Multiple Logistic Regression Models Research Articles

Association of preoperative frailty with suboptimal weight loss response among patients undergoing metabolic and bariatric surgery.

Preoperative patient frailty (i.e., aging-related functional decline across multiple physiological systems) has been linked to greater perioperative complications following metabolic bariatric surgery (MBS). This study evaluated whether preoperative patient frailty predicts 1-year suboptimal weight loss response after primary sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB). The Bariatric Frailty Score (BFS), an adapted version of the Canadian Study of Health and Aging-Frailty Index based on 10 variables from MBSAQIP, assessed degree of frailty based on number of deficits (i.e., 0-10). Suboptimal response to MBS was defined as < 20% and < 30% percentage total weight loss (%TWL) at 1year following SG and RYGB, respectively. Multiple linear and logistic regression models evaluated associations of preoperative BFS score with %TWL and %TWL response thresholds, respectively. Patients (n = 1574; 78.9% female, 28.3% non-white, mean age 45 ± 12year; 67% SG) had a mean BFS of 1.6 ± 1.3 (range = 0-7). Overall, higher BFS related to lower %TWL after SG and RYGB (ß = - 0.12 and ß = - 0.17, respectively, p = 0.001). Compared to patients with 0-1 deficits (BFS score ≤ 1; n = 785, 49.9%), those with multiple deficits (BFS score ≥ 2; n = 789, 50.1%) had higher odds of suboptimal weight loss response after SG (OR 1.88, 95% CI 1.40-2.52, p < 0.001) and RYGB (OR 2.18, 95% CI 1.43-3.32, p < 0.001). Having multiple preoperative frailty deficits is associated with higher odds of suboptimal weight loss response after MBS. These findings point to the need for increased frailty screening and appropriate adjunctive interventions (i.e., exercise, nutrition, and cognitive), as these interventions may improve frailty status and MBS outcomes.

How general practitioners in France are coping with increased healthcare demand and physician shortages. A panel data survey and hierarchical clustering

BackgroundGeneral practitioners (GPs) face quantitative and qualitative changes in patient demand and doctor shortages. ObjectivesTo investigate how GPs cope with doctor shortage issues. Materials and methodsTwo cross-sectional surveys of a representative panel of 1530 GPs in 2019 and 2022 about their perceptions of physician shortages, working hours worked (WHW), and adaptive behaviors. Hierarchical clustering enabled identification of profiles with different adaptation patterns. Multiple Poisson or logistic regression models studied associations between GPs’ profiles and professional characteristics. Results87.4 % of GPs applied at least one adaptation to control patients’ healthcare demand. 24 % adopted task-shifting while their average WHW decreased by 3.6 h between 2019 and 2022. Four GP profiles were identified. “Low adapters/low workload” and “Low adapters/high workload” (25 % of the sample each) reported 2.4 adaptive measures: 75.5 % refused to be new patients' preferred doctor in the former group (vs 5.1 %). “High adapters/unchanged consultations” (30.7 %) and “High adapters/shortened consultations” (18.9 %) reported 4.8 and 6.1 adaptations, respectively. They were more likely to practice in medically underserved areas. ConclusionThese results call into question GPs’ gatekeeper role in the French healthcare system. Moreover, the marked reduction in WHW in underserved areas is likely to exacerbate their uneven distribution nationwide. Encouraging vertical integration between HCPs while enhancing cooperation and task-shifting is probably a pathway toward improving the relative GP shortage.

Correlations between oxidative balance score and female asthma among U.S. adults

In order to explore the association of oxidative balance score (OBS) with female asthma among U.S. adults, we applied multiple logistic regression models, restricted cubic spline, and subgroup analysis using a cross-sectional study from the National Health and Nutrition Examination Survey (NHANES). 17,582 female out of the 91,351 participants from 2001 to 2018 in NHANES were enrolled in the analysis and 2,795 female participants had asthma. In three models, the OBS was negatively associated with female asthma incidence with the odds ratios (OR) = 0.99. When comparing the ratio of Q2, Q3, and Q4 of OBS quartiles against the Q1 quartile, the adjusted OR with 95% confidence intervals (95%CI) were 0.88 (0.75–1.03), 0.84 (0.73–0.97), and 0.82 (0.70–0.96) respectively, with p < 0.01 in the all covariates adjusted models. The restricted cubic splines indicated a linear relationship between OBS and female asthma. Subgroup analysis revealed no significant interaction effects except in the smoke group (p < 0.001), and there was a significant difference in the former smoker with OR 0.97 (0.96–0.99). We observed that there is negative relationship between OBS score and female asthma incidence, which suggests OBS probably is a protective factor for female on-set asthma. According to the subgroup analysis, smoking should be recommended to reduce asthma morbidity.

Association of mid-pregnancy ferritin levels with postpartum glucose metabolism in women with gestational diabetes

BackgroundFerritin, a key indicator of body iron levels, has been reported to associate with type 2 diabetes (T2DM) and the onset of Gestational diabetes mellitus (GDM). However, limited research explores the association between mid-pregnancy ferritin levels and the risk of postpartum abnormal glucose metabolism (AGM) in patients with GDM.MethodsA retrospective cohort study was conducted in 1514 women with GDM recruited from January 2016 to January 2021, and 916 women were included. Demographic characteristics, medical history and family history, pregnancy complications were recorded. Multiple logistic regression models were performed to assess the association between mid-pregnancy ferritin levels and the risk of postpartum AGM.ResultsFollowing the postpartum oral glucose tolerance test, 307 (33.5%) exhibited AGM. The AGM group had higher mid-pregnancy serum ferritin levels [AGM vs NGT: 23 (11.7, 69) µg/L vs 17.80 (9.85, 40.7) µg/L, P < 0.001] and had a larger proportion of women with ferritin levels ≥30 µg/L (AGM vs NGT: 43.6% vs 31.4%, P < 0.001). Logistic regression analysis demonstrated that women with ferritin levels≥ 30 µg/L had a 1.566 times higher risk of developing postpartum AGM.ConclusionsThese findings indicate that elevated mid-pregnancy ferritin levels are significantly and independently associated with increased postpartum AGM risk in women with previous GDM. Consequently, cautious consideration is necessary for prescribing iron supplements in prenatal care, particularly for non-anemic women with GDM at high risk of developing diabetes after delivery.

Exposure to family planning messages on social media and its association with maternal healthcare services in Mauritania

BackgroundMauritania, a lower-middle-income country in Northwest Africa, has one of the highest maternal and infant mortality rates worldwide and struggles to ensure optimal use of maternal healthcare services. Raising health awareness through family planning messages can promote maternal healthcare use, potentially reducing preventable maternal and child mortalities. The objective of the study was to assess the potential impact of exposure to family planning messages through social media on the utilization of maternal healthcare services among Mauritanian women.MethodsData from the 2019-20 Mauritania Demographic and Health Survey (MDHS) on 7,640 women were analyzed. Multiple logistic regression models were applied to examine the associations between exposure to family planning messages through social media and maternal healthcare services, specifically the timing and adequacy of ANC visits, and facility-based childbirth. Adjusted odds ratios with 95% confidence intervals (CI) were estimated.ResultsThe percentage of timely initiation and adequate use of ANC among the participants were 65.6% and 45.1%, respectively. Approximately 75.0% of the women reported giving birth to their last child at a healthcare facility. Exposure to family planning messages on social media was significantly associated with increased odds of receiving adequate antenatal care visits (OR = 1.38, 95% CI = 1.12,1.71) and giving birth in a health facility (OR = 1.83, 95% CI = 1.09,3.08), Other factors such as age, health insurance, wealth, and desired timing of the last child were also found to be important predictors of maternal healthcare.ConclusionThe findings suggest that exposure to family planning messages on social media is strongly associated with adequate antenatal care and health facility-based childbirth, but not with early timing of antenatal care. Comprehensive maternal healthcare policies should consider the role of social media in promoting family planning messages.

Prevalence and associated factors of chronic kidney disease among Truká Indigenous adults in Cabrobó, Brazil: a population-based study

The prevalence of chronic kidney disease (CKD) is increasing worldwide, especially in developing countries, due to factors such as lifestyle changes and the rise of non-communicable diseases. Populations living in socioeconomically disadvantaged areas are subject to a higher burden of CKD. However, the burden of CKD on Brazilian Indigenous people, especially those undergoing an advanced urbanisation process, has not yet been described. This cross-sectional study included 1715 Truká Indigenous adults from Cabrobó, Brazil. CKD was defined according to the Kidney Disease Improving Global Outcomes guidelines classification as a urinary albumin/creatinine ratio ≥30mg/g and/or an estimated glomerular filtration rate <60mL/min/1.73m2. Univariate and multiple logistic regression models were used to evaluate factors associated with CKD. Odds ratio (OR) with a 95% confidence interval (CI) was used to measure association. Out of the 1654 participants analysed (61 excluded due to missing data), the prevalence of CKD was 10% (95% CI, 8.6%-11.5%), with a higher prevalence in women compared to men (12.4% versus 6.9%, p<0.001). The mean age was 40.5 years, with 55.6% being women. In univariate analysis, female sex (OR, 1.9; 95% CI, 1.3-2.7), age ≥60 years (OR, 4.6; 95% CI, 3.2-6.6), cardiovascular disease (OR, 2.1; 95% CI, 1.1-4.1), and dyslipidemia (OR, 1.6; 95% CI, 1.1-2.4) were identified as associated factors with CKD. Multiple logistic regression analysis identified age ≥60 years, female sex, and dyslipidemia as independently associated factors with CKD. The prevalence of CKD among Truká Indigenous adults analysed is high and affects a higher proportion of women. Our study found no association between hypertension, diabetes, obesity, and CKD risk, despite their high prevalence. These findings assist in developing early CKD detection strategies in Brazilian Indigenous communities, supporting disease treatment and prevention. National Council for Scientific and Technological Development (CNPq)-Ministry of Science, Technology, and Innovation of Brazil, and the Maria Emília Foundation.

Sagittal Fragment Rotation and Ogden Type-I Classification Are Hallmarks of Combined Tibial Tubercle Fracture and Patellar Tendon Injury.

Tibial tubercle fractures (TTFs) are uncommon injuries, comprising <3% of all proximal tibial fractures. These fractures occasionally occur in conjunction with a patellar tendon injury (PTI). We aimed to identify risk factors associated with combined TTF and PTI. A retrospective review was performed of patients presenting to a single, tertiary children's hospital with TTF between 2012 and 2023. Demographic data, operative details, radiographs, and injury patterns were analyzed. Radiographs were assessed for the epiphyseal union stage (EUS), Ogden classification, and fracture patterns. Multiple logistic regression models were used to assess the impact of body mass index, comminution, fracture fragment rotation, EUS, bilateral injury, and Ogden classification on injury type. We identified 262 fractures in 252 patients (mean age, 13.9 ± 1.31 years). Of the patients, 6% were female and 48% were Black. Of the 262 fractures, 228 (87%) were isolated TTFs and 34 (13%) were TTFs with PTI. Multivariable analysis demonstrated fragment rotation on lateral radiographs (p < 0.0001) and Ogden Type-I classification (p < 0.0001) to be the most predictive risk factors for a combined injury. Rotation was associated with a substantial increase in the odds of a combined injury, with an odds ratio of 22.1 (95% confidence interval [CI], 6.1 to 80.1). Ogden Type-I fracture was another significant risk factor, with an odds ratio of 10.2 (95% CI, 3.4 to 30.4). The Ogden classification and fragment rotation are the most useful features for distinguishing between isolated TTF and combined TTF with PTI. This is the first study to identify risk factors for TTF combined with PTI. Surgeons may use this information to aid in preoperative planning. Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Health service utilization, substance use treatment response, and death in patients with opioid use disorder and comorbid hepatitis C findings from prospective cohort study with administrative database linkage

BackgroundAmong patients with opioid use disorder (OUD), high rates of overdose and death have been reported in subgroups with Hepatitis C Virus (HCV). Evidence on the comorbid effect of HCV on clinical and substance use trajectories has been limited by small sample sizes, short follow-up, and heavy reliance on administrative data which lacks granularity on important prognostic factors. Additionally, few studies include populations on substance use treatment. AimTo establish the impact of HCV exposure (antibody positivity) on health care utilization patterns, substance use treatment response, and death in a cohort of patients with OUD on opioid agonist therapy (OAT). MethodsThis multi-center prospective cohort study recruited adult patients with OUD on OAT from 57 substance use treatment centers in Ontario, Canada. The study collected substance use outcomes, and classified patients with ≥50 % positive opioid urine screens over one year of follow-up as having poor treatment response. Additional data obtained via linkage with ICES administrative databases evaluated the relationship between HCV status, healthcare service utilization, and death over 3 years of follow-up. Multiple logistic regression models established the adjusted impact of HCV on various outcomes. ResultsAmong recruited participants (n = 3430), 44.10 % were female with a mean age of 38.64 years (Standard deviation: 10.96). HCV was prevalent in 10.6 % of the cohort (n = 365). Methadone was used most often (83.9 %, n = 2876), followed by sublingual buprenorphine (16.2 %, n = 554). Over the three-year follow-up, 5.3 % of patients died (n = 181). Unadjusted results reveal rates of hospitalization (all-cause, mental-health related, critical care) and emergency department visits (mental health-related), were significantly higher among HCV patients. Associations diminished in adjusted models. Active injection drug use exhibited the highest predictive risk for all outcomes. ConclusionA high degree of acute physical and mental illness and its resulting health service utilization burden is concentrated among patients with OUD and comorbid HCV. Future research should explore the role for targeted interventions and how best to implement integrated healthcare models to better address the complex health needs of HCV populations who inject drugs.

On-Pump or Off-Pump Impact of Diabetic Patient Undergoing Coronary Artery Bypass Grafting 5-Year Clinical Outcomes.

For diabetic patients undergoing coronary artery bypass grafting (CABG), there is still a debate about whether an off-pump or on-pump approach is advantageous. A retrospective review of 1269 consecutive diabetic patients undergoing isolated, primary CABG surgery from January 1, 2013 to December 31, 2015 was conducted. Among them, 614 received non-cardiopulmonary bypass treatment during their operation (off-pump group), and 655 received cardiopulmonary bypass treatment (on-pump group). The hospitalization outcomes were compared by multiple logistic regression models with patient characteristics and operative variables as independent variables. Kaplan-Meier curves and Cox proportional-hazard regression models for mid-term (2-year) and long-term (5-year) clinical survival analyses were used to determine the effect on survival after CABG surgery. In order to further verify the reliability of the results, propensity-score matching (PSM) was also performed between the two groups. Five-year all-cause death rates were 4.23% off-pump vs. 5.95% on-pump (p = 0.044), and off-pump was associated with reduced postoperative stroke and atrial fibrillation. These findings suggest that off-pump procedures may have benefits for diabetic patients in CABG.

High affective temperamental load as a clinical marker of bipolar disorder: applications in low-resource settings

Objective We aimed to test the performance of the short version of the Temperamental Evaluation of Memphis, Pisa, Paris, and San Diego-Auto questionnaire (Short-TEMPS-A) as a tool for bipolar disorder (BD) status detection in an outpatient sample with affective disorders, using Cyclothymic-Hyperthymic High Temperamental Load (HTL-CH) as the criterion for a positive test. Methods We enrolled 201 euthymic female and male adult outpatients (73.1% female; mean age 47.3 ± 16 years), with BD (42.79%), and other affective disorders (major depressive disorder (20.9%), or anxiety disorders (36.32%)) in a public general hospital in South-Central Chile. Diagnosis was made using the Structured Clinical Interview for axis I. All subjects completed the Short-TEMPS-A. HTL-CH was defined using a cutoff of ≥75% in the hyperthymic or cyclothymic subscales of the Short-TEMPS-A. We estimated the HTL-CH likelihood of BD versus non-BD using multiple logistic regression modeling to control for possible confounders. The performance of HTL-CH as a tool for BD status evaluation was assessed using area under receiver operating characteristic curve (AUC ROC) analysis. Results Patients with HTL-CH had an OR = 7.55 (CI95% = 2.11–26.96) of having a BD status. HTL-CH showed good psychometric properties for BD status detection, correctly classifying 74.13% of patients. AUC ROC was 0.74 (CI95%=0.68–0.81). Conclusions HTL-CH, as assessed by the Short-TEMPS-A, was able to detect BD status accurately and reliably in affective outpatients. The Short-TEMPS-A might be a useful tool in aiding clinicians to detect BD, particularly during initial assessment of affective patients in low-resource settings.

Star Ratings in Long-Term Care Facilities in Australia: Facility Characteristics Associated With High Ratings and Changes in Ratings Over Time

ObjectivesA Star Rating system (1 to 5 stars) of long-term care facilities in Australia is based on 4 sub-categories: compliance, quality measures, residents’ experience, and staffing. The objectives were to examine associations between facility characteristics and the odds of receiving a 4- or 5-star rating, and changes in ratings between the earliest reporting period (October–December 2022) to the most recent (April–June 2023). DesignCross-sectional, ecological study, with an additional longitudinal component. SettingLong-term care facilities in Australia. MethodsAssociations between facility characteristics and the odds of receiving a 4- or 5-star rating were examined using a multiple logistic regression model. Average changes in overall star rating and each sub-category weighted by fractional contribution to overall star rating were estimated. ResultsOf 2476 facilities, 53.7% received a 4- or 5-star rating, 44.1% a 3-star rating, and 2.1% a 1- or 2-star rating in the April–June 2023 reporting period. Facility characteristics associated with higher odds of 4- or 5-star ratings included small (≤60 residents) and medium-size (61–100 residents) (odds ratios, 3.16; 95% CI, 2.51–3.98 and 1.72; 05% CI, 1.38–2.13, respectively), and Queensland location compared with New South Wales (2.42; 95% CI, 1.87–3.14). Facilities in socioeconomically disadvantaged areas (0.45; 95% CI, 0.33–0.62) and for-profit (0.12; 95% CI, 0.07–0.22) or not-for-profit facilities (0.16; 95% CI, 0.09–0.29) compared with government-operated were associated with lower odds of 4- or 5-star ratings. Between the 2 reporting periods, 25.1% of facilities' star ratings increased and 10.2% decreased (average change 0.156). Residents’ experience, compliance, and staffing had the largest weighted average sub-category rating changes (0.051, 0.042, and 0.042, respectively). ConclusionsSmaller size, government ownership, and location in socioeconomically advantaged areas were associated with higher odds of 4- or 5-star ratings in long-term care facilities. Average star ratings increased over time but increases and decreases in overall and sub-category ratings were observed.

Association of neutrophil-to-lymphocyte ratio with age and 180-day mortality after emergency surgery

BackgroundTo examine the relationship between neutrophil-to-lymphocyte ratio (NLR), age, and mortality rates after emergency surgery.MethodsIn this observational study, a total of 851 patients undergoing emergency surgery between January 2022 and January 2023 were retrospective examined. Using 30 and 180 days mortality data, NLR differences and receiver operating characteristic (ROC) curves were analyzed using a 65-year threshold. A multiple logistic regression model was constructed incorporating age and NLR. Finally, Kaplan–Meier curves were constructed for mortality.ResultsAmong 851 patients, the 30 and 180 days mortality rates were 5.2% and 10.8%, respectively. Median NLR in 30 days was 5.6 (3.1 to 9.6) in survivors and 8.7 (4.6 to 13.4) in deceased patients (p < 0.0001); in 180 days, it was 5.5 (3.1 to 9.8) and 8.8 (4.8 to 14.5), respectively (p < 0.0001). In the 30- and 180-days mortality analyses, median NLRs were 5.1 (2.9 to 8.9) and 4.9 (2.9 to 8.8) in survivors and 10.6 (6.9 to 16.6) and 9.3 (5.4 to 14.9) in deceased patients aged < 65 years, respectively. The ROC AUC in patients younger than 65 years was higher for 30 days (AUC 0.75; 95% CI 0.72 to 0.87) and 180 days (AUC 0.73; 95% CI 0.64 to 0.81). Multivariate logistic regression revealed that the NLR (odds ratio, 1.03 [95% CI 1.005 to 1.053; p = 0.0133) and age (odds ratio, 1.05 [95% CI 1.034 to 1.064; p < 0.0001) significantly contributed to the model. Survival analysis revealed differences in the 180 days mortality (p = 0.0006).ConclusionWe observed differences in preoperative NLR between patients who survived and those who died after emergency surgery. Age impacts the use of NLR as a mortality risk factor.Trial registrationNCT06549101, retrospectively registered.

Factors Influencing Juvenile Recidivism at Narathiwat Province's Observation and Protection Center

The purpose of this study was to investigate the factors that contribute to juvenile recidivism at Narathiwat Province's Observation and Protection Centre. The data used are secondary data gathered from the risks and needs assessment from the Juvenile Observation and Protection Centre of Narathiwat province, which was recorded between 2017 and 2021. There are 843 offenses committed by juveniles, and this study compares juvenile recidivism to juvenile non-recidivism. The multiple logistic regression model was applied, and the results showed that the overall proportion of juvenile recidivism is approximately 13.45%. Factors associated with juvenile recidivism include the year of the offence, the month, location, type of litigation, substance abuse history, theft history, and whether the individual has ever run away from home. The model indicates that the juvenile recidivism rate was higher than the overall proportion in 2021, especially during July, August, and September. Additionally, juveniles from rural areas, those who have ever used substances, committed theft, or run away from home are more likely to recidivism. According to the study's findings, to effectively address the issue of juvenile recidivism in Narathiwat Province, organizations and institutions in the community, families and guardians, law enforcement and related legal agencies as well as community members, should collaborate to solve the problem at various levels, focusing on each individual and receiving support from the Observation and Protection Center.

Dental Anxiety Amongst Pregnant Women: Relationship with Dental Attendance and Sociodemographic Factors

Purpose: The purposes of this study were to investigate the relationship between dental anxiety amongst pregnant women and their dental attendance patterns, considering various sociodemographic factors, at health centers in the Kingdom of Saudi Arabia. Materials and Methods: Participants in this cross-sectional descriptive study were 386 pregnant women seeking care at Saudi Ministry of Health centers. A validated version of the Modified Dental Anxiety Scale (MDAS) was used to measure dental anxiety. Questionnaires including background data and dental anxiety were used and clinical data were collected. The association between oral health literacy and dental anxiety was evaluated with Spearman’s correlation coefficient. A multiple linear regression model with dental anxiety (MDAS score) as the dependent variable was developed to investigate further the relationship dental anxiety amongst pregnant women and their dental attendance patterns. Results: The prevalence of dental anxiety was very anxious (3.595). According to a multiple binary logistic regression model, previous experiences with dentists, household income, educational level, number of times and months of pregnancy, and the perception that oral care should be avoided during pregnancy were independently associated with dental anxiety. Conclusions: Dental anxiety in pregnant women is linked to social and psychological factors, in addition to oral health. Specifically, prior experiences with dentists, attitudes toward dental care, and general fear appear to have the strongest influence on dental anxiety. The prevalence of dental anxiety was high among this sample of pregnant women. The study shows that dental care providers need to pay attention to providing a supportive dental care situation, where patients should not experience pain. There is a need to understand the psychological factors associated with dental care procedures.

Effects of Non-Tariff Barriers on Promotion of East African Community Integration: A Case of Magasins Généraux du Rwanda

Regional integration in East Africa has proven to strengthen investments within member nations. However, differing non-tariff barrier policies among East African Community (EAC) partner states have posed significant challenges to progress. This study assessed the effects of non-tariff barriers on the promotion of EAC integration, using Magasins Généraux du Rwanda (MAGERWA) as a case study. Specifically, the study evaluated the effects of technical barriers to trade, analysed the impact of import quotas, and scrutinised the effects of foreign exchange restrictions on EAC integration. The study was anchored in three theories: Liberal Intergovernmentalism Theory, Economic Integration Theories, and the Heckscher-Ohlin Theory. It used a descriptive research design with both quantitative and qualitative approaches. The target population consisted of 2,045 individuals. A sample size of 335 was determined using the Yamane formula and selected through both simple random and purposive sampling techniques. Data were collected using a questionnaire survey and analysed using SPSS version 26. Bivariate analysis, including P-values, was used to evaluate the relationship between independent and dependent categorical variables. Descriptive statistics such as mean and standard deviation, as well as single and multiple logistic regression models, were used to assess the strength of the relationships. A p-value &lt; 0.05 and a 95% confidence interval were used for inference. Results were presented in frequency and cross-tabulation tables. The study found that technical barriers to trade had a statistically significant relationship with the promotion of EAC integration (r = 0.953, p&lt;0.05). Similarly, import quotas showed a significant relationship with EAC integration (r = 0.954). Foreign exchange limitations also demonstrated a significant correlation with EAC integration, with a correlation coefficient of.966. The regression analysis showed a mean square of 199.267 and a residual mean square of 0.107, with an F-value of 1864.147 and a p-value of.000b. The researcher suggested that EAC member states should implement the planned goals of the community to promote free trade in the region, thereby enhancing economic integration.

Genetic Risk, Lifestyle Adherence, and Risk of Developing Hyperuricaemia in a Japanese Population.

To investigate the inter-relationships among genetic risk, healthy lifestyle adherence, and hyperuricaemia susceptibility. This prospective cohort study was conducted with 7,241 hyperuricaemia-free individuals aged ≥ 20 years from the Tohoku Medical Megabank Community-based cohort study. A comprehensive lifestyle score included body mass index, smoking, drinking, and physical activity, and a polygenic risk score (PRS) was constructed based on uric acid loci from a previous genome-wide association study meta-analysis. A multiple logistic regression model was used to estimate the association between genetic risk, healthy lifestyle, and hyperuricaemia incidence and calculate the area under the receiver operating characteristic curve (AUROC). Hyperuricaemia was defined as a uric acid level ≥7.0 mg/dl or a self-reported history of hyperuricaemia. Of the 7,241 adults (80.7% females; mean [SD] age: 57.7 [12.6] years), 217 (3.0%) developed hyperuricaemia during 3.5 years of follow-up. Genetic risk correlated with hyperuricaemia development (P for interaction = 0.287), and lifestyle risks were independently associated. Those with a high genetic risk and poor lifestyle had the highest risk (odds ratio: 5.34; 95% confidence interval [CI]: 2.61-12.10). Although not statistically significant, incorporating the PRS in the model with lifestyle information improved predictive ability (AUROC = 0.771, 95% CI: 0.736-0.806 for lifestyle; AUROC = 0.785, 95% CI: 0.751-0.819 for lifestyle and PRS; p = 0.07). : A healthy lifestyle to prevent hyperuricaemia, irrespective of genetic risk, may mitigate the genetic risk. Genetic risk may complement lifestyle factors in identifying individuals at a heightened hyperuricaemia risk.

Prevalence and Association of Caries and Enamel Hypomineralisation/Molar-Incisor Hypomineralisation in 8- to 10-Year-Old Children from Bavaria, Germany

Introduction: The aim of this cross-sectional epidemiological study was to record caries and enamel hypomineralisation (EH), including molar-incisor hypomineralisation (MIH), and assess associations between both entities in 8- to 10-year-olds from Bavaria, Germany. Methods: A total of 5,418 children (mean age 9.8 years; 2,726 females, 2,692 males) were examined using the dmft/DMFT index with additional inclusion of initial or non-cavitated carious lesions (it/IT). EHs were recorded in the primary (eh) and permanent dentition (EH), and individuals with different EH phenotypes were determined as follows: at least one EH, at least one hypomineralised second primary molar (HSPM), at least one hypomineralised first permanent molar (MIH), and at least one hypomineralised first permanent molar and incisor (M+IH). Multiple logistic regression models were constructed to assess association between caries and EH. Results: The percentage of children without caries in the permanent dentition (DMF = 0) was 88.9%. When data regarding initial carious lesions were included (IDMF = 0), the prevalence decreased to 75.7%. The caries experience was idmf/t = 1.6 and the IDMF/T = 0.6. The mean number of carious teeth in subjects with no eh/EH was higher than that in subjects with HSPM, MIH, or M+IH. The presence of HSPM, MIH, and M+IH was associated with a significantly lower probability of caries in the permanent dentition; the corresponding adjusted odds ratios were 0.55 (95% CI: 0.41−0.75), 0.67 (95% CI: 0.56−0.81), and 0.54 (95% CI: 0.41−0.72), respectively. Conclusions: Caries and EH are prevalent conditions in 8- to 10-year-old Bavarian schoolchildren; both dental diseases were negatively associated with each other.

Presence of Anxiety or Depression Feelings and Its Associated Risk Factors among Immigrants in Korea: A Nationwide Cross-Sectional Study.

The influx of immigrants into Korea has increased in recent years, affecting Korean society and the healthcare system. This study analyzed the frequency of anxiety and depression in immigrants, which negatively affects their quality of life. We analyzed data from a 2020 survey on the Health Rights of Migrants and the Improvement of the Medical Security System. Bivariate analyses and a multiple logistic regression model were used to identify the risk factors associated with the presence of anxiety or depression among immigrants. We included 746 immigrants, 55.9% of whom were female. The overall rate of anxiety or depression was 31.77%, with 38.3% in females, which was significantly higher than the 26.62% in males. The frequency of anxiety and depression was also strongly associated with certain immigrant groups, including immigrants of African or Western Asian origin (over 64%); those with student visas (60.53%); those who self-reported poor health (52%), physical or mental disabilities (69.23%), or chronic diseases (58.43%); and those facing difficulties accessing medical services (59.47%). This study showed the frequency of feelings of anxiety or depression and associated risk factors among immigrants. These findings may have implications for policymakers in reducing the likelihood of developing anxiety or depression in the future and improving the quality of life of immigrants in Korea.

Smartphone use associated with overweight and obesity in adolescents in a family medicine unit in Mexico

Introduction: The use of smartphones has been increasing globally and in the case of adolescents it represents greater vulnerability and health risks. Clinical research that relates Body Mass Index (BMI) or body weight alterations with Information and Communication Technologies (ICT) demonstrates an association. However, the specific association of problematic smartphone use with overweight or obesity is limited and inconclusive in adolescents. General objective: To associate smartphone use with overweight and obesity in adolescents in a family medicine unit (FMU). Material and methods: A cross-sectional and analytical study was carried out from September 2022 to December 2023 in a first-level medical unit, in adolescents aged 10 to 19 years, in whom the Mobile Phone Problem use Scale (MPPUS-A) was applied and BMI was calculated. A Multiple Binary Logistic Regression (RLM) model was used that included age &gt; 14 years, smartphone use and female sex. Odds Ratio (OR), 95% CI and p. Results: Of 338 subjects, it was found that 39% were overweight or obese and had problematic use of the smartphone. 9.1% of overweight or obese adolescents have an adequate use of the smartphone. In the bivariate analysis, it was found that the inappropriate use of smartphones presented a PMR of 2.68 [95% CI (1.63-4.41)] and p&lt;0.001. The multivariate model showed inappropriate smartphone use with an OR of 1.06 [95% CI (1.73-4.87] with p&lt;0.001 and age &gt; 14 years an OR of 1.68 [95% CI (2.80-10.25)] and p &lt;0.001. Conclusion: Adolescents who have problematic smartphone use and an age &gt; 14 years have a higher risk of being overweight or obese. Longitudinal studies are required to verify the findings shown here.

Association between cardiometabolic index and congestive heart failure among US adults: a cross-sectional study.

The risk of congestive heart failure (CHF) is significantly affected by obesity. However, data on the association between visceral obesity and the risk of CHF remain limited. We explored the relationship between CHF and cardiometabolic index (CMI). Drawing from the National Health and Nutrition Examination Survey (NHANES) for 2011-2018, we enrolled 9,008 participants in a cross-sectional study. We calculated the CMI as triglyceride (TG)/high density lipid-cholesterol (HDL-C) × weight-to-height ratio (WHtR), and CMI-age as CMI × age. Then, we analyzed CMI and CMI-age as categorical and continuous variables to assess its correlation with CHF. To assess the relationships of CMI and CMI-age with CHF, we used multiple logistic regression models and performed subgroup analysis. To examine the predictive ability of CMI and CMI-age on patients with CHF, we used receiver operating characteristic (ROC) curves. The overall prevalence of CHF was 3.31%. The results revealed significant differences in demographic data, comorbidities, lifestyle variables, standing height, BMI, WC, WHtR, TG, and HDL-C among the four groups classified by CMI quartile and CMI-age quartile. When indicators were analyzed as continuous variables, CMI and CMI-age showed positive correlations with CHF in both the crude and adjusted models (all P < 0.05). When indicators were analyzed as categorical variables, it was found that in all four models, the ORs of group Q4 was significantly different compared to Q1 (all P < 0.05), suggesting the risk of CHF is significantly increased with higher CMI, and CMI-age. The associations of CMI and CMI-age with CHF were similar in all stratified populations (P for interaction > 0.05). The areas under the ROC curve (AUCs) of CMI and CMI-age in predicting CHF were 0.610 (95% CI, 0.578-0.642) and 0.697 (95% CI, 0.668-0.725) separately, suggesting that CMI-age was significantly better than the CMI in predicting CHF (P < 0.001). Both CMI and CMI-age were independently correlated with the risk for CHF. These results suggested that the CMI-age, which provides new insights into the prevention and management of CHF. CMI-age could serve as effective tools to identify CHF during primary care examinations and in medically resource-limited areas.