Objective: To investigate the diagnostic consistency and the risk factors for extrauterine growth restriction (EUGR) assessed by the Fenton 2013 preterm growth charts (Fenton 2013) and the growth charts by International Fetal and Newborn Growth Consortium for the 21st Century (IG-21). Methods: This multicenter retrospective cohort study included 5 591 preterm infants with a gestational age (GA) at birth of less than 32 weeks admitted to 19 member hospitals of the Neonatal Perinatal Collaborative Network of Suxinyun from 2019 to 2024. Clinical data including baseline characteristics, complications, feeding practices and anthropometrics were processed and analyzed. EUGR was assessed using both the Fenton 2013 and the IG-21. A decrease in weight Z-score at discharge compared to admission by more than 1 was defined as longitudinal EUGR, and discharge weight below the P10 for the corresponding corrected GA was defined as cross-sectional EUGR. Diagnostic consistency was assessed using the Kappa coefficient between the 2 standards, and diagnostic performance of the 2 standards was compared using the McNemar test. Risk factors for EUGR under different definitions were analyzed using univariate analysis and multivariate Logistic regression analysis. Results: A total of 5 591 preterm infants were included, with a GA at birth of (29.7±1.6) weeks and a birth weight of (1 360±315) g and at discharge with a corrected GA of (36.3±2.0) weeks and weight of (2 246±370) g. Detection rates of cross-sectional and longitudinal EUGR diagnosed by Fenton 2013 were both higher than those by IG-21 (37.0% (2 214/5 991) vs. 23.7% (1 324/5 591), 61.1% (3 662/5 991) vs. 30.7% (1 714/5 591), χ2=326.77 and 1 358.05, both P<0.001). Using Fenton 2013 as a reference, IG-21 demonstrated superior diagnostic value and consistency in identifying cross-sectional EUGR compared with longitudinal EUGR (sensitivity of 100.0% (3 377/3 377) vs. 99.6% (1 922/1 929), specificity of 59.8% (1 324/2 214) vs. 46.6% (1 707/3 662), positive predictive value of 79.1% (3 377/4 267) vs. 49.6% (1 922/3 877), negative predictive value of 100.0% (1 324/1 324) vs. 99.6% (1 707/1 714), accuracy of 84.1% (4 701/5 591) vs. 64.9% (3 629/5 591), and Kappa 0.64 vs. 0.37, all P<0.001). In multivariate Logistic regression models, risk factors common to EUGR across both standards included smaller GA at birth, lower birth weight, boy, early-onset sepsis, late-onset sepsis and the elder age at full enteral feeding (all P<0.05). Hemodynamically significant patent ductus arteriosus remained an independent risk factor for longitudinal EUGR regardless of whether by the Fenton 2013 or IG-21 standard (adjust odds ratio (aOR)=1.25 and 1.27, 95%CI 1.09-1.42 and 1.11-1.45). In addition, under the IG-21 standard, severe bronchopulmonary dysplasia was an independent risk factor for cross-sectional EUGR (aOR=1.54, 95%CI 1.00-2.38), while severe necrotizing enterocolitis was an independent risk factor for longitudinal EUGR (aOR=2.18, 95%CI 1.01-4.73). Conclusions: IG-21 showed lower detection rates of both cross-sectional and longitudinal EUGR than Fenton 2013, suggesting greater clinical applicability of IG-21 by reducing overdiagnosis while maintaining sensitivity for predicting complications. Across both standards, cross-sectional EUGR facilitates early identification of growth restriction, whereas longitudinal EUGR better tracks dynamic growth patterns and complications of preterm infants.

Preclinical Mobility Limitations (PCML) represent an early transitional stage in which individuals compensate for functional decline, yet do not exhibit overt disability. Recognition of PCML may identify individuals at elevated risk for future disability. Despite its importance, PCML has been understudied using nationally representative datasets. The purpose of this study is to operationalize and validate PCML using the National Health and Aging Trends Study (NHATS) and to examine its prevalence among community dwelling older adults. We analyzed 4,566 participants from NHATS 2022/2023. PCML was operationalized based on expert consensus, incorporating task modifications and reduction in frequency of tasks without overt difficulty. We examined the prevalence of PCML and its association with sociodemographic and health factors. Concurrent validity was assessed using the Short Physical Performance Battery (SPPB) measure and an assessment of participation restrictions. We evaluated whether PCML predicts incident manifest limitations one year later using logistic multivariate regression models. PCML was identified in 46.8% of older adults and was more prevalent among those that were between the ages of 75-84 years and women. The mean SPPB composite score for those with PCML was 9.7 out of 12 and 30.6% reported participation restrictions. Those with PCML had 1.8 times increased odds of developing manifest limitations within one year, compared to those without PCML. This PCML measure has strong criterion validity, highlighting its utility as an early marker of functional decline. Screening for PCML in primary care may provide opportunities to prevent mobility disability and improve quality of life among older adults.

Comparison of outcomes among generations in endovascular treatment for unruptured intracranial aneurysms: insights from a single-center study.

ObjectiveTo clarify the influence of daylight access on patients' and their companions' stress perception and coping behavior (communication) in cancer hospital waiting areas.BackgroundIn patient care, managing stress and encouraging effective coping strategies are essential. Daylight has shown as a modulator of stress responses and coping behaviors. Limited research has been done regarding the impact of daylight access on the waiting experience of cancer patients and their companions.MethodsEmpirical data were collected through on-site observations and questionnaire surveys in 30 waiting areas across seven cancer hospitals in China. Based on responses from 419 patients and 371 family companions, we examined differences in stress and communication between groups in the areas with and without daylight access. Multivariate logistic regression models were used to assess the significance of daylight access and communication in predicting stress.ResultsPatients and families in the areas with daylight access communicated more with peers (p ≤ .05) and perceived less stress (p ≤ .10) compared to those in windowless areas. They also communicated more with nurses, though this difference was not statistically significant (p > .10). Participants who engaged in more peer communication reported less stress (p = 0.00). Daylight access and peer communication significantly contributed to stress reduction, explaining over 15% of the variance in stress, along with personal and social variables in modeling.ConclusionAccess to daylight in the waiting areas of cancer hospitals reduces stress and promotes communication among patients and family companions. Healthcare facilities should provide daylight access in their waiting areas to reduce stress and encourage communication.

Objective To evaluate whether a simple biomarker can identify possible sarcopenia (PS) in a community-dwelling elderly population. Methods This study included 289 individuals ≥ 65 years of age who underwent medical examinations in Sobetsu in 2017. The validation cohort consisted of 183 individuals ≥ 65 years of age who were surveyed in the same town in 2018, 2019, 2022, and 2023, without participating in the 2017 survey. The predictive factors for PS were identified, and a simple scoring system was developed. Results The mean ages of the 2017 and validation cohorts were 74 years and 72 years, respectively. The prevalence of PS did not differ between the 2017 and validation cohorts, with rates of 31.5% and 32.8%, respectively. A univariate logistic regression analysis, using the presence of PS as the dependent variable, identified age [odds ratio (OR) 1.13], anemia (OR 4.54), and hemoglobin (OR 0.63) as significant factors (p <0.001). A multivariate logistic regression model, adjusted for age, BMI, and hemoglobin level and selected based on the lowest AIC, achieved an AUC of 0.747 for predicting PS. External validation of this model yielded an AUC of 0.733. A simplified prediction score, derived from cutoffs for age, BMI, and hemoglobin, demonstrated an AUC of 0.711 for PS prediction in the initial cohort, with an AUC of 0.658 in the external validation cohort. Conclusion A simple score based on age, BMI, and hemoglobin level effectively estimated PS in a community-dwelling elderly population, offering a practical and accessible tool for screening.

Identifying Predictors of Recurrent Pilonidal Disease in Adolescents and Young Adults: A Secondary Analysis of a Randomized Controlled Trial.

Prevalence and risk factors of postpartum depressive symptoms in Central China: A longitudinal, real-world study.

Mildly elevated left ventricular outflow tract gradients are associated with increased short-term mortality in inpatients without septal hypertrophy.

Significant disparities persist in timely, guideline-concordant breast cancer treatment across the US, impacting cancer outcomes. The influence of both patient-level and facility-level socioeconomic status (SES) on adherence to Commission on Cancer quality measures remains incompletely understood. We conducted a retrospective cohort study using the National Cancer Database to assess associations between patient and facility SES and concordance with timeliness of 3 Commission on Cancer breast cancer quality measures: surgery, multiagent chemotherapy, and radiotherapy, among patients diagnosed from 2018 to 2022. Multivariable logistic regression models were used to evaluate predictors of concordant care, including a composite measure of facility-level social risk. The analytic cohorts included 471,425 patients for surgery, 82,734 for chemotherapy, and 311,523 for radiotherapy. Black race, uninsured status, and lower educational attainment were each independently associated with lower odds of receiving guideline-concordant care across all measures. Patients treated at low-SES facilities had higher odds of receiving timely surgery (adjusted odds ratio [OR] 1.27, 95% CI 1.24 to 1.31) but lower odds of receiving timely chemotherapy (OR 0.85, 95% CI 0.79 to 0.91) and radiotherapy (OR 0.95, 95% CI 0.92 to 0.97) compared with those at other institutions. Facility type, fragmented care, and comorbidities also contributed to variation in concordance. Significant disparities in guideline-concordant breast cancer care persist by race, insurance, education, and facility-level social risk, highlighting intervention opportunities to improve outcomes for these already vulnerable populations. These findings highlight the importance of policy and institutional strategies that address both patient- and facility-level barriers to ensure equitable access to high-quality multidisciplinary treatment.

This study captures free tissue transfer reconstructions following head and neck neoplasm resection and assesses case volumes and clinical endpoints by surgeon specialty. The American College of Surgeons National Surgical Quality Improvement Program database was queried from 2012 to 2020 using Current Procedural Terminology and International Classification of Diseases codes specific for free tissue transfers in the setting of head and neck neoplasms. Primary 30-day outcomes of interest included wound complications, medical complications, postoperative length of stay, nonhome discharge, and return to operating room.Case volumes between plastic surgeons and otolaryngologists were compared. Bivariate statistics were performed to compare patient characteristics and outcomes between plastic surgeons and otolaryngologists during the study period. Multivariate logistic regression models using clinical covariates were constructed to assess whether surgeon specialty was an independent predictor of outcomes. Significance was set at P < 0.05 and a Bonferroni correction was applied to adjust for multiple hypothesis testing (n = 49). Overall, 3903 free tissue transfers were included (plastic surgeons: 1603, otolaryngologists: 2300). Reconstructions performed by plastic surgeons had increased operative time (583 minutes vs 528, P < 0.001) and were more likely osseous tissue transfers (P < 0.001). Multivariate analysis revealed increased postoperative length of stay in reconstructions performed by plastic surgeons (P = 0.002). Osseous tissue transfers had significantly increased operative time and length of stay when compared to soft-tissue transfers (P < 0.001). Outcomes between plastic surgeons and otolaryngologists are similar in the setting of head and neck free tissue transfer reconstructions before and after adjusting for patient-specific factors. Given this lack of difference, our study supports the notion that surgical specialty can effectively perform these reconstructions and efforts should be made to maintain case volumes for plastic surgeons.

Influence of childhood excess weight on cognitive, behavioural and emotional outcomes.

Clinical Correlates of Insomnia Symptoms in Young Children with Autism Spectrum Disorder.

High Risk Predictors for Thoracic Aortic Injury in Pediatric Blunt Chest Trauma.

Associations of sociodemographic factors, healthy habits, and weight stigma with non-alcoholic fatty liver disease risk in obese workers: Findings from a large occupational cohort.

Human papillomavirus (HPV) is a known risk factor for oropharyngeal cancer (OPC); however, its role in atherosclerosis remains controversial. This study aimed to investigate the association between HPV type 16 infection status and coronary artery calcification (CAC) in patients with OPC. We retrospectively reviewed patients who were referred to our hospital for initial treatment of OPC between October 2013 and October 2024. The Agatston score was calculated using non-gated, non-contrast computed tomography scans. HPV status was assessed using p16 immunohistochemistry according to guidelines. Patient characteristics were compared between the HPV-negative and HPV-positive groups. Independent risk factors for severe CAC (Agatston score >400) were identified using a multivariable logistic regression model. Among 114 patients, those with HPV-negative OPC had significantly higher Agatston scores compared to those with HPV-positive OPC [89.00 (0.00-864.25) vs. 2.20 (0.00-61.50), p=0.020]. They were also older, had lower body mass index and hemoglobin levels, and had a higher prevalence of diabetes. However, HPV infection status was not an independent risk factor for severe CAC. Patients with HPV-negative OPC exhibited more severe CAC, likely due to their older age rather than HPV status itself.

Clinical Use and Effectiveness of Colchicine for Secondary Prevention Following Acute Myocardial Infarction.

The association between COVID-19 vaccination with the prevalence of post-COVID conditions in Thai patients with mild COVID-19.

Trauma During Pregnancy: Predictors of Readmission and Maternal-Fetal Outcomes.

Comparison of landslide susceptibility assessment in volcanic terrains based on a landform unit model and two multivariate logistic regression models

Predicting suicide attempts in early-onset major depressive disorder: A nomogram-based approach.