Logistic Regression Analysis Research Articles

Understanding travel behaviour patterns and their dynamics: Applying fuzzy clustering and age-period-cohort analysis on longterm data of German travellers

This study examines how travel behaviour patterns change over time. It addresses the limitations of traditional segmentation studies, which often focus on static snapshots of travel behaviour. A comprehensive approach is proposed, integrating multi-dimensional segmentation and temporal analysis. Based on a large, repeated, cross- sectional dataset (1983–2018) from Germany, the study employs a research design that combines fuzzy clustering, to identify distinct tourist types including their heterogeneous behaviour, and additive logistic regression analysis, to analyse temporal changes in travel behaviour patterns. The findings reveal five tourist types based on their travel behaviour. These tourist types differ in sociodemographic characteristics and are related to each other. The chance of belonging to those tourist types changes over a tourists' life cycle (age), over time due to external factors (period) and across generations (cohort), providing insights into evolving travel behaviour. The findings from this study can help tourism stakeholders to adapt their strategies to changing tourist behaviour and improve destination management and marketing efforts.

Potential profiling of social alienation in older female patients with stress urinary incontinence

BackgroundWith the global trend of aging, stress urinary incontinence is becoming more common in older adults, which may have some impact on patients' quality of life. Social alienation can generate negative emotions such as anxiety, depression, loneliness, and morbid stigma, and reduce patients' quality of life. However, the current status of social alienation is different among different older adult female patients with stress urinary incontinence. Therefore, this study categorizes older adult female stress urinary incontinence patients through potential analysis to understand the category characteristics of social alienation level of older adult female stress urinary incontinence patients, and explores the influencing factors of social alienation level of different categories of older adult female stress urinary incontinence patients, which can provide a reference to personalized intervention programs for the characteristics of social alienation of older adult female stress urinary incontinence in the future.MethodA convenience sampling method was used to select 365 cases of older adult female stress urinary incontinence patients from March 2023 to April 2024 in three communities in Jinzhou City. The General Information Questionnaire, the Family Care Index Scale, the Toronto Alexithymia Scale, and the General Alienation Scale were used to conduct the survey.ResultsA total of 365 respondents were included, and three potential categories of social alienation were finally identified, namely, low social alienation (29.0%), medium social alienation-self alienation (49.4%), and high social alienation (21.6%). The results of multifactorial logistic regression analysis showed that occupational status, marital status, whether living alone, place of residence, BMI, whether other chronic diseases, level of narrative disorders, and level of family care were the influencing factors of social alienation in older adult female patients with stress urinary incontinence (P < 0.05).ConclusionThe social alienation of older adult female patients with stress urinary incontinence is characterized by a significant number of categories, and healthcare professionals can identify the characteristics and influencing factors of each category at an early stage, which can provide a basis for the development of targeted clinical interventions to help patients reduce the level of social alienation.

Risk factors for developing osteoporosis in diabetic kidney disease and its correlation with calcium-phosphorus metabolism, FGF23, and Klotho.

The progression of diabetic kidney disease (DKD) affects the patient's kidney glomeruli and tubules, whose normal functioning is essential for maintaining normal calcium (Ca) and phosphorus (P) metabolism in the body. The risk of developing osteoporosis (OP) in patients with DKD increases with the aggravation of the disease, including a higher risk of fractures, which not only affects the quality of life of patients but also increases the risk of death. To analyze the risk factors for the development of OP in patients with DKD and their correlation with Ca-P metabolic indices, fibroblast growth factor 23 (FGF23), and Klotho. One hundred and fifty-eight patients with DKD who were admitted into the Wuhu Second People's Hospital from September 2019 to May 2021 were selected and divided into an OP group (n = 103) and a normal bone mass group (n = 55) according to their X-ray bone densitometry results. Baseline data and differences in Ca-P biochemical indices, FGF23, and Klotho were compared. The correlation of Ca-P metabolic indices with FGF23 and Klotho was discussed, and the related factors affecting OP in patients with DKD were examined by multivariate logistic regression analysis. The OP group had a higher proportion of females, an older age, and a longer diabetes mellitus duration than the normal group (all P < 0.05). Patients in the OP group exhibited significantly higher levels of intact parathyroid hormone (iPTH), blood P, Ca-P product (Ca × P), fractional excretion of phosphate (FeP), and FGF23, as well as lower estimated glomerular filtration rate, blood Ca, 24-hour urinary phosphate excretion (24-hour UPE), and Klotho levels (all P < 0.05). In the OP group, 25-(OH)-D3, blood Ca, and 24-hour UPE were negatively correlated with FGF23 and positively correlated with Klotho. In contrast, iPTH, blood Ca, Ca × P, and FeP exhibited a positive correlation with FGF23 and an inverse association with Klotho (all P < 0.05). Moreover, 25-(OH)-D3, iPTH, blood Ca, FePO4, FGF23, Klotho, age, and female gender were key factors that affected the lumbar and left femoral neck bone mineral density. The Ca-P metabolism metabolic indexes, FGF23, and Klotho in patients with DKD are closely related to the occurrence and development of OP.

Expression of soluble factor-related apoptosis ligand in peripheral blood and microRNA-147b in monocytes in children with sepsis and their association with prognosis

To investigate the expression of soluble factor-related apoptosis ligand (sFasL) in peripheral blood and microRNA-147b (miR-147b) in monocytes in children with sepsis and their value in assessing prognosis. A prospective study was conducted on 124 children with sepsis (sepsis group), 60 children with common infections (infection group), and 60 healthy children undergoing physical examinations (healthy control group). The independent risk factors for poor prognosis in children with sepsis were analyzed, and the value of serum sFasL and monocyte miR-147b in predicting poor prognosis in children with sepsis was assessed. The serum level of sFasL and the relative expression of miR-147b in monocytes were highest in the sepsis group, followed by the infection group and the healthy control group (P<0.05). The multivariate logistic regression analysis showed that the serum level of sFasL and the relative expression of miR-147b in monocytes were closely associated with the poor prognosis of children with sepsis (P<0.05). The receiver operating characteristic curve analysis showed that the combination of serum sFasL level and relative expression of miR-147b in monocytes had a larger area under the curve compared to each indicator alone in predicting the prognosis of children with sepsis (P<0.05). There are significant increases in the level of sFasL in peripheral blood and the relative expression of miR-147b in monocytes in children with sepsis. The combined use of these two indicators has relatively high clinical value in assessing the prognosis of children with sepsis.

Determinants of Dropout From a Virtual Agent-Based App for Insomnia Management in a Self-Selected Sample of Users With Insomnia Symptoms: Longitudinal Study.

Fully automated digital interventions delivered via smartphone apps have proven efficacious for a wide variety of mental health outcomes. An important aspect is that they are accessible at a low cost, thereby increasing their potential public impact and reducing disparities. However, a major challenge to their successful implementation is the phenomenon of users dropping out early. The purpose of this study was to pinpoint the factors influencing early dropout in a sample of self-selected users of a virtual agent (VA)-based behavioral intervention for managing insomnia, named KANOPEE, which is freely available in France. From January 2021 to December 2022, of the 9657 individuals, aged 18 years or older, who downloaded and completed the KANOPEE screening interview and had either subclinical or clinical insomnia symptoms, 4295 (44.5%) dropped out (ie, did not return to the app to continue filling in subsequent assessments). The primary outcome was a binary variable: having dropped out after completing the screening assessment (early dropout) or having completed all the treatment phases (n=551). Multivariable logistic regression analysis was used to identify predictors of dropout among a set of sociodemographic, clinical, and sleep diary variables, and users' perceptions of the treatment program, collected during the screening interview. The users' mean age was 47.95 (SD 15.21) years. Of those who dropped out early and those who completed the treatment, 65.1% (3153/4846) were women and 34.9% (1693/4846) were men. Younger age (adjusted odds ratio [AOR] 0.98, 95% CI 0.97-0.99), lower education level (compared to middle school; high school: AOR 0.56, 95% CI 0.35-0.90; bachelor's degree: AOR 0.35, 95% CI 0.23-0.52; master's degree or higher: AOR 0.35, 95% CI 0.22-0.55), poorer nocturnal sleep (sleep efficiency: AOR 0.64, 95% CI 0.42-0.96; number of nocturnal awakenings: AOR 1.13, 95% CI 1.04-1.23), and more severe depression symptoms (AOR 1.12, 95% CI 1.04-1.21) were significant predictors of dropping out. When measures of perceptions of the app were included in the model, perceived benevolence and credibility of the VA decreased the odds of dropout (AOR 0.91, 95% CI 0.85-0.97). As in traditional face-to-face cognitive behavioral therapy for insomnia, the presence of significant depression symptoms plays an important role in treatment dropout. This variable represents an important target to address to increase early engagement with fully automated insomnia management programs. Furthermore, our results support the contention that a VA can provide relevant user stimulation that will eventually pay out in terms of user engagement.

Surgery for primary ventral hernias and risk of postoperative pain, nausea: a population-based register study

PurposeThe aim of this study was to evaluate risk factors for postoperative pain and nausea after open repair for primary ventral hernias.MethodA population-based registry study was conducted based on data assembled from the Swedish national ventral hernia repair register between January 2016 and December 2021and cross-matched with the Swedish perioperative register.ResultsAltogether 2064 open ventral hernia repairs were registered, including 816 (39.5%) performed on women. Of these, 91 (4.4%) were registered to suffer postoperative nausea or vomiting (PONV) and 403 (19.5%) postoperative pain (PP). In both univariable and multivariable logistic regression analyses, significant predictors of postoperative nausea and pain included male gender, which was associated with lower odds of both postoperative nausea (multivariable OR: 0.30, 95% CI: 0.18–0.49, P < 0.001) and postoperative pain (multivariable OR: 0.60, 95% CI: 0.44–0.83, P = 0.002). Additional predictors of postoperative nausea included emergency surgery (multivariable OR: 4.08, 95% CI: 1.10-15.08, P = 0.035), operative time > 40 min (multivariable OR: 4.15, 95% CI: 2.24–7.69, P < 0.001). Conversely total intravenous anesthesia was associated with lower incidence of PONV (multivariable OR: 0.40, 95% CI: 0.22–0.74, P = 0.003). Other factors, such as age, BMI, smoking status, ASA classification, hernia size, surgery type, operative time, and anesthesia type, were not significantly associated with postoperative pain after adjusting for other variables.ConclusionPostoperative nausea and vomiting (PONV) are significantly reduced with total intravenous anesthesia (TIVA) compared to inhalation anesthesia, with no notable difference in postoperative pain between the two methods.

Association between edaravone use and activities of daily living in older patients with atherothrombotic stroke: an observational study using Japanese real-world data

BackgroundEdaravone is marketed in nine countries, although only Japan has approved edaravone for improvement of neurological symptom, disability of activities of daily living (ADL), and functional disability associated with acute stroke. This study aimed to elucidate the association of edaravone use with ADL using real-world data of older patients with atherothrombotic stroke.MethodsThis retrospective observational research using the Medical Data Vision database in Japan included patients aged 65 years and older who had acute ischemic stroke of the atherothrombotic subtype. Primary outcome was ADL improvement defined as change in Barthel Index from admission to discharge of greater than zero points. The major secondary outcome was good functional outcome (Barthel Index ≥ 90 or modified Rankin Scale 0–2 at discharge). Multivariate logistic regression analyses were conducted to calculate odds ratios with 95% confidence intervals for the outcomes. We further compared the change in Barthel Index from admission to discharge and in-hospital death rate between the edaravone- and non-edaravone- treated patients.ResultsA total of 5,576 patients were included in this study, and were divided into edaravone group (n = 3,825) and non-edaravone group (n = 1,751). The median age of this cohort was 79 years, and median Barthel Index at admission was 30 points. Edaravone use was associated with improved ADL with an adjusted odds ratio of 1.18 (95% confidence interval: 1.01‒1.37). However, no significant association was observed between edaravone use and good functional outcome. The edaravone group had significantly greater change in Barthel Index from admission to discharge than the non-edaravone group, with a difference of 5 points. The in-hospital death rate was comparable between the two groups.ConclusionsEdaravone use may contribute to improve ADL at discharge in patients aged 65 years and older with atherothrombotic stroke.

Parathyroid Hormone-Related Protein Levels and Treatment Outcomes in Hypercalcemia of Malignancy: A Retrospective Cohort Study

Abstract The challenge of managing acute hypercalcemia in patients diagnosed with hypercalcemia of malignancy (HCM) merits further attention. Elevated levels of parathyroid hormone-related protein (PTHrP) may be a risk factor for treatment resistance in acute hypercalcemia; however, few studies have tested this hypothesis. This study aimed to investigate whether high PTHrP levels represent an independent risk factor that impedes the treatment of acute hypercalcemia. This retrospective cohort study recruited 159 patients aged 20–80 years with diagnosed malignancies who had been hospitalized for hypercalcemia with PTHrP levels above the reference value (1.1 pmol/L). The median (25–75%) patient age was 69 (61–76) years, and the median PTHrP level was 6.3 (3.3–11.1) pmol/L. The corrected calcium levels decreased from 12.8 mg/dL (11.9–14.1 mg/dL) to 10.6 mg/dL (9.8–11.7 mg/dL) following treatments, such as bisphosphonates and saline solution. Multivariate linear regression analysis showed less significant decreases in the corrected calcium levels as natural logarithm-transformed PTHrP levels increased (β coefficient [95% confidence interval]: 0.569 [0.225–0.914]; P=.001 for Model 3). Multivariate logistic regression analysis showed an association between high natural logarithm-transformed PTHrP levels and lack of treatment response, defined as a corrected calcium level of ≤10.4 mg/dL in the last blood test conducted within 2 weeks of treatment initiation (odds ratio [95% confidence interval]: 0.504 [0.312–0.814]; P=.005). Therefore, elevated PTHrP levels are a potential risk factor for treatment resistance in hypercalcemia in HCM patients, complicating management regardless of calcium levels.

Predictors of implant failure: A comprehensive analysis of risk factors in oral implant restoration for patients with partial defects of dentition

Implant failure remains a significant challenge in oral implantology, necessitating a deeper understanding of its risk factors to improve treatment outcomes. This study aimed to enhance the clinical outcomes of oral implant restoration by investigating the factors contributing to implant failure in patients with partial dentition defects within two years of treatment. Additionally, the study sought to develop an early risk prediction model for implant failure. A retrospective analysis was conducted on 300 patients with partial dentition defects, dividing them into two groups: a failed implant group and a successful implant group, based on the occurrence of implant failure within two years. General clinical data and condition-specific clinical information were compared between the groups. Multivariate binary logistic regression analysis was used to identify influencing factors, while the predictive effectiveness of the model was assessed using a receiver operating characteristic (ROC) curve. The analysis revealed that factors such as gender, post-implant smoking, oral hygiene status at the second-year follow-up, tooth position, number of implants, timing of loading, width of keratinized mucosa, and bone quantity significantly influenced the likelihood of implant failure (P&lt;0.05). Among these, post-implant smoking and tooth position were identified as independent risk factors. The area under the curve (AUC) for tooth position was 0.695, indicating low predictive performance. Although tooth position was determined to be an independent risk factor for implant failure within two years, its predictive performance was limited.

Development of a predictive scoring model for non-response to intravenous immunoglobulin in Kawasaki disease

To explore the predictive factors for non-response to intravenous immunoglobulin (IVIG) in children with Kawasaki disease (KD) and to establish an IVIG non-response prediction scoring model for the Sichuan region. A retrospective study was conducted by collecting clinical data from children with KD admitted to four tertiary hospitals in Sichuan Province between 2019 and 2023. Among them, 940 children responded to IVIG, while 74 children did not respond. Multivariate logistic regression analysis was used to identify the predictive factors for non-response to IVIG and to establish a predictive scoring model. The model's effectiveness was assessed using the receiver operating characteristic curve (ROC) and validated with an independent dataset. Multivariate logistic regression analysis showed that the platelet-to-lymphocyte ratio (PLR), hemoglobin (Hb), serum creatinine, aspartate aminotransferase (AST), and platelet count (PLT) were closely related to non-response to IVIG in children with KD (P<0.05). Based on these indicators, a predictive scoring model was established: PLR > 199, 0.4 points; Hb ≤ 116 g/L, 4 points; AST > 58 U/L, 0.2 points; serum creatinine > 38 µmol/L, 3.9 points; PLT count ≤ 275 × 109/L, 0.3 points. Using this model, children with KD were scored, and a total score greater than 4.3 was considered high risk of non-response to IVIG. The sensitivity of the model in predicting non-response to IVIG was 77.0%, specificity was 65.7%, and the area under the ROC curve was 0.746 (95%CI: 0.688-0.805). The predictive scoring model based on PLR, Hb, serum creatinine, AST, and PLT demonstrates good predictive performance for non-response to IVIG in children with KD in the Sichuan region and can serve as a reference for clinical decision-making.

Prevalence of suicidal ideation and its associated factors among the geriatric population in Vyas Municipality, Tanahun District, Nepal: a cross-sectional study

BackgroundSuicidal ideation among the geriatric population is a pressing concern, particularly in regions such as Nepal where mental health resources are limited. This study aimed to determine the prevalence of suicidal ideation and its associated factors among the geriatric population in Vyas Municipality, Nepal.MethodsA cross-sectional study was conducted among individuals aged 60 years and above in Vyas Municipality, Nepal. A total of 311 participants were selected using multistage sampling. The data were collected through face-to-face interviews using a structured interview schedule. Multivariate logistic regression analysis was performed to identify independent variables associated with suicidal ideation.ResultsThe overall prevalence of suicidal ideation within the last twelve months among the geriatric population was 6.4% (n = 20). After adjustment for covariates in multivariate logistic regression analysis, living in a nuclear family (OR: 3.033, C.I. 95%:1.007–9.136), and experiencing depressive symptoms [(Mild depression:- OR: 5.358, C.I. 95%:1.548–18.539), (Moderate depression:- OR: 15.739, C.I. 95%:2.536–97.687), and (Severe depression:- OR: 17.423, C.I. 95%:2.218-136.878)] were found to be significant influencing factors for suicidal ideation.ConclusionThis study emphasizes the need to enhance mental health services and strengthen family and community support systems to address suicidal ideation among older adults in Nepal. Further research is required to identify additional determinants and evaluate interventions to mitigate this risk.

Factors affecting decision making among nurse managers working in government hospitals

BackgroundEffective nursing management and leadership are essential for the provision of desired patient care that will contribute to the improvement of any country's health indicators. However, nurses' views and experiences on the multitude of personal and organizational factors which may impact their decision-making abilities are often neglected in the literature. The study aimed to assess magnitude of poor decision making and its associated factors among nurse managers in South Wollo Zone Governmental Hospitals, Amhara Regional State, Ethiopia, 2023.MethodsNon experimental cross-sectional study was conducted among 168 nurse managers in South Wollo Zone Public Hospitals from April 01 2023 to May 15/2023. Participants were selected by using a simple random sampling technique. The data were collected by using structured questionnaire from the study participants. Data were entered using EPI data version 4.6 and exported to SPSS version 26 for analysis. The bi-variable logistic regression analysis model was used to identify the potential predictor variable, with p-value &amp;lt;0.25 was fitted into the multivariable logistic regression analysis model; p-value less than 0.05 and an adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to declare, factors associated with the outcome variable. The model fitness was checked by using the Hosmer and Lemeshow test. Data were presented with frequency tables, graphs, and pie charts.ResultsThe study found that the overall magnitude of poor decision-making among nurse managers was 35.7%. Being self-confident [AOR = 0.01, 95% CI: (00.002, 0.05)], receiving feedback [AOR = 0.24, 95% CI: 0.08, 0.76], and getting managerial support [AOR = 0.22, 95% CI: (0.06, 0.81)] were negatively associated with poor decision-making among nurse managers.ConclusionSelf-confidence, receiving feedback, and getting managerial support were variables significantly associated with poor decision-making. Authors strongly emphasize providing managerial support for nurse managers, increasing their habit of receiving feedback from colleagues, and encouraging them to build their self-confidence.

Clinical characteristics and influencing factors of hyperkyphosis in a Chinese Cohort with axial spondyloarthritis: a multicentre retrospective study.

This study aimed to investigate the clinical characteristics and influencing factors of axial spondyloarthritis (axSpA) hyperkyphosis in a Chinese cohort. A cross-sectional study was conducted on 607 patients with axSpA attending 12 hospitals across 11 centers from March 2022 to March 2024.Univariate and multivariate logistic regression analyses were used to explore the relevant influencing factors of hyperkyphosis. A nomogram model for impact factor visualisation and spearman correlation analysis was used to analyze the relationship between the influencing factors. Multivariable logistic regression revealed that male sex,disease duration,patient global assessment (PGA),erythrocyte sedimentation rate (ESR),the modified stoke spondylitis score（mSASSS）,pharmacological treatment, and ankylosing spondylitis disease activity score-c-reactive protein (ASDAS-CRP) significantly influenced hyperkyphosis(all P < 0.05).Based on the results of the multivariate regression analysis, we constructed a nomogram model for clinical evaluation with an AUC of 0.98 and an accuracy of 0.95.Spearman correlation analysis showed a positive correlation between the spondyloarthritis international society health index (ASAS-HI) and mSASSS (R=0.16, P<0.001), while pharmacological treatment was negatively correlated with disease activity and mSASSS (R=-0.24, -0.18, P<0.001). Controlling disease activity in the clinic is crucial. Active pharmacological treatment should be employed to delay radiological progression, enhance patients' ASAS-HI, psychological status, and physical functioning. Additionally, strict smoking cessation and weight control are recommended to reduce disability.

Positive association between chronic hepatitis B virus infection and anemia in pregnancy in Southern China

This observational investigation aimed to explore potential risk factors for anemia in pregnancy. Firstly, a cross-sectional study was conducted, encompassing a review of clinical data of 43,201 pregnant women admitted to the Hainan Women and Children’s Medical Center between January 2017 and December 2020. Comparison between women with and without anemia in pregnancy revealed significant differences between the two groups concerning age, gestational diabetes, hypothyroidism, hyperthyroidism, chronic hepatitis B virus infection, syphilis infection, and human immunodeficiency virus infection. Multivariable logistic regression analysis showed that chronic hepatitis B virus infection was significantly associated with anemia during pregnancy (AOR 2.97, 95% CI 2.57–3.44, p < 0.0001). Subsequently, a retrospective cohort comprising 86 cases with chronic hepatitis B virus infection and 129 control subjects recruited from the Hainan Women and Children’s Medical Center from November 2021 and January 2023 was examined. Results of the examination revealed a corroborative association between chronic hepatitis B virus infection and anemia in pregnancy (OR 2.13, 95% CI 1.20–3.79, p = 0.0092), particularly manifesting in the third trimester of gestation. Further analysis unveiled distinctive hematological alterations among cases with chronic hepatitis B virus infection, characterized by diminished erythrocyte size and reduced levels of corpuscular hemoglobin. Collectively, these findings underscore a positive association of chronic hepatitis B virus infection with anemia during pregnancy.

Risk factors for plastic bronchitis in children with macrolide-unresponsive Mycoplasma pneumoniae pneumonia and establishment of a nomogram model

To investigate the risk factors for plastic bronchitis (PB) in children with macrolide-unresponsive Mycoplasma pneumoniae pneumonia (MUMPP) and to establish a nomogram prediction model. A retrospective analysis was conducted on 178 children with MUMPP who underwent bronchoscopy from January to December 2023. According to the presence or absence of PB, the children were divided into a PB group (49 children) and a non-PB group (129 children). The predictive factors for the development of PB in children with MUMPP were analyzed, and a nomogram prediction model was established. The model was assessed in terms of discriminatory ability, accuracy, and clinical effectiveness. The multivariate logistic regression analysis showed that older age and higher levels of lactate dehydrogenase and fibrinogen were closely associated with the development of PB in children with MUMPP (P<0.05). A nomogram model established based on these factors had an area under the receiver operating characteristic curve of 0.733 (95%CI: 0.651-0.816, P<0.001) and showed a good discriminatory ability. The Hosmer-Lemeshow goodness-of-fit test indicated that the predictive model had a good degree of fit (P>0.05), and the decision curve analysis showed that the model had a good clinical application value. The risk nomogram model established based on age and lactate dehydrogenase and fibrinogen levels has good discriminatory ability, accuracy, and predictive efficacy for predicting the development of PB in children with MUMPP.

Early applicability of retinopathy of prematurity score (ROPScore) and serum insulin growth factor-1 (IGF-1) for predicting treatment-requiring retinopathy of prematurity: a prospective cohort study

BackgroundRetinopathy of prematurity is a leading cause of blindness especially in developing countries where the accessibility to screening may not be available. Therefore, early prediction could help reallocate the resources for those at high risk.ObjectivesThis study aimed to evaluate the accuracy of the retinopathy of prematurity score (ROPScore) and serum insulin-like growth factor-1 (IGF-1) for predicting treatment-requiring retinopathy of prematurity.MethodsThis prospective cohort study included 87 preterm neonates (≤ 32 weeks). Neonates were screened using digital fundus photography with indirect ophthalmoscopy performed when retinopathy of prematurity changes was detected. Serum insulin-like growth factor-1 was measured in the 3rd week of life.ResultsNine cases (10.3%) developed treatment-requiring retinopathy of prematurity, while 78 patients had mild retinopathy of prematurity. According to logistic regression analysis, lower birth weight and longer duration of assisted ventilation were independent risk factors for treatment-requiring retinopathy of prematurity. At the 2nd week of life, cut-off value of 14.95 for the retinopathy of prematurity score showed a sensitivity of 100% and a specificity of 67.9% for predicting treatment-requiring retinopathy of prematurity. Moreover, serum insulin-like growth factor-1 was significantly lower in patients with treatment-requiring retinopathy of prematurity (p < 0.001).ConclusionsROPScore applied at week 2 and week 6 of life showed the same sensitivity and specificity to predict treatment-requiring retinopathy of prematurity. Furthermore, serum insulin-like growth factor-1 in the 3rd week of life was significantly lower in patients with treatment-requiring retinopathy of prematurity.

Knowledge, attitudes, and practices towards vector-borne diseases in changing climate in Finland.

With climate change, the geographic distribution of some VBDs has expanded, highlighting the need for adaptation, and managing the risks associated with emergence in new areas. We conducted a questionnaire survey on the knowledge, attitudes, and practices (KAP) about vector-borne diseases (VBDs) among sample of Finnish residents. The questions were scored and the level of KAP was determined based on scoring as poor, fair, good, or excellent. Binary logistic regression analysis was used to evaluate the associations of different KAP levels with sex, age, education, and possible previous VPD infection. We received 491/1995 (25%) responses across the country and detected generally good knowledge, but only fair practices towards VBDs. Sex and age of the respondents were most often significantly associated with the level of KAP (P>0.05). Despite the generally good knowledge, we detected major gaps, especially regarding the distinction of tick-borne encephalitis and Lyme borreliosis (LB), risk of disease, and protective measures. Additionally, many respondents thought the vaccination protects against LB or tick bites. This calls for awareness raising on disease risk and prevention measures. With increasing cases and the effects of climate change, surveillance of VBDs communication to the general public should be strengthened.

Reduction of vancomycin-associated acute kidney injury with montelukast.

Vancomycin ranks amongst the most utilized antimicrobial agents in the treatment of serious β-lactam-resistant Gram-positive infections, but its use has been associated with nephrotoxicity. Reduction of acute kidney injury (AKI) has been reported in pre-clinical models with adjuvant montelukast. The purpose of the study was to ascertain if montelukast was associated with a reduction in the prevalence of vancomycin-associated AKI. In this retrospective cohort study, adult patients who received intravenous vancomycin between January 2020 to January 2024 were examined. The RIFLE criteria was employed in identifying cases of AKI. Additionally, a pre-clinical vancomycin-associated nephrotoxicity model was established to provide insights into possible renal protective mechanisms. Patients receiving montelukast (n = 110) were compared to the control (n = 330); of which AKI was observed in 3 of 110 (2.7%) versus 35 of 330 (10.6%), respectively (P=0.01). A multivariate logistic regression analysis revealed that weight (OR: 1.02; 95% CI: 1.006 to 1.03; P-=0.005) and intensive care unit admission (OR: 6.88; 95% CI: 2.96 to 18.8; P<0.001) were independently associated with AKI, while montelukast (OR: 0.26; 95% CI: 0.06 to 0.77; P=0.03) and male gender were protective (OR: 0.41; 95% CI: 0.19 to 0.85; P=0.02). Our in vitro model also revealed that adjuvant montelukast can reduce injury to proximal tubule cells through activation of the p62/KEAP-1/HO-1 antioxidant pathway. Our study suggests that montelukast during vancomycin therapy may be protective against AKI, which may reduce patient harm and hospitalization costs. Further studies are warranted to validate our findings prospectively.

Impact of Concomitant Injuries on Clinical Outcomes in Patients with Isolated versus Non-Isolated Traumatic Brain Injury.

Traumatic brain injury (TBI) often occurs alongside injuries to other body regions, worsening patient outcomes. This study aimed to evaluate the impact of concomitant injuries on clinical outcomes in patients with isolated versus non-isolated TBI. A retrospective cross-sectional analysis was conducted using data from the Emergency Department-based Injury In-depth Surveillance System (EDIIS), encompassing 180,058 TBI patients admitted to 23 tertiary hospitals from January 1, 2020, to December 31, 2022. Patients were categorized into isolated TBI (iTBI, n = 127,673) and non-isolated TBI (niTBI, n = 52,385) groups based on injury diagnostic codes. Clinical outcomes-including 24-hour and 30-day mortality, hospital admission, and interhospital transfer-were compared. Multivariate logistic regression analyses adjusted for potential confounders were performed. niTBI patients exhibited significantly higher 24-hour mortality (1.5% vs. 0.4%), 30-day mortality (2.6% vs. 1.0%), hospital admissions (24.5% vs. 8.4%), and interhospital transfers (3.6% vs. 1.1%) compared to iTBI patients (all p < 0.001). Concomitant injuries increased the adjusted odds of 24-hour mortality (aOR = 1.456; 95% CI: 1.286-1.648) and 30-day mortality (aOR = 1.111; 95% CI: 1.022-1.208). Thoracic injuries were the most significant predictor of adverse outcomes in niTBI patients, nearly sixfold increasing the odds of 24-hour mortality (aOR = 5.958; 95% CI: 5.057-7.019). Concomitant injuries significantly worsen clinical outcomes in TBI patients, with thoracic injuries being the most critical predictor of mortality. These findings highlight the importance of comprehensive trauma assessment and targeted prevention strategies to improve survival rates and optimize resource allocation for patients with multiple injuries.

Perceived cognitive impairment and occupational functioning in prostate cancer survivors: an exploratory cross-sectional analysis.

Perceived cancer-related cognitive impairment (CRCI) has been reported in prostate cancer survivors. Little is known about how CRCI impacts occupational functioning in working-aged prostate cancer survivors (PCS). This study aimed to investigate the association between CRCI and occupational functioning in PCS. Data from 51 PCS, who were employed at the time of diagnosis, undergoing hormonal treatments (e.g., androgen deprivation therapy) or 'watchful waiting'/ 'active surveillance', were analysed. An online survey assessed CRCI using the FACT-Cog Perceived Cognitive Impairments (PCI20) subscale, the EORTC-QLQ-30 two-item cognitive functioning scale, and a single 'Yes/No' CRCI item (i.e., were 'changes in thinking (e.g., memory, attention)' experienced as a treatment side effect). PCS also indicated 'Yes/No' to changes to their ability to work, performance of work duties, and decreased work hours. Logistic regression analyses examined the relationship between CRCI measures and occupational outcomes. Of the 51 PCS, 19 (37%) endorsed experiencing cognitive side effects from treatment. The single 'Yes/No' CRCI question was significantly associated with perceived changes in work ability and ability to perform work duties at the same level. PCI20 and the EORTC-QLQ-30 cognitive functioning scale were not significantly associated with any occupational outcomes. Perceived CRCI is associated with adverse changes to occupational functioning and is important to consider when PCS are making plans to return-to-work following treatment. Prostate cancer survivors may experience cognitive changes, which may impact their work ability.