Cross-sectional Study Research Articles

Helicobacter pylori infection is associated with the risk and phenotypes of cholelithiasis: A multi-center study and meta-analysis

BACKGROUND Helicobacter pylori (H. pylori ) is a prevalent pathogen associated with various diseases. Cholelithiasis is also a common condition. H. pylori infection has been identified in the biliary system, suggesting its potential involvement in biliary diseases. However, the specific role of H. pylori in the development of cholelithiasis remains inconclusive. AIM To investigate the potential association between H. pylori infection and the development of cholelithiasis. METHODS We performed a retrospective study in more than 70000 subjects in health examination center from 3 institutions in the middle, northern and eastern China, from October 2018 to December 2021, to explore the potential association between H. pylori and cholelithiasis through univariate and multivariate analysis. Meanwhile, the influence of H. pylori on biliary-related parameters was investigated. A comprehensive analysis of previous studies concerned about H. pylori and cholelithiasis was also executed. RESULTS In our multi-center study, H. pylori was positively associated with cholelithiasis [odds ratio (OR) = 1.103, 95% confidence interval (CI): 1.001-1.216, P = 0.049]. Furthermore, H. pylori patients had less total and direct bilirubin than uninfected patients, while the total cholesterol and low-density lipoprotein cholesterol were more in H. pylori -positive participants (P < 0.05). In the published articles, the cohort studies indicated H. pylori was a risk factor of cholelithiasis (hazard ratio =1.3280, 95%CI: 1.1810-1.4933, P < 0.0001). The pooled results of case-control and cross-sectional studies showed positive association between H. pylori and cholelithiasis in Asia (OR = 1.5993, 95%CI: 1.0353-2.4706, P = 0.034) but not in Europe (OR = 1.2770, 95%CI: 0.8446-1.9308, P = 0.246). Besides, H. pylori was related to a higher choledocholithiasis/cholecystolithiasis ratio (OR = 3.3215, 95%CI: 1.1034-9.9986, P = 0.033). CONCLUSION H. pylori is positively correlated with cholelithiasis, choledocholithiasis phenotype particularly, especially in Asia, which may be relevant to bilirubin/cholesterol metabolism. Cohort studies confirm an increased risk of cholelithiasis in H. pylori patients.

Helicobacter pylori infection is associated with the risk and phenotypes of cholelithiasis: A multi-center study and meta-analysis

BACKGROUND Helicobacter pylori (H. pylori ) is a prevalent pathogen associated with various diseases. Cholelithiasis is also a common condition. H. pylori infection has been identified in the biliary system, suggesting its potential involvement in biliary diseases. However, the specific role of H. pylori in the development of cholelithiasis remains inconclusive. AIM To investigate the potential association between H. pylori infection and the development of cholelithiasis. METHODS We performed a retrospective study in more than 70000 subjects in health examination center from 3 institutions in the middle, northern and eastern China, from October 2018 to December 2021, to explore the potential association between H. pylori and cholelithiasis through univariate and multivariate analysis. Meanwhile, the influence of H. pylori on biliary-related parameters was investigated. A comprehensive analysis of previous studies concerned about H. pylori and cholelithiasis was also executed. RESULTS In our multi-center study, H. pylori was positively associated with cholelithiasis [odds ratio (OR) = 1.103, 95% confidence interval (CI): 1.001-1.216, P = 0.049]. Furthermore, H. pylori patients had less total and direct bilirubin than uninfected patients, while the total cholesterol and low-density lipoprotein cholesterol were more in H. pylori -positive participants (P < 0.05). In the published articles, the cohort studies indicated H. pylori was a risk factor of cholelithiasis (hazard ratio =1.3280, 95%CI: 1.1810-1.4933, P < 0.0001). The pooled results of case-control and cross-sectional studies showed positive association between H. pylori and cholelithiasis in Asia (OR = 1.5993, 95%CI: 1.0353-2.4706, P = 0.034) but not in Europe (OR = 1.2770, 95%CI: 0.8446-1.9308, P = 0.246). Besides, H. pylori was related to a higher choledocholithiasis/cholecystolithiasis ratio (OR = 3.3215, 95%CI: 1.1034-9.9986, P = 0.033). CONCLUSION H. pylori is positively correlated with cholelithiasis, choledocholithiasis phenotype particularly, especially in Asia, which may be relevant to bilirubin/cholesterol metabolism. Cohort studies confirm an increased risk of cholelithiasis in H. pylori patients.

Perception of scientific research in Dentistry

Scientific research is the fundamental basis for the complete education of dental students from the beginning of their studies since it provides them with the necessary tools to deal with real situations. Objectives: To determine the level of knowledge about scientific research in dental students of the Universidad Regional Autónoma de Los Andes. Methodology and methods: A comparative, descriptive and cross-sectional study was used, applied to students enrolled from first to tenth semester of the dental career of the Universidad Regional Autónoma de Los Andes in the academic period May 2023 - September 2023. Application of descriptive statistics. Results: The results obtained in the survey of 840 students, show that there is an average knowledge of scientific writing with 44.05% and 3.1% say they have no knowledge of it, being this a weakness as students to conduct research work that can help to progress academically, thus gaining experience and benefiting favorably to their resume that later will open more doors as a professional or student. Conclusions: Based on the results, deficient knowledge about the relationship between scientific research and dentistry was identified. This situation leads us to implement a plan for the development of efficient strategies to improve scientific activity, which will undoubtedly increase the level of research of the graduate student and give him/her the opportunity to practice evidence-based dentistry in an adequate manner.

Prognostic Significance of Immunohistochemical Expression of Cyclin D1 and β-Catenin in Invasive Ductal Carcinoma (IDC)

Introduction: Invasive ductal carcinoma (IDC) is the most prevalent subtype of breast cancer, distinguished by diverse clinical manifestations and molecular heterogeneity. Prognostic outcomes are influenced by multiple factors, including the patient’s age at diagnosis, tumor size, histological grade, disease stage, lymph node metastasis (LNM), and hormone receptor status (ER, PR, HER2). This research has highlighted the potential of emerging molecular biomarkers such as Cyclin D1 and β-Catenin in enhancing prognostic precision. Methodology: This retrospective, cross-sectional study analyzed the medical records of female patients diagnosed with IDC. Tumor size, grade, and stage were examined alongside lymph node involvement to assess the extent of disease dissemination. Immunohistochemistry (IHC) was employed to determine the expression of ER, PR, and HER2 receptors. Additionally, emerging biomarkers such as Cyclin D1 and β-Catenin were evaluated to explore their prognostic value. A total of 150 tumor samples were collected from multiple cancer treatment facilities across Rawalpindi, Punjab, Pakistan. Findings and Discussion: The mean age at diagnosis was 50.6 years, with the majority of patients (68%) between 36 and 55 years. Tumor analysis revealed that 76.7% of lesions were <30 mm in size, and 46.7% were classified as grade II. LNM was detected in 39.3% of patients, indicating significant metastatic potential. Regarding receptor expression, 45.5% of tumors were ER-positive, 42.9% PR-positive, and 54.8% HER2-positive, aligning with global incidence trends. The investigation of molecular markers showed Cyclin D1 overexpression in 60% of cases, predominantly in ER-positive tumors, suggesting better endocrine therapy responsiveness. β-Catenin was detected in 33.3% of samples and correlated with aggressive tumor phenotypes, emphasizing its potential role in identifying high-risk patients. These molecular markers align with globally research. Conclusion: This study emphasizes the significance of early detection and comprehensive molecular profiling in IDC management. Smaller tumors and receptor-positive cases are generally associated with more favorable outcomes. Additionally, emerging biomarkers such as Cyclin D1 and β-Catenin hold promise for refining prognostic models and optimizing individualized treatment plans. Incorporating these biomarkers into clinical practice can further enhance therapeutic decision-making and patient care.

Willingness of medical students to work on the COVID-19 frontline during the pandemic in China: A nationwide population-based cross-sectional study

Willingness of medical students to work on the COVID-19 frontline during the pandemic in China: A nationwide population-based cross-sectional study

Effects of increasing fitness through exercise training on language comprehension in monolingual and bilingual older adults: a randomized controlled trial

ABSTRACT Exercise training has been proposed to counteract age-related cognitive decline through improvements in cardiorespiratory fitness (CRF hypothesis). Research has focused on cognitive domains like attention and processing speed, and one cross-sectional study reported a positive relationship between CRF and language production in older adults. In a randomized controlled trial, we investigated whether these benefits could extend to language comprehension in healthy older adults, and whether bilinguals, for whom language processing is more costly, would exhibit greater benefits than monolinguals. Eighty older English monolinguals and 80 older Norwegian-English bilinguals were randomized into either a 6-month exercise training group or into a passive control group. We assessed CRF (VO2peak) and language comprehension (reaction times to spoken word monitoring) in first (L1, all participants) and second language (L2, bilinguals only), before and after the intervention. We found that monolinguals in the exercise group (compared to the control group) were faster in comprehension following the intervention. Moreover, this effect was mediated by exercise-induced increases in VO2peak, supporting the CRF hypothesis. This extends previous cross-sectional research and establishes a causal link between exercise training and speeded comprehension in older monolinguals. However, despite inducing increased VO2peak, exercise training did not affect bilingual (L1 or L2) comprehension, and bilinguals in both groups were slower after the intervention period. Exploratory analyses suggested that this slowing may be driven by participants with low L2 proficiency, but further research is needed to examine whether bilingual language processing is in fact unaffected by exercise training and its consequent improvements in CRF.

Pain, dietary habits and physical activity of children with developmental disabilities in Croatia, North Macedonia and Serbia: a cross-sectional study

BackgroundMultiple studies have shown that children with developmental disabilities (CDD) often live with unrecognized and untreated pain, consume inadequate diet and have inadequate levels of physical activity. This study aimed to analyze pain, dietary habits and physical activity of CDD in Croatia, North Macedonia and Serbia.MethodsA cross-sectional study was conducted in Croatia, North Macedonia and Serbia in March–April 2023 within the Erasmus+ SynergyEd project. The study included parents and caregivers of CDD. Data were collected via online survey.ResultsWe included 954 participants from Croatia (N=543; 57%), North Macedonia (N=205; 21%) and Serbia (N=206; 22%). Participants reported that 16% of children suffered from chronic pain related to their condition.The main findings of our study are that chronic pain is prevalent in CDD (16%). Almost half (48%) of participants avoid certain foods for their children. The majority of children (86%) were not on a special diet. Among those that were on a special diet, they were most commonly (60%) on a gluten-free diet. Most (54%) participants stated that their children used nutritional supplements. Less than half participants (45%) stated that the child is involved in some kind of physical activity. Only 17% of CDD engaged in physical activities 5 h or more per week.ConclusionOur findings indicate that chronic pain, inadequate dietary patterns and insufficient physical activity are common in CDD from Croatia, Macedonia and Serbia. Education of parents and caregivers can mitigate their use of interventions that have not been proven effective, such as for example the use of gluten-free diets in CDD.

Examining the relationship between weekend catch-up sleep and phenotypic age acceleration: Insights from a cross-sectional study.

Phenotypic age acceleration (PhenoAgeAccel) is a potential aging biomarker. While weekend catch-up sleep (WCS) is commonly practiced to compensate for weekday sleep deficits, its relationship with PhenoAgeAccel remains unclear. In this cross-sectional study, we analyzed data from 7,683 participants in the National Health and Nutrition Examination Survey (NHANES). WCS duration was calculated as weekend sleep duration minus weekday sleep duration, and WCS was further defined as WCS duration >0h. Multivariable logistic regression adjusted for confounders and subgroup analyses by weekday sleep duration were employed to examine the relationship of WCS with PhenoAgeAccel. WCS is associated with a modulated risk of PhenoAgeAccel, contingent on the amount of WCS and regular weekday sleep. Specifically, engaging in 0-1 hour of WCS was associated with significantly lower odds of PhenoAgeAccel (Odds Ratio [OR] = 0.80, 95% Confidence Interval [CI]: 0.68, 0.94, p = 0.007) compared to no WCS, particularly among individuals who averaged 7-8 hours of sleep on weekdays (OR = 0.67, 95% CI: 0.49, 0.93, p = 0.016). Conversely, those sleeping less than 6 hours on weekdays benefited from extending WCS beyond 2 hours (OR = 0.65, 95% CI: 0.44, 0.97, p = 0.036). No benefits were observed for those with more than 8 hours of weekday sleep. WCS is associated with a reduced likelihood of PhenoAgeAccel among individuals with inadequate weekday sleep, particularly those sleeping less than 6 hours or between 7 to 8 hours on weekdays.

Comparative evaluation of rapid diagnostic test and PCR-based diagnostic assay for identification of trypanosomes in cattle of Apac and Kiryandongo districts, Uganda: A cross sectional study

BackgroundDiagnostic tests and knowledge of their diagnostic accuracies are important for animal trypanosomosis surveillance and treatment.Methodology: A cross-sectional study was conducted in November 2021 to compare the performance of rapid diagnostic test (RDT) and PCR-based assay for the detection of trypanosome infections. Random sampling and probability proportional to size sampling were used to sample study households and animals from the sampled household respectively. Animals were screened for the presence of trypanosomes using both tests. A total of 100 cattle (52 from Apac and 48 from Kiryandongo districts) were included in the study. The percentage of positive tests, sensitivity, and specificity of the tests using mini PCR as a reference were computed. Cohen’s kappa statistics was computed to assess how well the rapid diagnostic test agrees with the mini PCR. McNemar’s statistic assessed if the proportion of positive tests identified by mini PCR significantly differed from that identified by the rapid diagnostic test.ResultsThe mini PCR test detected 31.2% Trypanosome spp positive samples in Kiryandongo while it detected only 5.7% positive samples in Apac district. The rapid diagnostic test (RDT) analysis detected 91.6% Trypanosome spp positive samples in Kiryandongo district and only 46.1% in Apac district. T. congolense was the most common Trypanosoma species identified in Apac (36.5%) and Kiryandongo (47.9%) by the RDT. The percentage of each of the Trypanosome species (T.vivax, T.congolense, and mixed infection of T.vivax and T. congolense) detected by RDT differed significantly (p < 0.001) between the two districts. The RDT had a high sensitivity of 94.4% (95% Confidence Interval (CI): 72.7–99.9) but a very low specificity of 36.6% (95% CI: 26.2–48.0). The kappa test showed evidence of only a slight agreement (kappa = 0.1547, Accuracy = 0.48 (95% Confidence Interval (CI): 0.379,0.5822) between the two tests. The observed agreement between the tests was 47% while the expected agreement was 37.84%.ConclusionThis study found high sensitivity but low specificity of RDT using mini PCR as a reference.

Intrinsic Capacity and Life Quality Among Taiwanese Older People: A Cross-Sectional Study.

Intrinsic capacity (IC), an internal composite ability proposed by the World Health Organization, is fundamental to older people's health. The present study examined potential models explaining the association between IC and quality of life (QoL) among older people in Taiwan. Frailty, basic activities of daily living (BADL), and instrumental activities of daily living (IADL) were hypothesized to be mediators in the association between IC and QoL. Older people aged 50 years or above from community or medical center (N = 1,235; Mage = 72.63 years [SD = 7.19]; 601 males [48.7%]) completed a series of self-report and functional measures assessing IC, frailty, ADLs, and QoL. Results showed that IC was significantly associated with frailty, BADL, IADL, and QoL in the mediation models. Frailty was found to be a significant mediator in the association between IC and QoL alone or together with IADL. The findings indicate that IC is an important factor for older people to maintain good health and live a fulfilling life.

Temporal trends in muscular fitness among French children and adolescents between 1999 and 2023

ABSTRACT The aim was to estimate national temporal trends in muscular fitness for French youth between 1999 and 2023. Data were obtained from five cross-sectional studies on 53,314 children and adolescents (age range: 6–16 years). Lower- and upper-body strength were assessed by standing broad jump (SBJ) and handgrip strength (HGS). BMI z-scores (BMIz) were calculated using WHO growth curves. We found a statistically significant negligible decline in SBJ performance (standardised effect size (ES) trend per decade [95%CI]: −0.08 [−0.10, −0.07] or −2.1 cm [95%CI: −2.4, −1.8]) and a statistically significant negligible improvement in HGS (ES trend per decade [95%CI]: 0.11 [0.08, 0.13]) or 0.6 kg [(95%CI: 0.4, 0.8]). We found evidence of significant increases in distributional variability and asymmetry, with poorer trends in the low performers (<25th percentile) and better trends in the high performers (>75th percentile) compared to the average performers. Our data suggest negligible trends in mean SBJ and HGS, coupled with increased distributional variability and asymmetry. Trends were not uniform across the population distribution with data suggesting an increase over time in the gap between low and high performers. These results reinforce the importance of interventions and programmes aiming at improving muscular fitness specifically in children and adolescents with low muscular strength.

Sports Medicine Physician Confidence in Concussion Assessments for Postconcussion Return-to-Play Decisions.

To identify sport-related concussion (SRC) assessments sports medicine physicians perform and in which they place confidence when making return-to-play (RTP) decisions. Cross-sectional study. Online survey. Active members of the American Medical Society for Sports Medicine (AMSSM) at the fellowship level or higher making RTP decisions following concussion within the last year. An electronic REDCap survey gathering demographic and practice information and responses to clinical scenarios was sent to AMSSM members. The primary outcome was the SRC assessment(s) in which physicians expressed the most confidence for RTP decisions. Four hundred thirty AMSSM members responded to the survey, 392 of which met inclusion criteria. The graded symptom checklist was rated the most useful test for making return-to-play decisions, and respondents felt most confident starting the RTP process if the graded symptom checklist was normal. An assessment was considered most useful if it closely reflected resolution of SRC's pathological processes. Computerized neurocognitive testing was most likely to be ignored if abnormal. An abnormal neurological examination made physicians feel least confident SRC had resolved. Sports medicine physicians view the graded symptom checklist as a useful tool for making RTP decisions. Physicians expressed less confidence in computerized neurocognitive testing to determine RTP readiness. This study uncovered reliance on symptom reporting by sports medicine physicians and an opportunity for the creation of concussion clinical decision tools.

Consumer views on the use of digital tools for reporting adverse drug reactions: a cross-sectional study.

The application of digital technologies has shown benefits in enhancing pharmacovigilance activities but consumers views on the use of these tools for this purpose are not well described. To explore consumers' views on using digital tools to report adverse drug reactions (ADRs) and identify key features that consumers want in digital tools for ADR reporting. An online survey was conducted among adults who had taken medicine in the previous six-months in Australia. The development of questions was guided by the Combined Technology Acceptance Model and Theory of Planned Behaviour (C-TAM-TPB) framework. Responses to closed-ended questions were analysed using descriptive statistics and chi-square/Fisher's exact test, while free-text responses were analysed using qualitative content analysis. A total of 494 responses were included in the analysis. Eighty-seven percent of respondents preferred using digital tools for reporting ADRs. Consumers indicated a free-text space for describing ADRs (90%) as important or very important features of digital tools for ADR reporting, followed by acknowledgement of their report submission (87%) and receiving summary of previously reported ADRs (87%). Women (p < 0.001), advanced smartphone users (p < 0.001), and previous digital healthcare tool users (p = 0.017) showed higher intention to use digital tools. Consumers emphasized the importance of ease-of-use, accessibility, receiving medicine safety information, feedback, and advice for reporting ADRs via digital tools. Consumers prefer using digital tools for reporting ADRs and place high value on features such as a free-text space for describing ADRs, acknowledgement of report submissions, and access to summaries of previously submitted reports.

Prevalence and associated factors of mental health distress among hospitalized patients in general hospitals: a multi-center cross-sectional study in Iran.

Understanding the prevalence of mental distress in hospitalized patients and identifying associated factors can help reduce the burden of mental disorders on their medical management and improve their quality of life. This study aimed to examine the prevalence of mental distress among hospitalized patients in general hospitals and assess its associated factors. In this cross-sectional study, we evaluated the mental health status of inpatients in seven cities in Iran, using the General Health Questionnaire-12 (GHQ-12), with a total GHQ-12 score ≥ 4 or higher categorized as "mentally distressed." Statistical analyses were conducted using independent t-tests, one-way analysis of variance, and cross-tabulations. A total of 524 patients (347 females) were assessed, with 208 (38.7%) being classified as mentally distressed. The prevalence of mental distress was significantly higher among males (52.0%) compared to females (34.0%) (p = 0.002). There were no significant differences in GHQ-12 scores among different age groups (p > 0.05). Significant differences were observed in mental health status based on job status, with retired (64.7%) and laborer (22.8%) patients showing the highest and lowest rates of mental distress, respectively (p < 0.001). Additionally, mental distress prevalence varied significantly across hospital wards, with internal medicine (47.6%) and obstetrics and gynecology (28.3%) having the highest and lowest prevalence, respectively (p = 0.004). A considerable proportion of patients hospitalized for medical reasons also experience mental distress. Various demographic factors are associated with their mental health status. This highlights the need for integrated mental health assessments alongside medical treatment to alleviate the burden of mental disorders.

Role of serum procalcitonin in differentiating disease flare and systemic bacterial infection among febrile children with known chronic rheumatic diseases: a cross-sectional study

Objectives. To evaluate the role of serum procalcitonin (PCT) as a diagnostic tool to differentiate bacterial sepsis from flare-ups during febrile episodes in children with known rheumatic disorders compared to other inflammatory markers like C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). Methods. Previously diagnosed patients with known rheumatic disorders presenting in emergency or outpatient departments with febrile episodes were included in the study. Blood samples were collected upon admission to test for signs of infection, including serum PCT levels with routine laboratory and radiological tests. Patients with juvenile idiopathic arthritis (JIA) and systemic lupus erythematosus (SLE) were stratified using the Juvenile Arthritis Disease Activity Score (JADAS-27) and SLE Disease Activity Index (SLEDAI) respectively. Patients without bacterial focus with high disease activity were included in the flare-up group and the rest in the sepsis cohort. The diagnostic value of PCT was calculated using receiver operating characteristic (ROC) curve analysis. Results. In the study (N=73), 41 (56.2%) patients were previously diagnosed with JIA and 28 (38.3%) had SLE. 38 patients had definite evidence of sepsis and 35 had disease flare-ups as per respective disease activity scores. There was a significant difference in PCT and CRP among the flare-up and sepsis groups. For detecting sepsis, the area under curve (0.959), sensitivity (94.7%), and specificity (74.3%) of PCT at a cut-off of 0.275 ng/mL were significantly better than those of CRP. Conclusion. PCT is a better diagnostic test than CRP or ESR during febrile episodes in differentiating flare-ups from infection and PCT &gt;0.275 ng/mL indicates bacterial infection with good specificity and sensitivity in children with low disease activity.

Sex difference in alexithymia and cognitive impairment in chronic schizophrenia: a large sample study based on Chinese Han population.

Sex differences in schizophrenia have been noted across domains such as alexithymia and cognitive function; however, how they interact remains unclear. This study aimed to explore sex differences in the relationship between alexithymia and cognitive function in patients with chronic schizophrenia. A total of 695 patients (464 males and 231 females) who met the DSM-IV diagnostic criteria for schizophrenia were recruited in this cross-sectional study. Demographic and clinical data were collected using self-reported questionnaires. We assessed alexithymia using the Toronto Alexithymia Scale (TAS-20), cognitive function using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), and psychiatric symptoms using the Positive and Negative Syndrome Scale (PANSS). Male schizophrenic patients have to read 56.7% of the alexithymia rate, and higher scores on the RBANS visuospatial/constructional, language and total score than female patients (all P < 0.05).Alexithymia patients had lower language than non-alexithymia patients(P = 0.001). In addition, there were significant differences of the correlation scores for men and women in immediate memory and delayed memory (P < 0.001). Our results indicate that there are sex differences in the prevalence comorbid alexithymia symptoms, as well as their association with cognitive function, in patients with schizophrenia. However, a cross-sectional design could not establish definitive causative associations between sex and alexithymia or cognitive function.

Analysis of the current status of red blood cell transfusion in very preterm infants from Chinese Neonatal Network in 2022

Objective: To analyze the current status of red blood cell transfusion in very preterm infants (VPI) (gestational age at birth <32 weeks) from Chinese Neonatal Network (CHNN) in 2022. Methods: This cross-sectional study was based on the CHNN VPI cohort. It included 6 985 VPI admitted to CHNN 89 participating centers within 24 hours after birth in 2022. VPI with major congenital anomalies or those transferred to non-CHNN centers for treatment or discharged against medical advice were excluded. VPI were categorized based on whether they received red blood cell transfusions, their gestational age at birth, the type of respiratory support received during transfusion, and whether the pre-transfusion hemoglobin levels exceeded the thresholds. General characteristics, red blood cell transfusion rates, number of transfusions, timing of the first transfusion, and pre-transfusion hemoglobin levels were compared among different groups. The incidence of adverse outcomes between the group of VPI who received transfusions above the threshold and those who received transfusions below the threshold were compared. Comparison among different groups was conducted using χ2 tests, Kruskal-Wallis H tests, Mann-Whitney U test, and so on. Trends by gestational age at birth were evaluated by Cochran-Armitage tests and Jonckheere-Terpstra tests for trend. Results: Among the 6 985 VPI, 3 865 cases(55.3%) were male, with a gestational age at birth of 30.0 (28.6, 31.0) weeks and a birth weight of (1 302±321) g. Overall, 3 617 cases (51.8%) received red blood cell transfusion, while 3 368 cases (48.2%) did not. The red blood cell transfusion rate was 51.8% (3 617/6 985), with rates of 77.7% (893/1 150) for those born before 28 weeks gestational age and 46.7% (2 724/5 835) for those born between 28 and 31 weeks gestational age. A total of 9 616 times red blood cell transfusions were administered to 3 617 VPI, with 632 times missing pre-transfusion hemoglobin data, and 8 984 times included in the analysis. Of the red blood cell transfusions, 25.6% (2 459/9 616) were administered when invasive respiratory support was required, 51.3% (4 934/9 616) were receiving non-invasive respiratory support, while 23.1% (2 223/9, 616) were given when no respiratory support was needed. Compared to the non-transfusion group, the red blood cell transfusion group had a higher rate of pregnancy-induced hypertension in mothers, lower rates of born via cesarean section and mother's antenatal steroid administration, smaller gestational age, lower birth weight, a higher proportion of small-for-gestational-age, multiple births, and proportions of Apgar score at the 5th minute after birth ≤3 (all P<0.05). They were also less likely to be female, born in hospital or undergo delayed cord clamping (all P<0.01). Additionally, higher transport risk index of physiologic stability score at admission were observed in the red blood cell transfusion group (P<0.001). The number of red blood cell transfusion was 2 (1, 3) times, with the first transfusion occurring at an age of 18 (8, 29) days, and a pre-transfusion hemoglobin level of 97 (86, 109) g/L. For VPI ≤7 days of age, the pre-transfusion hemoglobin levels for invasive respiratory support, non-invasive respiratory support, or no respiratory support, respectively, with no statistically significant differences between groups (H=5.59, P=0.061). For VPI aged 8 to 21 days and≥22 days, the levels with statistically differences between groups (both P<0.01). Red blood cell transfusions above recommended thresholds were observed in all respiratory support categories at different stages of life, with the highest prevalence in infants aged 8 to 21 days and≥22 days who did not require respiratory support, at 90.1% (264/273) and 91.1%(1 578/1 732), respectively. The rate of necrotizing enterocolitis was higher in the above-threshold group (χ2=10.59,P=0.001), and the duration of hospital stay was longer in the above-threshold group (Z=4.67, P<0.001) compared to the below-threshold group. Conclusions: In 2022, the red blood cell transfusion rate was relatively high among VPI from CHNN. Pre-transfusion hemoglobin levels frequently exceeded recommended transfusion thresholds.

Prevalence of heart failure pharmacotherapy utilisation, frailty and adverse drug events among hospitalised adults older than 75 years: a multicentre cross-sectional study.

Optimal heart failure (HF) pharmacotherapy (guideline-directed medical therapy and diuretics) in older people with frailty is uncertain due to limited evidence. To evaluate utilisation of HF pharmacotherapy and prevalence of polypharmacy, adverse drug events (ADEs), falls, delirium, renal impairment and duration of hospitalisation in older inpatients, according to frailty. A retrospective cross-sectional study of the TO HOME cohort of 2000 inpatients ≥75 years admitted for ≥48 h to rehabilitation, geriatricor general medicine from 1 July 2016 to 30 June 2017 across six hospitals in Sydney, Australia. Data were collected from electronic medical records. International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification identified HF diagnosis, ADEs and frailty using hospital frailty risk score. Outcomes included utilisation of HF pharmacotherapy; polypharmacy; ADEs, falls, delirium, renal and impairment; and duration of hospitalisation. Among 439 (22.0% of TO HOME cohort) patients with undifferentiated HF, 284 (69.5%) had intermediate or high risk of frailty, and 412 (94%) took ≥1 HF pharmacotherapy, with 357 (81.3%) patients on loop diuretics. Patients with high frailty risk frequently continued beta-blockers (70%) and discontinued renin-angiotensin system inhibitors (57%). Most patients experienced polypharmacy (n = 426, 97.0%). Renal impairment prevalence was 67%-76% across frailty groups. Increasing frailty risk (low, intermediate and high) was associated with increasing prevalence of ADEs (31%, 56% and 84%), falls (12%, 25% and 46%) and delirium (8%, 27% and 49%) and longer hospitalisation. Frailty, HF-pharmacotherapy changes in hospital and ADEs were common among older inpatients with HF. The association of adverse outcomes according to frailty needs further investigation. Poor documentation of HF phenotype may be a barrier to medication optimisation in older inpatients.

Addiction to smartphones in Arabs is associated with severe depressive symptoms and insomnia: a cross-sectional study.

Addiction to smartphones is a global issue. Mental health disturbance is an emerging factor implicated in smartphone addiction. Whether depressive symptoms and anxiety are implicated in smartphone addiction in developing countries such as Jordan is a nexus that warrants investigation. The present study investigated whether depressive symptoms and insomnia are correlated with smartphone addiction in a cohort of Jordanian participants. We adopted a cross-sectional design for a convenient sample, smartphone addiction, depressive symptoms, and insomnia were assessed using validated scales. Data analysis from 484 participants revealed that smartphone addiction was reported in 180 (37.1%) of the participants. Symptoms of severe depression and severe insomnia were reported in 174 (35.9%) and 198 (40.9%) of the participants respectively. The multivariable regression analysis showed that severe depressive symptoms and severe insomnia were significantly associated with addiction to smartphones (OR = 1.69, 95% CI = 1.11-2.55, p = 0.01) and (OR = 2.19, 95% CI = 1.46-3.29, p < 0.001) respectively. In conclusion, poor mental health outcomes are correlated with unhealthy lifestyle habits such as addiction to smartphones, the addressing these alarming mental health symptoms is required to optimize the well-being of the community.

Knowledge, attitudes and practices of the general population towards Marburg virus disease in sub-Saharan African countries: a cross-sectional study.

Marburg virus disease (MVD) is categorized among viral hemorrhagic fevers. MVD is associated with high rates of morbidity and mortality. This study aimed to identify factors affecting MVD knowledge, attitudes and practices in sub-Saharan African countries. Using a validated questionnaire, a cross-sectional survey was conducted from 21 April to 23 May 2023 in eight English-speaking sub-Saharan African countries (Ethiopia, Ghana, Kenya, Lesotho, Nigeria, Senegal, South Africa and Tanzania). Of 3142 participants, 51% were males, 66.0% were aged 18-29 y, 74.4% were living in urban areas, 47.9% completed their university education and 21.7% were healthcare workers (HCWs). Tanzanians had the highest good knowledge (89%), while Kenyans had the lowest (26%). Tanzanians had the highest positive attitude (82%), while Nigerians had the highest negative attitude (95%). The best practices exhibited were by Ethiopians (70%), and the poorest practices exhibited were by Ghanaians (94%). The predictors of good knowledge were marital status (adjusted OR [aOR]=0.75; 95% CI 0.59 to 0.94; p=0.013), knowing the correct mode of transmission (aOR=18.31; 95% CI 13.31 to 25.66; p<0.001), whether the participant has heard before about MVD (aOR=2.24; 95% CI 1.82 to 2.75; p<0.001), whether they modified their working habits (aOR=2.79; 95% CI 2.12 to 3.67; p<0.001), nationality (p<0.001) and being a HCW (aOR=2.71; 95% CI 2.01 to 3.67; p<0.001). The predictors of good attitude were being female (aOR=0.71; 95% CI 0.60 to 0.85; p<0.001), age (aOR=0.99; 95% CI 0.98 to 0.99; p=0.01), place of residence (aOR=3.13; 95% CI 2.46 to 3.99; p<0.001), level of education (aOR=1.67; 95% CI 1.37 to 2.04; p<0.001), knowing the correct mode of transmission (aOR=1.59; 95% CI 1.28 to 1.98; p<0.001), modification of working habits (aOR=1.30; 95% CI 1.01 to 1.68; p=0.039) and nationality (p<0.001). The predictors of practice were being female (aOR=1.17; 95% CI 1.01 to 1.37; p=0.042), place of residence (aOR=1.23; 95% CI 1.02 to 1.48; p=0.033), marital status (aOR=0.65; 95% CI 0.55 to 0.78; p<0.001), knowing the correct mode of transmission (aOR=0.46; 95% CI 0.38 to 0.56; p<0.001), modification of working habits (aOR=0.40; 95% CI 0.32 to 0.49; p<0.001) and occupation (aOR=0.37; 95% CI 0.30 to 0.46; p<0.001). Different modifiable and non-modifiable risk factors can be targeted to improve population perspectives towards MVD.