Multiple Logistic Regression Models Research Articles

Sex-specific associations between maternal thyroid peroxidase antibodies and cognitive development in preschool children: A prospective cohort study.

An association between maternal thyroid dysfunction throughout pregnancy and subsequent risk of neurodevelopmental abnormalities in offspring has been demonstrated. However, the potential effects of maternal thyroid autoimmunity on neurodevelopment in the absence of maternal hypothyroidism remain unclear. Therefore, in this study, we explored the association between maternal thyroid peroxidase antibody (TPOAb) positivity and cognitive development in preschool children. A total of 1849 mother-child pairs were recruited from the Ma'anshan Birth Cohort Study. During the follow-up period, an electrochemiluminescence immunoassay was used to retrospectively measure serum TPOAb levels in pregnant women. The cognitive development of preschool children was evaluated by using the Chinese version of the Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition. A growth mixture model was used to fit the trajectory of TPOAb. Multiple linear regression and logistic regression models were used to explore the associations between the developmental trajectory of TPOAb-positivity at different gestational periods and the cognitive development of preschool children by sex. A total of 1849 mother-child pairs (mean [SD] age: 26.7 [3.6] years) were enrolled in the final study. Maternal TPOAb positivity in the first trimester was associated with a risk of below-average processing speed index in girls (OR: 2.07; 95% CI 1.06-4.01) and below-average full-scale intelligence quotient (FSIQ) in boys (OR: 2.36; 95% CI: 1.10-5.05). Maternal TPOAb positivity in the third trimester was associated with below-average working memory (WMI) (OR: 2.51; 95% CI: 1.02-6.20) in girls. In girls, the WMI (β = -3.17, 95% CI: -5.82--0.52), fluid reasoning index (FRI) (β = -4.49, 95% CI: -7.18--1.80), and FSIQ score (β = -2.43, 95% CI: -4.77--0.08) decreased, whereas in mothers, the level of lgTPOAb increased during pregnancy. Positive maternal thyroid peroxidase antibody levels during pregnancy may be associated with poorer cognitive development in preschool children. These findings require independent confirmation in other populations.

Relationship between parity and the prevalence of chronic kidney disease in Japan considering hypertensive disorders of pregnancy and body mass index.

Global studies exploring the relationship between parity and chronic kidney disease (CKD) are scarce. Furthermore, no study has examined the relationship between parity and CKD in Japan. Therefore, this study aimed to examine the relationship between parity and the prevalence of CKD in a Japanese population, considering the clinical history of hypertensive disorders of pregnancy (HDP) and current body mass index (BMI) based on menopausal status. This cross-sectional study included 26,945 Japanese multiparous women (5,006 premenopausal and 21,939 postmenopausal women) and 3,247 nulliparous women (1,599 premenopausal and 1,648 postmenopausal women). Participants were divided into two groups based on their menopausal status (premenopausal and postmenopausal women). The relationship between parity and the prevalence of CKD was evaluated using a multiple logistic regression model adjusted for several covariates, including a clinical history of HDP and current BMI. The relationship between parity and the prevalence of CKD was not statistically significant in either premenopausal or postmenopausal multiparous women. A clinical history of HDP was significantly associated with an increased risk of CKD in premenopausal and postmenopausal multiparous women. However, the relationship between a clinical history of HDP and CKD in premenopausal women was weakened after adjusting for current BMI. Furthermore, the current BMI was significantly associated with an increased risk of CKD in both premenopausal and postmenopausal women. Parity is not significantly associated with the prevalence of CKD in premenopausal and postmenopausal multiparous women. A clinical history of HDP is a risk factor for CKD in both premenopausal and postmenopausal women. Current BMI is also associated with an increased risk of CKD in premenopausal and postmenopausal women. Therefore, continuous surveillance and preventive measures against CKD should be provided to women with a clinical history of HDP. In addition, maintaining an appropriate body weight is beneficial in reducing the risk of CKD.

Prevalence of cosmetic surgery and its relationship with psychosocial status: a population based study in Sulaymaniyah, Iraq

Purpose This study aims to investigate the prevalence of cosmetic surgery and its relationship with the level of mental health and socioeconomic variables in Sulaymaniyah city in Iraq. Design/methodology/approach This descriptive-analytical and cross-sectional study was conducted on 941 subjects who were selected using multistage sampling method. Data were collected using a checklist as well as a questionnaire. Data analysis was done using chi-square test and multiple logistic regression model using Stata software version 20. Findings The prevalence of cosmetic surgery was 13.4% (female: 17.5%; male: 8.2%). The most common types of cosmetic surgery were rhinoplasty (7.6%) in women and hair transplant (5.5%) in men. Overall, rhinoplasty (7.6%) was the most common type of cosmetic surgery among both groups. In total, the prevalence of having symptoms of mental disorders was 34.5% and it was significantly higher among people with a history of cosmetic surgery (65.1%) than those without any experience of having cosmetic surgery (29.8%) (p < 0.001). Being female (odds ratio [OR] = 2.07; 95% confidence interval [CI]: 1.33–3.22), having mild symptoms of mental disorders (OR = 2.76; 95% CI: 1.71–4.47) and having moderate or severe symptoms of mental disorders (OR = 7.48; 95% CI: 4.60–12.29) were among the important variables that could affect performing cosmetic surgery. Originality/value The prevalence of cosmetic surgery in Sulaymaniyah is high, and based on the findings of this study, gender and mental health status are effective factors in this regard. Designing targeted interventions is suggested with an emphasis on the findings of this study to reduce the rate of cosmetic surgeries.

A non-destructive predictive model for estimating the freshness/spoilage of packaged chicken meat using changes in drip metabolites

This study investigates the possibility of utilizing drip as a non-destructive method for assessing the freshness and spoilage of chicken meat. The quality parameters [pH, volatile base nitrogen (VBN), and total aerobic bacterial counts (TAB)] of chicken meat were evaluated over a 13-day storage period in vacuum packaging at 4 °C. Simultaneously, the metabolites in the chicken meat and its drip were measured by nuclear magnetic resonance. Correlation (Pearson's and Spearman's rank) and pathway analyses were conducted to select the metabolites for model training. Binary logistic regression (model 1 and model 2) and multiple linear regression models (model 3-1 and model 3-2) were trained using selected metabolites, and their performance was evaluated using receiver operating characteristic (ROC) curves. As a result, the chicken meat was spoiled after 7 days of storage, exceeding 20 mg/100 g VBN and 5.7 log CFU/g TAB. The correlation analysis identified one organic acid, eight free amino acids, and five nucleic acids as highly correlated with chicken meat and its drip during storage. Pathway analysis revealed tyrosine and purine metabolism as metabolic pathways highly correlated with spoilage. Based on these findings, specific metabolites were selected for model training: ATP, glutamine, hypoxanthine, IMP, tyrosine, and tyramine. To predict the freshness and spoilage of chicken meat, model 1, trained using tyramine, ATP, tyrosine, and IMP from chicken meat, achieved a 99.9 % accuracy and had an ROC value of 0.884 when validated using drip metabolites. This model 1 was improved by training with tyramine and IMP from both chicken meat and its drip (model 2), which increased the ROC value for drip metabolites from 0.884 to 0.997. Finally, selected two metabolites (tyramine and IMP) can predict TAB and VBN quantitatively through models 3-1 and 3-2, respectively. Therefore, the model developed using metabolic changes in drip demonstrated the capability to non-destructively predict the freshness and spoilage of chicken meat at 4 °C. To make generic predictions, it is necessary to expand the model's applicability to various conditions, such as different temperatures, and validate its performance across multiple chicken batches.

Analysis of the immunological response to antiviral therapy in patients with different subtypes of HIV/AIDS: a retrospective cohort study

ObjectiveTo evaluate the effectiveness of standardised antiretroviral therapy (ART) among different HIV subtypes in people living with HIV/AIDS (PLWHA), and to screen the best ART regimen for this patient population.DesignA...

Longitudinal assessment of real-world patient adherence: a 12-month electronic patient-reported outcomes follow-up of women with early breast cancer undergoing treatment

BackgroundElectronic patient-reported outcomes (ePROs) assess patients’ health status and quality of life, improving patient care and treatment effects, yet little is known about their use and adherence in routine patient care.AimsWe evaluated the adherence of invasive breast cancer and ductal carcinoma in situ (DCIS) patients to ePROs follow-up and whether specific patient characteristics are related to longitudinal non-adherence.MethodsSince November 2016, the Breast Center at Charité – Universitätsmedizin Berlin has implemented an ongoing prospective PRO routine program, requiring patients to complete ePROs assessments and consent to email-based follow-up in the first 12 months after therapy starts. Frequencies and summary statistics are presented. Multiple logistic regression models were performed to determine an association between patient characteristics and non-adherence.ResultsOut of 578 patients, 239 patients (41.3%, 95%CI: 37.3–45.5%) completed baseline assessment and all five ePROs follow-up during the first 12 months after therapy. On average, above 70% of those patients responded to the ePROs follow-up assessment. Adherence to the ePROs follow-up was higher during the COVID-19 pandemic than in the time periods before (47.4% (111/234) vs. 33.6% (71/211)). Factors associated with longitudinal non-adherence were younger age, a higher number of comorbidities, no chemotherapy, and a low physical functioning score in the EORTC QLQ-C30 at baseline.ConclusionsThe study reveals moderate adherence to 12-month ePROs follow-up assessments in invasive early breast cancer and DCIS patients, with response rates ranging from 60 to 80%. Emphasizing the benefits for young patients and those with high disease burdens might further increase adherence.

Reducing musculoskeletal disorders in iron ore mine operators: A fuzzy-based intervention approach.

This study focuses on evaluating the exposure to whole-body vibration (WBV) and association of musculoskeletal disorders (MSDs) with various risk factors among dumper operators in the mining industry. Despite the issue's significance, prior research has been limited. The study introduces a novel fuzzy-based approach for identifying, selecting, and prioritizing safety measures to mitigate MSD risks. Data collection comprised face-to-face interviews, anthropometric measurements, Rapid Upper Limb Assessment (RULA) scoring for posture assessment, and the Nordic Musculoskeletal questionnaire for assessment of MSD prevalence. Multiple linear and logistic regression models were used to analyse the contributing risk factors to MSDs and WBV exposure. These risk factors formed the basis for a practical approach to select appropriate safety measures based on fuzzy based aggregation method of expert's judgment aimed at mitigating the risk of MSDs. The results revealed that the risk factors such as poor work posture, WBV exposure and poor seat design were significantly associated with neck (adjusted odds ratio aOR = 4.81), upper limb and shoulder (aOR = 3.28), upper back (aOR = 5.09), and lower back pain (aOR = 3.67) at p < 0.05. Using these factors to formulate safety measures to reduce MSD risk, the minimization of sharp turns and abrupt changes in elevation in designing the haul roads, scheduled maintenance practices, and ergonomic seat design were found as important safety measures in this study. Our unique methodological approach in occupational health research could be highly beneficial for tailoring safety measures at the unit level with minimal effort.

THE DISTRIBUTION OF TRADITIONAL MEDICINE BODY CONSTITUTIONS AND THE FACTORS ASSOCIATED WITH DEPRESSION AMONG ELDERLY IN PATIENTS IN TRADITIONAL MEDICINE HOSPITAL OF THUA THIEN HUE

Objectives: The purpose of this study is to explore the distribution of Traditional Medicine (TM) body constitutions, examine the factors associated with depression among elderly inpatients in Traditional Medicine Hospital of Thua Thien Hue, and further contribute to enhancing the value of traditional medicine theory's quintessence in preventing depression in medical facilities and in the community. Subjects and methods: A cross-sectional study of 420 elderly inpatients in Traditional Medicine Hospital of Thua Thien Hue from July 2022 to March 2024, screening for depression, using the Geriatric Depression Scale 30 items (GDS-30) and determining the TM body constitutions, using the Constitution in Traditional Medicine questionnaire (CCMQ). The multiple logistic regression model was applied to examine the factors associated with depression. Results: The proportion of the balanced constitution was the lowest (0%). Among the unbalanced constitutions, the highest proportion was the Phlegm-dampness constitution (70.2%), followed by Qi stagnation constitution (66.9%), Yin deficiency constitution (62.6%), Blood-stasis constitution (58.3%), Qi deficiency constitution (56.6%), Dampness-heat constitution (46.9%), Inherited-special constitution (38.8%) and the lowest was Yang deficiency constitution (31.9%). The higher odds of depression were observed in Qi stagnation constitution (p &lt; 0.001, OR = 5.787, 95%CI: 3.275 – 10.227), Qi deficiency constitution (p &lt; 0.001, OR = 4.369, 95%CI: 2.643 – 7.222), Yang deficiency constitution (p &lt; 0.001, OR = 3.682, 95%CI: 2.097 – 6.277), Gender (p &lt; 0.001, OR = 3.451, 95%CI: 1.980 – 6.017), Dampness-heat constitution (p &lt; 0.001, OR = 2.534, 95%CI: 1.545 – 4.156), Inherited-special constitution (p = 0.003, OR = 2.160, 95%CI: 1.302 – 3.584) and Yin deficiency constitution (p = 0.028, OR = 1.771, 95%CI: 1.064 – 2.948). Conclusion: This study indicated the distributions of TM body constitutions and the factors associated with depression among elderly inpatients in Traditional Medicine Hospital of Thua Thien Hue. Therefore, the assessment of the TM body constitutions contributes to the prevention strategy and early detection of depression in the health facilities as well as in the community.

Early and late onset childhood eczema: Role of preconceptional, pre-natal and post-natal environmental exposures

BackgroundDespite mounting evidence linking indoor and outdoor environments to eczema, the role of indoor and outdoor environmental pollutant(s) exposure during critical time window(s) on eczema remains unknown. ObjectiveTo investigate the correlations between childhood eczema and itchy rashes and exposure to outdoor air pollution and the home environment. MethodsA combined cross-sectional and retrospective cohort study of 8689 kindergarten students was conducted. We collected information about each child's health outcomes and home environment, as well as calculated individual exposure to air pollutants. Multiple logistic regression models were used to investigate the links between indoor and outdoor environments and childhood eczema and itchy rashes. ResultsChildhood ever doctor-diagnosed eczema (DDE) was linked to NO2, CO, PM2.5, PM2.5-10 and PM10 exposure during the preconceptional, pregnant, and postnatal periods, with ORs (95 % CI) ranging from 1.06 (1.00–1.13) to 1.21 (1.08–1.37). Ever doctor-diagnosed itchy rash (DDIR) was associated with SO2, CO, PM2.5, PM2.5-10 and PM10 exposure during preconceptional and postnatal periods, with ORs (95 % CI) ranging from 1.11 (1.02–1.20) to 1.31 (1.13–1.52). Preconceptional outdoor air pollution was associated with a higher risk of ever, early, and late DDE and DDIR. Indoor smoke, renovation, and dampness were all associated with DDE and DDIR. Postnatal exposure to plants has been linked to both ever and early DDE. There was no link between indoor environments and late DDE. Furthermore, pregnancy has been identified as a critical indoor exposure time window for DDE and DDIR. ConclusionsEarly-life exposure to outdoor air pollutants and indoor environments, particularly before birth, played important roles in childhood eczema.

Choosing a maternity hospital: a matter of travel distance or quality of care?

BackgroundThe choice of a hospital should be based on individual need and accessibility. For maternity hospitals, this includes known or expected risk factors, the geographic accessibility and level of care provided by the hospital. This study aims to identify factors influencing hospital choice with the aim to analyze if and how many deliveries are conducted in a risk-appropriate and accessible setting in Bavaria, Germany.MethodsThis is a cross-sectional secondary data analysis based on all first births in Bavaria (2015-18) provided by the Bavarian Quality Assurance Institute for Medical Care. Information on the mother and on the hospital were included. The Bavarian Index of Multiple Deprivation 2010 was used to account for area-level socioeconomic differences. Multiple logistic regression models were used to estimate the strength of association of the predicting factors and to adjust for confounding.ResultsWe included 195,087 births. Distances to perinatal centers were longer than to other hospitals (16 km vs. 12 km). 10% of women with documented risk pregnancies did not deliver in a perinatal center. Regressions showed that higher age (OR 1.03; 1.02–1.03 95%-CI) and risk pregnancy (OR 1.44; 1.41–1.47 95%-CI) were associated with choosing a perinatal center. The distances travelled show high regional variation with a strong urban-rural divide.ConclusionIn a health system with free choice of hospitals, many women chose a hospital close to home and/or according to their risks. However, this is not the case for 10% of mothers, a group that would benefit from more coordinated care.

Factors Related to Maternal-fetal Attachment in Pregnant Mothers: An Analytical Cross-sectional Study

Aim:: The study investigated the relationship between Determining the Factors Related to Maternal-Fetal Attachment in Pregnant Mothers with Maternal-Fetal Attachment. Background:: Demographic policies in Iran emphasize population, fertility, and maternal health. Maternal-fetal attachment (MFA) is a term used to describe conditions that help the mother cope with the physiological changes during pregnancy. MFA contributes significantly to the future health of mother and child. Thus, it is essential to identify the nature of maternal-fetal attachment during pregnancy, when women need to prepare for and adapt to childbirth. The present study was conducted to determine the factors related to maternal-fetal attachment in pregnant mothers of Arak City. Objectives:: The study investigated the relationship between obstetric-demographic factors, emotional intelligence, marital satisfaction, and domestic violence with maternal-fetal attachment. Methods:: The present cross-sectional study was conducted on 177 pregnant mothers with a gestational age of 37-40 who were referred to health centers in Arak, Iran, for pregnancy care in 2022. Five questionnaires, including an obstetric-demographic questionnaire, Cranley's Standard Mother-Fetal Attachment Scale, Schutte Self-Report Emotional Intelligence Test, ENRICH marital satisfaction scale, and HITS domestic violence questionnaire, were used to measure the factors related to maternal-fetal attachment. Data were analyzed using SPSS21 software and descriptive and analytical statistics, including frequency distribution, Pearson correlation, t-test, Chi-square, Analysis of variance (ANOVA), and Multiple Logistic Regression model. Results:: The mean of age women and age of husbands was 29.07± 5.88 years and 32.93± 5.28 years, respectively. The mean maternal-fetal attachment score was 88.12± 15.76. The mean of the emotional intelligence, the marital satisfaction and, the domestic violence was 4.71± 2.81, 121.88± 17.30, 37.86± 7.25, 6.54± 3.35, respectively. The interval between the current and the previous pregnancy had a range of 1-7 years and a mean of 4.71± 2.8 years. : There was a positive significant correlation between the maternal-fetal attachment score and the interval between the current and the previous pregnancy (r=0.22, p=0.02), : There was a positive significant correlation between the maternal-fetal attachment score and the emotional intelligence (r=0.31, p=0.001) the marital satisfaction (r=0.25, P=0.001). There was a negative significant correlation between the maternal-fetal attachment score and the domestic violence (r=-0.26, p=0.001 Conclusion:: Identifying attachment-related factors helps the health staff carry out the necessary training and preventive measures to increase maternal-fetal attachment, especially in high-risk parents who need more care.

Impacts of Streetscape Features on Individual Social Capital: Applying Korea’s Neighborhood Data to Street View Images to Improve Lives of the Socially Vulnerable

Neighborhood social vulnerability is a dimension of vulnerability that influences society’s response to external factors, encompassing various social factors tied to socioeconomic and demographic attributes at the neighborhood level. While previous studies have explored the associations between vulnerable neighborhoods and stressors like environmental hazards, understanding of their impact on residents’ social capital remains limited. Moreover, the role of built environments in mitigating these effects is uncertain. This study investigates the impact of neighborhood social vulnerability, alongside streetscape features, on individual social capital in Seoul, South Korea. Using a stratified random sampling method, we surveyed 1000 Seoul residents, assessing their social capital and demographics. In particular, six questionnaires based on a four-point Likert scale were used to measure the individual level of social capital: two questions for social networks, three questions for social participation, and one question for sense of community. Additionally, we employed a deep learning-based model to analyze Google Street View images for detailed streetscape features. Our analysis, utilizing multiple and ordinal logistic regression models, reveals that walkable environments and neighborhood prosperity, indicated by factors like income, education, and street greenery, are linked to higher social capital. Moreover, less urbanized areas with lower land prices and greater openness to the sky also show positive associations. These findings underscore the potential of improving streetscape features to mitigate the negative impacts of neighborhood vulnerability, particularly in neighborhoods where low-income and less-educated residents are concentrated, offering insights for urban planners and community leaders.

Children's food allergy: Effects of environmental influences and antibiotic use across critical developmental windows

BackgroundIncreasing studies linked outdoor air pollution (OAP), indoor environmental factors (IEFs), and antibiotics use (AU) with the first wave of allergies (i.e., asthma, allergic rhinitis, and eczema), yet the role of their exposures on children’s second wave of allergy (i.e., food allergy) are unknown. ObjectivesTo investigate the association between exposure to OAP and IEFs and childhood doctor-diagnosed food allergy (DFA) during the pre-pregnancy, prenatal, early postnatal, and current periods, and to further explore the effect of OAP and IEFs on DFA in children co-exposed to antibiotics. MethodsA retrospective cohort study involving 8689 preschoolers was carried out in Changsha, China. Data on the health outcomes, antibiotic use, and home environment of each child were collected through a questionnaire. Temperature and air pollutants data were obtained from 8 and 10 monitoring stations in Changsha, respectively. Exposure levels to temperature and air pollutants at individual home addresses were calculated by the inverse distance weighted (IDW) method. Multiple logistic regression models were employed to assess the associations of childhood DFA with exposure to OAP, IEF, and AU. ResultsChildhood ever doctor-diagnosed food allergy (DFA) was linked to postnatal PM10 exposure with OR (95% CI) of 1.18 (1.03–1.36), especially for CO and O3 exposure during the first year with ORs (95% CI) = 1.08 (1.00–1.16) and 1.07 (1.00–1.14), as well as SO2 exposure during the previous year with OR (95% CI) of 1.13 (1.02–1.25). The role of postnatal air pollution is more important for the risk of egg, milk and other food allergies. Renovation-related IAP (new furniture) and dampness-related indoor allergens exposures throughout all time windows significantly increased the risk of childhood DFA, with ORs ranging from 1.23 (1.03–1.46) to 1.54 (1.29–1.83). Furthermore, smoke-related IAP (environmental tobacco smoke [ETS], parental and grandparental smoking) exposure during pregnancy, first year, and previous year was related to DFA. Additionally, exposure to pet-related indoor allergens (cats) during first year and total plant-related allergens (particularly nonflowering plants) during previous year were associated with DFA. Moreover, exposure to plant-related allergy during first and previous year was specifically associated with milk allergy, while keeping cats during first year increased the risk of fruits/vegetables allergy. Life-time and early-life AU was associated with the increased risk of childhood DFA with ORs (95% CI) = 1.57 (1.32–1.87) and 1.46 (1.27–1.67), including different types food allergies except fruit/vegetable allergy. ConclusionsPostnatal OAP, life-time and early-life IEFs and AU exposure played a vital role in the development of DFA, supporting the "fetal origin of childhood FA" hypothesis.

Risk of gestational diabetes in women with PCOS based on body mass index: The Japan Environment and Children's Study.

Women with polycystic ovary syndrome (PCOS), which is the most common endocrine disorder in women of reproductive age, have a potentially increased risk of gestational diabetes mellitus (GDM). To examine the impact of PCOS on GDM based on maternal body mass index (BMI) using data from a large birth cohort study in Japan. Prospective observational study using data from the Japan Environment and Children's Study (JECS). Singleton pregnancies in the JECS during 2011-2014 were included. Mothers with HbA1c levels of ≥6.5% in the first trimester and history of DM or steroid use during pregnancy were excluded. Participants were categorized according to their pre-pregnancy BMIs: G1 (<18.5 kg/m2), G2 (18.5-19.99 kg/m2), G3 (20.0-22.99 kg/m2), G4 (23.0-24.99 kg/m2), and G5 (≥25.0 kg/m2). The impact of PCOS on early (Ed) and late-onset (Ld) GDM for each group was estimated using a multiple logistic regression model. We included 92774 participants, comprising 2012 PCOS(+) cases. GDM occurrence was higher in women with PCOS (p<0.001). PCOS had no effect on GDM in G1, G2, and G3. In G4, PCOS increased the risk of Ed GDM (adjusted odds ratio [aOR]: 3.27, 95% confidence interval [CI]: 1.29-8.29). In G5, PCOS increased the risk of both Ed (aOR: 2.48, 95% CI: 1.53-4.02) and Ld GDM (aOR: 1.94, 95% CI: 1.23-3.07). The impact of PCOS on GDM occurrence depended on the pre-pregnancy BMIs, which may facilitate personalized preconception counseling among women with PCOS.

Abstract PO5-16-09: Associations of age, body mass index, diabetes and hypertension with relative dose intensity among women receiving anthracycline- and/or taxane-based chemotherapy for invasive breast cancer

Abstract Research suggests that medical comorbidity is associated with reduced relative dose intensity (RDI) in patients receiving chemotherapy for treatment of breast cancer. We aimed to determine factors associated with RDI of specific chemotherapy drugs in anthracycline- and/or taxane-based regimens. Women with a diagnosis of lymph node positive, invasive breast cancer who received neoadjuvant or adjuvant chemotherapy with either doxorubicin (DOX) + paclitaxel (PAC) or docetaxel (DOCE)-containing regimens at a single centerfrom2012 to2019 were included in this retrospective study. Age, race, comorbidities, height, weight, and chemotherapy regimen and dose were abstracted from the electronic health record. BMI was calculated using height and weight measured in clinic at the time initial chemotherapy orders were written and categorized according to US national guidelines (18.5 to &amp;lt; 25, 25 to &amp;lt; 30, and &amp;gt;30kg/m2). Presence of diabetes (DM) and hypertension (HTN) at time of diagnosis were determined by chart review. The oncologists’ initial chemotherapy orders (dose and duration) were used as the basis for RDI calculations. Cumulative actual dose received and duration of treatment were compared to planned dose and duration for individual chemotherapy drug and by regimen (DOX+PAC vs. DOCE). Associations between patient characteristics and RDI were evaluated in bivariate and multivariable analyses. A total of 230 women met the inclusion criteria, with 125 receiving a DOX+PAC regimen and 105 receiving a DOCE-based regimen. A higher percentage of women on DOX+PAC received &amp;gt;85% RDI compared to women receiving DOCE (80.8% vs 67.6%). Women aged 65+ years had lower median RDI [IQR] for DOCE than younger women (0.83 [0.67 - 0.98] vs 0.94 [0.84 - 1.00], p = 0.04), and a lower percentage in the older group received &amp;gt;85% RDI (35.3% vs 73.9%, p&amp;lt; 0.01). Median RDIs of PAC and DOX+PAC were lower for Black women than for White and Asian women (PAC: 0.91 [0.75 - 1.00] vs 1.00 [0.89 - 1.00], p = 0.02, DOX+PAC: 0.92[0.87-0.99] vs. 0.97 [0.91-1.00], p = 0.03), and the percent of Black women receiving &amp;gt;85% RDI of PAC was also lower (55.3% vs 77.6%, p = 0.01). BMI category was associated with median RDI for PAC (p= 0.03) and DOX+PAC (p = 0.01), with women in the &amp;gt;30kg/m2 category having the lowest median RDIs and PAC RDI &amp;gt;85% (p &amp;lt; 0.01). Median RDI of DOX+PAC was lower for women with DM (0.89 [0.84-0.92] vs. 0.96 [0.88-1:00], p = 0.03), and a lower percentage of women with DM received DOX RDI &amp;gt;85% compared to women without DM (66.7% vs 91.6%, p &amp;lt; 0.01). Median RDI was lower among women with HTN compared to women without for PAC (0.85 [0.73 - 1.00] vs 0.98 [0.83 - 1.00], p = 0.01) and DOX+PAC (0.91 [0.84 - 0.97] vs 0.97 [0.90 - 1.00], p = 0.01), and a lower percentage of women with HTN received &amp;gt;85% RDI for PAC (50.0% vs 73.3%, p = 0.01). Multiple logistic regression models adjusted for age (continuous), race, BMI (continuous), DM, and HTN had modestly improved predictive value compared to null models (McFadden’s R2 = 0.10 to 0.19); each year of increased age was associated with lower odds of RDI &amp;gt; 85% for DOX (OR [95% confidence interval] 0.91 [0.84-0.97], p = &amp;lt; 0.01), DOX+PAC (0.95 [0.90-0.99], p = 0.02), and DOCE (0.93 [0.88-0.97], p &amp;lt; 0.01), and DM with lower odds for DOX (0.26 [0.07-0.95], p = 0.04). Our findings of associations between increasing age, Black race, BMI, DM, and HTN and reduced RDI are consistent with prior research and present new data regarding associations between medical comorbidities and individual components of chemotherapy regimens. Citation Format: Heather Wopat, Annette Aldous, Adam Ciarleglio, Kendall Anderson, Kim Robien. Associations of age, body mass index, diabetes and hypertension with relative dose intensity among women receiving anthracycline- and/or taxane-based chemotherapy for invasive breast cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-16-09.

Eating Behaviors and Adiposity Indicators – Observations from the 2016/17 Examination of the Population Study of Women in Gothenburg

Eating Behaviors and Adiposity Indicators – Observations from the 2016/17 Examination of the Population Study of Women in Gothenburg

Prospective validation of a hospital triage predictive model to decrease undertriage: an EAST multicenter study

BackgroundTiered trauma team activation (TTA) allows systems to optimally allocate resources to an injured patient. Target undertriage and overtriage rates of <5% and <35% are difficult for centers to achieve,...

Prevalence and clinical correlates of suicide attempts in patients with first-episode drug-naïve major depressive disorder and comorbid autoimmune thyroiditis.

Autoimmune thyroiditis is closely associated with major depressive disorder (MDD) and suicide attempts. However, few studies have examined this relationship. The study aimed to assess the prevalence and correlates of suicide attempts in patients with first-episode drug-naïve (FEDN) MDD and autoimmune thyroiditis. We recruited 1718 out-patients with FEDN MDD and assessed depressive, anxiety and psychotic symptoms with the Hamilton Rating Scale for Depression, Hamilton Rating Scale for Anxiety (HRSA) and Positive and Negative Syndrome Subscale positive subscale, respectively. The serum levels of free triiodothyronine, free thyroxine, thyroid stimulating hormone (TSH), antithyroglobulin, thyroid peroxidase antibody (TPOAb) and several other metabolic parameters were assessed. Patients were divided into non-autoimmune thyroiditis, autoimmune thyroiditis only and autoimmune thyroiditis with abnormal TSH groups, based on autoimmune thyroiditis severity. Multiple logistic regression model was applied to identify the correlates of suicide attempts in patients with MDD and autoimmune thyroiditis with abnormal TSH. Compared with the non-autoimmune thyroiditis group, the autoimmune thyroiditis with abnormal TSH group had a nearly fourfold higher likelihood of reporting a suicide attempt, whereas no difference was found between the non-autoimmune thyroiditis and autoimmune thyroiditis only groups. HRSA score, lnTPOAb and lnTSH were independently associated with suicide attempts in patients with autoimmune thyroiditis with abnormal TSH. Patients with MDD and autoimmune thyroiditis with abnormal TSH are at higher risk for suicide attempt. TPOAb, TSH and anxiety are all independently associated with suicide attempts in this population, and regular thyroid checks are warranted.

Does the level of burnout differ between occupational groups in Lithuania?

The strain on workers of the healthcare system and education sector increased psychological distress and burnout. This study aimed to distinguish the occupational group that is the most affected by occupational burnout and to reveal the scope of psychosocial risk factors among each occupational group. This is a cross-sectional study that analyzed burnout syndrome among 1,046 participants of different occupational groups in association with psychosocial work environment factors in Lithuania. The anonymous questionnaire was composed of the standardized Job Content Questionnaire (JCQ), and the Copenhagen Burnout Inventory (CBI). To find out associations between psychosocial work environment factors and burnout dimensions, a multiple logistic regression model using the stepwise method was applied. The burnout levels in all three dimensions (personal, work-related, and client-related burnout) were significantly higher in physicians' and nurses' groups compared with public health professionals, teachers, and managers (p < 0.05). The job demands were associated with the personal burnout subscale for all occupations, except public health specialists - each one-unit increase of this variable significantly increased the probability of personal burnout from 10 to 16%, respectively by the occupation. Co-worker support was found to have a buffering effect for all occupational groups, except managers - and significantly reduced personal burnout for physicians (OR = 0.80), nurses (OR = 0.75), public health specialists (OR = 0.75), and teachers (OR = 0.79). The burnout levels in all three dimensions differed between occupational groups: there were significantly higher in physicians' and nurses' groups compared with public health professionals, teachers, and managers. Considering the occupational preventive measures in the healthcare sector attention should be paid to the reduction of workload and ensuring good relations between co-workers.

Race, Ethnicity, and Other Barriers to Access Dental Care During Pregnancy.

Historically, women of color showed poorer oral health and lower dental service utilization in the USA. These barriers to dental care during pregnancy included dental coverage, primary language, dental provider availability, safety concerns, affordability of dental care, and perceived oral health benefits during pregnancy. The purpose of this study is to examine whether race/ethnicity modified the associations between barriers to accessing dental care and dental service utilization during pregnancy. This cross-sectional study sample included 62,189 women aged 20 and older with a recent birth history in 21 states from the Pregnancy Risk Assessment Monitoring System (PRAMS) data from 2016 to 2019. We introduced a race/ethnicity by barrier interaction term to our multiple logistic regression models. After adjusting for other confounders, dental insurance during pregnancy and perceived oral health benefits were associated with 4.0- and 5.6-fold higher odds, respectively, of dental service utilization during pregnancy. Statistically significant effect modification by race/ethnicity was observed in crude and adjusted analyses of the relationship between dental service utilization for all barriers included in the interaction analyses with all adjusted p-values < 0.001. The interaction analysis found that racial/ethnic disparity in visiting dentists during pregnancy was significant among women who reported these dental barriers. In contrast, such racial/ethnic disparity was substantially attenuated among women who did not report such barriers. The observed racial/ethnic disparities could be mitigated by such supporting mechanisms: dental coverage, provider availability and willingness to treat pregnant women, oral health education on the safety of dental care during pregnancy, and affordable dental care costs.