Cross-sectional Observational Study Research Articles

Mastication and oral myofunctional status in excess weight children and adolescents: A cross-sectional observational study.

Masticatory function seems to play a role in the aetiology of obesity. However, literature on the association between oral myofunctional status and overweight and obesity in children and adolescents is scarce and contrasting. To compare masticatory performance, orofacial myofunctional status and tongue strength and endurance between children and adolescents with overweight and obesity and those with normal weight. Thirty children and adolescents with overweight and obesity and 30 subjects with normal weight matched for age and sex were recruited. All subjects were evaluated with the Test of Masticating and Swallowing Solids in Children (TOMASS-C) for masticatory performance and with the Italian Orofacial Myofunctional Evaluation with Scores (I-OMES) for the orofacial myofunctional status. Anterior and posterior maximum tongue pressures and tongue endurance were measured. Parents-reported (PRO) duration of meals was recorded. Data were compared between the groups through the paired samples t-test or the Wilcoxon signed-rank test. Children and adolescents with overweight showed significantly lower number of bites (p = .033), lower I-OMES scores (p < .05), and shorter meal duration (p = .005) compared to their peers with normal weight. No significant differences were found between the two groups for the number of swallows, the number of masticatory cycles and the total time of the TOMASS-C, and none of the tongue pressure measurements. Eating in children and adolescents with overweight and obesity is characterised by a larger bolus sizes and shorter PRO meal duration. Additionally, overweight and obesity seem to be associated with poorer orofacial skills and structures in the paediatric population.

Different meanings of a three-point decline in MMSE score in Alzheimer's disease and depressive disorder.

The Mini-Mental State Examination (MMSE) is a composite scale that is included in diagnostic algorithms and in procedures to assess severity of cognitive impairment and efficacy of therapeutic interventions. It is unclear, however, whether the MMSE provides information about the same deficits in different diseases. To assess patterns of MMSE scores in patients with confirmed diagnosis of Alzheimer's disease or depressive disorder. We used data from a previously published cross-sectional retrospective observational clinical cohort study. The final analysis included only patients in whom biomarker analysis showed results characteristic of Alzheimer's disease (n = 167) and patients with depressive disorder in whom Alzheimer's disease had been ruled out by analysis of biomarkers (n = 69). A three-point decline in MMSE score from 30 to 27 reflected impairment of memory recall in patients with Alzheimer's disease, whereas it reflected impairments in calculation and memory recall in patients with depressive disorder. A further three-point decline in MMSE score from 27 to 24 predominantly reflected additional calculation impairment in patients with Alzheimer's disease. Our results indicate that memory performance is the most important measure of disease severity and the main contributor to the decline in MMSE score at onset of clinical manifestation of Alzheimer's disease. In general, this suggests that memory should be the primary measure used in routine clinical care and the primary endpoint in clinical trials involving patients with Alzheimer's disease at onset of clinical manifestation. Changes in other measures of cognition should prompt consideration of possible comorbidities as a cause, rather than the impact of Alzheimer's disease itself.

Mepolizumab depletes inflammatory but preserves homeostatic eosinophils in severe asthma.

Eosinophils are key therapeutic targets in severe asthma that are suppressed by IL5 (mepolizumab) and IL5 receptor (benralizumab) blockade. The effect of IL5 pathway biologics on recently described homeostatic (hEOs) and inflammatory (iEOs) eosinophil subsets is unknown. We aimed to determine the relative impact of mepolizumab and benralizumab treatment on eosinophil subset and phenotype, and explore clinical associations of eosinophil subsets with severe asthma characteristics and treatment response. We performed a cross-sectional observational study of severe asthma (eosinophilic n = 32, non-eosinophilic n = 23, mepolizumab-treated n = 25), with longitudinal follow-up of 30 eosinophilic participants at two timepoints (4-24 weeks, >24 weeks) post-commencement of mepolizumab (n = 20) or benralizumab (n = 10). Blood hEOs and iEOs were measured by flow cytometry assessment of surface CD62L protein. iEO proportion was significantly lower in mepolizumab-treated participants in both the cross-sectional and longitudinal study. Mepolizumab and benralizumab depleted iEOs to a similar extent, however a significantly greater number of hEOs remained in mepolizumab participants at follow-up. Greater iEO proportion correlated with poorer asthma control in eosinophilic but not non-eosinophilic asthma. Higher residual iEO proportion correlated with poorer asthma control in mepolizumab-treated individuals. Reduced blood eosinophil viability was observed in around half of mepolizumab-treated participants, which was associated with significantly better asthma control and spirometry. Mepolizumab depletes iEOs and reduces circulating eosinophil viability in severe asthma but preserves a residual population of circulatory hEOs. In contrast benralizumab depleted both iEOs and hEOs. Higher iEO abundance and eosinophil viability are associated with poorer clinical outcomes following mepolizumab-treatment. Monitoring circulating eosinophil phenotype and viability may be useful to predict biologic treatment response in severe asthma.

Evaluation of the Prevalence and Pattern of Dyslipidemia in Newly Detected Type 2 Diabetes Mellitus Patients and Nondiabetic Controls

Abstract Introduction: Dyslipidemia comprises disorders of lipoprotein metabolism, which is usually characterized by increased plasma levels of total cholesterol (TC), triglycerides (TG), low-density lipoproteins (LDL), or reduced plasma level of high-density lipoprotein (HDL). Dyslipidemia is commonly found in Type 2 Diabetes Mellitus (T2DM) patients causing an increased risk of atherosclerosis and cardiovascular disease. Many studies done previously show variable prevalence of dyslipidemia (68 to 85 %) in known diagnosed patients of T2DM (with unknown history of onset), however, only limited studies have been done for finding prevalence of dyslipidemia in newly detected T2DM patients. Aim: This study is a cross-sectional observational study done in a tertiary care hospital in Mumbai (India), aiming to study prevalence and pattern in newly detected T2DM patients. The secondary objective is to compare the prevalence and pattern of dyslipidemia in newly detected T2DM patients with non-diabetic controls. Material and Method: For this, 100 newly detected T2DM patients were chosen along with 100 cases of age &amp; gender-matched non-diabetic controls. Their clinical profile and lipid profile of both groups were observed and compared. Result: Results showed higher prevalence of dyslipidemia in newly detected T2DM patients (64%) which was significantly more than the control group (32%). Moreover, the pattern of dyslipidemia showed greater mean levels of TC, TG, and LDL and low mean levels of HDL in T2DM patients compared to the control group. Conclusion: These findings show that there is an increased risk of Dyslipidemia in new onset T2DM patients.

Retrospective assessment of patients' risk for peri-implant diseases using the implant disease risk assessment (IDRA) tool: A cohort study.

The implant disease risk assessment (IDRA) tool was designed to assess an individual's risk of developing peri-implant diseases by evaluating and integrating multiple risk factors. This study aimed to evaluate the IDRA tool to determine the risk of developing peri-implant disease in patients rehabilitated with dental implants. A retrospective observational cross-sectional study was conducted, collecting data from 92 patients with 92 selected dental implants. Data included the history of periodontitis, sites with bleeding on probing (BoP), teeth and/or implants with probing depths (PDs) ≥ 5 mm, alveolar bone loss relative to the patient's age, susceptibility to periodontitis, the frequency of supportive periodontal therapy (SPT), the distance from the restorative margin (RM) of the implant-supported prosthesis to the marginal bone crest (MBC), and factors related to the prosthesis itself. Additionally, the validated instrument periodontal risk assessment (PRA) was employed for comparison. Statistical analyses utilized Chi-square, Mann-Whitney, and ROC curve. Outcomes indicated that 62 implants (67.4%) were classified as high-risk. Among the IDRA parameters, history of periodontitis was the primary factor contributing to an increased risk (p < 0.001). IDRA revealed high sensitivity (100%) and low specificity (63%) (AUC = 0.685; 95% CI: 0.554-0.816; p = 0.047), and there was a low agreement between the IDRA and PRA tools (Kappa = 0.123; p = 0.014). The peri-implant disease developed in 16 implants with 5.44 (±2.50) years of follow-up, however, no significant association was observed between the high- and low-medium risk groups and the occurrence of peri-implant diseases. Most of the evaluated implants presented high IDRA risk. The IDRA tool exhibited high sensitivity and low specificity; no significant association was observed between the risk profile and the development of peri-implant diseases.

Dietary Zinc Intake and the Association of Insulin Level and HOMA-IR with Telomere Shortening in Mexican Children.

The relationship between dietary zinc (Zn) intake, metabolic diseases, and telomere length has been little explored in the children population. This observational cross-sectional study assesses the association between obesity (OB), cardiometabolic traits, telomere length, and dietary Zn intake in children with normal weight (NW) and OB from Mexico City. Anthropometric data, blood pressure, biochemical measurements, the homeostatic model assessment of insulin resistance (HOMA-IR) and leucocyte telomere length (determined by quantitative-PCR) were analyzed in 171 children with NW and 172 with OB. Furthermore, dietary Zn intake was evaluated in 117 children NW and 120 with OB. Telomere shortening was associated with fasting plasma insulin (FPI) and HOMA-IR in NW (beta coefficient [β]FPI = -0.022 ± 0.008, p = 0.009; βHOMA-IR = -0.096 ± 0.040, p = 0.020) and OB (βFPI = -0.007 ± 0.002,p = 0.003; βHOMA-IR = -0.034 ± 0.012,p = 0.005) children. Dietary Zn intake resulted negatively associated with FPI (β = -2.418 ± 0.764, p = 0.002) and HOMA-IR (β = -0.399 ± 0.014, p = 0.009) in children with OB. Then, in children with OB, the association between FPI, HOMA-IR, and telomere shortening was evaluated separately in groups of low, medium, and high dietary Zn intake (according to tertiles). The association between FPI, HOMA-IR, and telomere shortening was not significant in the high Zn intake group (PFPI = 0.633; PHOMA-IR = 0.567). Our results suggest that a high Zn intake may ameliorate the telomere shortening related to high FPI and HOMA-IR.

A retrospective analysis of e-prescriptions for non-communicable diseases on a telehealth platform in Malaysia

BackgroundThe management of non-communicable diseases (NCDs) has benefited from telehealth services. As these services which include teleconsultation services and e-prescriptions are relatively new in Malaysia, the data generated provide an unprecedented opportunity to study medication use patterns for the management of NCDs in the country. We analyze e-prescriptions from a local telehealth service to identify medication use patterns and potential areas to optimize medication use in relation to clinical practice guidelines.MethodsA cross sectional observational study was conducted by retrieving e-prescription records retrospectively from a telehealth service. 739,482 records from January 2019 to December 2021 were extracted using a designated data collection form. Data cleaning, standardization and data analysis were performed using Python version 3.11. The diagnoses were classified according to the International Classification of Disease 10 (ICD-10), while medications were classified using the Anatomical Therapeutic Chemical (ATC) system. Diagnoses, frequency of use for medication classes and individual medications were analyzed and compared to clinical practice guidelines.ResultsThe top five NCD diagnoses utilized by the service were hypertension (37.7%), diabetes mellitus (25.1%), ischemic heart disease (24.3%), asthma (14.4%), and dyslipidemia (11.7%). Medications were prescribed mostly in accordance with guideline recommendations. However, angiotensin receptor blockers (ARBs) were significantly more frequently prescribed compared to angiotensin converting enzyme inhibitors (ACEIs). Several medication classes appeared underutilized, including ACEIs in hypertensive patients with diabetes or ischemic heart disease, sodium glucose cotransporter 2 inhibitors in diabetic patients with ischemic heart disease, and metformin in patients with diabetes.ConclusionsTelehealth services are currently being utilized for the management of NCDs. Medication use for the management of NCDs through these services are mostly in accordance with guideline recommendations, but there exist areas that would warrant further investigation to ensure optimal clinical and economic outcomes are achieved.

A cross-sectional analysis on the patterns and prevalence of anxiety, stress, and depression in patients at diagnosis with cancers of the oral cavity: A single institutional study

Background: It is a truth universally acknowledged that the diagnosis of cancer is a huge stress for both individuals and families. While many psychosocial variables have been shown to influence the mental well-being, these factors are so complicated and interlinked with each other, that their integrated effect on oral cancer patients, who constitute a large morbid group of patients, is yet to be recognized. Aims and Objectives: The present research work aims to find more about the prevalence of stress, anxiety, and depression among patients with cancers of the oral cavity and work out on some key potentially predictive factors associated with anxiety and depressive symptoms. Materials and Methods: A cross-sectional observational study was carried out for patients of oral cancer, attending the radiation oncology out-patient department (OPD) at Medical college, Kolkata, between April 2022 and March 2023, a 1-year period. A total of 89 patients with oral cancer were interviewed with questionnaires on demographic variables, depression anxiety stress scale 21, and National Comprehensive Cancer Network Distress Thermometer. Chi-square tests and Spearman Correlation tests were conducted where appropriate to explore relationships between different variables. Results: The prevalence of stress symptoms, anxiety symptoms, and depressive symptoms was 44% (39/89), 60% (53/89), and 84% (75/89), respectively, among the patients interviewed. Addiction history of the patients was an important association found in this study. Conclusion: The prevalence of stress and depressive symptoms was high among the oral cancer patients attending the Radiation Oncology OPD at our institution as well as levels of anxiety. Certain social variables such as relationship with spouse, children, and other family members had a profound effect on the mental well-being of the patients. Furthermore, certain factors such as addiction to tobacco and its different forms reduced the coping up capability of the patients.

Digital Maturity as a Predictor of Quality and Safety Outcomes in US Hospitals: Cross-Sectional Observational Study.

This study demonstrates that digital maturity contributes to strengthened quality and safety performance outcomes in US hospitals. Advanced digital maturity is associated with more digitally enabled work environments with automated flow of data across information systems to enable clinicians and leaders to track quality and safety outcomes. This research illustrates that an advanced digitally enabled workforce is associated with strong safety leadership and culture and better patient health and safety outcomes. This study aimed to examine the relationship between digital maturity and quality and safety outcomes in US hospitals. The data sources were hospital safety letter grades as well as quality and safety scores on a continuous scale published by The Leapfrog Group. We used the digital maturity level (measured using the Electronic Medical Record Assessment Model [EMRAM]) of 1026 US hospitals. This was a cross-sectional, observational study. Logistic, linear, and Tweedie regression analyses were used to explore the relationships among The Leapfrog Group's Hospital Safety Grades, individual Leapfrog safety scores, and digital maturity levels classified as advanced or fully developed digital maturity (EMRAM levels 6 and 7) or underdeveloped maturity (EMRAM level 0). Digital maturity was a predictor while controlling for hospital characteristics including teaching status, urban or rural location, hospital size measured by number of beds, whether the hospital was a referral center, and type of hospital ownership as confounding variables. Hospitals were divided into the following 2 groups to compare safety and quality outcomes: hospitals that were digitally advanced and hospitals with underdeveloped digital maturity. Data from The Leapfrog Group's Hospital Safety Grades report published in spring 2019 were matched to the hospitals with completed EMRAM assessments in 2019. Hospital characteristics such as number of hospital beds were obtained from the CMS database. The results revealed that the odds of achieving a higher Leapfrog Group Hospital Safety Grade was statistically significantly higher, by 3.25 times, for hospitals with advanced digital maturity (EMRAM maturity of 6 or 7; odds ratio 3.25, 95% CI 2.33-4.55). Hospitals with advanced digital maturity had statistically significantly reduced infection rates, reduced adverse events, and improved surgical safety outcomes. The study findings suggest a significant difference in quality and safety outcomes among hospitals with advanced digital maturity compared with hospitals with underdeveloped digital maturity.

Analysis of management factors influencing Anaplasma marginale transmission

The aim of this study was to identify factors that play a key role in the epidemiology of bovine anaplasmosis by adapting a model primarily developed for cattle babesiosis. A cross-sectional observational study was conducted to study the proportion of calf herds in endemic stability/instability for A. marginale in a semi-arid area of Argentina. The A. marginale inoculation rate (h) was calculated from age-specific seroprevalence using double-antigen sandwich ELISA in 58 herds of 4.5–8.5-month–old calves. Herds were considered to be in endemic instability (EI) at h < 0.005 and, therefore, at risk of anaplasmosis outbreaks. A generalized linear model was performed to explore husbandry practices associated with differences in A. marginale transmission. Additionally, spatial clustering of herds with the same immunological status was analyzed using spatial scan statistics (SatScan, Bernoulli model). Spearman's correlation was used to explore a possible association between A. marginale h and Babesia bovis and B. bigemina h (data obtained in previous works). Almost half (43 %) of the herds were in the EI zone for A. marginale. Calves raised under forage combinations had a greater risk of being in EI (OR = 5.41, CI95 %OR = 1.43–20.41) than those reared exclusively on permanent pastures, where cattle density is higher (P = 0.01). Moreover, calves from herds treated only with pyrethroids to control ticks had more chances of being in EI (OR = 4.16, CI95 %OR = 1.12–15.38) than calves from herds receiving different acaricide combinations (P = 0.03). Calves from herds subjected to more than two treatments against Haematobia irritans had higher odds for EI (OR = 5.69, CI95 %OR = 1.24–26.11) than those from herds using fewer than two treatments (P = 0.02). The spatial analysis revealed no spatial clustering of the immune status of the herds (P = 0.67 and P = 0.74 for low and high incidence rates, respectively). A significant variation between farms was observed in A. marginale h (CV = 90.38 %). The correlation analysis revealed a strong epidemiological link of A. marginale h with B. bovis h (Rho=0.794, P<0.001) and B. bigemina h (Rho=0.839, P<0.001). Given that R. microplus is the only vector of B. bovis and B. bigemina in the region, the results of this work strongly suggest an active and significant role of R. microplus in the transmission of A. marginale.

Disaster Preparedness among Healthcare Professionals in Lebanon

Background: Disaster disrupts the normal functioning of a community, causing significant damages and losses. In recent years, Lebanon faced multiple disasters, including one of the largest explosions ever recorded, the Beirut Blast, in August 2020. Limited studies in the literature have examined disaster medicine preparedness among healthcare professionals (HCPs). Objective: To examine the knowledge (K), attitude (A), readiness to practice (rP), and KArP associated with disaster medicine preparedness among HCPs in Lebanon. Methods: A cross-sectional observational study was conducted in Lebanon using data from participants answering an online survey. Participants enrolled in this study were HCPs (residents and faculty), medical students, and postdoctoral research scholars. Levels of knowledge, attitude, and readiness to practice were assessed and used to examine their association with participants’ socio-demographic characteristics. Results: A total of 195 participants (average age 30.6 ± 11.4 years) were included in this study. Participants reported moderate scores of knowledge, attitude, and readiness to practice. Older participants reported better readiness to practice and a KArP score. A significant difference was observed in all categories according to gender, with men having higher scores than women. No significant difference was observed between the level of education and knowledge, attitude, and total KArP scores. Conclusions: Our study’s findings showed that age and the level of education were positively correlated with readiness to practice. Men, compared to women, had significantly higher scores in all categories. Barriers to the KArP should be identified and targeted in future studies, as disaster preparedness at the institutional level may improve outcomes in future disaster encounters.

IL-6 LEVELS AND COGNITIVE COMPLICATIONS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS: A CROSS SECTIONAL STUDY

Objective: It is important to monitor and manage macrovascular and microvascular complications, which are significant causes of mortality and morbidity in type 2 diabetes (T2DM). Diabetes-related cognitive impairment is an important complication that has recently attracted more attention, but its pathophysiology and clinical features are not known. The aim of this study was to evaluate the potential role of inflammation in diabetes-related cognitive impairment. Material and Method: A total of 122 participants (67 patients with T2DM and 55 controls) took part in this cross-sectional observational clinical study. Cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA) test. IL-6 levels were measured using the ELISA method on blood samples obtained from the participants. Result and Discussion: Although IL-6 levels increased with diabetes and cognitive impairment, there was no significant difference between the groups (p&amp;gt;0.05). Except for attention and orientation, we observed significantly more impaired cognitive performance in T2DM patients. The MoCA total score was significantly correlated with age, education level, fasting glucose, HbA1c, and vitamin D levels (p&amp;lt;0.05). Our results found no evidence that IL-6 is involved in the pathophysiology of cognitive impairment in T2DM, but these findings the importance of cognitive screening in monitoring complications associated with diabetes.

Superficial Veins in the Cubital Fossa Regions among the Nepalese and Indian Medical Students of a Medical College in Nepal: A Descriptive Cross-Sectional Study

Background The veins in the upper limb are classified as superficial or deep, with deep veins, such as the venae comitantes and axillary vein, coming after the major arteries. The subcutaneous tissue contains the superficial veins, which link to the deep veins. These veins include the basilic, cephalic, median cubital, and median antebrachial veins. These superficial veins are clinically significant for phlebotomy, transfusion, and cardiac catheterization, and it joins the median cubital vein at the elbow. It is essential to comprehend the structure and patterns of cubital superficial veins in order to design dialysis access and minimise hazards. Materials and Methods Studying the superficial venous organisation in the cubital fossa of 192 MBBS preclinical sciences students, ages 18 to 24, was a cross-sectional observational study carried out at the Nobel Medical College Teaching Hospital in Nepal. A tourniquet and skin marker/tailor's chalk were used in the study to examine 384 anterior aspects of the arms. Six sets of veins were distinguished from the skin's veins. Tiny veins, cubital wounds, or thick tissue layers disqualified students. Results A study of 192 preclinical sciences students at Nobel Medical College Teaching Hospital in Biratnagar found that type II variant was the most common venous pattern in the cubital fossa region, followed by type I in 24.75%, and the lowest being the type VI pattern in 3.35%. Conclusion It was discovered that the patterns of superficial veins at the cubital fossa did not significantly alter based on the gender or nationality of the individual. Overall, the most common venous pattern was type II, though type I was more frequently seen in female subjects but the difference was statistically insignificant.

A Cross-Sectional Observational Study Analyzing the Knowledge, Attitude, and Practice of Young Female Nursing Officers and Female Doctors About the Human Papillomavirus Vaccine

A Cross-Sectional Observational Study Analyzing the Knowledge, Attitude, and Practice of Young Female Nursing Officers and Female Doctors About the Human Papillomavirus Vaccine

COVID-19 Pandemic School Disruptions and Acute Mental Health in Children and Adolescents.

There are suggestions that school pressure may be stressful and a factor in child and adolescent mental health disturbances, but data about this association are scarce and inconclusive. To assess whether varying degrees of school interruption were associated with changes in emergency department (ED) psychiatric visits of children and adolescents before and after the COVID-19 outbreak. A cross-sectional observational study was conducted at 9 urban university hospitals in Italy. All ED visits from January 1, 2018, to December 31, 2021, for psychiatric reasons of patients younger than 18 years were examined for demographic characteristics and type of psychopathologic factors. Data analysis was conducted from July 1 to August 31, 2023. The disruption in the usual succession of school and holiday periods brought on by the COVID-19 pandemic at different times and with various degrees of intensity. Total number of pediatric ED visits, psychiatric ED visits, and psychiatric ED visits categorized by specific reasons (eg, psychomotor agitation, suicide ideation [SI] or suicide attempt [SA], and eating disorders) on a weekly basis. A total of 13 014 psychiatric ED visits (1.3% of all pediatric ED visits) were recorded (63.2% females; mean [SD] age, 13.8 [3.8] years). The number of ED psychiatric visits increased over time (incidence rate ratio [IRR], 1.19; 95% CI, 1.16-1.22 for each year). Significant increases in ED visits were observed for eating disorders (294.8%), SI (297.8%), and SA (249.1%). School opening, but not social lockdown restriction, was associated with an increase in the number of ED psychiatric visits (IRR, 1.29; 95% CI, 1.23-1.34), which was evident for females and for SI with SA. Socioeconomic status was associated with an increase in psychiatric visits for males (IRR, 1.12; 95% CI, 1.04-1.20) but not females (IRR, 1.04; 95% CI, 0.98-1.10). In this study, school opening was associated with an increased incidence of acute psychiatric emergencies among children and adolescents, suggesting that school can be a substantial source of stress with acute mental health implications.

Knowledge, attitudes and practices (KAP) of medical university students towards vitamin D deficiency in Saudi Arabia: a cross-sectional study.

Vitamin D deficiency is a serious health problem that is associated with many health consequences. The study aimed to assess the knowledge, attitudes, and practices of medical students at Qassim University, Saudi Arabia, regarding vitamin D deficiency. An observational cross-sectional study was conducted among students of Unaizah Colleges of Pharmacy (UCP) and Medicine (UCM) at Qassim University, Saudi Arabia, over a period of 3 months. A well-structured self-administered questionnaire was used for the data collection. Statistical analysis was applied by using SPSS version 22. A 0/1 scoring process was employed to assess the KAP of the participants. The midpoint is considered the cutoff point. A total of 337 complete responses were received. The majority of participants (62.3%) were female. 291 (86.3%) were considered to have good knowledge, with a mean score of 6.326 out of 9. Moreover, 220 (65.2%) of participants had positive attitudes, with a mean score of 4.077 out of 7. Unfortunately, only 9 (2.6%) participants demonstrated satisfactory practices, with a mean score a 0.911 out of 6. Female participants were significantly better than male participants in terms of knowledge and attitudes, but worse in terms of practices. Sun exposure during safe daytime hours is considered the main cause of vitamin D deficiency. Nearly 60% confirmed that KSA indoor activities and the COVID-19 lockdown might maximise vitamin D deficiency. The study reveals a gap in vitamin D knowledge among participants influenced by gender and study year. It suggests educational initiatives for male students to enhance their knowledge regarding vitamin D, while female students are encouraged to prioritise safe sun exposure, minimising the use of umbrellas and sunscreen. It also highlights the role of educational institutions as reliable sources of information and the influence of the COVID-19 pandemic on participants' attitudes and practices towards vitamin D.

Hematological and Coagulation Factors in Term and Preterm Newborns of Mothers with Pre-eclampsia

Objective: Pre-eclampsia (preE) is pregnancy-induced hypertension affecting a significant proportion of pregnant women worldwide and can cause detrimental effects on the mother and newborn. Recognition of contributing factors of health in neonates with pre-eclamptic mothers is important to reduce the burden of the problem. The aim of the study was to determine the hematologic and coagulation factors in term and preterm neonates born to mothers with pre-eclampsia. Method and Materials: In this observational cross-sectional comparative study, 104 neonates born to mothers with pre-eclampsia in Imam-Hossein Hospital from 2018 to 2021 were enrolled. The neonates were divided into term and preterm groups according to the gestational age of the mothers. Maternal and fetal parameters of neonates were collected. The hematologic and coagulation factors were recorded and compared. Results: The finding of the study demonstrated that the mean leukocyte (P=0.030), hemoglobin (P=0.0001), and platelet (P=0.0001) were significantly higher in term neonates. The mean PT (P=0.003), PPT (P=0.001), and INR (P=0.003) were significantly higher in preterm cases. Conclusion: Totally, according to the obtained results it may be concluded that CBC indexes and coagulopathy in term and preterm neonates born to mothers with pre-eclampsia are significantly different.

Post-COVID-19 Condition: How Sociodemographic Factors, Physical Well-Being and Functionality Influence Quality of Life and Mental Health Symptoms

Background: Long COVID-19 syndrome remains a global public health problem, with more than 145 million people affected with multisystemic symptoms. Addressing the requirements of individuals impacted by a syndrome characterised by a complex and variable clinical presentation is of utmost importance. Identifying the variables that can exert influence and understanding their progression is essential for directing treatment strategies aimed at enhancing both independence and quality of life. Therefore, the aim of this study was to analyse the influence of sociodemographic and clinical variables on existence and their relationship with asthenia, anxiety symptoms and low mood. Methods: An analytical study secondary to an observational cross-sectional descriptive study. Results: Logistic regression showed significant univariate effects on asthenia [sex (p = 0.034); age (p = 0.042); Activities of Daily Living Questionnaire [ADQL (p = 0.002)] [physical functioning (p &lt; 0.001) and general health (p = 0.014)] and multivariate [sex (p = 0.019), adult age (p = 0.01) and physical functioning (p = 0.04)]]; low mood [time of evolution (p = 0.028) and multivariate [time course (p = 0.007), ADLQ (p = 0.011), role physical (p = 0.013) and general health (p = 0.001)]] and anxiety [physical functioning (p = 0.046) and multivariate [physical functioning (p = 0.034), age (p = 0.011), time of evolution (p = 0.001) and ADQL (p = 0.011)]]. Conclusions: Increased age, gender and longer evolution time seem to favour the prevalence and occurrence of mental health symptoms; greater independence and good physical functioning are protective factors with respect to the occurrence of mental health-related symptoms in patients affected by post-COVID-19 condition.

Development and validation of a clinical prediction rule for walking independence in hospitalized older adults with a vertebral compression fracture.

No reports on factors or Clinical prediction rules (CPRs) associated with walking independence among patients with vertebral compression fractures (VCFs) are available. Evidence regarding epidemiological walking independence rates is also sparse. Here, we sought to (i) obtain epidemiological data on the probability of inpatients with VCFs achieving walking independence, and (ii) develop and validate a CPR to determine walking independence in hospitalized patients with VCFs. We conducted a retrospective cross-sectional observational study of patients aged ≥60years who were hospitalized for VCF at four hospitals in Japan in 2019-2022. The outcome was walking independence at discharge. We performed a binomial logistic regression analysis to assess predictors of walking independence. Five independent variables were entered: age, American Society of Anesthesiologists physical status, cognitive function, Berg Balance Scale (BBS), and 10-m walking test. Among the independent variables that were significant, we converted the continuous variables to binary data by calculating cut-off values and then created the CPR. The area under the curve (AUC) was calculated as the measure of the CPR's diagnostic accuracy, and internal validation was conducted by bootstrapping. Of the 240 patients, 188 (78.3%) achieved walking independence. Cognitive function and the BBS score (with a cut-off of 45 points) were identified as significant predictors. We created a CPR using these two items (0-2 points). The CPR's AUC was 0.92 (0.874-0.967), and internal validation by bootstrapping yielded a mean AUC of 0.919 with a slope of 0.965. The walking independence rate of patients with a VCF during hospitalization was 78.3%, with cognitive function and BBS being predictors. The developed CPR performed well enough to retrospectively predict walking independence in VCF patients. The BBS cut-off value and the CPR may serve as useful indicators for clinicians to predict VCF patients' walking independence.

To find the correlation between transverse cerebellar diameter measured by cranial ultrasound within 48 h of birth and gestational age as estimated by last menstrual period

Background: Gestational age (GA) may be assessed at any time during pregnancy, and several modes of assessment exist, each requiring better diagnostic techniques that may result in more precise estimates of GA, which could lead to quicker medical management of a pregnant patient. The largest diameter across both hemispheres, measured from outer to outer margin, is the transverse cerebellar diameter (TCD). Aims and Objectives: We aimed to predict the correlation between TCD measured by cranial ultrasound within 48 h of birth and GA as estimated by the last menstrual period. Materials and Methods: The present study was conducted in the Department of Pediatrics, Dr. S. N. Medical College, Jodhpur, Rajasthan. Ethical clearance was obtained from the Institutional Ethical Committee. It was a cross-sectional observational study and the duration of the study was 6 months. We split the population into three groups based on GA: (a) &lt;32 weeks of GA, (b) 32–36+6 days of GA, and (c) 37–42 weeks of GA. We enrolled 25 neonates from each group. Results: A very strong positive correlation between TCD and GA in infants was &lt;32 weeks of gestation age, in infants 32–36 weeks+6 days of gestation age, and in infants 37–42 weeks of gestation age. Regression analysis shows a very strongly significant relationship. Hence, the TCD is a better predictor of GA in the third trimester. Our study reported that there is a close relationship between TCD and GA, with TCD increasing linearly from &lt;32 weeks to 42 weeks. GA can be predicted to be 1.43 weeks by assessing TCD on neonatal cranial ultrasonography images. Conclusion: The TCD is a better predictor of GA in the third trimester. Our study reported that there is a close relationship between TCD and GA, with TCD increasing linearly from &lt;32 weeks to 42 weeks.