Multinominal Logistic Regression Research Articles

Estimating Livelihood Vulnerability and Its Impact on Adaptation Strategies in the Context of Disaster Avoidance Resettlement in Southern Shaanxi, China

In order to alleviate ecological environmental degradation and to enhance sustainable rural household livelihoods, the Shaanxi government of China launched a disaster mitigation program: the disaster avoidance resettlement. Measuring household livelihood vulnerability and further assessing its influence, hold the key to strengthening livelihood adaptation in the context of disaster resettlement. Taking Ankang—in southern Shaanxi Province, China—as an example, this article explores the impact mechanism of household livelihood vulnerability on adaptation strategies through a multinominal logistic regression model in which 657 rural questionnaires were employed. In order to provide more integrated empirical evidence, we draw lessons from the livelihood of the previously proposed vulnerability framework, which has three dimensions: the degree of sensitivity, exposure, and adaptive capacity. The adaptive strategies were divided into pure farming, non-agricultural, and diversified adaptation types according to the types of income sources. The results indicated that livelihood vulnerability varies with different resettlement characteristics. In terms of adaptive strategy types, the vulnerability of pure farming households was the largest. This article found that the relocated households who had a lower sensitivity preferred the non-farming livelihood adaptation strategy. Local households with a high adaptive ability preferred to implement diversified adaptation strategies. The weaker the social support network of the relocated households, the more likely they were to choose off-farm adaptation strategies. Our research results are robust and have broader implications in terms of promoting rural household diversifications of adaptation strategies and reducing livelihood vulnerability.

Association of household motor vehicle ownership with overweight and obesity among Bangladeshi adults: A cross-sectional analysis of 2017–18 Bangladesh demographic and health survey

ObjectiveThis study investigated the relationship between motor vehicle ownership with overweight and obesity among Bangladeshi adults. MethodThis cross-sectional data was retrieved from 2017 to 18 Bangladesh Demographic and Health Survey (BDHS), and the total weighted sample of 12,798 male and female were included in the analysis. Both WHO and Asia-Pacific cut-off were used to categorize the weight status of the respondents. Multinominal logistic regression analysis was performed at 5% level of significance. ResultsOverall prevalence of overweight and obesity was 20.1% (95% CI 19.2 to 21.1) and 4.2% (3.8%–4.7%), respectively considering WHO cut-off. However, prevalence of overweight and obesity was found slightly higher when the Asia-Pacific cut-off was considered [29.4% (95% CI 28.4% to 30.4) and 10.8% (95% CI 10.1 to 11.5)], respectively. Adjusted model revealed that the risk of being overweight among the motor vehicle owned household was significantly higher in both cut-offs [WHO cut-off: RRR = 1.35, 95% CI 1.14 to 1.59, p < 0.001 and Asian-Pacific cut-off: RRR = 1.24, 95% CI 1.04 to 1.48, p = 0.014]. Regards to obesity, respondents whose households have motor vehicles were 1.54 times more likely to be obese according to the Asian-Pacific cut-off [RRR = 1.54, 95% CI 1.23 to 1.94, p < 0.001]. Gender stratified analysis suggest household motor vehicle ownership status significantly associated with-overweight (WHO cut-off) and-overweight and obesity (Asia-Pacific cut-off) among males. This association was only significant for obesity (Asian Pacific cut-off) among females. ConclusionHousehold motor vehicle ownership was significantly associated with overweight and obesity status. Interventions and policies promoting active transportation and raising awareness regarding harmful consequences of overweight and obesity could be useful.

Identifying HIV PrEP Attributes to Increase PrEP Use Among Different Groups of Gay, Bisexual, and Other Men Who Have Sex with Men: A Latent Class Analysis of a Discrete Choice Experiment.

Daily pre-exposure prophylaxis (PrEP) is highly effective at preventing HIV among gay, bisexual, and other men who have sex with men (GBMSM), although uptake remains suboptimal. By identifying the features of PrEP that appeal to various subgroups of GBMSM, this study aimed to improve PrEP uptake by examining preferences for PrEP use. Adults ≥ 18years old in six New England states completed an online discrete choice experiment survey. A latent class analysis (LCA) was conducted to identify groups of GBMSM based on four attributes of choices for PrEP (cost, time, side effects, and mode of administration). Multinominal logistic regression was conducted to compare the association between sociodemographic and behavioral characteristics and class memberships. Data from 675 GBMSM were analyzed. A 3-Class model was selected as the best fit model. Class 1 (47.7% of individuals) was identified as having "no specific preferences". Class 2 (18.5% of individuals) were "Cost- and time-conscious" and were significantly more likely to be older, have prior sexually transmitted infection (STI) testing, have low household income, private insurance, and have extreme concerns about HIV risk than those with no specific preference (Class 1). Finally, Class 3 (34.1% of individuals) were "Side effects-conscious" and were more likely to have low income, private insurance, and have moderate and extreme concerns about HIV risk than those with no specific preference (Class 1). Findings indicate that outreach to GBMSM who have never used PrEP should emphasize low cost and short travel times to increase potential PrEP use.

Factors affecting decreased physical activity during the COVID-19 pandemic: an age-, gender-, and body mass index-matched study.

This study aims to investigate the association between factors affecting decreased physical activity (PA) during the COVID-19 pandemic by matching groups based on age, gender, and BMI variables using public Community Health Survey (CHS) data. Data from the CHS was selected and used to investigate health-related factors related to PA, including demographic, psychological, behavioral characteristics, sociocultural, and chronic disease. Exact group matching was conducted based on age, gender, and BMI variables. Frequency analysis, Chi-square test (χ2 test), and multinominal logistic regression analysis were performed to analyze the data, and odds ratio (OR) and 95% confidence interval (95% CI) were presented. The study also examined the impact of COVID-19 on PA, the fear of PA infection. The logistic regression analysis by gender showed that PA decreased in all age groups, males, and females during the COVID-19 pandemic. The decrease in PA was lower in age groups other than those aged 60 or older. Stress experience, residence area, housing type, drinking, smoking, education level, and fear of infection were found to affect decreased PA due to COVID-19. Specifically, experiencing stress (Odds Ratio [OR] = 1.178; 95% Confidence Interval [CI] = 1.054 ~ 1.317) and increased smoking (OR = 1.332; 95% CI = 1.073 ~ 1.653) had a slightly higher impact on decreased PA. Conversely, living in a suburban area (OR = 0.653; CI = 0.585 ~ 0.728), having public housing (OR = 0.836; CI = 0.754 ~ 0.928), having less than a high school education (OR = 0.813; CI = 0.729 ~ 0.907), staying the same with alcohol (OR = 0.567; CI = 0.507 ~ 0.633) and smoking (OR = 0.836; CI = 0.728 ~ 0.959), and having low fear of infection (OR = 0.817; CI = 0.737 ~ 0.905) had a slightly lower impact on decreased PA. PA should be maintained or increased, particularly in the context of social distancing measures during the pandemic. To ensure that PA can be sustained, a program should be developed that considers the individual's geographical location, economic status, lifestyle, and environment.

The incongruence between objective and subjective rental affordability: Does residential satisfaction matter?

Addressing the rental affordability problem requires defining and measuring ‘affordability’ accurately. A variety of objective and subjective indicators have been suggested to measure rental affordability. However, several studies demonstrated that objective and subjective measures of rental affordability are not well aligned with each other, and the underlying cause of this mismatch is unknown. Drawing on Noll's (2013) objective and subjective social indicator framework, this paper examines the extent to which the objectively and subjectively measured levels of rental affordability are incongruent and the driver of the disparity. Using the longitudinal data of the Labor and Income Panel Study in Korea (2015–2020), we conducted a series of panel multinominal logistic regressions with fixed effects. The results show that there is a significant mismatch between objective and subjective rental affordability, and this incongruence is partly due to residential satisfaction, which influences subjective rental affordability. The paper calls for more in-depth exploration of residential satisfaction to benefit refined and nuanced policies to address rental affordability problems.

Latent Subtype of Cognitive Frailty among Multimorbidity Older Adults and Their Association with Social Relationships.

This study aimed to explore all the relevant subtypes of cognitive frailty among Japanese community-dwelling older adults with multimorbidity. Moreover, it examined the associations between these potential subtypes of cognitive frailty and social relationships. This study targeted relevant cross-sectional data regarding community-based older adults with multimorbidity. It employed a person-centered method to perform a latent class analysis and explore the subtypes of cognitive frailty among older adults. Moreover, a multinominal logistic regression analysis was employed to examine the association between potential subtypes of cognitive frailty and social relationships. Data for 396 participants (mean age, 75.8 [SD, 7.3] years; 51.3% females) were analyzed. Three cognitive frailty subtypes were subsequently revealed: the robust group (42.0%), the group with partial cognitive frailty (38.6%), and the group with cognitive frailty (19.4%). People with high levels of social relationships were more likely to be in the robust and the partial cognitive frailty groups. This study identified different subtypes of cognitive frailty among multimorbid older adults and highlighted the significance of social relationships. These findings could serve as a reference for conceptualizing cognitive frailty through the person-centered method. Promoting a high level of social relationships could be useful to prevent the cognitive frailty among older adults with multimorbidity.

잠재프로파일분석을 활용한 아동의 인성 유형 분류 및예측요인 검증

The purpose of this study is to classify the latent profiles based on personality amongchildren, and to explore the effects of parents’ martial conflict and parental monitoring, peerattachment of children, student-teacher relationship as predictors of latent proflie. Questionnairedata from the 13th wave of Panel Study on Korean Children(PSKC) were analyzed. The datawere analyzed by latent profile analysis(LPA) and multinominal logistic regression model. Majorfindings were as following. First, as a result of LPA, the three-profile model that include‘personality high level group’, ‘personality middle level group’ and ‘personality low level group’was selected as the final model. Second, parental factors such as martial conflict and parentalmonitoring, and environmental factors such as peer attachment and student-teacher relationshipof children had a significant effect on the classification of the latent profiles. Our findingsprovide valuable implications to help children to get better personality.

Vitamin D status & associations with inflammation in older adults.

Research studies have observed associations of vitamin D with inflammation but data in representative older adult studies is lacking. We aimed to investigate the association of C-reactive protein (CRP) with vitamin D status in a representative sample of the older Irish population. The concentrations of 25-hydroxyvitamin D (25(OH)D) and CRP was measured in 5,381 community dwelling Irish adults aged ≥50 years from the Irish Longitudinal Study on Ageing (TILDA). Demographic, health and lifestyle variables were assessed by questionnaire and categorical proportions of CRP were generated by vitamin D status and age. Multi-nominal logistic regression was used to investigate the association of 25(OH)D and CRP status. The prevalence (mean; 95% confidence interval (95% CI)) of normal CRP status (0-5 mg/dL) was 83.9% (82.6-85.0%), elevated status (5-10 mg/dL) 11.0% (9.9-12.0%) and high status (>10 mg/dL) was 5.1% (4.5-5.8%). Mean (95% CI) CRP concentrations were lower in those with normal vs. deficient 25(OH)D status (2.02 mg/dL (1.95-2.08) vs. 2.60 mg/dL (2.41-2.82); p<0.0001). In a logistic regression analysis, those with insufficient or sufficient 25(OH)D status were less likely to have a high CRP status compared to those with deficient 25(OH)D status (insufficient: coefficient (CE) -0.732, 95% CI -1.12-0.33, p<0.0001; sufficient: CE -0.599, 95% CI -0.95-0.24, p = 0.001). In conclusion older adults with deficient vitamin D status had higher levels of inflammation as measured by CRP. Given that inflammation is an important pathological driver of chronic diseases of ageing, and that emerging evidence suggests that vitamin D therapy can reduce inflammation in some disease settings, optimising vitamin D status could represent an effective low risk/low-cost pathway to modulate inflammation in community dwelling older adults.

Factors associated with subgroups of fatigue in maintenance hemodialysis patients: a cross-sectional study

Objective This study aimed to investigate affected factors for subgroups of fatigue and the degree of fatigue in maintenance hemodialysis (MHD) patients. Methods This study included 120 MHD patients. Questionnaires, pre- and post-dialysis clinical data, bioimpedance spectroscopy, and ultrasound assessment were involved. Results The prevalence of fatigue in participants was 83%, including 54% of patients with fatigue worsened by dialysis, 13% with fatigue lessened by dialysis, and 16% with undifferentiated fatigue. Based on multi-nominal logistic regression analysis, age was associated with worsened fatigue by dialysis (odds ratio (OR) = 1.06, 95% confidence interval (CI) 1.01–1.11, p = 0.019), lower post-dialysis phosphorus was associated with lessened fatigue by dialysis (OR = 0.03, 95% CI 0.001–0.981, p = 0.049), and there was an increasing trend of patients experiencing undifferentiated fatigue as the extracellular water / intracellular water (E/I) level increased (p for trend = 0.020). Based on multi-ordinal logistic regression analysis, age was also a significant predictor for more severe fatigue (OR = 1.042, 95% CI 1.008–1.059, p = 0.015). Conclusions Different subgroups of fatigue in MHD patients have different affecting factors. Older patients were prone to worsened fatigue by dialysis, patients with lower post-dialysis phosphorus were prone to lessened fatigue by dialysis, and patients with higher E/I levels were prone to undifferentiated fatigue. Meanwhile, older patients are prone to suffer from more severe fatigue. However, more in-depth studies are needed to clarify the pathogenesis of fatigue in MHD patients.

The impact of population pharmacogenomics and risk allele frequencies on cisplatin-induced peripheral sensory neuropathy (PSN).

12092 Background: Taxane-treated breast cancer patients with genetically African ancestry have worse PSN than other groups. However, no study has examined the association between ancestry and PSN after cisplatin-based chemotherapy. Increased risk could be partially explained by differing risk allele frequencies across populations for alleles increasing the general vulnerability to PSN or altering drug metabolism. Methods: The Platinum Study enrolled cisplatin-treated testicular cancer survivors (TCS) who completed clinical exams and surveys. A PSN score was derived from the mean of 8 sensory items (using EORTC-CIPN20), assigning severity on a 0-2 scale. Multidimensional scaling scores for each TCS were calculated, plotted and anchored by data from the 1000 Genomes Reference population to determine genetic ancestry. Multinomial logistic regression assessed the association between genetic ancestry and PSN. To determine risk alleles for PSN and allele frequencies across populations, risk allele panels were created, including ancestry-informative markers (AIMs) determined by the AncestrySNPMiner tool. Allele frequencies were calculated in each group; SNPs with frequency differences &gt; 0.3 in the African (AFRAFR) population vs. others were included. For filtering the AIMs, GTEx data was used to identify expression quantitative trait loci (eQTL) or splicing quantitative trait loci (sQTL) in nerve/brain tissue. Multinomial logistic regression assessed associations between SNP genotype and PSN phenotype for SNPs with differing allele frequencies across populations. Results: Despite small numbers of non-Europeans, TCS with African ancestry had increased incidence and severity of PSN vs. TCS with European ancestry. In a subset analysis of EUR (n = 681) and AFRAFR (n = 13) patients who received 400-450 mg/m2 of cisplatin, the relative risk ratio (RRR) in the AFRAFR vs. EUR TCS of severe neuropathy vs. none was 7.96 (P = 0.074) and the RRR for any neuropathy vs. none was 7.79 (P = 0.049). There were 394 independent AIMs with significant ( &gt; 0.3) allele frequency differences between the AFRAFR and other populations that were eQTLs and/or sQTLs in nerve/brain tissue. Using multinominal logistic regression between genotype and phenotype for all TCS (n = 1513) with covariates for age at survey and 10 genetic principal components: 16 SNPs had P-values &lt; 0.05 for severe PSN vs. none and/or any PSN vs. none. Although not statistically significant with multiple testing corrections, these suggestively significant SNPs could be potentially validated in additional populations. Conclusions: These results are preliminary evidence for the potential importance of differing risk allele frequencies across populations in explaining some disparities in cisplatin-related PSN. If confirmed, genotyping for risk variants could impact treatment decisions and enable monitoring to mitigate PSN.

Racial disparities in the treatment of unresectable, stage III non-small cell lung cancer: An analysis of the National Cancer Database.

e20560 Background: The standard of care (SOC) for treatment of unresectable, stage III non-small cell lung carcinoma (NSCLC) utilizes both chemotherapy and radiation therapy. Historically, concurrent chemo-radiation therapy (CCRT) has been associated with improved survival outcomes compared to sequential chemotherapy and radiation therapy (SCRT). Using data extracted from the National Cancer Database (NCDB). Our primary objective was to assess if a particular race cohort received less than the standard of care treatment (CCRT) and any impact on survival outcomes in unresectable, stage III NSCLC. Methods: From the complete dataset years of 2010-2016 of the NCDB, we extracted patients diagnosed with stage III NSCLC according to the AJCC 7th edition. Patients were classified according to the treatments received and include CCRT, SCRT, radiotherapy alone (RT), chemotherapy alone (CT) and no treatment. Chi-square test was performed to evaluate the baseline sociodemographic and clinico-pathologic categorical characteristics between the different treatment arms. Multivariable Cox regression analysis was utilized to identify the independent survival factors. In addition, Kaplan-Meier survival curves for different treatments in White and Black patients were evaluated. Multinominal logistic regression analysis was utilized to establish association of different treatment modalities with race. SAS version 9.4 was used to analyze the data. Results: There was 52,677 patient who met inclusion criteria. Multinominal logistic regression revealed that Black patients were 21% more likely to receive CT alone than standard CCRT compared to White patients (p &lt; 0.0001, OR 1.21 and CI 1.10-1.32). In addition, Black patients were 27% more likely to receive RT alone than standard CCRT compared to White patients (OR = 1.27 and CI 1.13-1.42 and p &lt; 0.0001). There was no statistically significant difference between the use of CCRT vs. SCRT among White and Black patients. Based on Kaplan-Meier survival curves, CCRT and SCRT were found to have superior median overall survival (mOS) in both Black patients (23 month for CCRT and 19 month for SCRT) and White patients (19 month for both) compared to other treatment modalities (P &lt; 0.001). Multivariable Cox regression analysis method revealed that there were several significant independent survival factors, such as age, Charlson-Deyo Score (CDS), histologic grade, insurance status, stage, and race. Conclusions: The use of either CCRT or SCRT was associated with improved overall survival in both Black and White patients with unresectable, stage III NSCLC compared to other treatment modalities. Interestingly, Black patients appear to benefit more from CCRT than SCRT compared to White patients. However, Black patients were less likely to receive standard CCRT and more likely to receive less effective RT or CT alone compared to White patients.

Co-occurrence of Aggression and Suicide Attempt Among Young People and Related Factors: Findings from Iranian Youth Cohort Study in Ravansar.

Aggression and suicide attempt are behaviors that affect public health. To better understand the nature of these behaviors, the present study was conducted to investigate the concurrence of suicide attempt and aggression in young people. This study sought to identify those factors which contribute to the co-occurrence of suicide attempt and aggression in young people. The present study was part of the recruitment phase of Ravansar youth cohort study (a branch of the PERSIAN Cohort) with a sample of 2991 people from Ravansar in western Iran. Registration and data collection were done between October 2014 and January 2017. Data were collected using structured interviews and standard questionnaires, and analyzed using multi-nominal logistic regression analysis. The results showed that the variables of age and education were significant correlates of concurrence of suicide attempt and aggression. Also, among the mental disorders, only major depressive disorder (MDD) (OR=8.34, P=0.001) predicted the concurrence of suicide attempt and aggression in the past 12 month. In contrast, the variables of generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), dysthymia, and substance use disorder were not significant in predicting the concurrence of attempted suicide and aggression. The occurrence of aggression and suicide in young people is a complex phenomenon, and more research should be done to better understand this phenomenon.

Pre-Ride Biomarkers and Endurance Horse Welfare: Analyzing the Impact of the Elimination of Superoxide Dismutase, δ-Aminolevulinic-Dehydratase, Thiobarbituric Acid Reactive Substances, Iron, and Serum Amyloid A Levels in Elite 160 km Endurance Rides.

High elimination rates and concerns for horse welfare are important issues in endurance riding. Improved understanding of the causes of elimination could increase completion rates in this sport. We have identified pre-ride laboratory risk factors that enable an assessment of potential elimination before the ride. A longitudinal cohort study was performed among 49 healthy horses competing in the 160 km endurance ride at the 2016 World Championship of Endurance Riding in Samorin/Slovakia. Blood samples were taken before the event. For statistical evaluation, horses were categorized into three groups: finishers, lame horses, and metabolically eliminated horses. Risk factors were calculated for each group using multinominal logistic regression. δ-Aminolevulinic-dehydratase (ALAD), thiobarbituric acid reactive substances (TBARSs), iron, and serum amyloid A (SAA) were measured and did not show an impact on the race outcome, but elevated pre-ride superoxide dismutase (SOD) was shown to have an effect on lameness elimination (p = 0.011). It might serve as an indicator for withdrawing horses at risk of later elimination before endurance rides, ultimately resulting in lower elimination rates and an increase in overall horse welfare.

Sleep-related factors associated with masked hypertension: the Nagahama study.

Masked hypertension, which is characterized by out-of-office hypertension but normal office blood pressure, is a risk factor for cardiovascular disease. However, the factors that contribute to masked hypertension are unclear. We aimed to determine the involvement of sleep-related characteristics in masked hypertension. The study included 3844 normotensive (systolic/diastolic blood pressure < 140/90 mmHg) community residents with no antihypertensive drug use at baseline (mean age 54.3 years). Home morning and evening blood pressure, oxygen desaturation during sleep (pulse oximetry), and sleep efficiency (actigraphy) were measured for 1 week. The number of nocturnal urinations during this period was obtained using a sleep diary. Masked hypertension (mean morning and evening blood pressure ≥135/85 mmHg) was detected in 11.7% of study participants, and 79.0% of the participants with masked hypertension had sleep hypertension (≥120/70 mmHg). Multinominal logistic regression analysis identified different factors involved in masked hypertension with and without sleep hypertension; factors for masked hypertension with sleep hypertension included the frequency of at least 3% oxygen desaturation (coefficient = 0.038, P = 0.001), nocturia (coefficient = 0.607, P < 0.001), and carotid intima-media thickness (coefficient = 3.592, P < 0.001). Only carotid intima-media thickness and measurement season were associated with masked hypertension without sleep hypertension. Low sleep efficiency was associated with isolated sleep hypertension but not masked hypertension. Sleep-related factors associated with masked hypertension differed depending on the presence of sleep hypertension. Sleep-disordered breathing and nocturnal urination frequency may help identify individuals who need home blood pressure monitoring.

Abstract 711: Plasma Carotenoids Are Not Independent Determinants Of Subclinical Atherosclerosis In Coronary And Carotid Arteries

The association between dietary intake and/or plasma carotenoids and increased risk of cardiovascular events is well-established. Carotenoids have been proposed to protect against atherosclerosis by regulating inflammation and oxidative stress, however, the association between carotenoids and subclinical atherosclerosis is sparsely documented. Here, we hypothesized that plasma carotenoids were independently associated with subclinical atherosclerosis in coronary and carotid arteries in a Swedish population-based cohort (50-64 years), thus supporting the therapeutic potential of high carotenoid intake. In total, 986 subjects (mean age 57, 50% females) without known cardiovascular disease received CT calcium scoring (CACS), CT coronary angiography and carotid ultrasonography. Major carotenoids (lutein + zeaxanthin, β-cryptoxanthin, lycopene, α- and β-carotene) were measured in plasma. Intake of β-carotene was calculated based on a food frequency questionnaire. Data on sedentary behavior was derived from tri-axial accelerometers. Multinominal logistic regression was used to compare lower and upper tertiles of carotenoids with regard to CACS and atherosclerosis. Of all 986 subjects, 103 (10.4%) had CACS &gt; 100, 197 (20.0%) had significant carotid atherosclerosis (&gt; 1 plaque in carotid arteries), 295 (29.9%) had any coronary atherosclerosis and 37 (3.8%) had significant coronary atherosclerosis (≥ 50% stenosis in any coronary artery). In unadjusted models, low levels of total carotenoids, α- and β-carotene were significantly correlated with CAC &gt; 100, coronary and carotid atherosclerosis. Low lutein correlated with carotid plaques and low intake of β-carotene with coronary and carotid plaques only. However, all associations lost significance after adjustment for age, sex, smoking status, abdominal obesity, BMI, sedentary behavior, hypertension, diabetes, total cholesterol, HDL cholesterol, triglycerides and C-reactive protein. To conclude, major carotenoids were not independent determinants of subclinical atherosclerosis. Data indicate that low levels of carotenoids depend on several other risk factors, such as male sex, obesity and sedentarism, and highlight the need of multifactorial lifestyle interventions.

Current Status of Core Competencies of Chinese Nurses in Burn Departments: A Latent Profile Analysis

Aim. To investigate the current status of NBDs’ core competencies through latent profile analysis, identify potential subgroups and their population characteristics, and analyze the influencing factors of different categories. Background. NBDs are essential in the treatment and rehabilitation of burn patients. However, the core competencies of Chinese NBDs are seldom reported. Methods. Our analyses were based on a cross-sectional and multicenter study of 267 Chinese NBDs. Latent profile analysis was employed to identify NBDs’ core competence profiles using the NBD Core Competencies Self-rating Scale (NBD-CCSS). We then explored the characteristics among different profiles and determined socio-demographic variables associated with profile membership by conducting ANOVA, Chi-square test, and multinominal logistic regression analyses. Results. A 3-profile model provided the best fit. The three profiles were titled “skillful competencies” (Class 1, n = 77, 28.8%), “moderate competencies” (Class 2, n = 140, 52.4%), and “poor competencies” (Class 3, n = 50, 18.7%). Regression analysis suggested that professional title, years of employment, and BICU experience were influencing factors of NBDs’ profile membership of core competencies. NBDs who were supervisor nurses or above (OR = 0.802, 95% CI: 0.009, 0.759), with more than 7 years of employment (OR = 0.091, 95% CI: 0.009, 0.906) and BICU experience (OR = 3.564, 95% CI: 1.423, 8.925) were more likely to fall into Class 1. Conclusions. Our findings could provide evidence for nursing administrators to develop training programs to enhance NBDs’ core competencies. In particular, variables associated with profile membership determined in the study may facilitate more tailored training strategies.

Quantifying the risk of ectopic pregnancy with a transient diagnosis of pregnancy of unknown location.

To quantify the risk of ectopic pregnancy among a transient diagnosis of pregnancy of unknown location (PUL). Retrospective cohort study between August 2016 and November 2020. The final cohort included 244 patients with 255 PULs who presented with vaginal bleeding and/or abdominal pain, positive serum quantitative β-human chorionic gonadotropin, and negative transvaginal ultrasound, with a subsequent definitive diagnosis. Two-way analysis of variance was used with significance set at P < 0.050. Bonferroni-corrected significance values were used in post hoc analysis. Multinominal logistic regression was used to predict adjusted risk for pregnancy outcome. Definitive diagnosis consisted of 101 (39%) intrauterine pregnancies, 33 (13%) ectopic pregnancies, and 121 (48%) resolved PULs or resolved/treated persisting PULs. A total 68% of the PULs subsequently became nonviable. Vaginal bleeding was associated with increased risk of nonuterine pregnancies. A total of 13% of PULs were subsequently diagnosed as ectopic pregnancies, which is higher than the 2% to 3% risk of an ectopic pregnancy in the general reproductive population. A total of 68% of PULs were subsequently nonviable, which is higher than the 31% early pregnancy loss rate in the general reproductive population. This study quantitatively confirms that a transient diagnosis of a PUL increases the odds for ectopic pregnancy and early pregnancy loss.

Student engagement profiles and the role of support in general upper secondary education

This study examined student engagement profiles, their stability and change, and the role of perceived support in engagement. The general upper secondary education participants (T1, N = 464) were followed yearly. Latent profile analyses identified four profiles at Year 1, four profiles at Year 2, and five profiles at Year 3. Three profiles, disengaged, moderately engaged, and highly engaged, were identified each year. The barely engaged profile was identified at Years 2 and 3, and the highly engaged, extrinsically motivated profile at Years 1 and 3. In general, the profile membership showed some stability, and the transitions were more likely from the higher to lower engagement profiles than vice versa. Multinominal logistic regression analysis revealed that perceived support predicted more likely belonging to the high-engagement profiles. The findings indicate that it is essential to recognize and support students with low engagement already in the beginning of general upper secondary education.

Antibody Levels with Cut off Points of 30 IU/ml blood, 50 IU/ml blood, and 80 IU/ ml blood after Employees Administering the Second Dose of the Covid19 Vaccine at Bontang Islamic Hospital (RSIB) in March, May and August 20

Several types of vaccines from the results of phase 3 trials such as mRNA vaccines were developed by American companies, namely Moderna and Pfizer which have been tested for the first time in humans on March 16 2020 in America, Brazil has also been vaccinated with the Sinovac Biotech China covid-19 vaccine in March January 2021 was reported to have an efficacy of 78%, in Turkey 91.25% and in Indonesia 65.3%. The aim of the study was to evaluate antibody (Ab) levels after the second dose of vaccination on day 14, 3 months, 6 months, with cut-off point Ab 30 IU/ml blood; 50 IU/ml of blood and 80 IU/ml of blood after being given the second dose of the covid19 vaccine, as well as factors that influence it such as gender, age and nutritional status. The research method of the Covid19 vaccine intervention study was given two doses, the number of respondents was 93 persons who were selected who had completed the second dose of vaccination and had their antibodies checked on day 14, 3 months and 6 months using the ELISA test method with cut-off point Ab 30 IU/ml blood; 50 IU/ml of blood and 80 IU/ml of blood after being given the second dose of the covid19 vaccine, as well as factors that influence it such as gender, age and nutritional status. The analysis was descriptive and analytic with Chy Square analysis and multinominal logistic regression. Results based on gender the majority were women 58.1%, adult age 92.5%, normal nutritional status 64.5%; 14 days after the second dose of Covid19 vaccination, the Ab level according to the cut-off point is ≥ 30 IU/ml amount 50.5% peoples, titer ≥ 50 IU/ml, the number is 43%; ≥80 IU/ml the number is 31.2%. 3 months Ab ≥ 30IU/ml amount 52.7% ≥ 50IU/ml amount 34.4%, ≥80IU/ml amount 24.7%; 6 months, sex has a significant effect only 6 months after vaccination with levels Ab≥30 IU/ml 66.7%, Ab≥50 IU/ml 50.5%, Ab≥ 80 IU/ml 41.9%peoples. Gender affects Ab levels at 6 months with Ab Cut off Point 30 IU/ml (p value 0.034, OR 0.396.95%CI 0.166-0.941) and Ab50 IU/ml (p value 0.033, OR 0.384.95%CI 0.157-0.936). Nutritional status affected Ab levels on day 14 with an Ab titter of 30IU/ml blood (p value 0.043, OR 2450.95%CI 1021-5880) and at 6 months with an Ab titre of 50IU/ ml blood (p value 0.014, OR 3000, 95% CI 1.233-7.299). The conclusion that BMI has an effect on Ab levels is 50 IU/ml blood, the effect is 8.5%, 6 months the most dominant variable in the formation of antibodies is gender, male good improved Ab days 14, and Female 6 moths was good increased Ab.

Exploring Why Police and Military Commanders Do What They Do: An Empirical Analysis of Decision-Making in Hybrid Warfare

In this study, a total of 102 high-ranking commanders from a military and police background were included in a simulation involving hybrid attacks on Norway. The aim was to explore the commanders’ decision-making in the context of hybrid warfare and changing threats. Data were collected in a simulated national headquarters and analyzed by a multinominal logistic regression method using a scenario that transformed from peacetime into war and returned to peace. The results demonstrated significant differences in the commanders’ preferences for unilateral or interagency forces depending on whether decisions were made in peacetime, war or the post-conflict phase. The results also showed how the commanders’ level of operational experience was associated with an increased preference for interagency forces. The current findings are new empirical insights into a thus far neglected aspect of decision-making research and have implications for improving police-military interoperability in major security crises.