Generalized Linear Models Research Articles

Predicting Winter Wheat Yield with Dual-Year Spectral Fusion, Bayesian Wisdom, and Cross-Environmental Validation

Winter wheat is an important grain that plays a crucial role in agricultural production and ensuring food security. Its yield directly impacts the stability and security of the global food supply. The accurate monitoring of grain yield is imperative for precise agricultural management. This study aimed to enhance winter wheat yield predictions with UAV remote sensing and investigate its predictive capability across diverse environments. In this study, RGB and multispectral (MS) data were collected on 6 May 2020 and 10 May 2022 during the grain filling stage of winter wheat. Using the Pearson correlation coefficient method, we identified 34 MS features strongly correlated with yield. Additionally, we identified 24 texture features constructed from three bands of RGB images and a plant height feature, making a total of 59 features. We used seven machine learning algorithms (Cubist, Gaussian process (GP), Gradient Boosting Machine (GBM), Generalized Linear Model (GLM), K-Nearest Neighbors algorithm (KNN), Support Vector Machine (SVM), Random Forest (RF)) and applied recursive feature elimination (RFE) to nine feature types. These included single-sensor features, fused sensor features, single-year data, and fused year data. This process yielded diverse feature combinations, leading to the creation of seven distinct yield prediction models. These individual machine learning models were then amalgamated to formulate a Bayesian Model Averaging (BMA) model. The findings revealed that the Cubist model, based on the 2020 and 2022 dataset, achieved the highest R2 at 0.715. Notably, models incorporating both RGB and MS features outperformed those relying solely on either RGB or MS features. The BMA model surpassed individual machine learning models, exhibiting the highest accuracy (R2 = 0.725, RMSE = 0.814 t·ha−1, MSE = 0.663 t·ha−1). Additionally, models were developed using one year’s data for training and another year’s data for validation. Cubist and GLM stood out among the seven individual models, delivering strong predictive performance. The BMA model, combining these models, achieved the highest R2 of 0.673. This highlights the BMA model’s ability to generalize for multi-year data prediction.

Factors Affecting Postpartum Bone Mineral Density in a Clinical Trial of Vitamin D Supplementation.

Background: Few studies evaluate the effects of vitamin D status and supplementation on maternal bone mineral density (BMD) during lactation and further lack inclusion of diverse racial/ethnic groups, body mass index (BMI), or physical activity. Objective: Determine the effects of vitamin D treatment/status, feeding type, BMI, race/ethnicity, and physical activity on postpartum women's BMD to 7 months. Methods: Women with singleton pregnancies beginning 4-6 weeks' postpartum were randomized into two treatment groups (400 or 6400 IU vitamin D/day). Participant hip, spine, femoral neck, and whole-body BMD using Dual-energy X-ray absorptiometry (DXA Hologic), serum 25-hydroxyvitamin D [25(OH)D] (RIA; Diasorin), BMI, and physical activity were measured at 1, 4, and 7 months postpartum. A general linear mixed modeling approach was undertaken to assess the effects of vitamin D status [both serum 25(OH)D concentrations and treatment groups], feeding type, race/ethnicity, BMI, and physical activity on BMD in postpartum women. Results: During the 6-month study period, lactating women had 1-3% BMD loss in all regions compared with 1-3% gain in nonlactating women. Higher maternal BMI was associated with less bone loss in femoral neck and hip regions. Black American women had less BMD loss than White/Caucasian or Hispanic lactating women in spine and hip regions. Exclusively breastfeeding women in the 6400 IU vitamin D group had less femoral neck BMD loss than the 400 IU group at 4 months sustained to 7 months. Physical activity was associated with higher hip BMD. Conclusion: While there was BMD loss during lactation to 7 months, the loss rate was less than previously reported, with notable racial/ethnic variation. Breastfeeding was associated with loss in BMD compared with formula-feeding women who gained BMD. Higher BMI and physical activity independently appeared to protect hip BMD, whereas higher vitamin D supplementation appeared protective against femoral neck BMD loss.

Comparing STEM and Non-STEM Teachers’ Self-Efficacy in Multicultural Classrooms: Insights from TALIS 2018 U.S. Data

AbstractDrawing on U.S. data from the Teaching and Learning International Survey (TALIS) 2018, this study first compared STEM and non-STEM teachers’ self-efficacy in multicultural classrooms (TSMC), then identified the factors related to TSMC for each group of teachers, and lastly explored the similarities and differences among the factors. Results from general linear model univariate analysis revealed that STEM teachers scored significantly lower in TSMC than their non-STEM counterparts. Results from multilevel modeling analysis indicated that gender and professional development needs were significant predictors of TSMC for both groups; factors such as initial teacher preparation, professional development topics, and school instructional leadership emerged as significant predictors only for non-STEM teachers. The implications and significance of these results were discussed.

An exploration of the deceptive effects of caffeine on morning performance

To compete in evening finals, athletes typically compete in competition heats or quarterfinals in the morning when their bodies are biologically weaker. Performance related qualities that are greater in the evening include force production, power output (~3-14% variation), time-trial performance, and repeated sprints which is ~3 and 5% greater (Drust et al., 2005, Acta Physiol Scand, 183, 181-190). The body clock, motivation and higher core and muscle temperatures in the evening are all related to this daily fluctuation in performance. The most effective nutritional ergogenic for performance is caffeine. The aim of this study was to investigate the effects of deception, a placebo pill vs. No Pill on repeated sprint performance (RSP) and grip strength (GP). The experimental protocol was approved by the institution ethics board. Nine participants ingested 1 pill (maltodextrin) at 06:30 h, entered the laboratory at 07:00 h and had their ear temperature recorded. They then completed a Perceived Onset of Mood questionnaire followed by measures of right- and left-hand grip strength followed by a repeated sprints protocol (10 × 20m, 30 s rest periods). Blood lactate, glucose levels and ear temperature were recorded three times during the protocol – with heart rate, rating of perceived exertion and finishing times (Witty GATE, Microgate Srl, Bolzano, Italy) measured at the end of each sprint. The data was analysed by General Linear modelling with repeated measures.

Early morning bright light therapy: its next-day effects on early morning physical performance, temperature, and mood

Many different popular sports such as swimming, rowing or team-based sports involve having to perform whether in training or competition at a high level in the early morning (Olympics.com, 2023). Various research papers in the past have shown that there is a distinct diurnal variation in physical performance. Finding ways to improve early morning performance would greatly benefit many athletes and teams in multiple disciplines. 11 active males [mean ± SD: age, 21 ± 1 years, body mass, 78 ± 8 kg and stature, 180 ± 5 cm) volunteered, completed two familiarisations. Then two experimental sessions randomly allocated in a counterbalanced order 1) bright light therapy/ 2) no bright light therapy was administered at 07:00 h for 1 h the next morning (07:00 h) participants came into the laboratory where Intra-aural temperature, mood was assessed using the Perceived Onset Mood State questionnaire and right and left grip strength using a hand grip dynamometer were taken. Finally, participants undertook a warmup, the completed 10 × 20 m repeated sprints (RS) with 30 s recoveries on an indoor running track, with heart rate, finishing time and perceived exertion measured every sprint. Blood lactate was measured at rest, after the warm-up and post RS. Data were analysed using general-linear models.

Does caffeine improve team-based morning performances more than habituation?

Repeated sprint performance (≤6 s) has a 3-10% diurnal variation of an evening compared to a morning (17:00-19:00 vs. 06:00-10:00 h; Pullinger et al., 2019). Research distinguishing the effect of habit in comparison to other stimuli on morning performance is unestablished. Therefore, the present study investigates whether caffeine can improve team-based morning performance of 20 m repeated sprints, more than habituation. Eight team-based participants (age: 21 ± 1 years, body mass: 83 ± 9 kg, stature: 181 ± 5 cm) participated in this study. The participants retired at 22:30 h and raised at 06:30 h to be in the laboratory for 07:00 h throughout the study period. The participants completed with two familiarisations and were randomly allocated to two experimental conditions either 1) having taken caffeine on waking (300 mg at 06:30 h), then enter the laboratory at 07:00 h or, 2) The participant rose and retire as above but enter the laboratory at 07:00 h to sit on a cycle ergometer (60 mins) prior to the day of testing. They return the following day at 07:00 h. On entering the laboratory participants were seated, completed sleep questionnaires and mood was assessed using Perceived Onset Mood State (POMS) questionnaire. After 30-min Intra-aural temperature and fingertip blood glucose and lactate measured (as well as post warm-up and immediately after the RSP test). Thereafter, right- and left-hand grip strength (the best of 3 were recorded) and maximal repeated sprint performance measures were taken (RSP, 10 x 20m, 30s recovery period). Heart rate (HR), thermal comfort (TC), and rating of perceived exertion (RPE) were all recorded after each sprint. Data were analysed using a general-linear model.

Chronobiological approaches and habitual routine: effect on morning physical performance in male team sport players

Achieving peak morning physical performance for team sport players is vital due to the vast degree of performances tend to take place in the morning. It has been well-documented that undertaking chronobiological approaches and having a habitual routine can have an impact on performance, however the combination of the two have not been clearly interpreted. Therefore, the aim of the present study was to examine how combined chronobiological approaches and habitual routine had an influence on morning physical performance. Using a double-blinded, randomized counterbalanced design, team sport male participants (n = 12) were recruited, with institutional ethics approval, and completed five sessions: (i) two familiarization sessions; (ii) one bright light (BL) morning exercise condition; (iii) two testing conditions either: habitual (the morning after BL), or No pill. The morning physical performance tests carried out were as followed: Intra-aural temperature and fingertip blood glucose and lactate, taken throughout: at rest, post warm-up and immediately after the RSP test, mood assessed using Perceived Onset Mood State (POMS) questionnaire, 3 right and 3 left hand grip strength measures, and a maximal repeated sprint performance (RSP) protocol (10 × 20 m, 30 s recovery period). Heart rate (HR), thermal comfort (TC), and rating of perceived exertion (RPE) were all recorded after each sprint. Data were analysed using a general-linear model.

Digital Preoperative Huddle Platform Use Leads to Decreased Surgical Cost.

Communication has a well-established effect on improving outcomes. The current study evaluated the effect of multidisciplinary preoperative team communication using a digital huddle software platform on operating room costs. A digital huddle software platform was implemented in March 2022 for neurosurgical procedures performed at a single tertiary care center. Surgeons were encouraged, but not required, to participate. General linear models were used to test the association between participation and the difference in supply-related cost and case length, using intergroup comparison and historical controls. A total of 29626 cases (performed by 97 surgeons), conducted between March 2021 and June 2023, were included in our analysis. Cases from participating neurosurgeons (12 surgeons, 4064 cases) were compared with cases from nonparticipating neurosurgeons (6 surgeons, 2452 cases), non-neurosurgery cases carried out by the same operating room staff (20 orthopedic spine surgeons, 6073 cases), and non-neurosurgery cases performed in a different operating room unit (59 surgeons, 21 996 cases). In aggregate, operating room (OR) costs increased by 7.3% (95% CI: 0.9-14.1, P = .025) in the postintervention period. In the same period, participation in the digital huddle platform was associated with an OR utilization and supply-related cost decrease of 16.3% (95% CI: 8.3%-23.6%, P < .001). Among neurosurgeons specifically, participation was associated with a supply-related cost decrease of 17.5% (95% CI: 6.0%-27.5%, P = .0037). There was no change in case length (median case length 171 minutes, change: +2.7% increase, 95% CI:-2.2%-7.9%, P = .28). The implementation of a digital huddle software platform resulted in an OR utilization and supply cost decrease among participants during a period when the overall nonparticipating control cohort experienced an increase in cost.

Renal fat deposition measured on dixon-based MRI is significantly associated with early kidney damage in obesity.

To investigate the renal fat deposition on Dixon-based magnetic resonance imaging (MRI) and to explore the predictive value of renal fat biomarkers of magnetic resonance (MR-RFBs) for early kidney damage in obesity. This prospective study included 56 obese volunteers and 47 non-obese healthy volunteers. All volunteers underwent renal magnetic resonance examinations. The differences in MR-RFBs [including renal proton density fat fraction (PDFF), renal sinus fat volume (RSFV), and perirenal fat thickness (PRFT)] measured on Dixon-based MRI between the obese and non-obese volunteers were analyzed using a general linear model, taking sex, age, diabetes, and hypertension as covariates. The relationship between estimated glomerular filtration rate (eGFR) and demographic, laboratory, and imaging parameters in obese volunteers was examined by correlation analysis. Obese volunteers had higher MR-RFBs than non-obese volunteers after controlling for confounders (all p < 0.001). Renal PDFF (r = -0.383; p = 0.004), RSFV (r = -0.368; p = 0.005), and PRFT (r = -0.451; p < 0.001) were significantly negatively correlated with eGFR in obesity. After adjusting for age, sex, body mass index, diabetes, hypertension, visceral adipose tissue, subcutaneous adipose tissue, renal PDFF, and RSFV, PRFT remained independently negatively associated with eGFR (β = -0.587; p = 0.003). All MR-RFBs are negatively correlated with eGFR in obesity. The MR-RFBs, especially PRFT, may have predictive value for early kidney damage in obesity.

The prevalence of unintended pregnancy and its influence on pregnancy experience in Tabriz, Iran, 2023: a cross-sectional study

BackgroundThere is a lack of quantitative studies that specifically measure the association between the experience of pregnancy and unintended pregnancy. The present study aims to address the prevalence of unintended pregnancy and identify its predictors. Additionally, the study explores whether unintended pregnancy is associated with pregnancy uplifts and hassles.MethodsThis cross-sectional study was conducted on 488 pregnant women between 20 to 40 weeks' gestation at the comprehensive health center in Tabriz City from February 2022 to January 2023. A cluster sampling method was used for sampling, and data were collected using socio-demographic questionnaires and the Pregnancy Experience Scale (PES). Descriptive statistics were used to describe the socio-demographic characteristics and the prevalence of unintended pregnancy. Binary logistic regression was employed to identify the predictors of pregnancy desirability. To examine the relationship between unintended pregnancy and pregnancy experience, an independent t-test was used for bivariate analysis, and a general linear model (GLM) was utilized for multivariate analysis, with control for potential confounding variables.ResultsThe prevalence of unintended pregnancies was 30.7% (24.3% unwanted pregnancies, and 6.4% mistimed pregnancies). The results of the binary logistic regression indicated that the lower age of both the woman and her spouse were significant predictors for unintended pregnancy (P < 0.05). Based on an independent t-test, the mean score for uplifts in women with unintended pregnancy was significantly lower than in women with intended pregnancy (mean difference (MD): -4.99; 95% confidence interval (CI): -5.96 to -4.02; p < 0.001), While the mean score of hassles in women with unintended pregnancy was significantly higher than women with intended pregnancy (MD: 2.92; 95% CI: 2.03 to 3.80; p < 0.001). The results of GLM showed that women who had unintended pregnancies had significantly lower scores for uplifts (B = -4.99; 95% CI: -5.96 to -4.03; P < 0.001) and higher scores for hassles (B = 2.92; 95% CI: 2.06 to 3.78; P < 0.001).ConclusionsThe high prevalence of unintended pregnancies in Tabriz highlights the importance of targeted interventions to address this issue, considering the policy framework and unique challenges faced by women. Future studies should focus on developing context-specific interventions that effectively meet the needs of women with unintended pregnancies.

Developing Machine Learning-based Control Charts for Monitoring Different GLM-type Profiles With Different Link Functions

ABSTRACT In certain situations, the quality of a process is determined by dependent variables in relation to independent variables, often modeled through a regression framework referred to as a profile. The practice of monitoring and preserving this relationship is known as profile monitoring. In this paper, we propose an innovative approach that uses different machine-learning (ML) techniques for constructing control charts and monitoring generalized linear model (GLM) profiles with three different GLM-type response distributions of Binomial, Poisson, and Gamma, and by examining different link functions for each response distribution. Through our simulation study, we undertake a comparative analysis of different training methods. We measure the charts’ performance using the average run length, which signifies the average number of samples taken before observing a data point that exceeds the predefined control limits. The result shows that the selection of ML control charts is contingent on the response distribution and link function, and depends on the shift sizes in the process and the utilized training method. To illustrate the practical application of the proposed ML control charts, we present two real-world cases as examples: a drug–response study and a volcano-eruption study, to demonstrate how each ML chart can be implemented in practice.

Mapping Kansas City cardiomyopathy, Seattle Angina, and minnesota living with heart failure to the MacNew-7D in patients with heart disease.

The Kansas City Cardiomyopathy Questionnaire (KCCQ), Seattle Angina Questionnaire (SAQ), and Minnesota Living with Heart Failure Questionnaire (MLHFQ) are widely used non-preference-based instruments that measure health-related quality of life (QOL) in people with heart disease. However, currently it is not possible to estimate quality-adjusted life-years (QALYs) for economic evaluation using these instruments as the summary scores produced are not preference-based. The MacNew-7D is a heart disease-specific preference-based instrument. This study provides different mapping algorithms for allocating utility scores to KCCQ, MLHFQ, and SAQ from MacNew-7D to calculate QALYs for economic evaluations. The study included 493 participants with heart failure or angina who completed the KCCQ, MLHFQ, SAQ, and MacNew-7D questionnaires. Regression techniques, namely, Gamma Generalized Linear Model (GLM), Bayesian GLM, Linear regression with stepwise selection and Random Forest were used to develop direct mapping algorithms. Cross-validation was employed due to the absence of an external validation dataset. The study followed the Mapping onto Preference-based measures reporting Standards checklist. The best models to predict MacNew-7D utility scores were determined using KCCQ, MLHFQ, and SAQ item and domain scores. Random Forest performed well for item scores for all questionnaires and domain score for KCCQ, while Bayesian GLM and Linear Regression were best for MLHFQ and SAQ domain scores. However, models tended to over-predict severe health states. The three cardiac-specific non-preference-based QOL instruments can be mapped onto MacNew-7D utilities with good predictive accuracy using both direct response mapping techniques. The reported mapping algorithms may facilitate estimation of health utility for economic evaluations that have used these QOL instruments.

The Relationship Between Body Weight and Growth Hormone Gene Polymorphism in Indigenous Turkeys of Nigeria

The candidate gene approach is a valuable tool for improving breeding programs, particularly in poultry, by identifying traits for enhanced production performance. This study investigates the growth hormone (GH) gene as a potential determinant of body weight in Nigerian indigenous turkeys. DNA was extracted from 60 twelve-week-old turkeys using blood samples, and a 466bp DNA fragment was amplified via PCR with primers designed from chicken sequences. The PCR product underwent Msp1 restriction enzyme digestion and was visualized on a 1.5% agarose gel. Genotypes associated with body weight were assessed using a General Linear Model. The GH/Msp1 locus revealed Two alleles (A and G) and three genotypes (AA, AG, and GG), with allele G being predominant. Genotype AG had the highest frequency (0.55), followed by AA (0.42), and GG had the lowest frequency (0.03). However, the least square means analysis showed that the polymorphism in the GH gene of the studied population was not significantly associated with body weight (p&gt; 0.05). Nonetheless, the polymorphic nature of the GH gene in Nigerian turkeys suggests potential for further exploration in quantitative traits.

Computed tomographic evaluation of the proximity of needles placed for perineural anesthesia of the palmar digital nerves to synovial structures in the foot: an ex vivo study.

Potential synovial penetration following palmar digital nerve blocks has not been investigated. To evaluate the proximity of needles placed for palmar digital nerve blocks to nearby synovial structures using computed tomography (CT). Descriptive observational study. In 18 cadaver forelimbs, sequential injection of the navicular bursa (NB), distal interphalangeal joint (DIPJ) and digital flexor tendon sheath (DFTS) was performed using 3, 5 and 10 mL diluted radiodense contrast medium, respectively. After each synovial injection, 25 gage needles were placed over the palmar digital nerves at the proximal aspect of the ungular cartilages (distal injections) and 1 cm further proximally (proximal injections), and CT examination was performed. Subsequently, needles were removed, and the synovial structures further distended with the same volume as for the first injection. Perineural needle placement and image acquisition were repeated. The distance between the needle tip and adjacent synovial structures was measured (mm) in reconstructed images. Results were analyzed in separate general linear mixed models, to determine the effect of needle position and synovial distension on the distance from the tip of the needle to the NB, DFTS and DIPJ. Synovial penetration was confirmed following 12/420 (3%) needle placements (NB n = 5, 1 after proximal and 4 after distal injections; DIPJ n = 2, DFTS n = 2, NB or DIPJ n = 3, all after distal injections). The mean distance from the needle tip to the NB and DIPJ was significantly smaller after the second distension (NB: p = 0.025; DIPJ: p < 0.001) and with the distal needle placements (NB: p < 0.001; DIPJ: p < 0.001). For the DFTS, the distance from the needle tip was significantly smaller with the proximal needle placements (p = 0.001). Ex-vivo study. There is a small risk of synovial penetration when performing palmar digital nerve blocks, especially when distension of adjacent synovial structures is present.

Cortical and subcortical structural changes in pediatric patients with infratentorial tumors.

This study aimed to detect supratentorial cortical and subcortical morphological changes in pediatric patients with infratentorial tumors. The study included 24 patients aged 4-18 years who were diagnosed with primary infratentorial tumors and 41 age- and gender-matched healthy controls. Synthetic magnetization-prepared rapid gradient echo images of brain magnetic resonance imaging were generated using deep learning algorithms applied to T2-axial images. The cortical thickness, surface area, volume, and local gyrification index (LGI), as well as subcortical gray matter volumes, were automatically calculated. Surface-based morphometry parameters for the patient and control groups were compared using the general linear model, and volumes between subcortical structures were compared using the t-test and Mann-Whitney U test. In the patient group, cortical thinning was observed in the left supramarginal, and cortical thickening was observed in the left caudal middle frontal (CMF), left fusiform, left lateral orbitofrontal, left lingual gyrus, right CMF, right posterior cingulate, and right superior frontal (P < 0.050). The patient group showed a volume reduction in the pars triangularis, paracentral, precentral, and supramarginal gyri of the left hemisphere (P < 0.05). A decreased surface area was observed in the bilateral superior frontal and cingulate gyri (P < 0.05). The patient group exhibited a decreased LGI in the right precentral and superior temporal gyri, left supramarginal, and posterior cingulate gyri and showed an increased volume in the bilateral caudate nucleus and hippocampus, while a volume reduction was observed in the bilateral putamen, pallidum, and amygdala (P < 0.05). The ventricular volume and tumor volume showed a positive correlation with the cortical thickness in the bilateral CMF while demonstrating a negative correlation with areas exhibiting a decreased LGI (P < 0.05). Posterior fossa tumors lead to widespread morphological changes in cortical structures, with the most prominent pattern being hypogyria. This study illuminates the neurological impacts of infratentorial tumors in children, providing a foundation for future therapeutic strategies aimed at mitigating these adverse cortical and subcortical changes and improving patient outcomes.

Comprehensive knowledge of mother-to-child HIV/AIDS transmission, prevention, and associated factors among reproductive-age women in East Africa: insights from recent demographic and national health surveys

BackgroundMore than 90% of babies acquire HIV/AIDS through vertical transmission, primarily due to low maternal comprehensive knowledge about Mother-To-Child Transmission (MTCT) of HIV/AIDS and its prevention, which is a cornerstone for eliminating MTCT of HIV/AIDS. However, there are limitations in terms of population data and literature evidence based on recent Demographic and Health Surveys (DHS) reports in East Africa. Therefore, this study aims to assess the comprehensive knowledge and PMTCT of HIV/AIDS among women, as well as the associated factors in East Africa.MethodsOur data was obtained from the most recent DHS conducted in East African countries between 2011 and 2022. For our research, we included DHS data from ten nations, resulting in a total weighted sample of 133,724 women for our investigation. A generalized linear model (GLM) with a log link and binomial family to directly estimate prevalence ratios (PR) and 95% confidence intervals (CI) for the association between the independent variables, and the outcome variable. Finally, we reported the adjusted prevalence ratios along with their corresponding 95% CIs. Factors with p-values ≤ 0.2 for univariate logistic regression and < 0.05 were considered statistically significant factors of HIV/AIDS knowledge and prevention in the final model.ResultsIn this study, 59.41% (95% CI: 59.15–59.67) of respondents had a comprehensive knowledge about MTCT of HIV/AIDS and its prevention among reproductive-age women in East Africa. Being in the older age group, better education level, being from a rich household, employment status, having ANC follow up, institutional delivery, and modern contraception usage were associated with higher prevalence ratios of comprehensive knowledge about MTCT of HIV/AIDS and its prevention. However, being single in marital status, rural women, and traditional contraception utilization were associated with lower ratios of comprehensive knowledge about MTCT of HIV/AIDS and its prevention.ConclusionOur findings indicate a significant deficiency in comprehensive knowledge and prevention of HIV/AIDS MTCT among women in East Africa. These results emphasize the need for significant improvements in maternal-related health services. It is crucial to effectively target high-risk populations during interventions, raise awareness about this critical public health issue, and address the catastrophic consequences associated with MTCT. By implementing these measures, we can make substantial progress in reducing the transmission of HIV/AIDS from mother to child and ensuring better health outcomes for both mothers and their children.

Quality of life and testosterone recovery after androgen deprivation therapy in patients with high-risk prostate cancer: Long-term data from a phase III trial.

11098 Background: No prospectively collected data exist assessing the impact a hypogonadal status has on quality of life (QoL). Using data from a randomized Phase III trial in high-risk prostate cancer (HRPC) and based on Patient Reported Outcomes (PRO), we compared QoL between patients (pts) with or without testosterone (T) recovery after ADT. Methods: From 10/2000 to 01/2008, 630 pts with HRPC were randomised to 36 (310 pts) vs. 18 months (320 pts) of ADT. We assessed QoL by the validated EORTC 30 items regrouped into 9 scales and the PR 25 items into 5 scales. All items and scales scores were linearly transformed to a 0 to100 points scale. T measured at baseline and during follow-ups. T recovery was defined as a return to normal level. PRO measured up to 5 years. We estimated means and standard deviation of items and scales for each group at each time point. We analyzed all items and scales scores with general linear model with repeated measures to evaluate changes between patients who did versus those who did not recover T to a normal level, over time, in both ADT groups. P-value &lt;0.01 was considered statistically significant to account for multiple comparisons and a difference in mean scores of ≥10 points was considered clinically relevant. Results: 494/630 patients were retained for the analysis. 515 had proper T data available (baseline and follow-up) from whom 21 were excluded (no QoL data). With a median follow-up of 13.1 years, the two groups were well-balanced. Over a period of 21 years, 5 982 T measurements were available: 3590 in 314 pts in the and 2392 in the 18- and 36-month cohort, respectively. A total of 256 (51.8%) recovered T to, at least, a pre-castrate level. A significantly higher percentage of pts recovered a normal T level in the 18-month cohort as compared to the 36-month (56.4% vs. 43.9%, p=0.008). Among pts regaining T to a normal level, the median time to recovery was significantly faster for the 18 compared to the 36-month cohort, 3.0 (95% CI: 2.55 to 3.65) vs. 5.00 (4.50 to 5.96) years, p&lt;0.001. Considering the unified 55 items, overall adherence to QoL questionnaires (QoLQ) was 83.1% (4554/5480), 88.2% vs. 93.3% at baseline and 61.5% vs 58.3% at 5 years, for 18 vs. 36-month, respectively. Patients recovering T had a significantly better QoL. In 32 out of 55 items and in 10 out of 21 scales (p&lt;0.01) in the 18-month and 30 out of 55 items and 10 out of 21 scales the 36-month cohort. Also 9 items and one scale reached clinical relevance in the 18-month cohort and 10 items and one scale in the 36-month cohort. Conclusions: In HRPC treated with RT and long-term ADT, T recovery to normal level is associated with major improvements in QoL in several domains. Since a higher proportion of pts recover a normal T level in a much shorter time without apparent detriment in long term outcomes, our results suggest that 18-month may be the most appropriate ADT duration for these pts.

The effect of the sense of Community on Depression, Anxiety, and Stress: the mediation role of a balanced time perspective

PurposeSocial context and time are two dimensions within which our entire existence is embedded. Therefore, prompting a positive set of attitudes and beliefs towards these elements is fundamental for individuals’ psychological well-being. Currently, there is limited understanding regarding the interplay between the sense of community and time perspective in relation to psychological distress. The present study aims, at investigating the effects that the sense of community and time perspective have on the levels of anxiety, depression, and stress. Particular attention has been dedicated to testing whether the effect of sense of community on anxiety, depression, and stress is mediated by the deviation from a balanced time perspective.MethodsTo accomplish our purposes, we asked 352 participants to complete an online survey and respond to the Depression, Anxiety, Stress Scale (DASS-21), the Zimbardo Time Perspective Inventory (ZTPI), and the Multi-Dimensional Sense of Community Scale (MTSOCS). From these scales, we obtained the scores for anxiety, depression, and stress as well as a general score for the sense of community and the deviation from a balanced time perspective. We computed three General Linear Mediation Models, one for each scale of the DASS-21.ResultsThe results showed that the relationship between sense of community and psychological distress was mediated by the deviation from a balanced time perspective extending previous findings and enriching the existing literature on time perspective.ConclusionThe results described so far could be applied to build a series of interventions aimed at promoting psychological well-being in the general population. Considering our findings, we suggest that individuals’ health could be promoted by both improving their sense of community, which in turn would decrease their levels of stress, and by restructuring their time perspective when it became dysfunctional and unbalanced.

Evaluating scholastic achievement in pediatric brain tumor survivors compared to healthy controls.

10065 Background: Radiotherapy (RT) causes cognitive deficits in pediatric brain tumor survivors (PBTS). This has traditionally been measured using exams such as serial IQ tests administered after diagnosis. Scholastic data provides pre-diagnostic measurements and is practical for patients and families. In our state, testing in reading and mathematics is mandated annually for grades 3-11. We sought to evaluate scholastic achievement in PBTS pre- and post-RT treatment. Methods: With IRB approval, we retrospectively analyzed scholastic achievement in children (&lt;21) with primary brain tumors treated with RT at our institution. Eligible children all resided within the state of the institution and were treated 2007-2020. The state’s Department of Education (DOE) provided test scores, school grades, and accommodations, which were matched to institutional clinical data. The other scholastic outcome of interest was Achievement Level (range 1-5 where 5 reflects highest achievement) from state-mandated standardized assessments in Mathematics and Reading, tested annually in grades 3-11. The DOE also provided scholastic data on healthy children matched 3:1 to treated patients by year, district, age, and whether the child was eligible for free or reduced lunch. A general linear mixed-effects model was performed with the above dependent variables and independent variables grade, time (a binary value being pre- or post-time of RT), and treatment (a child being treated or healthy). The interaction term of time*treatment was the outcome of interest, with α=0.1 for this pilot. Odds ratios (ORs) are reported. Results: A total of 200 students were available for analysis: 50 recruited patients and 150 matched controls identified by the DOE with median age 11.6 years at treatment and 7 years median follow-up. Fifty-two percent were eligible for free or reduced lunch. Fifty-six percent received craniospinal irradiation. Thirty-seven (60%) children had post-treatment scholastic data with 179 annual observations available. Of those, there were 10 (6%) physical education waivers, 32 (18%) testing accommodations, and 6 (3%) academic retentions. Compared to matched controls, treated patients were significantly more likely to receive accommodations (OR=31; p=0.001) and significantly less likely to receive a standard grade promotion (OR=0.57; p=0.005) or passing Mathematics scores (OR=0.47; p=0.05). Conclusions: We present the first reporting of scholastic data for United States PBTS. We demonstrate a novel method using existing state mandated school performance testing to evaluate academic performance in PBTS receiving RT. Compared to matched healthy children, we noted significantly increased needs and worse scholastic performance for PBTS. Evaluating scholastic success is an unmet need for PBTS, and we demonstrate the feasibility of using school performance as a novel patient-centered metric.

Normative values for body composition in 22,191 healthy Norwegian adults 20–99 years: The HUNT4 study

BackgroundBody mass, body mass index (BMI), and body composition components are essential for health and longevity. Considering the influence of demographic factors on body composition, there is a need for tailored reference values based on age-, sex-, and geography. We aimed to construct a comprehensive reference material on body composition in healthy Norwegian adults. MethodsIn this cross-sectional study, we estimated age- and sex-specific reference values for body-, fat-, and muscle mass variables using multi-frequency bioelectrial impedance analysis (such as body fat percentage, skeletal muscle mass and visceral fat area) in 22,191 healthy adults aged 20–99 years participating in the Trøndelag Health Study 4 (HUNT4). We calculated the fat mass and skeletal muscle mass index as the total fat and muscle mass relative to height squared and used general linear models to explore the associations between physical activity (PA), BMI, and age. ResultsWith a BMI (kg/m2) of 25.4 (SD 5.1) and 26.0 (4.5) for women and men, respectively, the youngest age group (20–39 yrs) had a lower BMI compared to their counterparts aged 40–59 years (26.3 [4.5] and 27.5 [3.8]) and ≥ 60 years (25.7 [4.1] and 26.5 [3.4]), respectively. Those aged 20–39 years also had the lowest values for the different body fat variables measured. Fat mass index (kg/m2) was 8.41 (4.00) and 5.81 (3.29) for women and men aged 20–39 years, respectively, compared to 9.25 (3.21) and 6.86 (2.46) for those aged ≥60 years. The oldest age group had the lowest values for the various muscle mass variables; women and men aged 60+ years had a skeletal muscle mass index (kg/m2) of 8.91 (0.85) and 10.96 (1.00), respectively. Corresponding values for those aged 20–39 years were 9.33 (0.97) and 11.49 (1.15). For all age groups and both sexes, regular physical activity was associated with lower levels of fat mass, whereas the association between muscle mass and PAwas less conclusive. When using body fat percentage as an obesity measure, we observed a much higher obesity prevalence (41.2%) in the study population compared to BMI (17.3%). ConclusionsOur study offers a comprehensive reference for body composition among healthy adults in Norway, aiding the identification of abnormal fat and muscle mass values across age groups. We also highlight that BMI often misclassifies individuals with adiposity levels in the overweight or obese category as lean. Therefore, incorporating body composition when defining obesity could enable early intervention to prevent cardiometabolic diseases.