Relative Risk Ratio Research Articles

Hospitalizations for depressive disorders in Ecuador: An eight-year nationwide analysis of trends and demographic insights.

Sociodemographic characteristics and limited mental health care access may contribute to higher depression rates in low- and middle-income countries. Aim This study aimed to analyze nationwide depressive disorder hospitalizations in Ecuador. We assessed the sociodemographic characteristics, severity, recurrence, and duration of hospitalizations for depressive disorders. The dataset used is publicly available on the Ecuadorian National Institute of Statistics and Censuses website. Multivariable multinomial logistic regression was performed to calculate adjusted relative risk ratios (aRRR). 14,586 hospitalizations were analyzed during 2015-2022. There was a significant increase in depressive disorders hospitalizations, from 9.41 cases per 100,000 inhabitants in 2015 to 13.9 in 2022. Females accounted for 65.7 % of hospital admissions. Depressive disorder hospitalizations had a mean age of 33.43 years. Severe depressive disorders without psychotic symptoms had the highest average hospitalization rate during 2015-2022 with 3.53 cases per 100,000 inhabitants. Individuals aged 20-29 years (aRRR 1.68, 95 % CI 1.27-2.22) and those aged 30-39 years (aRRR 1.81, 95 % CI 1.32-2.47) had higher probabilities of hospitalization for severe depressive disorder without psychotic symptoms. Patients with severe depression with or without psychotic symptoms were more likely of being hospitalized for seven or more days. Ethnic minorities were less likely to be hospitalized for severe depressive disorder without psychotic symptoms. These findings highlight the increasing rates of depressive disorders in low- and middle-income countries such as Ecuador and emphasize the necessity for public health strategies focused on vulnerable groups.

Impact of Government Healthcare Policy Changes on Consumption and Human Movements During COVID-19: An Interrupted Time Series Analysis in Korea.

The coronavirus disease 2019 (COVID-19) pandemic has altered daily behavioral patterns based on government healthcare policies, including consumption and movement patterns. We aimed to examine the extent to which changes in the government's healthcare policy have affected people's lives, primarily focusing on changes in consumption and population movements. We collected consumption data using weekly credit card transaction data from the Hana Card Corporation and population mobility data using mobile phone data from SK Telecom in Seoul, South Korea. Interrupted time-series analysis was used to calculate the relative risk ratio and perform the intervention effects when government healthcare policy changes. We found that leisure and outside movements were the most immediately affected by changes in government healthcare policies. It took over 2 years and 11 months, respectively, for these sectors to return to their pre-COVID-19 routines. Enhancing healthcare policies presents advantages and disadvantages. Although such policies help prevent the spread of COVID-19, they also reduce consumption and mobility, extending the time needed to return to pre-COVID-19 levels. Government healthcare policymakers should consider not only disease prevention but also the impact of these policies on social behaviors, economic activity, and mobility.

Morphometric Analysis of Kajali River Basin Using Geospatial Techniques

Soil and water are the important natural resources and important input for agricultural production. The present study has been attempted to delineate and determine morphometric characteristics of Sakharpa watershed in Ratnagiri district by using Remote Sensing and GIS. The delineation of watershed was performed in QGIS 3.18.3 software. The study area was obtained from SRTM DEM with 30meter resolution after delineation. Sakharpa watershed shows a dendritic drainage pattern. The results found for morphometric parameters were Bifurcation Ratio (Rb)2-5.5, Form factor (Ff) 0.32, Elongation ratio (Re) 0.63, Circulatory ratio (Rc) 0.32, Shape index (Sw) 3.18,Drainage density (Dd)1.18km/km2, Stream frequency (Fs)1.48 km-2, Texture ratio (Rt)1.08, Drainage texture (Dt)2.24,Constant of channel maintenance (C)0.84km2/km, Length of overland flow (Lg) 0.42, Basin relief (R) 763.92 m, Relief Ratio (Rr) 0.045,Relative Relief (Rhp) 1.27,Ruggedness Number (Rn) 0.904. The study concluded that the watershed is elongated in shape, have dense vegetation and homogeneous with less structural disturbance. This morphometric analysis of drainage basin helps to planning and development of watershed also helps to understand relation between linear, areal and relief parameters of drainage basin.

Investigating the influence of working status changes on physical activity and non-communicable diseases in Korean middle-aged and older adults: insights from a longitudinal panel study

BackgroundNon-communicable diseases (NCDs) are a major global health challenge and occupational status is a critical determinant influencing NCD development, yet many cross-sectional studies have only linked current occupational status with specific diseases, overlooking broader temporal factors. The primary aim of the present study was to comprehensively elucidate the intricate interplay between alterations in working status, NCDs, and physical activity (PA) among Korean middle-aged and older adults, employing a longitudinal panel study design.MethodsThis study utilized longitudinal data from the Korean Longitudinal Study of Aging, covering the period from 2006 to 2020, with a median follow-up duration of 10 years. (n = 5101 participants aged 45 years and older). Changes in working status were categorized, focusing on (1) yes–yes (e.g., indicative of sustained employment), (2) yes–no (e.g., denoting a transition from employment to non-employment), (3) no–yes (e.g., representing a shift from non-employment to employment), and (4) no–no (reflecting a continual non-employment status). PA was defined as the total minutes of moderate-to-vigorous PA per week and categorized into two groups: <150 min/week and ≥ 150 min/week. Confounding factors included age, gender, marital status, education level, and body mass index. Relative risk ratios (RRR) with 95% confidence intervals (CI) were calculated using random-effect multinomial logistic regression.ResultsIndividuals who were currently employed (adjusted RRR = 0.688, 95% CI = 0.656–0.722, p < 0.001) or who transitioned to employment (adjusted RRR = 0.755, 95% CI = 0.707–0.807, p < 0.001) had a reduced risk of physical inactivity. However, employed individuals had an increased risk of cardiovascular diseases (yes-yes: adjusted RRR = 1.653, 95% CI = 1.547–1.766, p < 0.001; no-yes: adjusted RRR = 1.168, 95% CI = 1.100–1.240, p < 0.001) and diabetes (yes-yes: adjusted RRR = 1.535, 95% CI = 1.464–1.610, p < 0.001; no-yes: adjusted RRR = 1.124, 95% CI = 1.078–1.173, p < 0.001). Additionally, current workers exhibited higher risks of cancer (yes-yes: adjusted RRR = 1.871, 95% CI = 1.721–2.035, p < 0.001; no-yes: adjusted RRR = 1.089, 95% CI = 1.018–1.166, p = 0.014) and chronic respiratory diseases (yes-yes: adjusted RRR = 1.467, 95% CI = 1.307–1.648, p < 0.001; no-yes: adjusted RRR = 1.121, 95% CI = 1.011–1.242, p = 0.029).ConclusionThis longitudinal study revealed that individuals engaged in or transitioning to employment displayed a reduced likelihood of regular PA. Moreover, those with work history, transitioning, or consistently working, exhibited increased vulnerability to all NCDs compared to those without work experience.

Impact of sarcopenic obesity on postoperative outcomes in patients with oesophago-gastric cancer: A systematic review and meta-analysis.

We elucidated the influence of sarcopenic obesity on postoperative outcomes in patients with oesophago-gastric cancer. We conducted a systematic search on MEDLINE, the Cochrane Central Register of Controlled Trials, EMBASE, the World Health Organization International Clinical Trials Platform Search Portal, and ClinicalTrials.gov to identify observational studies published from their inception to September 26, 2024. Studies involving patients who underwent radical resection for oesophago-gastric cancer and were evaluated for visceral fat mass and skeletal muscle mass through body composition were included in our analysis. The primary outcomes assessed were overall survival (OS) and postoperative complications. This protocol was registered in PROSPERO (CRD42023418403). Ultimately, 13 studies (involving 4912 patients) were included in our qualitative and quantitative analyses. Among these studies, three were prospective cohort studies, while the remaining 10 were retrospective cohort studies. Twelve studies specifically investigated gastric cancer, while one focused on esophageal cancer. The prevalence of sarcopenic obesity ranged from 5.7% to 28.7%. Compared to the absence of sarcopenic obesity, its presence worsens OS (hazard ratio: 1.52, 95% confidence interval: 1.08-2.15, heterogeneity (I2)=66%, certainty of the evidence: low) and increases the risk of postoperative complications (relative risk ratio: 1.88, 95% CI: 1.29-2.73, I2=77%, certainty of the evidence: moderate). The risk of bias in each study was deemed moderate to high. Sarcopenic obesity worsens OS and increases the risk of postoperative complications in patients with oesophago-gastric cancer undergoing radical resection.

Drug Overdose Deaths in Mexican-Heritage Arizonans: An Examination of Mortality Rates, Demographics, Drugs Involved, and Place of Death

Objective This study examined drug overdose deaths in Mexican-heritage Arizonans, with the goal of informing tailored overdose prevention programs for this community. Methods We analyzed death certificate data (from the Arizona Department of Health Services) for drug overdose deaths among Arizona residents from 2018-2022. We compared deaths in US-born and foreign-born Mexican-heritage Arizonans and, as a frame of reference, Non-Hispanic (NH) White Arizonans. We compared demographics, circumstances of death, and mortality rates, using descriptive statistics, multinomial logistic regression models, and age-standardized mortality rates and ratios. Results The age-standardized drug overdose mortality rate (per 100,000) was lower in the overall Mexican-heritage population (28.0) than in the NH White population (35.9). Nonetheless, the rate in the US-born Mexican-heritage male subgroup (59.5) was higher than in US-born NH White males (49.9) or any other subgroup examined. Synthetic opioids such as fentanyl were involved in higher proportions of deaths among US-born (64.6%) and foreign-born (65.1%) Mexican-heritage Arizonans than among NH White Arizonans (48.5%). In multinomial regression models, the risk of a medical place of death, relative to death at home, was significantly higher in the foreign-born (adjusted Relative Risk Ratio [aRRR] 1.82; 95% Confidence Interval [CI], 1.38-2.42) and US-born (aRRR 1.85; 95% CI, 1.62-2.11) Mexican-heritage groups than the NH White group, adjusting for age, sex, marital status, county of residence, overdose intent, and drugs involved. Conclusions Findings highlight disparate rates of overdose mortality in US-born Mexican-heritage Arizona men, also underscoring racial/ethnic/nativity-based differences in overdose circumstances and decedent characteristics.

Continuous natural fiber-reinforced shape memory polymer biocomposites: design and fabrication for sustainable self-folding architectural applications

Abstract The growing demand for sustainable building materials has driven the search for innovative solutions that minimize environmental impact while enhancing architectural functionality. Nature’s adaptability to environmental changes, such as the mimosa plant’s sensitivity to temperature and touch, has inspired the development of shape memory materials like shape memory polymers (SMPs). These materials change shape in response to external stimuli, offering promising solutions for responsive and eco-friendly applications. This study investigates the use of SMP biocomposites (SMPBCs) reinforced with continuous flax fibers for sustainable architectural applications. The main aim is to enhance the mechanical and shape memory properties of these materials, focusing on design exploration, fabrication methods, and performance evaluation for architectural use. Combining material science with digital fabrication techniques, particularly tailored fiber placement, this research integrates flax fiber into thermo-responsive epoxy-based SMPs. Origami-inspired designs, including rigid and curved folding origami, were explored using a moldless fabrication technique to optimize the SMPBCs’ performance and facilitate the creation of complex three-dimensional structures. The study began with initial prototypes of simple origami shapes, followed by three architectural prototypes representing distinct origami types. Curved folding origami enhances shape memory performance by enabling larger deformation, which increases strain energy storage and allows more effective recovery. Further exploration of single and multi degree of freedom (SDOF and MDOF) designs for architectural applications revealed that curved SDOF prototypes achieved the highest shape recovery ratio (Rr %) of 97%, while rigid MDOF prototypes showed the lowest Rr of 60% and 70%. All prototypes provided a high shape fixity ratio of nearly 100%. Moreover, initial load tests on the permanent shapes demonstrated their ability to support over 240 times their weight. This research advances sustainable architecture by showing how SMPBCs with optimal geometric designs can enable self-shaping and multifunctional applications, paving the way for more adaptive, eco-friendly building materials.

Do school-based prevention programs impact co-occurring alcohol use and psychological distress during adolescence?

Adolescence is a critical period for preventing substance use and mental health concerns, often targeted through separate school-based programs. However, co-occurrence is common and is related to worse outcomes. This study explores prevention effects of leading school-based prevention programs on co-occurring alcohol use and psychological distress. Data from two Australian cluster randomized trials involving 8576 students in 97 schools were harmonized for analysis. Students received either health education (control) or one of five prevention programs (e.g. Climate Schools, PreVenture) with assessments at baseline and 6, 12, 24, and 30 or 36 months (from ages ~13-16). Multilevel multinomial regressions were used to predict the relative risk ratios (RRs) of students reporting co-occurring early alcohol use and psychological distress, alcohol use only, distress only, or neither (reference) across programs. The combined Climate Schools: Alcohol and Cannabis and Climate Schools: Mental Health courses (CSC) as well as the PreVenture program reduced the risk of adolescents reporting co-occurring alcohol use and psychological distress (36 months RRCSC = 0.37; RRPreVenture = 0.22). Other evaluated programs (excluding Climate Schools: Mental Health) only appeared effective for reducing the risk of alcohol use that occurred without distress. Evidence-based programs exist that reduce the risk of early alcohol use with and without co-occurring psychological distress, though preventing psychological distress alone requires further exploration. Prevention programs appear to have different effects depending on whether alcohol use and distress present on their own or together, thus suggesting the need for tailored prevention strategies.

The evaluation of depression prevalence and its association with obesity phenotypes in a community-dwelling aged population

BackgroundDepression is one of the most debilitating mental disorders and a risk factor for many other chronic diseases that are commonly seen in the geriatric population. It has been claimed in previous studies that depression can be associated with obesity in this age group, but there is no common consensus between their results.AimThis study aims to evaluate the association between depression metabolic syndrome and obesity phenotypes in community-dwelling older adults living in the East of Iran.Method and materialsAs a part of the Birjand Longitudinal Aging Study, this retrospective cross-sectional study was conducted on participants older than 60. They were categorized based on their body mass index and components of metabolic syndrome into four phenotypes: metabolic non-healthy obese (MNHO), metabolic healthy obese (MHO), metabolic healthy non-obese (MHNO), and metabolic non-healthy non-obese (MNHNO). The relative risk ratio (RRR) of the obesity phenotypes, the severity of depressive symptoms, and the 95% confidence intervals (95% CI) were evaluated by univariate and multinomial logistic regression.ResultsOf 1344 eligible participants, 268 (19.94%) had depression. Moderate, moderate-severe, and severe depression were observed in 179 (13.32%), 67 (4.99%), and 22 (1.64%) participants, respectively. Our findings showed a non-significant increase in the RRR of mild depressive symptoms in MNHO (RRR:1.22, 95% CI 0.56–2.66) and severe symptoms in MNHNO (RRR:1.20, 95% CI 0.02–63.17) females. However, in male participants, the RRR of moderate-severe depressive symptoms only increased non-significantly for the MNHO category (RRR:1.34, 95% CI 0.45–3.98).ConclusionWe did not observe a meaningful association between depressive symptoms and obesity phenotypes. Also, other than malnutrition or its risk, various severities of depressive symptoms correlate with different sociodemographic and medical risk factors among male and female senior citizens.

Career choices and career mobility of chinese pharmacy graduates: a cross-sectional study

BackgroundThis study investigates the career mobility and employment status of Chinese pharmacy graduates, aiming to address workforce challenges and career planning within the pharmacy profession. Given the rapid expansion of the healthcare sector in China, understanding factors influencing job changes and career decisions is crucial for ensuring workforce stability and professional development. The study covers pharmacy graduates enrolled at Kunming Medical University from 1996 to 2012.MethodsA cross-sectional online survey collected data from 231 respondents in April 2022, focusing on demographic characteristics, career choices, job changes, and the factors influencing these decisions. Multivariate logistic regression and Chi-square (χ²) tests were used to analyze the data, with a particular focus on the pharmacy practice, pharmaceutical sciences, and clinical pharmacy.ResultsOf the 231 respondents, 52.4% (n = 121) had never changed jobs, and 32.5% (n = 75) had changed jobs once or twice. The majority preferred working in governmental institutions (n = 146, 63.2%), with fewer graduates choosing domestic (n = 48, 20.8%) or overseas pharmacy enterprises (n = 20, 8.7%). Income and personal growth were significant factors influencing job changes (p < 0.05). Respondents who had changed jobs three or more times placed a greater emphasis on personal growth (Relative Risk Ratio [RRR]: 2.96; 95% Confidence Interval [CI]: [1.6, 5.49]).ConclusionsThis study reveals significant variations in job mobility and career choices among Chinese pharmacy graduates. Graduates in governmental institutions showed lower mobility, while those in pharmacy enterprises and non-pharmaceutical sectors experienced higher job changes. Income, personal growth, and work environment were key factors.

Genetic Characterization of Plasmodium falciparum Histidine-Rich Protein 2 Deletions and Their Impact on Malaria Interventions in Odisha, India.

Diagnostic escape via Plasmodium falciparum (P. falciparum) histidine-rich protein 2 (pfhrp2) gene deletions is a major potential hurdle for global malaria elimination efforts. We investigated the prevalence of pfhrp2 gene deletions in 15 malaria-endemic villages in the state of Odisha, India, and modeled their impact on an ongoing in-country malaria intervention program. We found that 61.6% of subpatent P. falciparum infections (i.e., rapid diagnostic test [RDT]-negative and positive by polymerase chain reaction [PCR]) had pfhrp2 gene deletions, which were predominantly located in the exon 2 region (96.2%) and largely identified in samples from febrile individuals (82.6%). DNA sequencing and protein diversity features were characterized in a subset of samples from individuals with subpatent infections carrying intact pfhrp2 exon 2 loci. Our analyses revealed novel amino acid repeat motifs (231-293 amino acids), and these variant repeat sequences differed from those of RDT+/PCR+ samples. We also evaluated the state-sponsored mass screening and treatment intervention in the context of pfhrp2 gene deletions. We found that mass screening and treatment conducted alongside additional interventions (e.g., long-lasting insecticidal net distribution, indoor residual spraying) reduced the relative risk of infection for both P. falciparum parasites harboring a pfhrp2 deletion (adjusted relative risk ratio [aRRR] = 0.3; 95% CI = 0.1-1.0) and P. falciparum parasites with intact pfhrp2 genes (aRRR = 0.4; 95% CI = 0.2-1.1) when compared with the use of mass screening and treatment by RDT alone. Combined, our findings highlight the need for alternative diagnostic targets and tools as India moves toward its goal of malaria elimination by 2030.

Age-related characteristics of sedation in pediatric patients and their correlated adverse events: a cohort study.

The objective of this research was to examine the features and potential hazards of sedation in children of varying ages. Additionally, the study aimed to comprehend these variations to enhance the safety and efficacy of clinical applications. A retrospective analysis was conducted on case data involving pediatric patients who underwent imaging procedures in outpatient settings and necessitated procedural sedation from 2022 to 2024. The research participants were categorized into three age groups: ≤1 year, 1-3 years, and 3-12 years. The primary sedative agents administered were oral midazolam in conjunction with intranasal dexmedetomidine. We examined the effects of sedation and the occurrence of adverse events across various age groups. Additionally, we applied multivariate logistic regression to identify factors linked to these adverse events. The study observed 2,194 children, with 879 (40.1%) being ≤1-year-old. The ≤1-year-old group achieved faster sleep onset at 18.7 ± 0.3 min, with no significant variance in awakening time and length of stay among the groups. The incidence of adverse events varied significantly by age, with the highest rate of 12.2% in the ≤1-year-old group and the lowest rate of 9.7% in the 3-12-year-old group. Multivariate analysis revealed age as an independent factor affecting adverse event occurrence, with a relative risk ratio (AOR) of 2.21 (95% CI: 1.31-3.75) for delayed awakening in children ≤1-year-old, 15.03 (95% CI: 1.92-117.61) for hypoglycemia, and a relative risk ratio (AOR) of 4.58 (95% CI: 2.22-9.42) for receiving a significant intervention. Significant variations in sedation reactions and adverse events were observed across the different age groups. Specifically, children aged ≤1 year exhibited a higher susceptibility to adverse events such as delayed awakening and hypoglycemia. chictr.org.cn identifier (ChiCTR2400082774).

Menstrual cup acceptability and functionality in real-world use: A cross-sectional survey of young people in Australia.

Menstrual cups offer a cost-effective and environmentally sustainable product for many young people. While clinical trials have shown their safety and effectiveness, no studies have investigated their performance in real-world use. To describe the acceptability and functionality (continuation, discomforts, leakage, and adverse events) of menstrual cups and investigate the supportive role of product knowledge. A cross-sectional online survey of 530 people aged 15-24 living in Australia who had ever used a menstrual cup, recruited via a menstrual cycle tracking application. More than half of participants (55%) were still using their first menstrual cup at the time of the survey, 16% had switched to an alternative cup, and 29% had discontinued use. In their first cycle of use, 54% of participants reported leakage and 25% reported pain or discomfort with the cup in place. Many participants (45%) reported being unable to remove the cup on their first attempt, with subsequently 17% requiring help to remove it, and 2% reported displacement of an intra-uterine device during removal. These figures decreased for subsequent cycles. Half of the participants were aware prior to using a cup that different cup models may offer a better fit for different individuals. This knowledge was associated with decreased odds of needing help to remove the cup (adjusted odds ratio 0.57, 95% CI 0.35-0.94) or discontinuing use (adjusted relative risk ratio 0.66, 95% CI 0.44-1.00). Difficulties using menstrual cups are common in real-world use and higher than reported in clinical trials. Improved education provision may support more positive user experiences.

Association Between Dairy Products Consumption and Esophageal, Stomach, and Pancreatic Cancers in the PANESOES Multi Case-Control Study.

Background/Objectives: This study explored the association between dairy products consumption (total and subgroups) and cancer of the esophagus, stomach, and pancreas within the PANESOES case-control study. Methods: Data from 1229 participants, including 774 incident cases of cancer and 455 controls matched by age, sex, and region, were analyzed. Dietary intake was assessed using a validated Food Frequency Questionnaire, categorizing dairy intake by total and subgroups (fermented dairy, sugary dairy desserts, and milk). Multinomial logistic regression was used to estimate relative risk ratios (RRRs), adjusting for confounders. Results: We found an inverse association between moderate dairy consumption (T2) and esophageal cancer (RRR T2 vs. T1 = 0.59 (95%CI: 0.37-0.96)). The highest tertile (T3) of fermented dairy was associated with a lower risk of esophageal (RRR T3 vs. T1 = 0.55 (0.33-0.90)) and stomach cancers (RRR T3 vs. T1 = 0.68 (0.47-0.97)). By contrast, the highest tertile of consumption of sugary dairy desserts was associated with a higher risk of stomach cancer (RRR T3 vs. T1 = 1.85 (1.30-2.64)). No association was found for milk. Conclusions: This study suggests that fermented dairy may reduce the risk of esophageal and stomach cancers, while sugary dairy desserts may increase the risk of stomach cancer.

Impacts of hypertension and diabetes on the incidence of cardiovascular diseases and all-cause mortality: findings from the China Health and Retirement Longitudinal Study cohort.

The study aimed to examine the individual and joint effects of hypertension and diabetes on cardiovascular diseases and all-cause mortality among the middle-aged and older Chinese population. A total of 9681 individuals without preexisting CVD from the China Health and Retirement Longitudinal Study (CHARLS) were included. Participants were classified into four different groups: hypertension alone, diabetes alone, both conditions, neither condition. Multivariate Cox proportional hazards models were performed to estimate the risks of all-cause mortality and CVD. During the 7-year follow-up, 967 deaths and 1535 CVD events were documented. Compared to individuals without hypertension and diabetes, hypertension alone [adjusted hazard ratio (aHR) 1.571, 95% confidence interval (CI) 1.316-1.875, P < 0.001], diabetes alone (aHR 1.618, 95% CI 1.187-2.205, P < 0.01) and comorbid hypertension and diabetes (aHR 2.041, 95% CI 1.557-2.677, P < 0.001) increased risks of all-cause mortality. The aHRs for CVD events in individuals with both conditions, hypertension alone and diabetes only were 2.011 (95% CI 1.651-2.449, P < 0.001), 1.408 (95% CI 1.233-1.608, P < 0.001) and 1.036 (95% CI 0.808-1.327, P > 0.05), respectively. The risk of CVD among those with comorbid hypertension and diabetes exceeded the sum of the risks due to hypertension and diabetes alone (relative excess risk ratio = 0.567, 95% CI 0.136-0.999). Individuals with comorbid hypertension and diabetes had greater risks of CVD and all-cause mortality, beyond those associated with either condition alone. The synergistic interaction between hypertension and diabetes aggravated the risk of CVD.

Identifying food behavior profiles among adult US cancer survivors: a latent class analysis.

This study sought to identify subgroups of adult cancer survivors with distinct food behavior patterns and to examine group characteristics. Data from adult cancer survivors, ages 20-64, in the 2007-2016 National Health and Nutrition Examination Survey was used to conduct latent class analyses to identify food behavior subgroups, based on five indicator variables. Associations between latent food behavior class membership and key sociodemographic and cancer-related characteristics were examined using adjusted multinomial regression models. Four unique food behavior classes were identified and named, characterized by the degree to which they purchased and consumed convenience foods: Home Cooks (48.4% of the sample), Non-Cooks/Eats Out (29.8%), Need Convenience (11.3%), and Quick Food at Home (10.5%). Shorter time since diagnosis was associated with higher adjusted relative risk ratios (ARRR) of belonging to the Non-Cooks/Eats Out class (ARRR 12.4, 95% CI 2.3, 68.0) and the Quick Food at Home class (ARRR 18.6, 95% CI 3.5, 98.4). Older age, lower educational attainment, and larger household size were also associated with a higher likelihood of belonging to the Quick Food at Home class. There are certain patterns of food behaviors among cancer survivors, and these patterns are related to both cancer-related and sociodemographic factors. As food purchasing and consumption behaviors are precursors to dietary outcomes, identifying the food behavior profiles of cancer survivors may help providers recognize those who could benefit from dietary interventions or supports and receive the necessary resources that would support patients in improving their diets.

Blood pressure in young Aboriginal and Torres Strait Islander people: analysis of baseline data from a prospective cohort study.

To assess the distribution of blood pressure levels and the prevalence of hypertension and pre-hypertension in young Indigenous people (10-24 years of age). Prospective cohort survey study (Next Generation: Youth Wellbeing Study); baseline data analysis. Aboriginal and Torres Strait Islander people aged 10-24 years living in regional, remote, and urban communities in Central Australia, Western Australia, and New South Wales; recruitment: March 2018 - March 2020. Blood pressure categorised as normal, pre-hypertension, or hypertension using the 2017 American Academy of Pediatrics guidelines (10-17 years) or 2017 American College of Cardiology/American Heart Association guidelines (18-24 years); associations of demographic characteristics and health behaviours with hypertension and pre-hypertension, reported as relative risk ratios (RRRs) with 95% confidence intervals (CIs). Complete data were available for 771 of 1244 study participants (62%); their mean age was 15.4 years (standard deviation [SD], 3.9 years), 438 were girls or young women (56.8%). Mean systolic blood pressure was 111.2 mmHg (SD, 13.7 mmHg), mean diastolic blood pressure 66.3 mmHg (SD, 11.0 mmHg). Mean systolic blood pressure was higher for male than female participants (mean difference, 6.38 mmHg; 95% CI, 4.60-8.16 mmHg), and it increased by 1.06 mmHg (95% CI, 0.76-1.36 mmHg) per year of age. Mean systolic blood pressure increased by 0.42 mmHg (95% CI, 0.28-0.54 mmHg) and diastolic blood pressure by 0.46 mmHg (95% CI, 0.35-0.57 mmHg) per 1.0 kg/m2 increase in body mass index. Ninety-one participants (11.8%) had blood pressure readings indicating pre-hypertension, and 148 (19.2%) had hypertension. The risks of pre-hypertension (RRR, 4.22; 95% CI, 2.52-7.09) and hypertension (RRR, 1.93; 95% CI, 1.27-2.91) were higher for male than female participants; they were greater for people with obesity than for those with BMI values in the normal range (pre-hypertension: RRR, 2.39 [95% CI, 1.26-4.55]; hypertension: RRR, 3.20 [95% CI, 1.91-5.35]) and for participants aged 16-19 years (pre-hypertension: 3.44 [95% CI, 1.88-6.32]; hypertension: RRR, 2.15 [95% CI, 1.29-3.59]) or 20-24 years (pre-hypertension: 4.12 [95% CI, 1.92-8.85]; hypertension: RRR, 4.09 [95% CI, 2.24-7.47]) than for those aged 10-15 years. Blood pressure was within the normal range for most young Indigenous people in our study, but one in three had elevated blood pressure or hypertension. Community-level, culturally safe approaches are needed to avoid the early onset of cardiovascular risks, including elevated blood pressure.

The effect of tobacco use on clinical outcomes in total knee arthroplasty patients

Introduction Previous research has established that smoking significantly increases the complication rate of total knee arthroplasty (TKA). Risk of infection, prosthetic loosening, fractures, wound healing issues, and revisions are increased in smokers, but research is limited on the long-term clinical outcomes of pain, range of motion, stability, and functionality between smokers, nonsmokers, and former smokers, specifically utilizing Knee Society Scores (KSS). Methods This was a retrospective chart review of primary TKA patients (n = 203) at a single university hospital. The patients were divided by smoking status: nonsmoker, current smoker, or former smoker. One-way analysis of variance with associated f ratios was performed to assess variance in KSS by smoking status over time. Relative risk ratio analyses were employed to assess patients’ predictive risk of acquiring postoperative infection and requiring additional surgery following TKA based on smoking status. Results Postoperative KSS were significantly lower in the smoker group compared to nonsmokers and former smokers at 6 weeks and 1 year. For every 20 months a former smoker used tobacco, an approximate 1-point decrease in KSS was expected. The relative risk ratios for postoperative infection rates and patients requiring additional surgery were 2.13 and 1.44, respectively, when current smokers were compared to nonsmokers. Conclusions This analysis found that current smokers had lower KSS and higher infection rates following TKA when compared to nonsmoking controls. In addition, increased duration of smoking was correlated with poorer outcomes within the former smoker group.

Factors Associated with Occurrence of Amputation in Electrical Burns

Background: Electrical burns can cause damage to blood vessels in the burning extremities . This damage can lead to amputation that significantly impacts both physically and psychologically that affects the quality of life. This study aimed to determine the incidence and factors associated with the occurrence of amputation in electrical burns. Method: A retrospective cohort study was done to patients with electrical burns that came to RSHS from 2011 to 2013. Mulativariate analysis, logistic regression, was performed on the factors associated with the occurrence of amputation in electrical burns. Result: Most of the electrical burns were suffered by men (93.5%) at reproductive age (mean 34.1 years; range 10-60 years of age). The incidence of amputation in electrical burns is 54.8% from 31 patients. There is a significant relationship between the causes of high-voltage electrical burns&gt; 1000V with the occurrence of amputation (p = 0.008; Relative risk ratio 8,125 ; 95% CI= 1,62-40,752) and there is a significant relationship between the presence of third degree of burns with amputation (p = 0,011; Relative risk ratio 16; 95 % CI=1,643-155,76). There is no significant relationship between the extent of burns and lactate levels with the amputation on electrical burns. Conclusion: Amputation in electrical burns have a fairly high incidence. High electrical voltage&gt; 1000V and presence of third degree of burns are associated with the occurrence of amputation.

Testing the equality of response rate functions for paired binary data with multiple groups.

In clinical trials, we often encounter observations from patients' paired organs. In paired correlated data, there exist various measures to evaluate the therapeutic responses, such as risk difference, relative risk ratio, and odds ratio. These measures are essentially some forms of response rate functions. Based on this point, this article aims to test the equality of response rate functions such that the homogeneity tests of the above measures are special cases. Under an interclass correlation model, the global and constrained maximum likelihood estimations are obtained through algorithms. Furthermore, we construct likelihood ratio, score, and Wald-type statistics and provide the explicit expressions of the corresponding tests based on the risk difference, relative risk ratio, and odds ratio. Monte Carlo simulations are conducted to compare the performance of the proposed methods in terms of the empirical type I error rates and powers. The results show that the score tests perform satisfactorily as their type I error rates are close to the specified nominal level, followed by the likelihood ratio test. The Wald-type tests exhibit poor performance, especially for small sample sizes. A real example is given to illustrate the three proposed test statistics.