Statistical Logistic Regression Research Articles

Determinants of neonatal mortality among hospitalised neonates with sepsis at Queen Elizabeth Central Hospital, Blantyre, Malawi: A mixed-methods study.

Neonatal sepsis-related deaths remain a significant health problem contributing to higher morbidity and mortality rates, particularly in low resource settings, such as Malawi. However, there is limited information to associate risk factors and health system factors with mortality. This study investigated the risk factors associated with mortality and explored health system factors contributing to deaths among neonates with sepsis at Queen Elizabeth Central Hospital (QECH), Blantyre, Malawi. This mixed-method study utilised a convergent parallel approach to describe the determinants of neonatal mortality among neonates with sepsis. We selected this design because it allowed the researchers to triangulate, support and enhance the internal and external validity of the results. We retrospectively reviewed 237 neonatal records using a simple random sampling technique for cross-sectional quantitative data. Exploratory qualitative data was collected using a semi-structured interview guide from 10 purposively selected healthcare workers directly involved in providing neonatal care through in-depth interviews. Quantitative data were analysed using univariate and multivariate logistic regression in Stata v.14; qualitative data were analysed manually using a thematic analysis approach. We found that gestation age (OR 0.76 (95% CI: 0.58, 0.99), p-value = 0.040) and number of days spent in the hospital (OR 0.64 (95% CI: 0.48, 0.85), p-value = 0.002) were the most predictive risk factors. The qualitative inquiry showed the maternal behavioural factors; reporting late to hospital, cultural and religious beliefs; maternal health related factors: prolonged labour, unnecessary vaginal examinations, premature rupturing of membranes; Neonatal factors: prematurity, meconium aspiration, home deliveries and lastly, health system factors included delay in treatment, referrals and blood culture results, limited resources contributed to documented clinical outcomes. Determinants of neonatal mortality were gestation age, number of days spent in the hospital, maternal behavioural and health related, neonatal and health system factors. Reducing mortality among neonates with sepsis will require a multi-sectoral approach.

RECOMMENDATIONS TO IMPROVE EMPLOYEE PERSONAL ATTITUDE TOWARD REPORTING PATIENT SAFETY INCIDENTS

Background: Patient Safety Incidents (PSI) in hospitals are adverse events that need to be reported for effective identification and risk management, aiming to prevent reoccurrence of incidents. However, not all incidents are documented, as evidenced by the discrepancy in the number of phlebitis reported by employees as well as Infection IPCLN at three hospitals. Aims: Provide recommendations to improve employee Personal Attitude towards reporting PSI at three hospitals owned by Company A. Methods: The method adopted was a cross-sectional research design; data were collected from three hospitals owned by company A and tested using multiple logistic regression statistics tests. Data on Phlebitis reported from January to July 2018 at three hospitals owned by Company A was used. Furthermore,135 respondents were taken from the service installations of the three hospitals. The Lameshow formula and proportional random sampling are applied to determine the sample. Results: The variables of error orientation (p = 0.001; β = 0.349), behavioral belief (p = 0.008; β = 0.234), and perceived behavioral control (p = 0.003; β = 0.222) had a positive and significant effect on the personal attitude of employees reporting PSI. Conclusion: Two approaches were recommended to improve the personal attitude of employees in reporting PSI. Keywords: Hospital, Patient safety incidents, Personal attitude, Underreporting

Surgically treated chronic maxillary sinusitis: Does the odontogenic etiology alone or in combination with a fungus ball matter?

PurposeTo determine whether odontogenic maxillary sinusitis, either alone (OMSw/oFB) or in combination with fungus ball (OMSwFB), is associated with specific clinical characteristics and treatment outcomes compared to non-odontogenic maxillary sinusitis. Materials and MethodsA retrospective cohort study was performed on patients who underwent surgical treatment for chronic maxillary sinusitis between 2013 and 2021. OMSw/oFB and OMSwFB patients, were selected as the study group, while patients diagnosed with non-odontogenic maxillary sinusitis (non-OMS) were enrolled as the control group. Predictor variables were OMSw/oFB and OMSwFB. Outcomes were clinical presentation, postoperative complications, and treatment outcome. Descriptive, bivariate, and multiple logistic regression statistics were calculated, and the significance level was set at P ≤ 0.05. ResultsThe sample included 200 patients with a mean age of 49.6 ± 20.1 years and 57.5 % were men. Of the 200 patients, 123 (61.5 %) had non-OMS, 55 (27.5 %) had OMSw/oFB, and 22 (11 %) had OMSwFB. Multivariate analysis showed that OMSw/oFB was associated with more successful treatment rates (OR = 8.19, p < 0.01), whereas OMSwFB was associated with a less favorable outcome (OR = 0.27, p = 0.03). Age was associated with an unfavorable outcome in both OMS groups (OR: 0.98, p = 0.03 and p = 0.03, respectively), but no significant associations with other outcomes were found. ConclusionThis study suggests that OMSwFB is a recalcitrant form of OMS associated with a higher risk of persistent symptoms and less favorable outcome. These patients should be informed about the challenging nature of the disease and closely monitored.

Comparative analysis of postoperative complications and outcomes in outpatient versus inpatient orthognathic surgery: a retrospective cohort study

The purpose of this study was to assess and compare the complication rates of single-jaw orthognathic surgery between outpatients and inpatients, and to examine their impact on the outcome of care setting.A retrospective cohort study was performed of patients who underwent single-jaw orthognathic procedures. Outpatients between 2008 and 2023 were selected as the study group, while inpatients between 1997 and 2023 were enrolled as the control group. The predictor variable was the patient care setting. The primary outcome variable was the occurrence of overall complications. Secondary outcomes included surgery-, anesthesia-, and patient-related complications. Other study variables included age, sex, surgery, and anesthesia procedures. Descriptive, bivariate, and multiple logistic regression statistics were computed and the significance level was set at p ≤ 0.05.The sample included 307 patients with a mean age of 23.1 years ± 9.5 years, of whom 55% were female. The outpatient and inpatient groups consisted of 123 (40.1%) and 184 (59.9%) patients, respectively. Of the 123 outpatients, 104 (85.5%) were discharged on the day of surgery. Age (p = 0.012) and ketamine administration (p = 0.022) were significantly associated with complications among outpatients. Outpatient setting and age were significantly associated with overall complications (OR 2.48; 95% confidence interval [CI] 1.34–4.66, p = 0.003 and OR 0.94, 95% CI 0.88–0.98, p = 0.021, respectively) and anesthesia-related complications (OR 4.43, 95% CI 2.03–10.5, p = 0.0003 and OR 0.92, 95% CI 0.83–0.98, p = 0.041, respectively).The study demonstrated that outpatient orthognathic surgery had a high success rate but also identified a higher rate of anesthesia-related complications among outpatients, particularly in younger patients and in those receiving ketamine.

Factors influencing limb movements in post-stroke patients

BackgroundStroke is the leading cause of long-term disability impacting patients’ daily lives. Adequate and ongoing rehabilitation is a necessity. Due to disability problems, rehabilitation in the health care system is limited. Traditional medicine has been promoted in Thailand for stroke rehabilitation, with physical therapy as the primary treatment plan. However, despite more options, many patients still receive inadequate rehabilitation. The development of an appropriate rehabilitation model is still necessary. This study aims to study factors influencing limb movements in post-stroke patients.MethodsThis cross-sectional study comprised 120 ischemic stroke patients obtained by multi-stage sampling in Muang district, Phitsanulok province. The data were collected using questionnaires with Cronbach’s alpha coefficient of 0.89. The ability to move the muscles of the limbs of the patients was assessed using the motor power assessment form, and binary logistic regression statistics analyzed the factors influencing limb movements.ResultData analysis shows that 76% of the stroke patients were female, 39.3% aged 61–70 years had a mean of 62 years and a standard deviation (S.D.) of 8.9, 4.6% of stroke patients had a duration of illness of 6–12 months, and 94.2% had a caregiver. 53.1% received rehabilitation once a week, and 92.5% received Thai massage. Thai traditional medicine utilization methods consist of Thai massage, herbal compresses, herbal steam, and taking herbal medicines. There are two factors influencing the ability to move the limb muscles of stroke patients as follows: (1) the massage with the Thai traditional medicine rehabilitation method (Adj OR = 28.917, p-value = 0.006) and (2) the number of rehabilitation sessions per week (Adj OR = 2.465, p-value < 0.001). These two variables explain the variance of regaining limb movement among post-stroke patients of 42.5% at a significance level of 0.05. In this analysis, the predictive accuracy was 70%.ConclusionRehabilitation using Thai massage, together with the number of rehabilitation sessions per week, influenced the ability of limb movement in post-stroke patients. In other words, increasing the number of rehabilitation times per week and using Thai massage in rehabilitation will help stroke patients move their limbs better.

Determinants of Ethiopian Men’s Attitudes Toward Wife Emotional Abuse Using Logistic Regression

The purpose of this study was to determine the contributing elements to emotional abuse against women. The data was analyzed using binary logistic regression and descriptive statistics, with women&amp;apos;s emotional violence serving as the response variable. In order to achieve the goal, 4720 women between the ages of 15 and 49 who were acquired from the 2016 Ethiopian Demographic and Health Survey were included. The Hosmer and Lemeshow test indicates that the model matches the data quite well. Descriptive statistics show that, out of the 4720 women respondents who participated in the survey, 3667 (77.69%) were not subjected to emotional violence, while 1053 (22.31%) were. Based on the outcome of the binary logistic regression study indicates that the variable level of education, marital status, smoking cigarette, drink alcohol, chat chewing and religion are statistically significant factors on emotional violence. The variable level of education is one of significance variable on emotional violence. Therefore, the concerned body should include topics elimination of violence against women in the education system.

FOXP3 serum concentration; a likely predictor of CIN and cervical cancer: Secondary analysis from a case control study at a clinic in South western Uganda

Biomarkers including Forkhead/winged-helix transcription factor box P3 have been proposed in immunohistochemical techniques to diagnose cervical lesions, but can be objectively quantified and measured in blood using methods that can be standardised. In this study we quantified the serum FOXP3 concentrations and assessed their association with cervical lesions at the cervical cancer clinic of Mbarara Regional Hospital (MRRH) Southwestern Uganda.We performed secondary analysis on archived serum samples from a previous unmatched case control study in which we recruited 90 cervical cancer (CC) cases, 90 cervical intraepithelial neoplasia (CIN) cases before any form of treatment and 90 controls. Clinical and demographic data were recorded. We measured FOXP3 concentrations using quantitative ELISA. We performed descriptive statistics and logistic regression in STATA 17 and took P-values of < 0.05 as statistically significant.The mean concentration of FOXP3 was higher in serum samples from CC cases compared with CIN cases and controls, and this difference was statistically significant (P value < 0.001). More than half (52/90,58 %) of serum samples from CC cases had FOXP3 concentrations greater than 0.0545 ng/ml (P value < 0.001). Increase serum FOXP3 expression was not associated with CIN. Increase in serum FOXP3 concentrations were observed to increase the chances of CC by 2 times (OR: 2.094, P value 0.038, 95 % CI: 1.042–––4.209).Serum FOXP3 is likely associated with cervical lesions especially CC in our study population. Serum FOXP3 testing may be useful in resource limited settings to aid detection of such lesions given the challenges associated with cytology and VIA. We recommend diagnostic utility studies for circulating FOXP3 as a biomarker for detection of cervical cancer.

An Analysis of the Association of Arrival Hemoglobin With Overtransfusion at 24 Hours in a Trauma Population.

Hemorrhage control and resuscitative concepts have evolved in recent years, leading to aggressive use of blood products in trauma patients. There is subsequently a potential risk for overtransfusion, adverse effects, and waste associated with unnecessary transfusion. Methods for conserving blood products are of particular importance in future large-scale combat operations where supply chains are likely to be strained. This study examined the association of emergency department (ED) arrival hemoglobin (HGB) with overtransfusion among survivors at 24 hours after major trauma at a military trauma center. We performed a retrospective cohort study of patients who had a "major trauma" activation and received any red blood cells. Overtransfusion was defined as a HGB level ≥11.0 g/dL at 24 hours (outcome variable). Multivariable logistic regression statistics were used to compare groups and adjust for confounders (injury severity score, arrival modified shock index, injury type, age, and gender). A receiver operating characteristic was constructed with overtransfusion at 24 hours as the outcome (binary) and arrival HGB (continuous) as the independent variable. A total of 382 patients met inclusion criteria. Overtransfusion occurred in 30.4% (n = 116) of patients, with mean ED HGB levels of 13.2 g/dL (12.9 to 13.6) versus 11.6 g/dL (11.3 to 11.8, P < .001). Receiver operating characteristic analysis showed that ED HGB was highly sensitive (0.931) for predicting 24-hour overtransfusion. In our multivariable logistic regression analysis, when adjusting for injury severity score, arrival modified shock index, injury type, age, and gender, we found that the ED HGB value had a per-unit odds ratio of 1.60 (95% CI, 1.38 to 1.86) for 24-hour overtransfusion. Hospital and intensive care unit length of stay, mechanical ventilator days, and mortality did not increase. We found that the arrival HGB value was associated with overtransfusion among 24-hour survivors in a civilian trauma setting. Our findings will inform future prospective studies that investigate blood sparing clinical practice guidelines.

Social Determinants of Health Needs Among Immigrant and U.S.-Born Pregnant Persons in Central Brooklyn: A Cross-Sectional Survey [ID 2683549

INTRODUCTION: Social determinants of health (SDOH) have been linked to poor health outcomes in maternal and infant populations. An epicenter of the maternal health crisis in New York City, Central Brooklyn has a disproportionately high population of immigrants. This cross-sectional survey assesses demographic distributions and SDOH needs of immigrant and U.S.-born pregnant individuals in Central Brooklyn. METHODS: The American Academy of Family Practitioners (AAFP) SDOH screening tool was given to 700 pregnant persons with immigrant status defined by country of origin. Institutional review board-approved data were collected through REDCap, and associations were evaluated via χ2, Fisher's exact tests, and logistic regression in STATA. RESULTS: Compared to U.S.-born pregnant persons, immigrants tended to be older (P=.000), married (P&lt;.000), and more educated (P=.028). Social determinants of health needs differed significantly by nativity status for housing instability (P=.039), food worry (P=.000), and food inadequacy (P=.018), all of which were higher for immigrants. After adjusting for age and education level, immigrant pregnant persons were significantly more likely to report five or more SDOH needs. Rates of food insecurity (39.86% among immigrants and 27.02% among U.S.-born) were much higher than the national average of 10.2%. Rates of all other SDOH needs were higher for immigrants, except for transportation, but these differences were insignificant. CONCLUSION: Our study underscores the criticality of monitoring SDOH needs in marginalized populations to inform targeted interventions aimed at dismantling systemic barriers to health care access during pregnancy. By doing so, we can foster greater engagement in care and promote more equitable health outcomes for pregnant and postpartum individuals.

Examination of Crash Injury Risk as a Function of Occupant Demographics.

The objectives of this study were to provide insights on how injury risk is influenced by occupant demographics such as sex, age, and size; and to quantify differences within the context of commonly-occurring real-world crashes. The analyses were confined to either single-event collisions or collisions that were judged to be well-defined based on the absence of any significant secondary impacts. These analyses, including both logistic regression and descriptive statistics, were conducted using the Crash Investigation Sampling System for calendar years 2017 to 2021. In the case of occupant sex, the findings agree with those of many recent investigations that have attempted to quantify the circumstances in which females show elevated rates of injury relative to their male counterparts given the same level bodily insult. This study, like others, provides evidence of certain female-specific injuries. The most problematic of these are AIS 2+ and AIS 3+ upper-extremity and lower-extremity injuries. These are among the most frequently observed injuries for females, and their incidence is consistently greater than for males. Overall, the odds of females sustaining MAIS 3+ (or fatality) are 4.5% higher than the odds for males, while the odds of females sustaining MAIS 2+ (or fatality) are 33.9% higher than those for males. The analyses highlight the need to carefully control for both the vehicle occupied, and the other involved vehicle, when calculating risk ratios by occupant sex. Female driver preferences in terms of vehicle class/size differ significantly from those of males, with females favoring smaller, lighter vehicles.

Equivalence of state equations from different methods in high-dimensional regression

State equations (SEs) were first introduced in the approximate message passing process to describe the mean square error in compressed sensing. Since then a set of state equations has appeared in studies of logistic regression, robust estimator, and other high-dimensional statistics problems. Recently, a convex Gaussian min-max theorem approach was proposed to study high-dimensional statistic problems accompanying with another set of different state equations. This article provides a uniform viewpoint on these methods and shows the equivalence of their reduction forms, which causes that the resulting SEs are essentially equivalent and can be converted into the same expression through parameter transformations. Combining these results, we show that these different state equations are derived from several equivalent reduction forms. We believe that this equivalence will shed light on discovering a deeper structure in high-dimensional statistics.

Factors associated with high-risk drinking among men in Korea: a secondary analysis

Purpose: This study was conducted to identify factors associated with high-risk drinking in Korean men. Methods: This study was a secondary analysis using data from the Korea National Health and Nutrition Examination Survey (KNHANES VIII-2), 2020. Data were downloaded from the KNHANES website. The subjects of this study were 1,653 alcohol-drinking men between 19 and 65 years of age. Data were analyzed using the Rao-Scott chi-square test and complex sample logistic regression statistics. Results: The high-risk drinking rate among alcohol-drinking men was 27.1%. High-risk drinking was more common in men who smoked (odds ratio [OR] = 2.11, p &lt; .001), men with a middle school education or lower (OR = 1.91, p = .016), men who lived with a spouse (OR = 1.61, p = .025), men who slept less than 6 hours on weekends (OR = 1.51, p = .016), and men who perceived stress (OR = 1.30, p = .044), while it was lower in men who were underweight (OR = 0.19, p = .006). Conclusion: To reduce the rate of high-risk drinking, it is necessary to provide an intervention that considers factors associated with high-risk drinking among men. In particular, smoking was the most important factor associated with high-risk drinking, implying that the integrated management of drinking and smoking is necessary to reduce high-risk drinking.

Statistical Associations between Vestibular Pathologies and Hypothyroidism: A Retrospective Study.

The association between vestibular pathologies and thyroid hormone disorders has been known for several decades. However, very little information is available on the types of vestibular symptoms that may be affected by altered thyroid hormone levels. The aim of this study was to provide patient data in order to identify statistical associations between vestibular pathologies and thyroid hormone disorders. A retrospective review of the records of 422 patients seen for physiotherapy treatment of vertigo was carried out. Statistical analysis of the data was performed using logistic regression, providing Chi2 and Odds Ratio statistics. Our results show that hypothyroidism statistically significantly increases the expression of certain symptoms, such as vestibular instability and gait disorders, in vestibular pathologies such as Menière's disease or central vertigo. By analyzing patient data, our study provides new evidence of dependence between altered thyroid status and the expression of vestibular pathologies.

Predictors of HIV Knowledge, Perceived Stigma and Risk among Transport Workers in Mbarara City, Southwestern Uganda.

The human immunodeficiency virus (HIV) prevalence among transport workers in sub-Saharan Africa remains high, estimated at as high as 9.9% in western Uganda compared with the national prevalence of 5.4%. The prevalence of HIV among transport workers has been partly attributed to the level of knowledge regarding HIV prevention, perceived HIV risk, and stigma. Accordingly, these have been linked to high-risk HIV transmission behaviours that increase the chances of acquiring HIV among adults. Therefore, this study investigated the predictors of HIV knowledge, perceived HIV risk, and stigma among transport workers in Mbarara city in southwestern Uganda. The survey was conducted between November 2021 and February 2022 among transport workers (motorcycle taxi riders, motor vehicles taxi, and truck drivers), aged 18 to 55 years. Face-to-face interviews using a semi-structured questionnaire were conducted with the study's participants. Chi-square and binary multivariate logistic regression statistics were used to assess the predictors of knowledge about HIV prevention, HIV perceived risk, and stigma. Out of 420 participants, 69.3%, 75.4%, and 62% had good knowledge of HIV prevention, a high perceived HIV risk, and stigma, respectively. Predictors of knowledge of HIV prevention comprised education level (AOR=2.28, 95% CI=1.36-3.84), knowing HIV status (AOR=0.47, 95% CI=0.27-0.81), and perceived HIV risk (AOR=3.04, 95% CI=1.74-5.32). Whereas the determinants of perceived HIV risk included education level (AOR=1.34, 95% CI=1.34-4.24), knowing HIV status (AOR=0.26, 95% CI=0.15-0.48), HIV knowledge (AOR=2.38, 95% CI=1.36-4.178), and perceived stigma (AOR=0.47, 95% CI=0.24-0.89). Last, the predictors of perceived HIV stigma included perceived HIV risk (AOR=0.41, 95% CI=0.21-.791), and knowledge of HIV prevention (AOR=0.29, 95% CI=0.16-0.54). The study found a high proportion of participants with good knowledge about HIV prevention, a high HIV perceived risk, and HIV-related stigma. In addition, this study suggests that the level of education and awareness of one's HIV status positively influences HIV knowledge and perceived risk. Whereas HIV-related stigma was in turn negatively influenced by the transport workers' HIV knowledge and perceived risk. This calls for multifaceted approaches at individual, group (interpersonal), and community levels to reduce HIV stigma among this study group. Incorporating continuous health education programs about HIV and encouraging HIV testing among transport workers remains critical.

Hospital Admissions Associated With Head and Neck Injuries From Olympic-style Sports and Activities Between 2010 and 2022.

The objective of this study was to evaluate which Olympic-style sports and activities are most likely to result in hospitalizations relating to head and neck injuries. This was a cross-sectional study using the National Electronic Injury Surveillance System (NEISS) database. Subjects with head and neck injuries from selected Olympic-style sports and activities between 2010 and 2022 were included. Independent variables were demographics and injury characteristics (injury location and sport). The primary outcome variable was hospitalization (yes/no). Survey-weighted descriptive, bivariate, and logistic regression statistics were computed to measure the association between demographic/injury variables and hospitalization. There were 175,995 subjects (national estimate, 5,922,584) meeting inclusion criteria. After adjusting for demographic and injury characteristics, head injuries (odds ratio [OR] = 2.17; 95% CI, 1.83-2.56; P <0.001) demonstrated higher odds of hospitalization compared with facial injuries. Injuries from cycling (OR = 2.52; 95% CI, 2.16-2.95; P <0.001), mountain biking (OR = 2.56; 95% CI, 1.80-3.65; P <0.001), and horseback riding (OR = 4.01; 95% CI, 2.76-5.83; P <0.001) demonstrated higher odds of hospitalization relative to baseball injuries. In conclusion, head and neck injuries associated with high velocity Olympic-style sports and activities such as cycling, mountain biking, and horseback riding had the highest odds of hospitalization.

Image Timing After COVID-19 Infection in Athletes.

Coronavirus disease 2019 (COVID-19) has significantly impacted National Collegiate Athletic Association (NCAA) athletics, with specific concerns for cardiac involvement after infection. Pericardial abnormalities have been seen in up to 39.5% of athletes after COVID-19 infection, while myocardial involvement has been reported at a lower rate of 2.7%. To date, myocardial injury has been seen in 0.6% to 0.7% of athletes when using symptom screening and imaging as clinically indicated, which increases to 2.3% to 3.0% when all athletes with COVID-19 undergo cardiac magnetic resonance (CMR) imaging. This study will examine whether there exists an ideal time from positive COVID-19 results to obtaining imaging to increase the likelihood of finding abnormalities. Prospective cohort study. Level 3. NCAA athletes at West Virginia University who were found to be COVID-19 positive on routine screening were required to undergo echocardiography (ECG) and CMR. These data were reviewed by cardiology and determined to be normal or abnormal. Statistical analysis with logistic regression and descriptive statistics was performed to evaluate whether a time existed where abnormalities on imaging were most likely to be found. A total of 41 athletes were included in this study. ECG was performed earlier on average than CMR imaging, at 18.2 days versus 27.5 days. No significant difference was found in timing from COVID-19 infection diagnosis and abnormalities seen on imaging for either ECG or CMR imaging. The risk of cardiac involvement in athletes in the setting of COVID-19 has already been documented. This study suggests that imaging timing is independent of cardiac involvement with no correlation to specific time periods where more abnormalities may be found. However, CMR imaging showing changes at day 54 after infection suggests cardiac findings can be seen months after imaging. Cardiac imaging for athletes after contracting COVID-19 does not show a significant relationship to time of imaging. However, given the cardiac involvement seen months after diagnosis, further examination of prolonged cardiac effects must be carried out.

Demographic differences in receiving external beam vs brachytherapy radiation in primary ocular cancers.

163 Background: Primary ocular cancers are rare but may be lethal if not treated appropriately. Previously, enucleation was commonly recommended as treatment but has been associated with increased psychosocial disturbances. More recently, brachytherapy and external beam radiation therapy (EBRT) have been used instead due to similar survival outcomes and the opportunity to salvage the eye. Brachytherapy allows for more precise, high dose radiation to be localized to the tumor and minimizes exposure to nearby tissues and, thus, secondary complications. Due to this possible variance of outcomes between radiation therapies, it would be beneficial to examine the demographic differences of those who undergo each modality in the treatment of primary eye cancers. Methods: 2,783 patients diagnosed with a primary ocular cancer that underwent phase I treatment via either EBRT or brachytherapy were isolated using the National Cancer Database from the years 2016 – 2020. Multivariate binary logistic regression and descriptive statistics were used to compare the demographics associated with those who underwent EBRT vs brachytherapy. A p-value of &lt; 0.05 was used to determine significance. Results: Private-insured and Medicare-insured patients were 224.9% and 155.2%, respectively, more likely than uninsured patients to receive brachytherapy. Patients in the third quartile for median household income were 28.4% less likely than those in the upper quartile to receive brachytherapy. Males were 40.2% less likely than females to receive brachytherapy. Compared to White patients, Black and Asian patients were less likely (81.6% and 83.8%) to undergo brachytherapy. Patients identifying as Hispanic/Spanish were 58.4% less likely than non-Hispanic/non-Spanish patients. There were no significant differences found when comparing Charlson-Deyo scores. Conclusions: Patients who are uninsured, in the third quartile for median household income, male, Black, Asian, or Hispanic/Spanish were less likely to undergo brachytherapy compared to EBRT. These findings illustrate that there are significant differences in the groups who undergo recommended radiation modalities for primary ocular cancers. Awareness of these disparities can help us understand the importance of ameliorating healthcare inequalities in the treatment of eye cancers.

Nutritional Information and Food Consumption Pattern of Adolescents’ Secondary School Students in the Urban-Slum Communities of Ibadan, Oyo State, Nigeria

Nutritional status is influenced by the food consumed, health status, sanitary environment and accessibility to nutritional information. This study explored nutritional information and food consumption pattern of adolescents’ secondary school in urban slums, using students in public secondary schools in Ibadan North Local Government Area (IBNLGA), Oyo State, Nigeria. A descriptive study was conducted using a three stage random sampling technique to select 467 respondents. Data were collected using a semi-structured interviewer-administered questionnaire, anthropometric measurements, observational checklist, and Hellen Keller International food frequency questionnaire. Data were analyzed using descriptive statistics, Chi-square and logistic regression statistics. Results revealed among others that respondents’ favourite foods were cassava-based, and sources of nutrition information included teachers (41.8%), parents (33.8%), television (22.1%), radio (16.7%) and siblings (1.3%). The study concluded that many respondents were underweight partly due to poor food consumption pattern as a result of inadequate access to nutritional information. This study recommended more intensive approach to address health and nutrition issues by providing adequate nutritional information in this age group.

High Physical Exposure During Female Recruits' Basic Military Training inSweden-A Descriptive Study.

There is a knowledge gap concerning the occurrence of physical complaints/injuries, i.e., musculoskeletal disorders (MSD), among Swedish women who undergo basic military training (BMT). The aims were to describe prevalence and factors related to MSD and explore physical exposure and performance in Swedish female recruits during BMT. A total of 144 females (mean age 22 years) who underwent BMT in 2016 participated in this cross-sectional study. Data regarding self-reported MSD, physical performance, physical activity and exercise, motivation and mental and physical preparation, and physical exposure during BMT and perceived health were collected at the end of BMT through the Musculoskeletal Screening Protocol questionnaire. Additional data on muscle strength were retrieved from IsoKai isokinetic lift tests. Descriptive and analytic (paired samples t-test and logistic binary regression) statistics were used. The prevalence of MSD was high, with 33% (n = 48) reporting MSD before BMT, 78% (n = 113) during, and 50% (n = 72) at the end of BMT. Knee and upper back were the most frequently reported MSD locations. Forty-four (30%) participants felt insufficiently physically prepared for BMT. The physical exposure was high with loaded marches/runs and carrying heavy loads as the most demanding tasks. The longest walking distance was reportedly 55 km, and the reported maximum load was 50 kg. Forty-five participants (31%) had carried a load representing over 50% of their body weight. Most participants reported good to excellent health at the end of BMT. There was a small (8 N) but significant (P = 0.045) increase in mean force over time. Two variables, MSD before BMT (odds ratio 2.24, P = 0.03) and being physically unprepared (odds ratio 3.03, P < 0.01), were associated with MSD at the end of BMT. This study showed that the prevalence of MSD in Swedish female recruits was high before, during, and at the end of BMT, with knee and upper back as the most frequent locations. Although the physical exposure during BMT was occasionally high, self-rated health was mainly perceived as good to excellent at the end of BMT. Previous MSD and being physically unprepared were related to MSD at the end of BMT. These important and relevant findings indicate the necessity for implementing interventions to increase physical fitness and treat MSD at the beginning of BMT.

Does the type of craniomaxillofacial fracture (CMF) differ between patients with intracranial hemorrhage (ICH) and those with blunt cerebrovascular injury (BCVI)? A retrospective study

The purpose of the present study was to investigate and compare craniomaxillofacial fracture (CMF) type in patients with intracranial hemorrhage (ICH) versus blunt cerebrovascular injury (BCVI).A retrospective cohort study was performed. The predictor variables were the types of CMF. The primary outcomes variables were ICH and BCVI. Secondary outcomes were death and survival with or without neurological sequelae. Descriptive, bivariate, and multiple logistic regression statistics were computed, and the significance level was set at P ≤ 0.05.The sample was composed of 1440 patients with a mean age of 46.6 years ±24 years, and 71% were men. Pure orbital wall (odds ratio [OR]), 3.62; 95% confidence interval [CI], 1.32-12.69; P < 0.022), Le Fort III (OR, 16.08; 95% CI, 5.89-43.50; P < 0.001), cranial vault (OR, 9.74; 95% CI, 3.83.24.32; P < 0.001), skull base (OR, 9.42; 95% CI, 3.86-24.02; P < 0.001) and cervical fractures (OR, 5.50; 95% CI, 1.65-15.97; P = 0.003) were significantly associated with BCVI. All of the CMFs (P < 0.001), except for Le Fort I (OR, 0.79; 95% CI, 0.18-2.63; P = 0.731), nasal (OR, 1.05; 95% CI, 0.77-1.42; P = 0.758), and mandibular (OR, 0.68; 95% CI, 0.45-1.01; P = 0.066) fractures, were significantly associated with ICH. Secondary outcomes were negatively influenced by ICH and BCVI (P < 0.001).Within the limitations of the study it seems that Le Fort I and nasal fractures could be protective of cerebrovascular injuries, by cushioning impact forces. On the other hand it seems that patients with pure orbital wall, Le Fort III and cranio-cervical fractures are more prone to having concomitant life-threatening cerebrovascular injuries. This category of patients should have an immediate and comprehensive neurological assessment and CT angiography to rule out BCVI and to determine its severity.