Multiple Logistic Regression Models Research Articles

Inflammatory burden index: associations between osteoarthritis and all-cause mortality among individuals with osteoarthritis

BackgroundThe newly described inflammatory burden index (IBI) reflects a patient’s inflammatory burden. This study aimed to estimate the association between IBI, osteoarthritis (OA), and all-cause mortality in patients with OA.MethodsWe extracted the data of adults from the National Health and Nutrition Examination Survey database between 1999 and 2018. After using appropriate survey weights to correct for sample bias, we conducted multivariate logistic regression analyses to explore the association between IBI and OA across three models: in the unadjusted model, partially adjusted model (adjusting age, sex, race, education level, marital status, PIR, BMI, smoking status, drinking status, stroke, CVD, DM, and hypertension) and fully adjusted model (which included additional variables: HBA1C, ALT, AST, BUN, TC, and HDL). And the odds ratios (OR) and 95% confidence intervals (CI) were calculated. Similarly, using comparable survey weights and covariates adjustments, we employed Cox proportional hazards regression analysis to investigate the association between IBI and all-cause mortality in the other 3 models. The Cox proportional hazards regression models were fitted to calculate the hazard ratios (HR) and 95% CI of the association between IBI and all-cause mortality. A restricted cubic spline (RCS) was used to explore the nonlinear relationships between association effects. Subgroup analysis was performed to validate the reliability of their effects.ResultsIn total, 22,343 eligible participants were included. Multiple logistic regression models revealed that participants with the highest IBI had 2.54 times (95%CI, 2.23, 2.90)) higher risk of OA than those with the lowest IBI in Model 1, whereas the OR was 1.21 (95%CI, 1.03, 1.42) in Model 2 and 1.23 (95%CI,1.05, 1.45) in Model 3. Multiple Cox regression models showed participants with the highest IBI had 186% (95%CI, 1.50, 2.31) times risk of developing all-cause death than those with the lowest IBI in Model 1. This trend remained stable in Models 2 (HR,1.54; 95%CI,1.22, 1.95) and 3 (HR, 1.41; 95%CI, 1.10, 1.80). The RCS revealed a significant positive association between IBI and OA risk. With respect to the association between IBI and all-cause mortality, a slight decrease in mortality was observed from the lowest quartile to the second quartile of IBI, and the mortality risk increased with increasing IBI. Subgroup analyses showed that age, cardiovascular disease, and hypertension were pivotal in the association of IBI with all-cause mortality, whereas the association of IBI with OA remained stable after stratification by other factors such as sex, race, education level, marital, smoking, and drinking status, hypertension, and most serological indices.ConclusionsThis study provides evidence of a positive association between IBI, OA, and all-cause mortality. IBI may be a promising signature for assessing the inflammatory burden in patients with OA, which, in turn, is conducive to precise references for high-risk population recognition, anti-inflammatory guidance, and reducing mortality intervention.

Greater perceived stress and lower cortisol concentration increase the odds of depressive symptoms among adolescents

BackgroundAdolescent depression is a major public health concern. Although stress has been linked to more severe depression, its association with mild depression among adolescents is not understood. This study assesses the relationship between perceived stress and cortisol (a physiologic measure of stress) and examines the relationships between these stress measures and depressive symptoms among adolescents 13–19 years of age. MethodsStress was measured with the Perceived Stress Scale-10 and through salivary sampling for cortisol four times throughout the day. The Patient Health Questionnaire-9 was used to measure depressive symptoms (range 0–27), where ≥5 indicated the threshold for experiencing at least mild depressive symptoms. Spearman coefficients and multiple logistic regression models were used to examine the relationships between our variables of interest. ResultsThe mean age of the 73 participants in our study was 15.82 years. 49 % of the participants reported depressive symptoms (PHQ-9 score ≥ 5). Both higher perceived stress (odds ratio [OR] = 1.11, p = 0.022) and lower cortisol (area-under-the curve; AUCG) (OR = 0.99, p = 0.009) were associated with increased odds of having depressive symptoms. LimitationsFew participants had moderate to severe PHQ-9 depression, therefore our study reported findings on mild depression or greater. ConclusionsPerceived stress and cortisol appear to reflect distinct, independent components of the stress experience. However, both greater perceived stress and less circulating cortisol may indicate difficulties in regulating stress as potential factors underlying depressive symptoms. Future research should focus on the different types of adolescent stressors and the importance of routine screening of stress and depression, including mild depression.

Beyond the Classroom: The Influence of Food Insecurity, Mental Health, and Sleep Quality on University Students' Academic Performance.

We aimed to analyze the association between food insecurity (FI) and academic performance in university students, including mental health and sleep quality (SQ), in an association model. A cross-sectional design included university students (n = 466, 72.5% women) from Mexico. We applied the Latin American and Caribbean Food Security Scale, the Depression Anxiety and Stress Scale (DASS-21), and the Pittsburgh Sleep Quality Index. Students self-reported their academic grading (AG) and perceptions about their academic performance. Spearman's rho and multiple logistic regression models were used. Almost half (47%) experienced some level of FI. The median AG was 95. AG was not significantly (p > 0.05) correlated with FI, nor with depression, anxiety, stress, and SQ. Considering mental health and SQ, moderate/severe FI remained significantly associated with perceived overall progress in college (OR: 2.96; 95%CI: 1.49, 5.88) and attendance to classes (OR:3.14; 95%CI: 1.19, 8.28) as poor or regular, and it was positively related to perceiving difficulties in completing their studies (OR:2.75; 95%CI: 1.43, 5.29). Stress, anxiety, depression symptoms, and poor SQ were also significantly associated with poor/regular perception of academic performance. These findings highlight the need to address psychological and nutritional factors in university students to promote their well-being and academic success.

Impact of the COVID-19 pandemic on self-paid vaccination intentions for children: a cross-sectional study in China

ObjectivesWhile it is widely accepted that COVID-19 has disrupted routine vaccination globally, the long-term impact of COVID-19 on parental vaccination intentions is uncertain. This study aims to estimate whether COVID-19...

Cardiovascular risk factors among Roma and non-Roma populations in underprivileged settlements.

The 'Taking the screening tests close to the people' program offers cardiovascular screening to the inhabitants of underprivileged settlements. This study aimed to evaluate the cardiovascular risk factors of underprivileged populations, including individuals who described themselves as belonging to the Roma population. During the program, we collected information about demographic features, lifestyle and current illnesses. A general health assessment (body weight, height, blood pressure and fasting blood glucose) and cardiovascular examination were performed. We analysed data on both Roma and non-Roma groups and used Pearson's chi-squared test and multiple logistic regression models to analyse the factors that contribute to the onset of comorbidities, with a special focus on ethnicity. Data from 6211 participants were processed. Based on self-reports, the non-Roma population consisted of 5352 respondents (1364 men (25.5%) and 3988 women (74.5%)), and the Roma population comprised 859 respondents (200 men (23.3%) and 659 women (76.7%)). A total of 91.2% (4849) of the non-Roma population and 92.5% (788) of the Roma population exercised less than 3h per week (p < 0.001). Of the non-Roma population, 71.7% (3512) had a body mass index above 25kg/m2, while the corresponding figure was 72.4% (609) in the Roma population (p = 0.709). The median body mass index was 28.0 (24.6-31.9) in the non-Roma population and 28.8 (24.5-33.0) in the Roma population (p < 0.001). The prevalence of active smokers was 28.7% (1531) in the non-Roma population and 60.3% (516) in the Roma population (p < 0.001). The prevalence of hypertension was 54.9% (2824) in the non-Roma population and 49.8% (412) in the Roma population (p < 0.001). The prevalence of diabetes was 11.5% (95) in the Roma population and 12.2% (619) in the non-Roma population (p < 0.001). We found a high prevalence of overweight and obesity, a lack of physical activity and an remarkably high smoking rate in the studied underprivileged population. Both type 2 diabetes and hypertension were more common among people living in underprivileged settlements than in the general Hungarian population. People living in underprivileged settlements need more attention in primary care.

Red and Processed Meat Intake, Polygenic Risk and the Prevalence of Colorectal Neoplasms: Results from a Screening Colonoscopy Population.

High red and processed meat intake and genetic predisposition are risk factors of colorectal cancer (CRC). However, evidence of their independent and joint associations on the risk of colorectal neoplasms is limited. We assessed these associations among 4774 men and women undergoing screening colonoscopy. Polygenic risk scores (PRSs) were calculated based on 140 loci related to CRC. We used multiple logistic regression models to evaluate the associations of red and processed meat intake and PRS with the risk of colorectal neoplasms. Adjusted odds ratios (aORs) were translated to genetic risk equivalents (GREs) to compare the strength of the associations with colorectal neoplasm risk of both factors. Compared to ≤1 time/week, processed meat intake >1 time/week was associated with a significantly increased risk of colorectal neoplasm [aOR (95% CI): 1.28 (1.12-1.46)]. This risk increase was equivalent to the risk increase associated with a 19 percentile higher PRS. The association of red meat intake with colorectal neoplasm was weaker and did not reach statistical significance. High processed meat intake and PRS contribute to colorectal neoplasm risk independently. Limiting processed meat intake may offset a substantial proportion of the genetically increased risk of colorectal neoplasms.

Association between a combination of cognitively stimulating leisure activities and long-chain polyunsaturated fatty acid intake on cognitive decline among community-dwelling older Japanese individuals.

Multifactorial lifestyle approaches could be more effective than a single factor for maintaining cognitive function. This study investigated the association of combining cognitively stimulating leisure activities (CSLAs), including puzzles, quizzes, and cognitive training games, with intake of long-chain polyunsaturated fatty acids (LCPUFAs), including docosahexaenoic acid (DHA), eicosapentaenoic acid (EPA), and arachidonic acid (ARA), on cognitive function in the older Japanese individuals without dementia. Participants were community-dwelling Japanese individuals without a self-reported history of dementia (n = 906, aged 60-88 years) from datasets of a 2-year longitudinal study (baseline: 2006-2008 and follow-up: 2008-2010). CSLA engagement and LCPUFA intake were divided into high and low groups according to frequency (≥once/week and <once/week) for CSLA engagement and median intake level for LCPUFA intake according to sex, then categorized into four groups. The associations of multivariate-adjusted odds ratio (OR) for a cognitive decline, shown as a decrease in the Mini-Mental State Examination score by 2 or more points, and the combination of CSLA engagement with LCPUFA intake were assessed using a multiple logistic regression model. Subgroup analysis involved participants with low DHA and EPA intakes (n = 303; median intake, 325 mg/day), mirroring those in North America. The HIGH-CSLA/HIGH-ARA group cumulatively yielded a lower OR for cognitive decline (0.41; 95% confidence interval, 0.25-0.70) than did the LOW-CSLA/LOW-ARA group (p for trend = 0.001). In the subgroup analysis, the OR for the HIGH-CSLA/HIGH-DHA group was notably reduced (0.31; 95% confidence interval, 0.11-0.87; p for trend = 0.025) compared with the LOW-CSLA/LOW-DHA group. High CSLA engagement frequency combined with high ARA intake may cumulatively reduce the risk of cognitive decline among older Japanese individuals. Furthermore, combining CSLA engagement frequency with DHA intake could have a positive association with maintaining cognitive function among older individuals, particularly those with low DHA and EPA intakes.

An imaging-based model to predict the malignant potential of intraductal papillary mucinous neoplasm of the pancreas.

To develop and validate imaging-based models for predicting the malignancy risk of intraductal papillary mucinous neoplasm (IPMN). We retrospectively analyzed data from 241 IPMN patients who underwent preoperative CT and MRI for model development. Cyst size, presence and size of the enhancing mural nodule (EMN), main pancreatic duct (MPD) diameter, thickened/enhancing cyst wall, abrupt MPD caliber change with distal atrophy, and lymphadenopathy were assessed. Multiple logistic regression models predicting malignancy risk were created using either continuous (Model C) or dichotomized variables (Model D) using these imaging features. Validation included internal (n = 55) and external (n = 43) datasets. Model performance was assessed using the area under the receiver operating characteristic curve (AUC) and compared with that of the international guideline-based model (Model F). Model C identified age, EMN size, MPD diameter, and lymphadenopathy as independent predictors on CT, and age and presence and size of EMN on MRI. Model D identified age ≥ 68, cyst size ≥ 31 mm, EMN ≥ 6 mm, MPD ≥ 7 mm, and lymphadenopathy as independent predictors on CT, and age ≥ 68, EMN ≥ 4.5 mm, and lymphadenopathy on MRI. Model C (AUC, 0.763-0.899) performed slightly better than Model D (AUC, 0.753-0.912) without statistical significance. No significant difference was observed between Models C and F (AUC, 0.729-0.952). Combining Model C with obstructive jaundice improved performance (AUC, 0.802-0.941) without statistical significance. Our imaging-based models effectively predicted the malignancy risk of IPMNs, comparable to international consensus guidelines. Imaging features are important for predicting the malignant potential of IPMNs. Our imaging-based model may help determine surgical candidacy for patients with IPMNs. Non-invasively determining the malignant potential of intraductal papillary mucinous neoplasms (IPMNs) allows for appropriate treatment decision-making We identified multiple imaging features that are associated with malignant transformation and developed models for this prediction. Our model performs comparably with international consensus guidelines in predicting the malignant potential of IPMNs.

Determining the effect of environmental factors, work postures and mental workload on musculoskeletal disorders in rescue workers and accidents of one of the water and sewage companies in Iran.

Musculoskeletal disorders are one of the most important problems faced by ergonomists today. This study was conducted with the aim of investigating the effect of weather conditions, working conditions and mental workload on musculoskeletal disorders of rescuers and water and sewage company accidents in hot and cold seasons. The present study was a longitudinal study that was performed on all employees of rescue and disaster teams of Shiraz Water and Sewerage Company in Iran (184 people) by census. Demographic and Nordic questionnaires, NASA Load Index (NASA-TLX), work environment assessment with temperature screening checklist and workplace ergonomic risk factor (WERA) assessment method were performed by the researcher. The collected data were analyzed using SPSS version 23 software and parametric and non-parametric statistical tests. The results showed that the highest and lowest prevalence of musculoskeletal disorders related to knee and back in winter and thigh in summer with prevalence of 57.1, 55.4 and 6%. The comparison of exposure to heat stress factors in summer and winter seasons showed that the temperature factors and work clothes of the workers in both seasons are in worse conditions than other factors (P < 0968). The results of the mental workload of people in two seasons showed that the highest and lowest mental workload is related to physical changes in the winter season and frustration in the summer season, and this relationship was significant (P < 0.001). Using multiple logistic regression model, the potential risk factors for musculoskeletal injuries including age, height, BMI, level of education and work experience in both hot and cold seasons were compared. The results showed that in summer, work experience (OR = 1.16 (1.06-1.28.)) and height (OR = 1.03(0.98-1.08) had a direct effect on the prevalence of pain and discomfort arranged in the back areas. One year of increase in work experience significantly increases the chance of a disorder in the back by 16% and a one centimeter increase in height increases the chance of a disorder in the lumbar region by 3%, although this relationship is significant. It is recommended that suitable solutions such as using appropriate and up-to-date mechanical tools, reducing activity time, increasing rest time, increasing the number of personnel in order to reduce mental workload, using work clothes suitable for the season and type of work, and ergonomics training for workers are on the agenda of company officials. Water and sewage should be placed.

Online Gambling and At-Risk Gambling Behaviour in a Cross-Sectional Survey Among 13-19Year-Old Adolescents in Barcelona.

Gambling forms part of social and leisure activities for adolescents but is not free of potential harms. Moreover, with the emergence of new technologies, gambling has become increasingly accessible and appealing to this population. The aim of this study was to determine the magnitude of gambling behaviour and its associated factors in adolescents aged 13-19years in the city of Barcelona in 2021. A cross-sectional study was conducted using data from the 2021 Survey of Risk Factors in Secondary Schools. A bivariate analysis was carried out and multiple logistic regression models were constructed to estimate adjusted odds ratios and their 95% confidence intervals for online, non-online, and at-risk gambling. The prevalence of gambling among adolescents in Barcelona was 18.6% in boys and 6.1% in girls. Gambling was associated with various sociodemographic, health, and lifestyle factors, with differences observed by sex and gambling modality (online vs. non-online). The prevalence of at-risk gambling was 6.2% in boys and 1% in girls. At-risk gambling was associated with male sex, engaging in online gambling, poor mental health, and participating in more than two different types of gambling. The results of this study show that gambling is a widespread activity among adolescents in Barcelona, with significant associated risks. Preventive programmes and regulations are needed to reduce gambling involvement and gambling-related harms.

Gender Difference in the Impact of Total Energy Intake on the Association between Low Fiber Intake and Mental Health in Middle-Aged and Older Adults.

The effect of dietary fiber intake on mental health is controversial. This study aimed to examine the association of fiber intake with mental health in Korean adults. This cross-sectional study included 11,288 participants aged ≥40 years who participated in the Korean Genome and Epidemiology Study (2004-2013). Fiber intake was assessed using a food frequency questionnaire and categorized into sex-specific quintiles. Multiple logistic regression models were used to investigate the association between the lowest quintile of fiber intake and poor mental health. Mental health was assessed using acute stress perception, the Psychosocial Well-Being Index-Short Form, self-rated health, and the Center for Epidemiological Studies-Depression Scale in Korea. Compared to those with higher fiber intake, having the lowest quintile of fiber intake was associated with higher odds of poor mental health risk, a higher risk of high-stress perception, poor psychosocial distress in males, poor psychosocial distress, and depression in females. Low fiber intake had profound negative mental health effects on males with high total energy intake and females with low total energy intake. In conclusion, there is a gender difference in the impact of total energy intake on the deleterious effect of low fiber intake on mental health.

Sex Differences in Profile and In-Hospital Death for Acute Stroke in Chile: Data From a Nationwide Hospital Registry.

Knowledge of local contextual sex differences in the profile and outcome for stroke can improve service delivery. We aimed to determine sex differences in the profile of patients with acute stroke and their associations with in-hospital death in the national hospital database of Chile. We present a retrospective cohort based on the analysis of the 2019 Chilean database of Diagnosis-Related Groups, which represents 70% of the operational expenditure of the public health system. Random-effects multiple logistic regression models were used to determine independent associations of acute stroke (defined by main diagnosis International Classification of Diseases, Tenth Revision [ICD-10] codes) and in-hospital death, and reported with odds ratios (ORs) and 95% CIs. Of 1 048 575 hospital discharges, 15 535 were for patients with acute stroke (7074 [45.5%] in women), and 2438 (15.6%) of them died during hospitalization. Differences by sex in sociodemographic and clinical characteristics were identified for stroke and main subtypes. After fully adjusted model, women with ischemic stroke had lower in-hospital death (OR, 0.79 [95% CI, 0.69-0.91]) compared with men; other independent predictors included age per year increase (OR, 1.03 [95% CI, 1.03-1.04]), chronic kidney disease (OR, 1.47 [95% CI, 1.20-1.80]), atrial fibrillation (OR, 1.50 [95% CI, 1.26-1.80]), and other risk factors. Conversely, for intracerebral hemorrhage, women had a higher in-hospital mortality rate than men (OR, 1.19 [95% CI, 1.02-1.40]); other independent predictors included age per year increase (OR, 1.009 [95% CI, 1.003-1.01]), chronic kidney disease (OR, 1.55 [95% CI, 1.23-1.97]), oral anticoagulant use (OR, 1.88 [95% CI, 1.37-2.58]), and other risk factors. Sex differences in characteristics and in-hospital death of hospitalized patients exist for acute stroke in Chile. In-hospital death is higher for acute ischemic stroke in men and higher for intracerebral hemorrhage in women. Future research is needed to better identify contributing factors.

SARS-CoV-2 co-detection with other respiratory pathogens-descriptive epidemiological study

BackgroundCo-detection of respiratory pathogens with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is poorly understood. This descriptive epidemiological study aimed to determine the effect of the interaction of different respiratory pathogens on clinical variables. MethodsWe retrospectively reviewed the results of comprehensive multiplex polymerase chain reaction (PCR) testing from November 2020 to March 2023 to estimate respiratory pathogen co-detection rates in Shinjuku, Tokyo. We evaluated the interactions of respiratory pathogens, particularly SARS-CoV-2, between observed and expected co-detection. We estimated the trend of co-detection with SARS-CoV-2 in terms of age and sex and applied a multiple logistic regression model adjusted for age, testing period, and sex to identify influencing factors between co-detection and single detection for each pathogen. ResultsAmong 57,746 patients who underwent multiplex PCR testing, 10,516 (18.2%) had positive for at least one of the 22 pathogens. Additionally, 881 (1.5%) patients were confirmed to have a co-detection. SARS-CoV-2 exhibited negative interactions with adenovirus, coronavirus, human metapneumovirus, parainfluenza virus, respiratory syncytial virus, and rhino/enterovirus. SARS-CoV-2 co-detection with other pathogens occurred most frequently in patients of the youngest age group (0–4 years). A multiple logistic regression model indicated that younger age was the most influential factor for SARS-CoV-2 co-detection with other respiratory pathogens. ConclusionThe study highlights the prevalence of SARS-CoV-2 co-detection with other respiratory pathogens in younger age groups, necessitating further exploration of the clinical implications and severity of SARS-CoV-2 co-detection.

Influence of Medical Mistrust on Prevention Behavior and Decision-Making Among Minoritized Youth and Young Adults During the COVID-19 Pandemic.

Medical mistrust (MM) is seen as a barrier to assessing healthcare needs and addressing health disparities; however, limited literature has focused on assessing MM for vulnerable populations, especially racial/ethnic minority and sexual/gender minority youth and young adults (YYA). Between February 2021 and March 2022, we conducted the Youth and Young Adults COVID-19 Study, a prospective cohort of minoritized YYA aged 14 to 24years (n = 1027), within the United States and its territories. Participants were recruited through a combination of paid social media ads, outreach with organizations serving marginalized youth, and an existing registry, targeting racial and ethnic minority and LGBTQ + youth for a study on COVID-19 health behaviors. Multiple multinomial logistic regression models were developed to examine associations between demographics and three dimensions of MM including healthcare experience, government information, and scientific information. Most participants were between the ages of 18 and 21years (48.3%), identified as Hispanic (33.3%) or white (22.5%), and bisexual or pansexual (34.3%). Queer YYA had higher odds of reporting worse personal healthcare experiences than their straight peers. The odds of gay/lesbian YYA that reported somewhat or extreme trust in doctor's sources were two times higher than their straight peers. Except for those who identified as Asian, racial/ethnic minority YYA were less likely to report somewhat or extreme trust in the CDC's general information or its COVID-19 data than white YYA. Transgender and gender diverse YYA were more than twice as likely to report being very or extremely influenced by statistics of the dangers of COVID-19 than cisgender YYA. Our study indicated the importance of incorporating marginalized identities into the assessment of medical mistrust to better understand YYA's health prevention and treatment behaviors and to develop public health prevention and treatment strategies, especially for minoritized communities.

Association Between Dominant-Shoulder Internal-Rotation Restriction and Low-Back Pain in Elite Male High School Soft Tennis Players.

The incidence of low-back pain (LBP)is high among elite male high school soft tennis players. A previous report showed that hip internal-rotation (IR) restriction in the non-dominant leg could increase the risk of LBP. Moreover, IR in the dominant shoulder is important for serve and stroke movements, suggesting that IR restriction in the dominant shoulder can contribute to LBP. The simultaneous incidence of non-dominant-hip IR restriction may help in developing a good LBP-related factor model; therefore, this study aimed to investigate the association between dominant-shoulder IR restriction and LBP in elite male high school soft tennis players. This is a single-center cross-sectional study. This study included 176 male high school soft tennis players from 14 elite teams. The main measures were IR and external-rotation range of motion (ROM) in the dominant and non-dominant shoulders and hip, assessed using a goniometer with a bubble attached. Multiple logistic regression analyses were performed with the presence of LBP as a categorical variable (LBP, 1; non-LBP (NLBP), 0). Multiple logistic regression models were created as follows: Model 1 included dominant-shoulder IR restriction (loss of glenohumeral IR (GIRLoss)), Model 2 included non-dominant-hip IR ROM, and Model 3 included both GIRLoss and non-dominant-hip IR ROM as the main explanatory variables to test the association between dominant-shoulder IR restriction and LBP, compare its suitability as an associated factor with non-dominant-hip IR restriction, and determine if either or both should be considered in an LBP association model based on model fit. The significance of each multiple logistic regression model was examined using the model χ2 test, and a model with P<0.05 was judged as a significant model. Model fit was examined using the Hosmer-Lemeshow test, and P≥0.05 was judged as a good model fit. The Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) were used to compare the goodness-of-fit among multiple logistic regression models. Results: The LBP and non-LBP groups comprised 59 and 117 players, respectively. GIRLoss in the dominant shoulder was a significant independent factor (odds ratio: 1.06, 95% CI: 1.02-1.09; P<0.01) in Model 3, which included hip IR restriction in the non-dominant leg (odds ratio: 0.90, 95% CI: 0.86-0.94; P<0.01).In all models, the explanatory variables fitted were significantly associated with LBP, indicating that the models were significant and fitted well: the AICs (and BICs) for Models 1, 2, and 3 were 198.4 (207.6), 178.6 (187.9), and 168.8 (181.1), respectively, indicating that Model 3 was the best fit. In elite male high school soft tennis players, IR restriction in the dominant shoulder was associated with LBP. IR restriction in the dominant shoulder and non-dominant hip as a significant factor for LBP may contribute to developing an optimal multiple logistic regression model for LBP.

G-tube placement in patients with robin sequence undergoing mandibular distraction osteogenesis: A multi-institutional review

The goal of this study was to investigate the relationship between mandibular distraction osteogenesis (MDO) and rates of postoperative gastrostomy tube (G-tube) placement among patients with isolated and syndromic Robin sequence (RS). This study was a multi-institutional retrospective chart review of patients with RS who underwent MDO at one of three different pediatric tertiary medical centers. The primary aim of the study was to compare rates of G-tube placement following MDO among the three institutions. The primary outcome was analyzed using Fischer's exact test. The secondary aim of the study was to assess for other contributing factors to G-tube placement such as demographic differences, length of hospital stay, and age at MDO. Analysis of secondary outcomes was assessed using multiple logistic regression models. A total of 125 patients met the inclusion criteria, which required RS diagnosis, completion of MDO between 2004 and 2019, and adequate medical record availability. Sixty percent (n = 75) of subjects were categorized as isolated RS (iRS) and forty percent (n = 50) as syndromic RS (sRS). After MDO, 20% (n = 25) of all patients had G-tubes placed. Of the iRS group, 14.7% (n = 11) required a G-tube, while 28% (n = 14) of the sRS group required a G-tube. The post-operative G-tube rate was similar between institutions when considering all patients. When considering only those patients with iRS, the post-MDO G-tube rate at one center was significantly higher than the other two. Overall, most patients with RS did not require a G-tube after MDO, regardless of diagnosis. However, the significant differences in rates of G-tube placement among patients with iRS may indicate differing practice philosophies, surgical protocols, thresholds for G-tube placement, or regional influences between institutions.

Risk Factors for Anemia in Adolescent Pregnancies: Evidence From the Lembah Pantai Urban Health District in Malaysia.

Introduction Adolescent pregnant mothers are at higher risk of acquiring anemia during pregnancy, which has detrimental consequences for the mother and baby. Untreated and prolonged anemia can lead toperinatal morbidity and mortality and antepartum, intrapartum, and postpartum maternal morbidity.Anemia among adolescent pregnant mothers can be attributed to many factors, such as poor nutrition and the physiological demands of pregnancy. Hence, this study aimed to determine the prevalence and characteristics of anemia among adolescent pregnancies in Lembah Pantai Health District in an urban setting. Materials and methods This cross-sectional study utilized secondary data from registry records of adolescentpregnant mothers in the Lembah Pantai District Health Office in Kuala Lumpur,Malaysia from 2019 to 2022. All adolescent pregnancies aged 10 to 19 years were included in this study. Those with a prior diagnosis of thalassemia or other hematological disorders, as indicated in their medical records, were excluded from the study. The chi-square (χ2) test was applied to elicit the association at a univariate level, and those variables with a p-value of <0.25 were included in a multiple logistic regression model. Results A total of 307 records were reviewed, and 272 pregnant adolescent cases were eligible for the analyses. The prevalence of anemia among teenage pregnancies from 2019 to 2022 was 28.7% (95% CI: 23.0-33.6). This prevalence was lower than in many lower-income countries and developing countries.Factors that were significant on using multiple logistic regression analysis included marital status (unmarried) (AOR: 1.87, 95% CI: 1.01-3.45, p=0.046), residing area Seputeh (AOR: 0.29, 95% CI: 0.14-0.61, p=0.001), and third trimester of first antenatal visit/booking (AOR: 5.08, 95% CI: 2.02-12.70, p<0.001).The population in the Seputeh area has a higher overall household income in comparison toLembah Pantai. Conclusions According to the WHO classification, the prevalence of anemia among adolescent pregnant women at the Lembah Pantai District Health Office reflects amoderate public health issue. Consequently, anemia may exacerbate the impact of other health conditions in this population.Hence, local health authorities should ensure that anemia is adequately addressed without ignoring other crucial health issues. A multidisciplinary, comprehensive, holistic strategy involving healthcare providers, school health teams, and community assets offers a potential solution. Strategies that can be employed include providing targeted health and nutrition education in schools through school health teams. Additionally, establishing adolescent-friendly health clinics tailored to the specific needs of pregnant adolescents and enhancing antenatal services to ensure comprehensive screening and management of anemia should also be implemented.Hence, this will ensure achieving safe motherhood goals through an effective healthcare response.

Physical function is associated with cognitive status, brain amyloid-beta deposition, and blood biomarkers in Chinese Han population.

The physical function of elderly individuals reflects whether they have had a history of regular physical activity over the long term. Such indicators have been found to have a certain connection with cognitive function these years. However, there is limited research that associates it with mechanisms such as cerebral Aβ deposition. We aim to investigate this relationship and unveil the underlying mechanisms. Physical function and cognition data of 4189 participants were obtained from the Chinese preclinical Alzheimer's disease study. Participants were divided into six groups according to disease severity. Among them, 1048 participants underwent the positron emission tomography-computed tomography (PET-CT) and plasma biomarker test. Grip strength and gait were combined into a score indicating physical function. Multiple linear regression models and logistic regression models were mainly used to conduct the analysis. There was a significant positive correlation between physical function and cognitive function (R = 0.48, p < 0.001), independent of sex, age, apolipoprotein E-ε4 genotype, and disease stages (p < 0.001). Physical function was effective in distinguishing individuals with cognitive impairment from those without (AUC = 0.835). Physical function was negatively associated with brain Aβ deposition (p = 0.008) and brain Aβ had an intermediary effect (p < 0.01) on the association between physical function and cognition in women. This association was mainly evident in the lateral parietal, lateral temporal, posterior cingulate, frontal, occipital, and precuneus regions. Physical function was negatively associated with plasma neurofilament light-chain (Nfl) level (p < 0.001). Physical function is strongly associated with cognitive function in the Chinese elderly, and brain Aβ deposition partly mediates the linkage in women. Plasma Nfl can be used as a potential target for exercise intervention in cognitive function. Improving physical function will contribute to the alleviation of cognition decline.

Uptake of COVID-19 vaccines and association with hospitalisation due to COVID-19 in pregnancy: Retrospective cohort study

ObjectivesTo determine demographic and clinical characteristics associated with uptake of COVID-19 vaccines among pregnant women, and quantify the relationship between vaccine uptake and admission to hospital for COVID-19. BackgroundPregnant women are at increased risk of severe adverse outcomes from COVID-19. Since April 2021, COVID-19 vaccines were recommended for pregnant women in the UK. Despite this, evidence shows vaccine uptake is low. However, this evidence has been based only on women admitted to hospital, or on qualitative or survey-based studies. MethodsRetrospective cohort study including all pregnancies ending between 18 June 2021 and 22 August 2022, among adult women registered with a Northwest London general practice. Statistical analyses were mixed-effects multiple logistic regression models. We conducted a nested case-control analysis to quantify the relationship between vaccine uptake by end of pregnancy and hospitalisation for COVID-19 during pregnancy. ResultsOur study included 47,046 pregnancies among 39,213 women. In 26,724 (57%) pregnancies, women had at least one dose of vaccine by the end of pregnancy. Uptake was lowest in pregnant women aged 18–24 (33%; reference group), Black women compared with White (37%; OR 0.55, 95% CI: 0.51 to 0.60), and women in more deprived areas (50%; reference group). Women with chronic conditions were more likely to receive the vaccine than women without (Asthma OR 1.21, 95% CI: 1.13 to 1.29). Patterns were similar for the second dose. Women admitted to hospital were much less likely to be vaccinated (22%) than those not admitted (57%, OR 0.22, 95% CI: 0.15 to 0.31). ConclusionsWomen who received the COVID-19 vaccine were less likely to be hospitalised for COVID-19 during pregnancy. COVID-19 vaccine uptake among pregnant women is suboptimal, particularly in younger women, Black women, and women in more deprived areas. Interventions should focus on increasing uptake in these groups to improve health outcomes and reduce health inequalities.

Prevalence of Certain Corneal Conditions and their Demographic Risk Factors; Tehran Geriatric Eye Study.

Corneal abnormalities are one of the important reasons for visual impairment. There is little evidence of the prevalence of different types of corneal abnormalities. The aim of this study was to assess the prevalence of various corneal abnormalities and identify the key risk factors associated with these abnormalities in an elderly population residing in Tehran. The Tehran Geriatric Eye Study (TGES) was conducted as a cross-sectional study, utilizing a population-based approach and employing stratified cluster random sampling. The study focused on individuals aged 60 years and above residing in Tehran. An ophthalmologist performed a slit lamp examination to evaluate the eyelid, cornea, and crystalline lens. The prevalence of posterior embryotoxon (PE), punctate epithelial defect (PED), pigment on endothelium (POE), corneal dystrophy (CDys), corneal vascularization (CV), and corneal degeneration (CDeg) were estimated to be 0.08% (95% confidence interval [CI]: 0.02 to 0.40), 8.77% (95% CI: 6.64 to 11.51), 0.57% (95% CI: 0.33 to 0.98), 0.53% (95% CI: 0.33 to 0.82), 0.95% (95% CI: 0.60 to 1.52), and 44.87% (95% CI: 41.80 to 47.98), respectively. Overall, approximately 49.08% of the participants exhibited some form of corneal abnormality in at least one eye. The multiple logistic regression model revealed that increasing age was significantly associated with PED, CV, and CD. Furthermore, illiterate participants had a significantly higher prevalence of PE. The findings of this study indicate that approximately half of the elderly population aged 60 years and above in Tehran have at least one corneal abnormality, with corneal degeneration being the most prevalent. Age was identified as the primary determinant of corneal abnormalities.