General Linear Regression Model Research Articles

Parental Involvement With Early Adolescents: Variations Related to the Gender in Rural and Urban Areas

The current study addressed the variations of parental involvement according to the home location and the gender of adolescents, considering the mother’s education. Through a cross-sectional design, variations in parental involvement were analyzed with 1,079 mothers and their adolescents between 11 and 14 years old (mean age = 12.88, SD = 0.98) in Colombia, registering the home location, gender of adolescents, educational level of mothers, and the perceived parental involvement at home and at school. The data were analyzed through a multivariate general linear model and multiple linear regression. In the results, there were no significant differences in direct effects of home location and gender of adolescents in involvement, but they were found in the interaction, where less parental involvement of mothers is dedicated to girls in urban areas compared with girls in rural areas and boys in urban areas. It was possible to establish that the interaction between variables seems to be related to the educational level of the mothers. The findings supported a situated approach to parental involvement in the case of mothers, where factors associated with parents and adolescents are relevant in specific settings.

Improvement of protective facilities in vinyl chloride units on liver injury status of occupational exposed group

To comprehensively evaluate the effectiveness of improvement of protective facilities in a vinyl chloride monomer(VCM) on promotion toward health status of occupational exposed group and safety production at poly-vinyl chloride(PVC) by comparing the liver function indicators and inspection result before and after the improvement, and to analyze the possible influential factors. The information collection concerning facilities improvement in 2013 and 2016, identification toward critical controlling points, data or detection result from occupational on-site survey and physical examination were originated in July 2020, and 227 VCM exposed workers and 179 others without chemical reagents exposure history from production factory with calcium carbide process in Tianjin City were selected as objects. The effectiveness toward improvement of protective facilities in critical controlling points that occupational exposed workers usually involve in were evaluated through comparison toward VCM concentration result, thiodiglycolic acid(TDGA) content in urine, indicators on liver function and biochemistry and liver ultrasound. At the mean time, both binary Logistic regression analysis was used to screen the possible factors that contributed to abnormal symptoms and single dependent variable general linear regression model was used to find out the mutual interaction among influential factors. Prior to improvement on protective facilities, the C_(TWA)of VCM exposed by all 8 positions in G had exceeded 1 to 2 folds of occupational exposure limit(OEL=10 mg/m~3) and the position of synthetic operator and field sampling man were ones exposed to 1, 2-DCE with the range from 50% to 1 OEL, others hazard factors were found to meet relative OELs. Next, the content of TDGA in urine of exposed group was found to correlate strongly to the average concentration of VCM(r=0.79, P<0.05), and result of TDGA content, alanine aminotransferase(ALT), γ-glutamyl transpeptidase(GGT) and abnormal rate toward liver ultrasound test in exposed group were much higher than ones in control group with significant differences(P<0.05 or P<0.001). By contrast, after the improvement, the exposure level toward all identified hazard factors were declined to meet OEL levels with significant differences in TDGA content, and result of ALT, GGT and abnormal rates toward symptoms in liver ultrasound test such as liver calcification with thickened liver echo, peripheral fibrosis of the liver, multiple hepatic cysts were markedly lower than ones before improvement and still were higher than ones in control group(P<0.05 or P<0.001). Further, parameters of gender, length of employment, weekly contact time, VCM exposed level, TDGA content were all important contributing factors to abnormal symptoms in liver ultrasound test before and after improvement on protective facilities(P<0.05 or P<0.001), in which a significant interaction effect between gender and length of employment(F=4.028, P=0.044), weekly contact time and TDGA content(F=2.183, P=0.046) in urine were found in contribution analysis to abnormal symptoms in liver ultrasound test(P<0.05). The improvement measure carried out in VCM facilities by this PVC production factories with calcium carbide process effectively reduced the ambient concentration of hazard factors mainly led by VCM, but workers might still be at risk of liver injury even under VCM exposure at relative lower level, which may referred to factors of long weekly contact time, long length of employment and high fat diet.

A Three-Dimensional Real-Time Gait-Based Age Detection System Using Machine Learning

Human biometric analysis has gotten much attention due to its widespread use in different research areas, such as security, surveillance, health, human identification, and classification. Human gait is one of the key human traits that can identify and classify humans based on their age, gender, and ethnicity. Different approaches have been proposed for the estimation of human age based on gait so far. However, challenges are there, for which an efficient, low-cost technique or algorithm is needed. In this paper, we propose a three-dimensional real-time gait-based age detection system using a machine learning approach. The proposed system consists of training and testing phases. The proposed training phase consists of gait features extraction using the Microsoft Kinect (MS Kinect) controller, dataset generation based on joints’ position, pre-processing of gait features, feature selection by calculating the Standard error and Standard deviation of the arithmetic mean and best model selection using R2 and adjusted R2 techniques. T-test and ANOVA techniques show that nine joints (right shoulder, right elbow, right hand, left knee, right knee, right ankle, left ankle, left, and right foot) are statistically significant at a 5% level of significance for age estimation. The proposed testing phase correctly predicts the age of a walking person using the results obtained from the training phase. The proposed approach is evaluated on the data that is experimentally recorded from the user in a real-time scenario. Fifty (50) volunteers of different ages participated in the experimental study. Using the limited features, the proposed method estimates the age with 98.0% accuracy on experimental images acquired in real-time via a classical general linear regression model.

Kibria-Lukman Estimator for General Linear Regression Model with AR(2) Errors: A Comparative Study with Monte Carlo Simulation

The sensitivity of the least-squares estimation in a regression model is impacted by multicollinearity and autocorrelation problems. To deal with the multicollinearity, Ridge, Liu, and Ridge-type biased estimators have been presented in the statistical literature. The recently proposed Kibria-Lukman estimator is one of the Ridge-type estimators. The literature has compared the Kibria-Lukman estimator with the others using the mean square error criterion for the linear regression model. It was achieved in a study conducted on the Kibria-Lukman estimator's performance under the first-order autoregressive erroneous autocorrelation. When there is an autocorrelation problem with the second-order, evaluating the performance of the Kibria-Lukman estimator according to the mean square error criterion makes this paper original. The scalar mean square error of the Kibria-Lukman estimator under the second-order autoregressive error structure was evaluated using a Monte Carlo simulation and two real examples, and compared with the Generalized Least-squares, Ridge, and Liu estimators.
 The findings revealed that when the variance of the model was small, the mean square error of the Kibria-Lukman estimator gave very close values with the popular biased estimators. As the model variance grew, Kibria-Lukman did not give fairly similar values with popular biased estimators as in the model with small variance. However, according to the mean square error criterion the Kibria-Lukman estimator outperformed the Generalized Least-Squares estimator in all possible cases.

Local People's perception of forest ecosystem services, traditional conservation, and management approaches in North Wollo, Ethiopia

For their livelihoods, many people rely on the services offered by forest ecosystems. Nevertheless, forests are being lost and degraded on a global scale, endangering the delivery of important services. This is the situation in Ethiopia, a nation where land degradation and deforestation pose a threat to the majority of forest ecosystems. Studies in North Wollo are very scarce and limited despite the present growth in evidence bases measuring environmental services and risks across the globe. The traditional knowledge and attitudes of the locals concerning trends in forest management, conservation, and ecosystem services were investigated in this study. We used many approaches for gathering data. The quantitative data were analyzed and interpreted using descriptive statistics, one-way ANOVA, multiple linear regression, and general linear regression models. The main threats to forest ecosystems in North Wollo included deforestation for the production of firewood and charcoal, increased population growth and agricultural needs, environmental pollution, the allelopathic influence of exotic species, and loss of soil fertility. These dangers cause instability and a decline in the range of ecological services provided by forests. Regarding this, the customary rules, social exclusion, and indigenous beliefs were utilized as a conservation technique to maintain and protect the remaining natural resources. In addition, the community uses terracing, gully prevention, and hillside planting with native trees to restore the ecology that has been damaged. As a result, efforts should be made to solve the current difficulties and dangers since local people, the government and non-governmental organizations have an interest in preserving forest ecosystems. In general, encouraging the direct involvement of locals in decision-making and equitable distribution of the benefits resulting from the ecosystems could aid in addressing the difficulties and risks to the ecosystems.

Transdisciplinary allied health assessment for patients with stroke: a pre-/post- mixed methods study protocol

BackgroundTransdisciplinary approaches can streamline processes and build workforce capacity by blurring traditional responsibilities and integrating aspects of care. Emerging evidence shows transdisciplinary approaches can improve time-efficiency, quality of care and cost-effectiveness across various healthcare settings, however no empirical study is based on an acute stroke unit.MethodsThe SPIRIT checklist was used to guide the content of the research protocol. The study is a pragmatic pre−/post- mixed methods four-phase study with a 3-month follow up, based at the Mater Hospital Brisbane. Participants experiencing stroke symptoms will be recruited as they are admitted to the acute stroke unit. Patients presenting with mild stroke symptoms or Transient Ischaemic Attack will be allocated to Phase 1 (baseline) or Phase 2 (implementation), while patients presenting with moderate to severe stroke symptoms will be allocated to Phase 3 (baseline) or Phase 4 (implementation). Participants in baseline Phases 1 and 3 will receive standard allied health assessment, while participants in implementation Phases 2 and 4 will receive the novel transdisciplinary assessment. For the primary aim, allied health professionals will time their assessments to evaluate time taken to administer a novel transdisciplinary assessment, compared to usual discipline-specific assessments. Non-inferiority of the novel transdisciplinary assessment will also be explored in terms of patient safety, compliance to national standards, use of the assessment, and stakeholder perceptions. A retrospective medical record audit, staff focus group, patient/staff surveys, and patient phone interviews at 3-months will be completed. Quantitative results will be estimated using general linear and logistic regression models in Stata 15.1. Qualitative results will be analysed using frequency counts and NVivo software. An economic evaluation will be performed using three scopes including the allied health assessment, hospital admission, and patient outcomes at 3-months.DiscussionWhen designing the study, pragmatic factors related to staff willingness to be involved, patient safety, and existing clinical pathways/processes were considered. To address those factors, a co-design approach was taken, resulting in staff buy-in, clinically relevant outcome measures, and the pre−/post- four-phase study design.Trial registrationAustralian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12621000380897. Registered 06 April 2021 - retrospectively registered, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=381339&isReview=true

Possible contribution of COVID-19 vaccination to the subsequent mental well-being in Japan

The coronavirus disease 2019 (COVID-19) pandemic has had a severe impact on mental well-being. Vaccination may have played a pivotal role in enduring this mental health crisis. The present study aimed to longitudinally investigate the association between COVID-19 vaccination and mental health status among Japanese population in 2021. Longitudinal data of 17,089 individuals aged 15–79 years who participated in a nationwide online study were analyzed. Baseline and follow-up mental health statuses were assessed using the Kessler Psychological Distress Scale (K6). General linear and multivariable logistic regression models adjusted for baseline levels of mental distress were used to examine the association between vaccine receipt and follow-up levels of mental health. Mean K6 scores were lower in the vaccinated than in the non-vaccinated participants. Those who had received one or two doses of COVID-19 vaccines were associated with improved mental health at follow-up in subjects with psychological distress at baseline (odds ratio [OR] 1.31 and 1.35, respectively) and were inversely associated with deteriorated mental health status at follow-up in subjects without psychological distress at baseline (OR 0.66 and 0.70, respectively) compared with no vaccination groups, respectively. The present study would indicate that one or two doses of COVID-19 vaccinations contributed to mental well-being in Japan. This finding might provide evidence for promoting vaccination against COVID-19 and emerging infectious diseases in the future.

Liver Fibrosis and Hearing Loss in an Older Mediterranean Population: Results from the Salus in Apulia Study.

Aging is the main negative prognostic factor for various chronic diseases, such as liver fibrosis, and clinical disorders such as hearing loss. This study aimed to investigate the association between age-related hearing loss (ARHL) and age-related central auditory processing disorder (CAPD), and the risk for liver fibrosis in a cross-sectional study on an aging population. Liver fibrosis risk was judged on the fibrosis-4 (FIB-4) score. Peripheral ARHL was evaluated with pure tone audiometry using a calibrated audiometer. The pure tone average (PTA), calculated as a threshold ≤ 40 dB (HL) in the better ear, was measured at the frequencies 0.5-4 kHz. For age-related CAPD assessment, we employed the Synthetic Sentence Identification with an Ipsilateral Competitive Message test (SSI-ICM). General linear Logistic regression models were used to estimate the association. The increase in the PTA 0.5-2 kHz (coefficient: 0.02, SE: 0.01, CI 95%: 0.01 to 0.03) was directly associated with a higher risk of liver fibrosis (FIB-4 ≥ 2.67). Moreover, the reduction in SSI (coefficient: -0.02, SE: 0.01, CI 95%: -0.03 to -0.01) was inversely associated with FIB-4 values < 2.67. Our results show an association between liver fibrosis and both ARHL and CAPD, linked by the typical consequence of aging. We also assume a role of inflammatory responses and oxidative stress.

Blood immune response genes are correlated with brain glucose metabolism

AbstractBackgroundImaging techniques such as positron emission tomography (PET) have been fundamental to develop our understanding about Alzheimer's disease (AD) underlying features. Evidence suggests that neuroinflammation plays a complex role in the pathophysiology of AD. Nevertheless, whether peripheral inflammation affects brain function remains to be defined. In this context, the integration of blood‐based measures and imaging modalities can facilitate the understanding of the periphery‐brain interface in AD. Here, we developed a method to integrate immune response‐related genes, derived from blood transcriptomics, with [18F] Fluorodeoxyglucose ([18F]FDG)‐PET imaging data. We hypothesized that the differential expression of immune‐related genes would be associated with brain metabolism as indexed by [18F]FDG‐PET signal.MethodBlood transcriptome profiles and imaging data were obtained from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. Differential gene expression analysis was performed in 99 Cognitively Unimpaired (CU) and 218 Cognitively Impaired (CI) individuals, whose differentially expressed genes (DEGs) underwent functional enrichment analysis Gene Ontology (GO). Immune‐related GO terms were clustered by semantic similarity using the GOSemSim method for biological processes ontology. All computations analysis were performed in the R statistical environment. Integration with [18F]FDG‐PET images was performed using voxel generalized linear regression (GLR) models considering the covariates age, gender, education, and APOE ε4 status (RMINC package).ResultsPeripheral blood cells transcriptome analysis identified 10 enriched GO terms associated with the immune response. For each term, the GLR models were used to calculate voxel‐wise associations between [18F]FDG and gene expression, resulting in a t‐statistical map. Figure 1 demonstrated the uncorrected statistically significant correlated voxels (t‐value > 2.0). At the voxel level, biological processes related to regulatory mechanisms of innate immunity presented a 32% Correspondence with [18F]FDG‐PET signal in the gray matter of the medial frontal‐orbital gyrus.ConclusionHere, we demonstrated a significant association between brain glucose metabolism and immune‐related blood DEGs. Our findings suggest that peripheral inflammation that occurs in AD patients might have an impact on [18F]FDG‐PET metabolism.

Association of maternal TSH and neonatal metabolism: A large prospective cohort study in China.

Neonatal metabolites are very important in neonatal disease screening, and maternal thyroid hormones play an important role in fetal and neonatal health. Our study aimed to explore the association of maternal thyroid hormones with neonatal metabolites and identify an important time windows. Pregnant women were recruited in Jinan Maternity and Child Care Hospital and followed up until delivery. Multivariate generalized linear regression models (GLMs) and restricted cubic spline (RCS) regression analysis models were used to investigate the associations of maternal TSH and FT4 with neonatal metabolites. In total, 6,653 pairs of mothers and newborns were enrolled in our study. We identified 5 neonatal metabolites, including arginine/ornithine (Arg/Orn), C14:1/C2, C18:1, C3DC+C4OH and C8:1, that were significantly associated with maternal serum TSH during the whole pregnancy (P < 0.05), especially in the first trimester. Moreover, 10 neonatal metabolites were significantly associated with maternal serum FT4 (P < 0.05), most of which had positive correlations with maternal FT4 in the first trimester (P < 0.05). Some neonatal metabolites also had linear or nonlinear dose-effect relationships with maternal serum TSH and FT4 during the whole pregnancy, particularly in the first trimester. Our study, for the first time, provides epidemiological evidence that maternal serum TSH and FT4, especially during the first trimester, are associated with linear or nonlinear variations in neonatal metabolites. Efforts to identify newborn metabolism levels should carefully consider the effects of maternal thyroid function.

Association of mental disorders and psychotropic medications with bone texture as measured with trabecular bone score.

Mental disorders and psychotropic medications are known to increase the risk of osteoporosis and fractures. However, current evidence is mostly limited to studies that used bone mineral density (BMD), which does not provide information about the texture of bone tissue and can underestimate fracture risk. We tested the association between bone texture, as measured with lumbar spine trabecular bone score (TBS), and both diagnosed mental disorders and psychotropic medication use in a large population-based BMD registry from Manitoba, Canada. General linear and logistic regression models were used to test the association of TBS with mental disorders (anxiety, depression, schizophrenia, and alcohol use disorder) and psychotropic medications use (selective serotonin reuptake inhibitors [SSRI], tricyclic antidepressants [TCA], other antidepressants, lithium, non‑lithium mood stabilizers, antipsychotics, and benzodiazepines), adjusted for comorbidities and confounding factors. The study population contained 45,716 women (mean age=64.1, SD=10.4), which included 21.1% with diagnoses for mental disorders and 18.7% using psychotropic medications. We observed significant negative covariate-adjusted effects on TBS from diagnosed alcohol use disorder (3.1% reduction in TBS, p<0.001) and exposure to SSRI (0.6% reduction, p<0.001), TCA (0.8% reduction, p<0.001), other antidepressants (0.8% reduction, p<0.001), and lithium (3% reduction, p<0.001). Logistic regression revealed that TBS in the lowest (versus highest) tertile was associated with alcohol use disorder (adjusted odds ratio [OR]=2.87, 95% confidence interval [CI]: 1.95, 4.21), exposure to SSRI (OR=1.21; 95% CI: 1.08, 1.35), TCA (OR=1.18, 95% confidence interval [CI]: 1.04, 1.35), other antidepressants (OR=1.26; 95% CI: 1.09, 1.45), and lithium (OR=1.97; 95% CI: 1.09, 3.57). Our results suggest that alcohol use disorder, antidepressants, and lithium are associated with poorer bone texture in women. These findings add to the current literature on the link of bone pathology with mental disorders and psychotropic medications.

Assessment of the Community Pharmacists' Knowledge and Attitudes Toward Pain and Pain Management in Saudi Arabia.

Pain is a global health issue that affects an individual's quality of life. Its alleviation and management will enhance patients' experience. Community pharmacists can help manage pain severity through their valuable roles in medical teams and by managing the consequences of pain. This study aimed to evaluate community pharmacists' knowledge and attitudes toward pain and pain management in Saudi Arabia. A cross-sectional study was performed to evaluate community pharmacists' knowledge and attitudes toward pain and pain management in Saudi Arabia. Pharmacists aged ≥ 21 years, with a degree in pharmacy were included in this study. Each respondent participated in an online survey covering cancer-oriented pain and assessment of pain; pharmacology; abuse of substances; and physical dependence. An independent t-test and One-way ANOVA, with least significant difference as a post-hoc test, were employed, in addition to the General Linear Regression Model using Main Effect as the model. This study revealed that the pain-related knowledge and attitude among community pharmacists in Saudi Arabia were inadequate. Age (p = 0.003), work experience (p = 0.036), nature of work (p = 0.001), and work location (p = 0.003) were determined as significant factors affecting their overall knowledge and attitude toward pain. Overall, attempts to expand community pharmacists' knowledge and foster an appropriate attitude toward pain management among them in Saudi Arabia are highly recommended. Additional academic courses, studies, and tailored neuroscience courses will improve their awareness and knowledge of pain and pain management.

Evaluation of some factors on birth and weaning weights in Awassi sheep by using GLM and CART analysis.

Birth weight (BW), which is the first physiological record of the postnatal period, is an important indicator that affects growth and development, reproduction, and some yields of living things in the future. The present study was carried out using the birth records of 5417 heads of Awassi lambs from 2013 to 2018 in MeMuTa dairy sheep farm in Zengen town of Ereğli district of Konya city in Türkiye. In this study, the effects of some environmental and genetic factors on birth and weaning weight in Awassi lambs were evaluated using both general linear model (GLM) and classification and regression tree (CART) analysis. As a result of the GLM analysis, the least squares' means of birth and weaning weights (BW and WW) were determined as 4.15 ± 0.05kg and 16.39 ± 0.13kg, respectively. Fixed genetic factors such as birth type and sex, and environmental factors such as season and year were found to be significant on birth weight (P < 0.01). As for weaning weight, other factors except birth type were found to be similarly important like birth weight (P < 0.01). Also, linear regression of birth weight on weaning weight was found to be significant (P < 0.01). In GLM and CART analyses, the determination coefficient (R2) was determined to be 23.80% and 11.70% for BW, and 24.11% and 13.18% for WW, respectively. The findings of the analysis results showed that the factors in the model have a similar tendency both in terms of their relative ratios in the total variation in the GLM analysis and in their relative importance in the CART algorithm. It was seen that CART data mining algorithm in the prediction of some genetic and environmental factors on birth and weaning weights using some factors in Awassi lambs produced successful results in predictive performance. Briefly, it was determined that there is a similar tendency to GLM analysis according to CART algorithm analysis in the current study.

A Retrospective Study of Antibody Titers in Patients with Plasma Cell Disorders

Background: Recent studies have estimated that infections occur with increased risk in patients with plasma cell disorders as compared to the general population. Our group has previously shown that patients who show response to vaccination following autologous hematopoietic stem cell transplantation (AHCT) have better overall survival and progression free survival than those who do not. In clinical practice, antibody titers against pathogens that are targeted by vaccines are measured infrequently in patients with monoclonal gammopathy of undetermined significance (MGUS), smoldering multiple myeloma (SMM) and multiple myeloma (MM) at the time of diagnosis. Moreover, studies have previously shown that AHCT and maintenance therapy can cause seroconversion of titers in MM patients but the effect of induction chemotherapy on seroconversion of antibody titers is unknown. Methods: The study population comprised of controls and patients with plasma cell disorders who were seen at Roswell Park Comprehensive Cancer Center from 2018-2022. Controls were defined as patients consulted to our service to rule out gammopathies but found to be negative on initial testing. Immunoparesis was defined as deficiency of uninvolved immunoglobulins. All individuals had antibody titers tested at the time of first diagnosis. Patients with MM who underwent induction chemotherapy followed by AHCT had antibody titers tested prior to AHCT. Serological titers were measured according to Roswell Park Central Clinical Laboratory standards. Interpretation of individual titer results was in accordance with the manufacturers’ recommendations and published literature. Differences of the titers were compared by non-parametric Kruskal-Wallis Test /General Linear Regression Model (for continuous variables) and Fisher's Exact Test. SAS version 9.4 (SAS Institute, Cary, NC) was used for statistical analyses. All tests were two-sided and performed at a nominal significance level of 0.05. Results: A total of 101 patients including 24 (23.8%) controls, 21 (20.8%) MGUS patients, 16 (15.8%) SMM and 40 (39.6%) MM patients were included in the study. At the time of first diagnosis, controls had the greatest number of positive titers (mean 14.21, SD 3.48) followed by patients with MGUS (mean 13.86, SD 3.18), SMM (mean 11.06, SD 3.89) and MM (mean 9.33, SD 4) (p<0.0001), respectively (Figure 1). A total of 66 (65%) patients had a bone marrow biopsy performed at the time of diagnosis, including 12 (11.9%) patients with MGUS, 16 (15.8%) patients with SMM and 38 (37.6%) patients with MM. On linear regression analysis, there was a negative correlation between the number of positive titers and bone marrow plasma cell percentage (p=0.0009). Next we stratified patients with plasma cell disorders into those with immunoparesis (n=54) and those without immunoparesis (n=23) at the time of measurement of antibody titers. The number of positive titers were significantly higher in patients without (Mean 13.57, SD 3.53) than those with immunoparesis (Mean 9.80, SD 3.97) (p=0.0002). In total 48 patients including 12 (11.9%) MGUS patients, 10 (9.9%) SMM patients and 26 (25.7%) MM patients had peripheral blood flow cytometry for CD19+ B cell percentage at the time of measurement of antibody titers. On linear regression analysis, there was a positive correlation between the number of positive titers and the CD19+ B cell percentage (p=0.018). We further studied the seroconversion of antibody titers with induction chemotherapy and 22 out of 40 patients had both pre-and post induction treatment titers. Among them, 8 (36.4%) had seroconversion of titers from negative to positive for at least 3 pathogens without revaccination. Conclusion: Antibody titers for vaccine preventable diseases are lower in patients with MGUS, SMM and MM as compared to controls at the time of diagnosis. Current guidelines for revaccination are not extended to patients with MGUS and SMM and have to be investigated in prospective clinical trials before they can be generally recommended. Factors such as bone marrow plasma cell percentage, immunoparesis and CD19+ B cell percentage correlate with the number of positive titers. In MM patients undergoing AHCT, more than a third showed seroconversion of antibody titers from negative to positive prior to AHCT without revaccination, suggesting a role of induction chemotherapy in augmenting the immune response by reducing tumor burden. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Association between exposure to phenols and parabens and cognitive function in older adults in the United States: A cross-sectional study

BackgroundPeople are commonly exposed to mixtures of parabens and phenols. Most studies investigating such exposure and cognitive performance tend to assess only single chemicals, and the tools used to assess cognitive function are not uniform. ObjectiveThis study aimed to examine the association between multiple parabens and phenols and cognitive function in older Americans. MethodsThe study included data of older Americans from two cycles of the NHANES survey. Participants were divided into normal cognitive performance and low cognitive performance groups based on the scores of four cognitive tests: the Immediate Recall test (IRT), the Delayed Recall test (DRT), the Animal Fluency test (AFT) and the Digit Symbol Substitution test (DSST). Generalized linear regression models (GLMs), restricted cubic spline (RCS), weighted quantile sum (WQS) and Bayesian kernel machine regression (BKMR) were used to assess relationships between chemical exposure and cognitive performance. ResultsIn this cross-sectional study, a total of 961 participants, 470 males and 491 females, were included. GLMs revealed positive association between high levels of bisphenol A (BPA) and low cognitive performance on DRT, especially in male (OR (95%CI): 2.25 (1.10–4.61)), and this association was consistent with WQS and BKMR. In female participants, the third quartile of BPA exposure showed a positive association with low cognition on IRT and global cognition. GLMs also showed that high levels of propylparaben were positively associated with cognitive performance on the IRT in male participants (OR (95%CI): 0.37 (0.18–0.76)). In BKMR, an overall positive correlation between the mixture and low cognition as measured with DRT was observed in male subjects when the mixture was at the 65th percentile or higher. ConclusionExposure to a mixture of parabens and phenols was positively associated with low cognitive performance on DRT in older male subjects, while BPA was the main driver of this outcome.

COVID-19-related future anxiety is associated with the health-related quality of life in school-aged children and adolescents-A cross-sectional study.

Over the course of the COVID-19 pandemic, previous studies have shown that the physical as well as the mental health of children and adolescents significantly deteriorated. Future anxiety caused by the COVID-19 pandemic and its associations with quality of life has not previously been examined in school children. As part of a cross-sectional web-based survey at schools in Mecklenburg-Western Pomerania, Germany, two years after the outbreak of the pandemic, school children were asked about COVID-19-related future anxiety using the German epidemic-related Dark Future Scale for children (eDFS-K). Health-related quality of life (HRQoL) was assessed using the self-reported KIDSCREEN-10. The eDFS-K was psychometrically analyzed (internal consistency and confirmatory factor analysis) and thereafter examined as a predictor of HRQoL in a general linear regression model. A total of N = 840 8-18-year-old children and adolescents were included in the analysis. The eDFS-K demonstrated adequate internal consistency reliability (Cronbach's α = 0.77), and the confirmatory factor analysis further supported the one-factor structure of the four-item scale with an acceptable model fit. Over 43% of students were found to have low HRQoL. In addition, 47% of the students sometimes to often reported COVID-19-related fears about the future. Children with COVID-19-related future anxiety had significantly lower HRQoL (B = - 0.94, p < 0.001). Other predictors of lower HRQoL were older age (B = - 0.63, p < 0.001), and female (B = - 3.12, p < 0.001) and diverse (B = - 6.82, p < 0.001) gender. Two years after the outbreak of the pandemic, school-aged children continue to exhibit low HRQoL, which is further exacerbated in the presence of COVID-19-related future anxiety. Intervention programs with an increased focus on mental health also addressing future anxiety should be provided.

Adolescents' Self-Perceived Weight and Metabolic Syndrome.

Background and Objective: The aim of this study was to assess the relationships of self-perceived weight with having more metabolic syndrome (MetS) components and the MetS score regardless of body mass index (BMI)-based weight category. Methods: Utilizing data from the Korea National Health and Nutrition Examination Survey 2014 to 2019, weight categories according to BMI and self-perception (underweight, normal weight, or overweight), MetS components defined by the International Diabetes Federation for adolescents, the MetS score, and confounding factors were evaluated in 1441 female adolescents and 1646 male adolescents aged 10 to 18 years. A complex samples general linear model and ordinal regression were used to analyze those relationships. Results: The odds of having more MetS components were 1.67 (95% confidence interval, CI: 1.38-2.03) in adolescents who self-perceived as overweight than in those who self-perceived as normal weight after controlling for sociodemographic and health-related factors and BMI-based weight categories. Compared with adolescents who accurately self-perceived as normal weight (reference group), the odds were 1.48 (95% CI: 1.19-1.84) in those with normal weight, but self-perceived as overweight; 2.90 (95% CI: 1.69-4.98) in those who were overweight, but self-perceived as normal weight; and 9.38 (95% CI: 7.52-11.71) in those who accurately self-perceived as overweight. In relation to the MetS score, similar findings were observed. The combined weight categories had significant interactions with sex and age groups (10-12 years vs. 13-18 years) in those relationships. Conclusions: Regardless of actual weight status, adolescents' self-perceived weight may be a crucial consideration when determining whether or not MetS components may be present.

Abstract 11816: Association of Increased Adiposity and Presentation and Outcomes for Kawasaki Disease versus Multisystem Inflammatory Syndrome in Children Associated With Covid-19

Introduction: Obesity is a pro-inflammatory state and may influence presentation and outcomes of both Kawasaki disease (KD) and Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19. Methods: From January 2020 to January 2022, n=2566 contemporaneous KD, MIS-C and acute COVID-19 pediatric patients from 39 sites in 8 countries were enrolled into the International KD Registry. The study population was confined to 1077 MIS-C patients meeting CDC criteria with confirmed or probable COVID-19 infection, and 657 KD patients meeting AHA guideline criteria without COVID-19 infection who had body mass index (BMI) recorded at presentation. BMI was converted to Z scores using WHO formulas for age and sex, and associated factors were sought using general linear regression modeling. Results: Mean zBMI was higher for MIS-C (+0.58) vs KD patients (-0.06; p&lt;0.001), and MIS-C patients were more likely to be overweight (BMI 85 th -&lt;95 th %ile; 18% vs 11%), obese (95 th -&lt;99 th %ile; 14% vs 6%) or morbidly obese ( &gt; 99 th %ile; 8% vs 2%; p&lt;0.001). MIS-C patients were significantly more likely to present with shock, and had higher peak troponin I and NTproBNP, with no association or interaction with adiposity. Higher adiposity was significantly associated with higher peak white cell count for MIS-C but not KD. Higher peak CRP for MIS-C and higher peak ESR for KD were not associated with adiposity. Higher peak creatinine was associated higher adiposity, more so for MIS-C. Both higher adiposity and MIS-C were significantly associated with lower LV ejection fraction, although there was no significant interaction (Figure A). Higher maximum coronary artery Z score was associated with KD but not with adiposity, with no significant interaction (Figure B). Conclusions: MIS-C patients have higher levels of adiposity than KD patients. Higher adiposity is associated with greater renal dysfunction in the setting of MIS-C, and greater cardiac dysfunction in both MIS-C and KD.

Assessing the sustainability of agricultural production - a cross-sectoral comparison of the blackberry, tomato and tree tomato sectors in Ecuador

ABSTRACT Achieving a sustainable agricultural system requires an effective assessment of economic, environmental, and social conditions. Existing research has mainly focused on a single sector and lacks critical comparisons of determinants and trade-offs between sustainability dimensions. This study adopts a cross-sectoral perspective to assess and compare the sustainability performance of fruit and vegetable farms in Ecuador. Furthermore, the study analyzes the relation between sustainability outcomes on the one hand and farm resources, farmer demographics, and farm size on the other. Principal Component Analysis and a General Linear Regression model are used in the analysis. The results show that clear disparities in sustainability performance exist between different fruit and vegetable sectors. Furthermore, on average, farms with a higher social- and economic-oriented sustainability performance are more proficient in exploiting conventional resources (land and labour). In contrast, farms with a higher environmental-oriented performance display better handling of ecological resources such as water and forests. A sustainable use of resources is needed to prevent conflicts between sustainability dimensions. The research provides novel insights to stakeholders on the integrated assessment of agricultural sustainability and its results.

Elevated IGF-1 and GH Levels Are Correlated With a Thicker Iris and Wider Anterior Chamber Angle in Treatment-Naïve Acromegaly Patients.

To compare the difference in anterior segment biometrics derived from anterior segment optical coherence tomography (AS-OCT) between treatment-naïve acromegaly patients and normal controls and evaluate the correlations between above biometrics and insulin-like growth factor 1 (IGF-1) and growth hormone (GH) levels. Sixty eyes of 30 acromegaly patients and 60 eyes of 30 normal controls were included in this case-control study. Central corneal thickness, pupil diameter, iris thickness (IT), iris curvature (IC), anterior chamber depth (ACD), anterior chamber width, lens vault (LV), angle open distance (AOD) 500, AOD750, and trabecular iris space area (TISA) 500 and TISA750 were measured by AS-OCT. General linear regression models were constructed to evaluate the independent endocrine factors affecting iris morphology and anterior chamber angle (ACA) width. The acromegaly patients had an evenly thicker iris (P &lt; 0.001), a smaller IC (P &lt; 0.05), a smaller LV (P = 0.040) and significantly larger AOD500, AOD750, TISA500 and TISA750 (P &lt; 0.001). There was a positive correlation between the serum GH level and ACD in the acromegaly patients (P = 0.031). Linear regression models showed the lower LV and smaller IC were independent influencing factors of the increase in the AOD500, AOD750, and TISA750 and nasal TISA500. Serum IGF-1 was an independent factor for the increase in pupil diameter (β = 0.002, P = 0.031) and both the average nasal (β = 6.781*10-5, P = 0.049) and temporal (β = 7.736*10-5, P = 0.045) IT values and for the decrease in temporal IC (β &lt; 0.001, P = 0.037). GH was an independent factor for the increase in temporal AOD750 (β = 0.001, P = 0.030) and temporal TISA750 (β = 0.002, P = 0.016). Patients with acromegaly have a thicker IT, smaller IC, and lower LV with a wider ACA than normal controls. Serum GH is independently correlated with the temporal ACA width, whereas serum IGF-1 is independently correlated with IT, pupil diameter, and IC.