-balanced diet at least twice daily. After excluding chicken dishes and nuts from the eight recommended items of the planetary health diet, goodness-of-fit became acceptable. Frequent consumption of the remaining six recommended items (fish, eggs, soybeans/soybean products, dairy foods, vegetables, and fruits) was significantly positively correlated with regular breakfast consumption and a significant positive path to a well-balanced diet. Among male university students, regular breakfast consumption and the planetary health diet may lead to a well-balanced diet.

Exploring Determinants of Health-Related Quality of Life in Emerging Adults with Type 1 Diabetes Mellitus: A Cross-Sectional Analysis.

(1) Background: Emerging adulthood, from the age of 18 to 29 years, is a crucial phase for individuals with Type 1 Diabetes Mellitus, as it affects their Health-Related Quality of Life. (2) Methods: This cross-sectional study analyzes the influence of the Mediterranean diet, Diabetes duration, Hemoglobin A1c, and sleep disorders on Health-Relate Quality of Life in Type 1 Diabetes Mellitus. In this study, conducted in Andalusia, Spain, 362 emerging adults with Type 1 Diabetes Mellitus completed the Oviedo Sleep Questionnaire, the Adaptation of Mediterranean Diet Adherence Screener, and the Vida con Diabetes Tipo 1 (ViDa1) Health-Related Quality of Life questionnaire between October 2021 and July 2022. Pearson correlation coefficients and a multiple regression analysis were conducted for each Health-Related Quality of Life in Type 1 Diabetes Mellitus dimension (Interference with Life, Well-being, Self-care, and Concern about the Condition) for overall sample and separately for males and females. (3) Results: Different and significant correlations are found among factors such as Age, Body Mass Index, Currently being a student, Hemoglobin A1c, Sleep satisfaction, Insomnia, Hypersomnolence, and Adherence to Mediterranean diet. Notably, Insomnia is a main predictor for Interference with Life, Well-being, and Concern about the Condition, especially for females. (4) Conclusions: Insomnia is the main predictor of Health-Related Quality of Life in Type 1 Diabetes Mellitus among Andalusian emerging adults with this condition. Consequently, a regular assessment of sleep and Health-Related Quality of Life from a gender perspective in this age group is crucial.

Bayesian Interim Analysis and Efficiency of Phase III Randomized Trials.

Improving the efficiency of interim assessments in phase III trials should reduce trial costs, hasten the approval of efficacious therapies, and mitigate patient exposure to disadvantageous randomizations. We hypothesized that in silico Bayesian early stopping rules improve the efficiency of phase III trials compared with the original frequentist analysis without compromising overall interpretation. Cross-sectional analysis. 230 randomized phase III oncology trials enrolling 184,752 participants. Individual patient-level data were manually reconstructed from primary endpoint Kaplan-Meier curves. Trial accruals were simulated 100 times per trial and leveraged published patient outcomes such that only the accrual dynamics, and not the patient outcomes, were randomly varied. Early stopping was triggered per simulation if interim analysis demonstrated ≥ 85% probability of minimum clinically important difference/3 for efficacy or futility. Trial-level early closure was defined by stopping frequencies ≥ 0.75. A total of 12,451 simulations (54%) met early stopping criteria. Trial-level early stopping frequency was highly predictive of the published outcome (OR, 7.24; posterior probability of association, >99.99%; AUC, 0.91; P < 0.0001). Trial-level early closure was recommended for 82 trials (36%), including 62 trials (76%) which had performed frequentist interim analysis. Bayesian early stopping rules were 96% sensitive (95% CI, 91% to 98%) for detecting trials with a primary endpoint difference, and there was a high level of agreement in overall trial interpretation (Bayesian Cohen's κ, 0.95; 95% CrI, 0.92 to 0.99). However, Bayesian interim analysis was associated with >99.99% posterior probability of reducing patient enrollment requirements ( P < 0.0001), with an estimated cumulative enrollment reduction of 20,543 patients (11%; 89 patients averaged equally over all studied trials) and an estimated cumulative cost savings of 851 million USD (3.7 million USD averaged equally over all studied trials). Bayesian interim analyses may improve randomized trial efficiency by reducing enrollment requirements without compromising trial interpretation. Increased utilization of Bayesian interim analysis has the potential to reduce costs of late-phase trials, reduce patient exposures to ineffective therapies, and accelerate approvals of effective therapies. Question: What are the effects of Bayesian early stopping rules on the efficiency of phase III randomized oncology trials?Findings: Individual-patient level outcomes were reconstructed for 184,752 patients from 230 trials. Compared with the original interim analysis strategy, in silico Bayesian interim analysis reduced patient enrollment requirements and preserved the original trial interpretation. Meaning: Bayesian interim analysis may improve the efficiency of conducting randomized trials, leading to reduced costs, reduced exposure of patients to disadvantageous treatments, and accelerated approval of efficacious therapies.

Analysis of tower structure for fatigue taking into account wind vortex shedding

Vortex shedding is manifested in all tower structures with a solid or lattice cross-section with relatively equal width and depth of the cross-section. The phenomenon is associated with the alternate breakdown of vortices from the edges of the structure, which cause it to oscillate under the influence of inertial masses in a plane perpendicular to the wind. The main condition for the manifestation of vortex shedding is the action of wind with a speed exceeding a certain critical one. As shown by calculations of a real tower structure, oscillations according to the first natural frequency and shape occur already under the influence of a moderate wind. This requires attention, assessment of the number of oscillation cycles and the implementation of criteria for taking into account the combined effect of frontal wind and vortex shedding on the structure and calculation of the structure for endurance. The paradox is that this phenomenon is not widely known in engineering practice, and instructions on the mandatory calculation of structures for vortex excitation appeared only with the implementation of amendment 2 to DBN B.1.2-2:2006 "Loads and influences. Design norms" in 2020. In this analyzed state of research on this issue, an available method for calculating vortex excitation, introduced in EN 1991-1-4:2005, is presented. The calculation and analysis of the McDonald's advertising totem with a height of 25.575 m, implemented in Kyiv in 2016, was performed. Calculations showed that this structure is characterized by oscillations due to vortex shedding. From the available sources of meteorological data, an approximate number of oscillation cycles was determined, criteria for calculating the structure's durability were determined, and generalizations were made that can be applied to all structures. In particular, it is pointed out the need to limit stresses beyond the endurance limit in two ranges - parametric resonance from the frontal wind, and sign-changing cyclic oscillations from vortex excitation. An analysis of the effective cross-sections and effective structural forms of building details when working under the action of a frontal wind with vortex shedding was carried out.

Disparities Across the CREOG Districts: Annual Variations of Wellness and Inclusivity Efforts in Obstetrics &amp; Gynecology Residency Websites

Over the past few years, CREOG has emphasized improving resident well-being, decreasing physician burnout, and supporting efforts toward inclusivity. This focus has also been shared by various medical specialties and their training programs. The recent emphasis on wellness and inclusivity partly stems from the concern for burnout and higher attrition rates among Underrepresented In Medicine (URIM) learners. However, limited assessment exists of how residency programs have addressed this focus nationally. As virtual interviews have become the ‘current’ standard, timely updates have become critical as websites are an essential resource for residency applicants. As the perceived value of some updates differs by program, an assessment of the inclusivity and wellness variations over the years has been limited, especially across Obstetrics and Gynecology (ObGyn) residency program websites. This study aimed to identify the annual variations in website depictions of wellness and inclusivity across CREOG districts in the past two years, while suggesting optimized platforms to convey the commitment to such efforts. Methods: This study is a cross-sectional analysis of the websites of ACGME-accredited ObGyn residency programs across the United States in April 2022 and again in April 2023. The assessment was based on a compilation of 22 attributes devised by a nine-person focus group and piloted and tested on a 40-person focus group. Six medical students and two residents at Louisiana State University in Shreveport and the University of Toledo conducted the website benchmarking comparison. All cohorts were racially, ethnically, and gender diverse to ensure representative benchmarking. Racial diversity in this study was defined by visual representation as identified by the medical student researcher’s self-perceived report of at least one African-American/Black, Hispanic/Latino, American Indian/Alaska Native, or Native Hawaiian/Pacific Islander faculty member and resident among their colleagues based on publicly-accessible website photographic representation. Gender diversity was defined similarly by visual representation as identified by the medical student researcher’s photo-based self-perceived report of at least one member of a differing gender compared to the majority (a minimum of female and/or one male) within the faculty members and resident class. Percentages were used to compare the data due to the program count discrepancy across both years, as a result of an increase in accredited programs and website accessibility. Results: A total of 560 websites were analyzed. Minimal change in inclusivity sections of websites was noted across the two years, but a reduction in leadership referencing inclusivity (by 30%) and wellness (by 22%) occurred in 2023. Wellness efforts remained unchanged in both years from the standpoint of website investment, dedicated support personnel, and group activities. Wellness support was persistently the highest in District 5, with overall wellness efforts appearing unchanged between the two years across all districts. Similarly, District 5 had the highest DEI referencing with dedicated staff and webpage support across both years. References to holistic reviews were less identified in 2023 (by 7%), while curricula referenced DEI less frequently in their mission statement (by 15%). Similarly, a 14% reduction in DEI-focused research was noted on the websites, with an 8% reduction in resident testimonies to such efforts. District I showed the highest incorporation (32%) and increase (7%) in inclusive pronoun usage between the two years, whereas District 5 had the highest increase in supplementary LGBTQI verbiage (8%) on their website. A 17% increase in the use of inclusive pronouns was noted, whereas a reduction in gender diversity was identified in 9% of faculty and 5% of residents. Similarly, a 6-7% reduction in URIM faculty and residents was noted. Regarding racial representation, District 4 had the highest loss of resident body diversity (21%), whereas District 3 had the highest loss of faculty diversity (22%). Regarding gender diversity, District 1 was impacted by a 30% decline in gender diversity, while District 3 by 23%. Conclusion: This study demonstrates the variations in support across the country and the past two years. With some components of inclusivity being adopted more readily, the hope is that websites ultimately provide an accurate reflection of the investment in resident wellness and equity efforts across all districts.

Characteristics associated with SARS-CoV-2 testing, infection and vaccine uptake among essential non-healthcare workers in Montréal, 2021.

Essential non-healthcare workers experienced higher rates of SARS-CoV-2 infection compared to non-essential workers. Identify characteristics associated with SARS-CoV-2 testing, infection and vaccine uptake among essential non-healthcare workers in Montréal, Québec. Secondary, cross-sectional analysis of data collected from participants prospectively recruited in two observational studies (first study, Onsite Testing Study, January-March 2021; second study, Self-Testing Study, July-October 2021) of essential non-healthcare workers in 2021. Logistic regression with generalized linear mixed models was used to explore characteristics associated with our outcomes (previous SARS-CoV-2 testing, exposure and vaccination). Overall, 2,755 participants were included (first study, Onsite Testing Study, n=2,128; and second study, Self-Testing Study, n=627). A higher proportion of participants identified as male (n=1,601; 58%), non-White (n=1,527; 55%) and worked in the manufacturing/supplier sector (n=1,706; 62%). Relative to the first study, Onsite Testing Study, participants in the second study, Self-Testing Study, had higher odds (78% vs. 46%; aOR 4.1, 95% CI: 3.2-5.2) of previous SARS-CoV-2 testing and of testing positive prior to study enrolment (6.2% vs. 4.3%; aOR 1.7, 95% CI: 1.1-2.6). Individuals reporting recent SARS-CoV-2 exposure had higher odds of previous SARS-CoV-2 testing (aOR 4.0, 95% CI: 3.0-5.4), while older age (aOR 0.98, 95% CI: 0.98-0.99 per one-year increase) and being male (aOR 0.6, 95% CI: 0.5-0.7) were associated with lower odds of previous testing. Results were similar in stratified analyses. Participants from businesses with more than 50 employees had higher odds of having received a SARS-CoV-2 vaccine (91% vs. 80%; aOR 2.6, 95% CI: 1.4-4.8). Consideration of individual and business characteristics associated with testing and vaccination programs for SARS-CoV-2 could improve equity, uptake and impact.

Factors related to H. pylori infection in Nablus region: cross sectional analysis from west bank

Factors related to H. pylori infection in Nablus region: cross sectional analysis from west bank

Risk of Traumatic Brain Injury in Deployment and Nondeployment Settings Among Members of the Millennium Cohort Study.

To describe and quantify the prevalence and risk of deployment and nondeployment service-related traumatic brain injury (TBI) among participants of the Millennium Cohort Study. Survey data. 28 759 Millennium Cohort Study participants who were active duty, Reserves, or National Guard at the time of the survey. Cross-sectional secondary data analysis. Estimates of prevalence and rates of TBI were calculated. Multivariable Poisson regression estimated rate ratios of TBI overall and stratified by deployment and nondeployment settings. The rate of TBI over the 362 535 person-years (PY) was 2.95 p/100 PY. the nondeployment rate was 2.15 p/100 PY, with a significantly higher rate (11.38 p/100 PY) in deployment settings. Bullets/blasts were the most common TBI mechanisms in deployed settings, while sports/physical training and military training were common in nondeployed settings. The risk of TBI as well as its mechanism varies by deployment and nondeployment, suggesting that targeted prevention strategies are needed to reduce the risk for TBI among military personnel based on their deployment status.

Disparities in Telehealth Offer and Use among U.S. Adults: 2022 Health Information National Trends Survey.

Objective: Understanding the sources of telehealth disparities can inform efforts to ensure equity. This study examines disparities in telehealth offer and use to understand the role of health care providers in increasing telehealth access. Methods: This cross-sectional analysis of the 2022 Health Information National Trends Survey (n = 5,295) used survey-weighted proportions to characterize telehealth use and multivariable logistic regressions to test associations of sociodemographic and social determinants with (1) telehealth offer and (2) use among those offered the option. Results: Among U.S. adults, 57% were offered telehealth, 80% of whom used it. Technology difficulties and privacy concerns were barriers for 15%-20% of U.S. adults. Compared to telehealth users, most nonusers preferred in-person care (25% versus 84%). Age, education, geographic location, and broadband internet access were related to telehealth offer, whereas no significant disparities emerged in telehealth use. Conclusions: Telehealth use is widespread, but structural and provider-level engagement are needed to achieve equity.

Infant consumption of 100% lactose-based and reduced lactose infant formula in the United States: Review of NHANES data from 1999 to 2020.

An acceptable alternative to human milk is US Food and Drug Administration (US FDA)-registered infant formula, which must meet the requirements of the US FDA Infant Formula Act. Human milk contains lactose, but some infant formulas may contain alternative carbohydrate sources such as corn syrup solids, maltodextrin, and sucrose. Recent research shows that infant-formula made with corn syrup solids may be associated with increased obesity risk in the first 5 years of life. A previous study found that of all formulas purchased, 59.0% were lactose-reduced. More US infants consume infant formula with nonlactose carbohydrates more frequently than is medically necessary. The purpose of this study is to use National Health and Nutrition Examination Survey (NHANES) data to describe the type and prevalence of nonlactose carbohydrates consumed in infant formula. NHANES data from 1999 to 2020 was used to perform cross-sectional analyses and analyses of comparison of prevalence over time on consumption of nonlactose carbohydrate sources in infant formulas. We identified 3709 unique infant IDs associated with 36,084 feeding sessions. More than half of the feeding sessions involved a formula with at least one nonlactose carbohydrate. Feeding sessions involving a formula with at least one nonlactose carbohydrate increased by 163% from 1999-2004 to 2017-2020; formulas containing single or multiple nonlactose carbohydrate types account for the increase in prevalence. This study highlights an increase in the consumption of infant formula containing a nonlactose carbohydrate. More studies are needed to understand the short- and long-term effects of early exposure to these carbohydrates.

Relationship between frailty and depressive symptoms in older adults: role of activities of daily living and sleep duration.

Previous studies have demonstrated that frailty is associated with depressive symptoms among older people and significantly increase the risk of difficulty in activities of daily living (ADL). However, uncertainties remain regarding the mechanisms behind such relationship. The aim of this study was to investigate the mediating effect of ADL in the relationship between frailty and depressive symptoms among older adults in China, and to explore to what extend sleep duration moderated the association between ADL and depressive symptoms. In this study, we carried out cross-sectional descriptive analysis and 1,429 participants were included in the analysis. A survey was conducted using questionnaires and instruments measuring frailty, depressive symptoms, ADL and sleep duration. Bootstrap analyses served to explore the impact of ADL in mediating frailty and depressed symptoms, as well as the effect of sleep duration in moderating ADL and depressive symptoms. Compared to the robust group, the mediating effects of ADL between frailty and depressive symptoms were significant in the prefrail group and the frail group. The interaction term between sleep duration and ADL was significantly presented in the regression on depressive symptoms. Specifically, the Johnson-Neyman technique determined a range from 8.31 to 10.19 h for sleep duration, within which the detrimental effect of frailty on depressive symptoms was offset. Sleep duration moderated the indirect effect of ADL on the association between frailty and depressive symptoms. This provides support for unraveling the underlying mechanism of the association between frailty and depressive symptoms. Encouraging older adults to enhance ADL and obtain appropriate sleep duration might improve depressive symptoms for older adults with frailty and prefrailty.

Seasonal Trends in Suicide Attempts-Keywords Related Searches: A Google Trends Analysis.

Suicide is a significant public health concern globally, with its varying rates influenced by numerous factors, including seasonal changes. Online search behaviors, particularly searches related to suicide and mental health, have been proposed as real-time indicators of suicidal ideation in populations. In this study, a cross-sectional time series analysis was conducted, utilizing data on suicide attempts from the Polish Police Headquarters and online search behavior from Google Trends over a decade. Suicide attempt data were analyzed alongside the frequency of Google searches for suicide-related keywords derived from the Polish Corpus of Suicide Notes. A total of 66 keywords were selected for analysis to identify seasonal trends and patterns in search behavior. The study employed linear regression, Seasonal Mann-Kendall tests, and TBATS models to analyze the data. Suicide rates show seasonal patterns, peaking in warmer months. However, keyword searches did not strongly correlate with peak suicide months. This study enhances our understanding of suicide-related search trends and their potential connection to suicide rates. It suggests avenues for more effective prevention efforts and the potential for future algorithms to predict suicide rates and identify at-risk groups.

Predicting response to stepped-care cognitive behavioral therapy for insomnia using pre-treatment heart rate variability in cancer patients

ObjectiveThis study examined whether high frequency heart-rate variability (HF-HRV) and HF-HRV reactivity to worry moderate response to cognitive behavioural therapy for insomnia (CBT-I) within both a standard and stepped-care framework among cancer patients with comorbid insomnia. Biomarkers such as HF-HRV may predict response to CBT-I, a finding which could potentially inform patient allocation to different treatment intensities within a stepped-care framework. Methods177 participants (86.3 % female; Mage = 55.3, SD = 10.4) were randomized to receive either stepped-care or standard CBT-I. 145 participants had their HRV assessed at pre-treatment during a rest and worry period. Insomnia symptoms were assessed using the Insomnia Severity Index (ISI) and daily sleep diary across five timepoints from pre-treatment to a 12-month post-treatment follow-up. ResultsResting HF-HRV was significantly associated with pre-treatment sleep efficiency and sleep onset latency but not ISI score. However, resting HF-HRV did not predict overall changes in insomnia across treatment and follow-up. Similarly, resting HF-HRV did not differentially predict changes in sleep diary parameters across standard or stepped-care groups. HRV reactivity was not related to any of the assessed outcome measures in both cross-sectional and longitudinal analyses. ConclusionAlthough resting HF-HRV was related to initial daily sleep parameters, HF-HRV measures did not significantly predict longitudinal responses to CBT-I. These findings suggest that HF-HRV does not predict treatment responsiveness to CBT-I interventions of different intensity in cancer patients.

Increased alcohol consumption during the COVID-19 pandemic: A cross-sectional study.

The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted health, mental well-being, and societal functioning, particularly for individuals with psychiatric conditions and substance use disorders. Recent evidence highlights a concerning increase in alcohol consumption during the pandemic, with a study spanning 2015-2020 indicating heightened usage, especially among young and middle-aged adults, for relaxation and tension relief. Additionally, addressing challenges exacerbated by the pandemic, another study underscored persistent barriers to healthcare access, resulting in increased alcohol and tobacco use rates and limited healthcare options. These findings shed light on the unique vulnerabilities exposed by the pandemic, emphasizing the need to investigate further its impact on alcohol consumption in diverse non-urban American communities. To investigate the impact of the COVID-19 pandemic on alcohol abuse using socioeconomic and medical parameters in diverse non-urban community in America. Based on a cross-sectional analysis of 416 participants the United States in 2021, the study utilized The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria to categorize alcohol consumption levels. Participants aged 21 years and above were surveyed through an online platform due to COVID-19 challenges. The survey was conducted from January 14 to January 31, 2022, recruiting participants via social media and ensuring anonymity. Informed consent was secured, emphasizing the voluntary nature of participation, and participants could only take the survey once. Out of 416 survey respondents, 396 met eligibility criteria, with 62.9% reporting increased alcohol consumption during COVID-19. Males (68.8%) and ages 21-29 years (34.6%) predominated. Low alcohol consumption decreased by 2.8% (P = 0.237), moderate by 21.4% (P < 0.001), and heavy increased by 14.9% (P < 0.001). Alcohol abuse rose by 6.5% (P = 0.0439), with a 7% increase in self-identified alcohol abusers/alcoholics. Seeking treatment during COVID-19 rose by 6.9%. Easier alcohol access (76.0%) was reported, while 80.7% found it harder to access medical care for alcohol-related issues. These findings highlight the pandemic's impact on alcohol consumption and healthcare access, emphasizing the need for targeted interventions during public health crises. The COVID-19 pandemic exacerbated alcoholism and abuse, with increased heavy consumption (P < 0.001) and abuse (P = 0.0439). Access to medical programs for addressing alcohol abuse declined, highlighting the need for targeted intervention.