Linear Logistic Regression Analysis Research Articles

Analysis of risk factors for prolonged stay in the intensive care unit after cardiac surgery in children with pneumonia.

Preoperative pneumonia in children with CHD may lead to longer stays in the ICU after surgery. However, research on the associated risk factors is limited. This study aims to evaluate the pre-, intra-, and postoperative risk factors contributing to extended ICU stays in these children. This retrospective cohort study collected data from 496 children with CHD complicated by preoperative pneumonia who underwent cardiac surgery following medical treatment at a single centre from 2017 to 2022. We compared the clinical outcomes of patients with varying ICU stays and utilised multivariate logistic regression analysis and multiple linear regression analyses to evaluate the risk factors for prolonged ICU stays. The median ICU stay for the 496 children was 7 days. Bacterial infection, severe pneumonia, and Risk Adjustment for Congenital Heart Surgery-1 were independent risk factors for prolonged ICU stays following cardiac surgery (P < 0.05). CHD complicated by pneumonia presents a significant treatment challenge. Better identification of the risk factors associated with long-term postoperative ICU stays in these children, along with timely diagnosis and treatment of respiratory infections in high-risk populations, can effectively reduce ICU stays and improve resource utilisation.

Unveiling Gender Dynamics in Strategic Risk-Taking and Risk-Aversion Among Indonesian Executives

In this research, we aims to examine how gender disparities among corporate leaders (executives) and their level of risk aversion can impact the organization's strategic risk-taking. A questionnaire survey method was employed to collect data from executives in Indonesia holding minimum positions of senior manager (BOD-1), director or commissioner (C-Level). Standard behavioral economics expected utility approach is employed to quantify the degree of risk aversion, while respondents will also make investment choices to assess their inclination towards strategic risk-taking. The research employed the t-test and linear logistic regression analysis to examine the hypothesis. The research findings indicate that female executives exhibit a higher degree of risk aversion compared to their male counterparts. In line with most st udies, risk averse executives prefer to engage in more cautious strategic risk-taking. Nevertheless, there are no discernible disparities between female executives and male execautives when it comes to engaging in strategic risk-taking.

Tear levels of apoptotic, matrix-degrading and antioxidant biomarkers in patients with and without keratoconus: A cross sectional study

PurposeTo assess the tear levels of a set of apoptotic, matrix-degrading and antioxidant biomarkers, including Metalloproteinase 9 (MMP9), High Mobility Group Box 1 (HMGB1) and Superoxide Dismutase 3-Extracellular (SOD3). MethodsSandwich-ELISA commercial kits were used to test the expression of the three tear biomarkers in the lacrimal fluid of eligible participants. Linear logistic regression analysis was performed todetermine whether the set of tear biomarkers could be associated with clinically manifest keratoconus. ROC curve analysis using 10-fold cross-validation was performedto evaluate the prediction accuracy of the model. ResultsEighty-one participants aged 30–48 years old were enrolled in this study; 48 were patients with keratoconus and 33 were age-matched healthy subjects. The linear combination of the three tear biomarkers levels (AUC = 0.811; CI 95 %: 0.712–0.911) accurately indicated the existence of keratoconus; higher levels of MMP9 (Odd Ratio: 1.069; CI 95 %: 1.029–1.130) and HMGB1 (OR: 1.011; CI 95 %: 1.003–1.022) and lower levels of SOD3 (OR: 0.994; CI 95 %: 0.989–0.997) were significantly associated with a higher probability of keratoconus. ConclusionMultivariable analysis of the set of tear levels of MMP9, HMGB1 and SOD3 biomarkers confirmed a chronic state of inflammation in the ocular surface of patients with keratoconus.

Estimating the Effect of Disclosure of Patient Safety Incidents in Diagnosis-Related Patient Safety Incidents: A Cross-sectional Study Using Hypothetical Cases.

Disclosure of patient safety incidents (DPSIs) is a strategic measure to reduce the problems of patient safety incidents (PSIs). However, there are currently limited studies on the effects of DPSIs on resolving diagnosis-related PSIs. Therefore, this study aimed to estimate the effects of DPSIs using hypothetical cases, particularly in diagnosis-related PSIs. A survey using 2 hypothetical cases of diagnosis-related PSIs was conducted in 5 districts of Ulsan Metropolitan City, Korea, from March 18 to 21, 2021. The survey used a multistage stratified quota sampling method to recruit participants. Multiple logistic regression and linear regression analyses were performed to determine the effectiveness of DPSIs in hypothetical cases. The outcomes were the judgment of a situation as a medical error, willingness to revisit and recommend the hypothetical physician, intention to file a medical lawsuit and commence criminal proceedings against the physicians, trust score of the involved physicians, and expected amount of compensation. In total, 620 respondents, recruited based on age, sex, and region, completed the survey. The mean age was 47.6 (standard deviation, ±15.1) years. Multiple logistic regression showed that DPSIs significantly decreased the judgment of a situation as a medical error (odds ratio [OR], 0.44; 95% confidence interval [CI], 0.24-0.79), intention to file a lawsuit (OR, 0.53; 95% CI, 0.42-0.66), and commence criminal proceedings (OR, 0.43; 95% CI, 0.34-0.55). It also increased the willingness to revisit (OR, 3.28; 95% CI, 2.37-4.55) and recommend the physician (OR, 8.21; 95% CI, 4.05-16.66). Meanwhile, the multiple linear regression demonstrated that DPSIs had a significantly positive association with the trust score of the physician (unstandardized coefficient, 1.22; 95% CI, 1.03-1.41) and a significantly negative association with the expected amount of compensation (unstandardized coefficient, -0.18; 95% CI, -0.29 to -0.06). DPSIs reduces the possibility of judging the hypothetical case as a medical error, increases the willingness to revisit and recommend the physician involved in the case, and decreases the intent to file a lawsuit and commence a criminal proceeding. Although this study implemented hypothetical cases, the results are expected to serve as empirical evidence to apply DPSIs extensively in the clinical field.

A systematic risk assessment approach for urban roadside infrastructure assets

Revealing potential risks and the influence of these risks on urban roadside vulnerable/risky zones has been a great deal for the last decades owing to increasing vehicular mobility. This study aimed to develop a risk assessment methodology for urban roadside infrastructure assets. In this context, seven risk parameters that are likely to affect hazardous aboveground assets installed on urban roadsides were determined, and weights of each parameter (order of importance) were presented based on expert surveys and literature information using the Analytic Hierarchy Process (AHP) method. Mathematical models were set up for each risk parameter using real field data, The American Association of State Highway and Transportation Officials (AASHTO), literature, related standards, and expert surveys by linear, nonlinear, and binary logistic regression analyses. Risk groups were created, and precautions were offered. The efficiency of the models was verified based on the 28 accident records and field observations in 172 assets. When considering the assets that undergo traffic accidents, 71% of the total assets are ranked in the critical and high-risk group. This ratio is consistent with the risk group definitions assigned in this study; thus, the model proposed is accurate and can be applied reliably. The verification process of the total risk model was sufficiently successful to be used in practice and can be generalized by considering the road and traffic characteristics, infrastructure facilities, and future requirements of the regions or countries that reflect similar historical and cultural concerns. Practitioners, governmental institutes, and researchers can apply this methodology to provide their own data with high transparency and reliability.

Disparities in Spatial Access to Sleep Health Care in the United States: A Population-Based Geospatial Analysis

ObjectivesTo examine spatial access to sleep health care in the United States and investigate associations with demographic and socioeconomic characteristics, thereby identifying high-risk communities with limited spatial access to sleep health service. DesignA cross-sectional population-based geospatial analysis. Settings and ParticipantsResidents in US Census tracts across the 48 contiguous states, Alaska, and Hawaii. MethodsThe 2020 American Community Survey 5-year estimates, 2010 rural-urban commuting area codes, 2020 Area Deprivation Index, and sleep care provider locations from the National Provider Identifier file were used to assess the spatial access and related demographic/socioeconomic characteristics. Spatial access was measured by spatial access ratio using enhanced 2-step floating catchment area methods. The associations were investigated using logistic regression analysis and multivariate linear regression analysis. ResultsA total of 45.8 million residents experienced low spatial access to sleep health care. Spatial access decreased in rural and high Area Deprivation Index areas, and in areas characterized by higher population with uninsured status, vehicle unavailability, internet unavailability, cognitive difficulties, and hearing difficulties. With a 10% increase in the percentage of the racial minority (non-white) population, metropolitan census tracts experienced an increase in spatial access (3.268%), whereas micropolitan (−1.526%) and rural (−4.493%) areas experienced a decrease in spatial access. Similar findings were observed within the ethnic minority (Hispanic or Latino) population. Conclusions and ImplicationsDisparities exist in spatial access to sleep health care across the United States, especially for disadvantaged individuals. Racial/ethnic minorities exhibit contrasting spatial access patterns in urban and rural areas, with those in rural areas facing more challenges in spatial access to sleep health care.

Abstract A030: Racial Disparities in Cancer Beliefs among Oregon Residents

Abstract Introduction: Beliefs and perceptions about cancer risks significantly influences a person’s cancer screening and overall health behaviors. To better understand the factors associated with perceptions surrounding cancer in Oregon, this study examined racial differences in cancer risk beliefs among Oregon adults as part of the Population Health Assessment in Cancer Center Catchment Areas effort. Methods: This study utilizes data from the Understanding Cancer in Oregon (UCanOR) project, which included a 47-item cross-sectional survey capturing demographic and behavioral information. The survey was administered to participants selected through an area-based sampling strategy (51.8%) and a convenience sample (48.2%). Cancer beliefs and perceptions were assessed through five questions: 1) “There are so many different recommendations about preventing cancer, it's hard to know which ones to follow;” 2) “Cancer is most often caused by a person's behavior or lifestyle;” 3) “It seems like everything causes cancer; 4) When I think about cancer, I automatically think about death;” 5) “There is not much you can do to lower your chances of getting cancer.” Multivariable generalized linear regression and logistic regression analyses were used to assess the association between race/ethnicity and cancer beliefs either as a summed continuous variable or five specific binary variables with Agree vs. Disagree as the outcome, adjusting for confounders (age, sex, employment status, marital status, BMI, cancer history, insurance status). Results: The study included 1,357 respondents aged over 18 years old with a mean age of 50.0 (SD = 17.8), with the majority being Non-Hispanic White (87.3%), followed by Asian/Pacific Islanders (8.4%), Hispanic White (3.5%), and Black (0.8%). Asian/Pacific Islanders were significantly more likely than individuals of other racial backgrounds to have negative beliefs about cancer. Specifically, compared to Non-Hispanic White, Asian/Pacific Islanders were 2.5 times as likely to agree that “cancer is most often caused by a person’s behavior or lifestyle” [OR (95% CI) = 2.48 (1.64-3.75)] and that “there is not much you can do to lower your chances of getting cancer” [OR (95% CI) = 2.80 (1.70-4.62))], and 1.5 times as likely to agree that “when I think about cancer, I automatically think about death” [OR (95% CI) = 1.61 (1.07-2.41)]. Conclusion: This study found that Asians/Pacific Islanders in Oregon had significantly more negative cancer beliefs. In terms of future directions, interventions aimed at promoting healthy cancer prevention behaviors should particularly target Asian/Pacific Islander communities. This study enhances our ability to effectively plan and implement outreach, tailor interventions, engage patients, and recruit for clinical trials. Citation Format: Sophie Feng, Jian Li, Paige E. Farris, Jessica Currier, Zhenzhen Zhang, Jackilen Shannon. Racial Disparities in Cancer Beliefs among Oregon Residents [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A030.

Factors Associated With Prolonged Operative Times in Laparoscopic Right Hemicolectomy and Its Association With Short-Term Outcomes.

This study aimed to investigate factors associated with prolonged operative time in laparoscopic right hemicolectomy for colon cancer. This was a retrospective review of patients with colon cancer who underwent laparoscopic right hemicolectomy between 2011 and 2021. Linear and binary logistic regression analyses were performed to determine factors associated with prolonged operative time. The association between longer operative times and complications and hospital stay was assessed. One hundred and ninety-seven patients (52.3% female; mean age: 68.8 ± 14.1 years) were included. Factors independently associated with operative time were male sex (β = 17.3, 95% CI: 2, 32.5; p = 0.026) and extended hemicolectomy (β = 67.7, 95% CI: 27.6, 107.9; p = 0.001). American Society of Anesthesiologists (ASA) IV classification had a borderline significant association with operative time (β = 100.4, 95% CI: -2.05, 202.9; p = 0.055). Male sex (r = 0.158; p = 0.026), body mass index (r = 0.205; p = 0.004), ASA classification (r = 0.232; p = 0.001), extended hemicolectomy (r = 0.256; p < 0.001), and intracorporeal vessel control (r = 0.161; p = 0.025) had significant positive correlation with operative times. Patients with operative times ≥ 160 min had significantly longer hospital stays (5 vs. 4 days; p = 0.043) and similar complication rates to patients with shorter operative times. Male sex, advanced ASA classification, and extended hemicolectomy were independently and significantly associated with longer operative times in laparoscopic right hemicolectomy. Longer operative times were associated with longer hospital stays and similar complication rates.

Associations between cardiorespiratory fitness and executive function in Chinese adolescents

Executive function (EF) has a significant impact on career achievement in adolescence and later adulthood, and there are many factors that influence EF. Cardiorespiratory fitness (CRF) is an important factor in the physical fitness of adolescents and is of great significance to healthy development. However, the current association between CRF and EF in Chinese adolescents is still unclear. For this reason, this study analysed the association between CRF and EF. A three-stage stratified cluster sampling method was used to investigate the demographic information, CRF, EF and multiple covariates of 1245 adolescents in China. One-way analysis of variance and chi-square test were used to compare the EF status of different CRFs. The association between CRF and EF was analysed using multiple linear regression analysis and logistic regression analysis. Multiple linear regression analysis showed that, after adjusting for relevant confounding factors, compared with Chinese adolescents with VO2max < P25, the inhibition function reaction time, 1back reaction time, 2back reaction time, and cognitive flexibility response time of adolescents with VO2max > P75 decreased by 1.41 ms, 238.73 ms, 273.09 ms, 74.14 ms. Logistic regression analysis showed that compared with Chinese adolescents with VO2max > P75, Chinese adolescents with VO2max < P25 developed inhibitory function dysfunction (OR 2.03, 95% CI: 1.29, 3.20), 1back dysfunction (OR 6.26, 95% CI 3.94, 9.97), 2back dysfunction (OR 8.94, 95% CI 5.40, 14.82), cognitive flexibility dysfunction (OR 2.26, 95% CI 1.44, 3.57) The risk was higher (P < 0.01). There is a positive association between CRF and EF in Chinese adolescents. High-grade CRF adolescents have higher EF levels, that is, shorter response times. This study provides reference and lessons for better promoting adolescents' executive function development in the future.

Triglyceride-HDL index as a predictor of post-stroke outcomes: A retrospective analysis of 6,235 ischemic stroke patients from the Qatar Stroke Database

Objectives: In this study, we explored the Qatar stroke database to study the independent effect of sex- specific TG-HDL index on neurologic and cardiovascular outcomes following stroke in a predominantly Arab and Southeast Asian population. Methods: All patients admitted with acute ischemic stroke between 2014-2022 were included. TG-HDL index on admission was calculated and patients were stratified into sex-specific quartiles. We studied the 90-day modified Rankin Score (mRS), and 1-year major cardiac adverse events (MACE). Multivariate linear and binary logistic regression analyses were performed to identify the independent effect of TG-HDL index on short- and long-term outcomes. Results: A total of 6,235 stroke patients were identified. Overall, mean age was 55±13 years; 5,122 patients (82%) male; 1,989(32%) Arab; 1,628(26%) BMI ≥30; 3,526 (57%) diabetes mellitus; 4,598 (74%) hypertension, 3,158 (51%) dyslipidemia, and 1,876 (30%) smokers. The median TG levels were 1.5 (1.0-2.3), HDL levels 1.0 (0.8-1.2), and TG-HDL index was 1.5 (1.0-2.3). On long term follow-up, 120 (2%) had a recurrent stroke, 314 (5.1%) had MACE, 38 (0.6%) had post-stroke MI, and 37 (0.6%) had post-stroke cardiac revascularization procedures. On multivariate analyses, higher sex-specific TG-HDL index was independently associated with lower adjusted odds of severe stroke and lower inpatient mortality, and higher 1-year adjusted odds of post-stroke MI (p&lt;0.05). Conclusion: TG-HDL was strongly associated with in-patient mortality and long-term post-stroke cardiovascular outcomes but not long-term stroke recurrence. Our finding of an independently increased 1-year risk of post-stroke MI with higher TG-HDL index may warrant consideration of this index as a cardiac risk stratification tool for stroke patients.

Association of Serum Tsukushi Levels with Urinary Albumin-Creatinine Ratio in Type 2 Diabetes Patients.

Tsukushi is a newly identified hepatokine. Recent studies have shown that it relates to diabetes, lipid metabolism and fibrosis, but there is currently no investigation about whether Tsukushi is associated with diabetic kidney disease. Therefore, this study aimed to investigate the relationship between Tsukushi and diabetic kidney disease by characterizing Tsukushi levels in healthy subjects and type 2 diabetes with urinary albumin-creatinine ratio. Serum Tsukushi level was quantified by enzyme-linked immunosorbent assay in 167 normoalbuminuria, 80 microalbuminuria, and 31 macroalbuminuria patients with type 2 diabetes as compared with 53 healthy subjects. The correlation analysis was used to investigate the relationship between urinary albumin-creatinine ratio or Tsukushi level and other metabolic parameters. Multiple linear regression and logistic regression analysis were used to analyze the independent factors for urinary albumin-creatinine ratio and estimated glomerular filtration rate. The Tsukushi level in the macroalbuminuria group was significantly higher than that in the normoalbuminuria or the microalbuminuria group. Multiple linear regression showed that the significantly independent factors for UACR included high Tsukushi quartile, systolic blood pressure, creatinine, homeostasis model assessment of insulin resistance, low 2-h post-oral glucose tolerance test c-peptide and female. Logistic regression demonstrated that the odds ratio of Tsukushi for glomerular filtration rate ≤90(mL/min/1.73m2) was 1.636 (95% CI 1.091-2.452, P=0.017). The circulating Tsukushi increased in type 2 diabetes patients with albuminuria and was associated with urinary albumin-creatinine ratio, implying that Tsukushi may be involved in the pathogenesis of diabetic kidney disease, which deserves future studies.

Emotional State Evaluation of Retinitis Pigmentosa Patients with the Beck Depression Inventory.

To evaluate the incidence and severity of depression in patients with retinitis pigmentosa (RP). The Beck Depression Inventory (BDI) was administered to 74 patients with RP and 60 healthy controls. Biomicroscopic anterior segment and fundus examination, visual field, optical coherence tomography, and full-field electroretinography tests were performed in all cases. Variables were evaluated with bivariate, multiple linear, and ordinal logistic regression analyses. The RP group included 40 (54%) male and 34 (46%) female patients, while the control group included 23 (38%) male and 37 (62%) female subjects. The patient group had a mean age of 39.20±12.4 years, median best corrected visual acuity (BCVA) of 0.10 decimal (1.0 logarithm of the minimum angle of resolution [logMAR]; range, 1.3-0.7 logMAR), and median visual field mean deviation (MD) score of -28.00 decibels (dB) (range, -1.00 to -34.00 dB). The median BDI score was statistically significantly higher in the patient group (19 points) than in the control group (12 points) (p<0.001). Moderate to severe depression (BDI ≥20) was detected in 61% of patients, while this rate was 25% in healthy controls. BCVA and visual field MD values were identified as predictors of depression score and severity level. The patients' age and gender did not affect total depression score or severity. The prevalence and severity of depression were found to be higher in RP patients than in healthy controls. There was a significant relationship between the patient's functional vision tests and the frequency and severity of depression. Depression reduces the reliability of visual function tests and impairs patients' quality of life. Therefore, assessing mental health as well as functional tests is important in patients with RP.

Iron status correlates strongly to Insulin Resistance among U.S. adults: A nationwide population-base study.

Evidence on the link between iron status markers and insulin resistance (IR) is limited. We aimed to explore the relationship between iron status and IR among U.S. adults. This study involved 2993 participants from the National Health and Nutrition Examination Survey (NHANES) 2003-2006, 2017-2020. IR is characterized by a HOMA-IR value of ≥2.5. Weighted linear and multivariable logistic regression analyses were used to examine the linear relationships between iron status and IR. Furthermore, restricted cubic splines (RCS) were used to identify the non-linear dose-response associations. Stratified analyses by age, sex, BMI and PA were also performed. Last, ROC curve was used to evaluate the predictive value of iron status in IR. In weighted linear analyses, serum iron (SI) exhibited a negative correlation with HOMA-IR (β (95% CI) = -0.03(-0.05, -0.01), P = 0.01). In weighted multivariate logistic analyses, iron intake and serum transferrin receptor (sTfR) were positively correlated with IR (OR =1.02; 95% CI=1.00-1.04, P = 0.04; OR =1.07; 95% CI=1.02-1.13, P = 0.01). Also, SI and transferrin saturation (TSAT) were negatively correlated with IR (OR =0.96; 95% CI=0.94-0.98, P <0.0001; OR =0.98; 95% CI=0.97-0.99, P <0.001) after adjusting for confounding factors. RCS depicted a nonlinear dose-response relationship between sTfR and TSAT and IR. This correlation remained consistent across various population subgroups. ROC curve showed that TSAT performed better than iron intake, SI, sTfR and TSAT in ROC analyses for IR prediction. All biomarkers demonstrated significantly lower risk of IR with increasing iron levels, which will contribute to a more comprehensive and in-depth understanding of the relationship between the two and provide a solid foundation for future exploration of the mechanisms underlying their relationship.

Straightforward and immediate ultrasound-guided kidney biopsy using a guide needle technique to get adequate tissue with reduced procedural time.

A streamlined and effective renal biopsy technique is essential for all nephrologists, particularly those who are less experienced, such as residents. Herein, we report the efficacy of a Straightforward and Immediate ultrasound-guided kidney biopsy using a Guide Needle (SIGN) technique, which allows operators to insert a biopsy gun through a guide needle placed into the fascia of the posterior abdominal wall. A retrospective cross-sectional study was conducted at a nephrology training institution to compare the time spent on the procedure and the number of glomeruli obtained between a group using the SIGN (n = 81) and a group using the conventional ultrasound-guided kidney biopsy technique with a needle guide device (n = 143). The median procedure time in the SIGN group (2min, interquartile range [IQR]: 1-3min) was significantly shorter than that in the conventional group (3min, IQR: 2-4min) (P < 0.001). Multivariable linear regression and logistic regression analyses adjusted for covariates, including operators (board-certificated nephrologists or nephrology residents), showed that the use of the SIGN technique was independently associated with a high number of glomeruli obtained and a procedure time above 2min as the median value (odds ratio: 0.17, 95% confidence interval CI 0.09-0.34). The prevalence of complications was comparable between the two groups (P = 0.681). The SIGN technique reduces the procedure time and obtains adequate biopsy tissue regardless of the operator's experience. SIGN can be applied in nephrology training programs and used as a standard biopsy technique.

When Every Minute Counts: REBOA Before Surgery Is Independently Associated With a 15-Minute Delay in Time to Definitive Hemorrhage Control.

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a temporizing hemorrhage control intervention, but its inevitable effect on time to operating room (OR) has not been assessed. The aim of our study is to assess the impact of undergoing REBOA before surgery (RBS) on time to definitive hemorrhage control surgery. In this retrospective analysis of 2017-2021 ACS-TQIP database, all adult (≥18 years) patients who underwent emergency hemorrhage control laparotomy (≤4 hours of admission) and received early blood products (≤4 hours) were included, and patients with severe head injury (Head-abbreviated injury score > 2) were excluded. Patients were stratified into those who did (RBS) vs those who did not undergo REBOA before surgery (No-RBS). Primary outcome was time to laparotomy. Secondary outcomes were complications and mortality. Multivariable linear and binary logistic regression analyses were performed to identify the independent associations between RBS and outcomes. A total of 32,683 patients who underwent emergency laparotomy were identified (RBS: 342; No-RBS: 32,341). The mean age was 39 (16) years, 78% were male, mean SBP was 107 (34) mmHg, and the median injury severity score was 21 [14-29]. The median time to emergency hemorrhage control surgery was 50 [32-85] minutes. Overall complication rate was 16% and mortality was 19%. On univariate analysis, RBS group had longer time to surgery (RBS 56 [41-89] vs No-RBS 50 [32-85] minutes, P < 0.001). On multivariable analysis, RBS was independently associated with a longer time to hemorrhage control surgery (β + 14.5 [95%CI 7.8-21.3], P < 0.001), higher odds of complications (aOR = 1.72, 95%CI = 1.27-2.34, P < 0.001), and mortality (aOR = 3.42, 95%CI = 2.57-4.55, P < 0.001). REBOA is independently associated with longer time to OR for hemorrhaging trauma patients with an average delay of 15 minutes. Further research evaluating center-specific REBOA volume and utilization practices, and other pertinent system factors, may help improve both time to REBOA as well as time to definitive hemorrhage control across US trauma centers. III. Epidemiologic.

Dark tea consumption is associated with a reduced risk of dysglycaemia and increased urinary glucose and sodium excretion in Chinese adults.

To examine the associations of tea consumption (both frequency and type) with (1) prediabetes and diabetes and (2) urinary glucose and sodium excretion in Chinese community-dwelling adults. In 1923 participants (457 with diabetes, 720 with prediabetes, and 746 with normoglycaemia), the frequency (occasional, frequent, daily, or nil) and type (green, black, dark, or other) of tea consumption were assessed using a standardized questionnaire. Morning spot urinary glucose and urine glucose-to-creatinine ratios (UGCRs) were assessed as markers of urinary glucose excretion. Tanaka's equation was used to estimate 24-h urinary sodium excretion. Logistic and multivariate linear regression analyses were performed. Compared with non-tea drinkers, the corresponding multivariable-adjusted odds ratios (ORs) for prediabetes and diabetes were 0.63 (95% confidence interval [CI] 0.48, 0.83) and 0.58 (95% CI 0.41, 0.82) in participants drinking tea daily. However, only drinking dark tea was associated with reduced ORs for prediabetes (0.49, 95% CI 0.36, 0.66) and diabetes (0.41, 95% CI 0.28, 0.62). Dark tea consumption was associated with increased morning spot urinary glucose (0.22 mmol/L, 95% CI 0.11, 0.34 mmol/L), UGCR (0.15 mmol/mmol, 95% CI 0.05, 0.25 mmol/L) and estimated 24-h urinary sodium (7.78 mEq/day, 95% CI 2.27, 13.28 mEq/day). Regular tea consumption, especially dark tea, is associated with a reduced risk of dysglycaemia and increased urinary glucose and sodium excretion in Chinese community-dwelling adults.

Determinants of Health Outcomes of Patients Presenting with Massive Traumatic Bleeding in the Emergency Department in Selected Hospitals in Kiambu County, Kenya

Purpose: The study sought to identify the determinants of the health outcomes of patients presenting with massive traumatic bleeding in the emergency department of selected hospitals in Kiambu County, Kenya. Methods: The research employed an analytical cross-sectional study design, utilizing quantitative data. Data was collected using a questionnaire, an observation checklist, and extraction of secondary data from patient records. A census sampling was done. The collected data underwent analysis using IBM SPSS version 26. Simple linear regression and multiple logistic regression analysis was used to analyze the data. Results: Regarding the health outcomes of patients presenting with massive traumatic bleeding, three outcomes were observed: 68.39% of the patients were discharged in fair general condition (FGC), 21.70% were referred and 9.90% were deceased. The experience of the healthcare workers, 11.6% of the variability of the health outcome of the patient is explained by experience of healthcare workers (p-value = 0.0138). Comparing the health outcomes in the two facilities, there was no difference in health outcome (p&lt;0.001). According to the multinomial logistic regression the results indicate that age is a significant predictor of the deceased outcome (B=0.064, p=0.014). Therefore, age is the most significant predictor of the health outcomes of patients presenting with massive traumatic bleeding. Unique Contribution to Theory, Policy and Practice: To reduce poor health outcomes of pediatric and geriatric patients, it is recommended that a specific area in the emergency department should be set aside for the trauma patients in these age categories. Due to adding special areas in the emergency department, more staff and resources will need to be allocated to the emergency department.

Association Between Prebiotic or Probiotic Consumption and Risk of Type 2 Diabetes Mellitus in the General Adult Population

Introduction: Decrease in microbiota diversity increases risk of diabetes by increasing harmful metabolites and activating insulin resistance pathways. Adequate prebiotic and probiotic food consumption may be a potential tool in order to prevent type 2 diabetes. Aim: The aim of the research was to examine at the relationship between probiotic and prebiotic consumption and the risk of type 2 diabetes. Method: A cross-sectional research design was used in this study. Data was obtained from December 2021 and June 2022 using Personal Information Form, Assessment of Probiotic and Prebiotic Food Consumption Form, and Finnish Type 2 Diabetes Risk Questionnaire via online survey. General adults were included in this study. Univariate analysis, logistic and multiple linear regression analyses were conducted. Results: Of 401 adults, 51.6% were male and 78.80% were under 45 years of age. 89% of the sample stated they consumed prebiotic-probiotics. Logistic regression analysis showed that prebiotic-probiotic consumption was not a significant predictor of low (p = 0.127), mild (p = 0.381), moderate (p = 0.819), high (p = 0.588) and very high risk of type 2 diabetes (p = 0.998). In the research, linear regression research revealed that there was no meaningful connection between prebiotic-probiotic consumption status and type 2 diabetes risk (β = -0.072; p = 0.151). Conclusion: This research shown that using probiotics or prebiotics did not increase the risk of type 2 diabetes. Thus, more research is required to determine the relation between the usege of probiotics or prebiotics and the risk of type 2 diabetes.

Exploring the association between adherence to home-based exercise recommendations and recovery of nonspecific low back pain: a prospective cohort study

BackgroundAdherence to home-based exercise (HBE) recommendations is critical in physiotherapy for patients with low back pain (LBP). However, limited research has explored its connection with clinical outcomes. This study examined how adherence to HBE relates to changes in physical function, pain intensity, and recovery from LBP in patients undergoing physiotherapy treatment.MethodsData from a multicenter cluster randomized controlled trial in the Netherlands involving patients with LBP from 58 primary care physiotherapy practices were used. Adherence to HBE was assessed with the Exercise Adherence Scale (EXAS) at each treatment session. Previously identified adherence trajectories served as a longitudinal measure of adherence and included the classes “declining adherence” (12% of participants), “stable adherence” (45%), and “increasing adherence” (43%). The main outcomes included disability (Oswestry Disability Index), pain (Numeric Pain Rating Scale), and recovery (pain-free for > 4 weeks), which were measured at baseline and after three months. Linear and binomial logistic regression analyses adjusted for confounders were used to examine adherence–outcome relationships.ResultsIn the parent trial, 208 participants were included. EXAS scores were available for 173 participants, collected over a median of 4.0 treatment sessions (IQR 3.0 to 6.0). Forty-five (28.5%) patients considered themselves to have recovered after three months. The median changes in the Oswestry Disability Index and Numeric Pain Rating Scale were − 8 (IQR − 1 to -20) and − 2 (IQR − 0.5 to -4), respectively. The mean EXAS scores varied among patient classes: “declining adherence” (46.0, SD 19.4), “stable adherence” (81.0, SD 12.4), and “increasing adherence” (39.9, SD 25.3), with an overall mean of 59.2 (SD 25.3). No associations between adherence and changes in physical functioning or pain were found in the regression analyses.ConclusionsNo association between adherence to HBE recommendations and changes in clinical outcomes in patients with LBP was found. These findings suggest that the relationship between adherence to HBE recommendations and treatment outcomes may be more complex than initially assumed. Further research using detailed longitudinal data combined with qualitative methods to investigate patient motivation and beliefs may lead to a deeper understanding of the relationship between adherence and clinical outcomes in patients with LBP.

Association between organophosphorus pesticides and obesity among American adults

ObjectiveTo investigate any connections between urinary organophosphorus pesticide (OPP) metabolites and adiposity measures.MethodsIn this study, data from the National Health and Nutrition Examination Survey (NHANES) projects from 2003 to 2008, 2011 to 2012, and 2015 to 2018 were analysed. Obesity was defined as a body mass index (BMI) of 30 kg/m² or higher. Abdominal obesity was defined as a waist circumference (WC) over 102 cm for men and 88 cm for women. Four urinary OPP metabolites (dimethyl phosphate [DMP], diethyl phosphate [DEP], dimethyl phosphorothioate [DMTP], and diethyl phosphorothioate [DETP]) and adiposity measures were examined using multiple linear regression and logistic regression analyses. The correlations between a variety of urinary OPP metabolites and the prevalence of obesity were investigated using weighted quantile sum regression and quantile g-computation regression.ResultsIn this analysis, a total of 9,505 adults were taken into account. There were 49.81% of male participants, and the average age was 46.00 years old. The median BMI and WC of the subjects were 27.70 kg/m2 and 97.10 cm, respectively. Moreover, 35.60% of the participants were obese, and 54.42% had abdominal obesity. DMP, DMTP, and DETP were discovered to have a negative correlation with WC and BMI in the adjusted models. DMP (OR = 0.93 [95% CI: 0.89–0.98]), DEP (OR = 0.94 [95% CI: 0.90–0.99]), DMTP (OR = 0.91 [95% CI: 0.86–0.95]), and DETP (OR = 0.85 [95% CI: 0.80–0.90]) exhibited negative associations with obesity prevalence. Similar correlations between the prevalence of abdominal obesity and the urine OPP metabolites were discovered. Moreover, the mixture of urinary OPP metabolites showed negative associations with adiposity measures, with DMTP and DETP showing the most significant effects.ConclusionTogether, higher levels of urinary OPP metabolites in the urine were linked to a decline in the prevalence of obesity.