Self-reported Information Research Articles

Self-Reported SARS-CoV-2 Vaccination Is Consistent with Electronic Health Record Data among the COVID-19 Community Research Partnership.

Introduction: Observational studies of SARS-CoV-2 vaccine effectiveness depend on accurate ascertainment of vaccination receipt, date, and product type. Self-reported vaccine data may be more readily available to and less expensive for researchers than assessing medical records. Methods: We surveyed adult participants in the COVID-19 Community Research Partnership who had an authenticated Electronic Health Record (EHR) (N = 41,484) concerning receipt of SARS-CoV-2 vaccination using a daily survey beginning in December 2020 and a supplemental survey in September–October 2021. We compared self-reported information to that available in the EHR for the following data points: vaccine brand, date of first dose, and number of doses using rates of agreement and Bland–Altman plots for visual assessment. Self-reported data was available immediately following vaccination (in the daily survey) and at a delayed interval (in a secondary supplemental survey). Results: For the date of first vaccine dose, self-reported “immediate” recall was within ±7 days of the date reported in the “delayed” survey for 87.9% of participants. Among the 19.6% of participants with evidence of vaccination in their EHR, 95% self-reported vaccination in one of the two surveys. Self-reported dates were within ±7 days of documented EHR vaccination for 97.6% of the “immediate” surveys and 92.0% of the “delayed” surveys. Self-reported vaccine product details matched those in the EHR for over 98% of participants for both “immediate” and “delayed” surveys. Conclusions: Self-reported dates and product details for COVID-19 vaccination can be a good surrogate when medical records are unavailable in large observational studies. A secondary confirmation of dates for a subset of participants with EHR data will provide internal validity.

Implementation of a Structured Surgery Mentorship Program and Success in the Surgical Residency Match

IntroductionGeneral Surgery residency programs remain competitive, with over a quarter of US MD seniors failing to match into a categorical program each year. While previous literature has shown the role of mentorship in attracting medical students to surgery, there is a dearth of information demonstrating the role of mentorship in successfully matching those students to surgery programs. MethodsWe implemented a structured mentorship program for medical students interested in applying to general surgery or integrated plastics, vascular, or cardiothoracic residencies over the course of one year, consisting of seven standardized meetings and events spanning the students’ MS3 and MS4 years. Following Match Day, we sent students a five-point Likert scale survey to assess the perceived utility of each event and solicited self-reported application information. ResultsOf the 22 students at a single institution who attended the structured mentorship program and applied to general surgery residency, 100% matched into a categorical program, significantly higher than the 73% national match rate of US MD seniors into general surgery (P < 0.01). There were no significant differences between the two cohorts in terms of United States Medical Licensing Examination board scores, Alpha Omega Alpha Honor Society status, or median number of publications, research experiences, work experiences, or volunteer experiences. Nineteen of the 22 students responded to the survey, yielding an 86% response rate. Ninety percent of the students attended at least six out of the seven events. Six out of the seven events had median helpfulness scores (out of five) that were significantly higher than a “neutral” baseline (P < 0.05). ConclusionsA structured mentorship program may play a useful role in successfully matching general surgery applicants to residencies and would be a simple and low-cost program to implement at other medical schools.

Sex differences in association between Internet addiction and aggression among adolescents aged 12 to 18 in mainland of China

BackgroundPrevious studies have reported that Internet addiction (IA) is an important predictor of aggression. However, little is known whether aggression is a risk factor of IA. This study aims to explore whether IA can predict total and sub-types of aggression, whether aggression also can predict IA, and the potential sex difference. MethodA total of 15,977 adolescents aged 12 to 18 were recruited though a stratified cluster sampling across five representative provinces in mainland of China. Young's Internet Addiction Test (IAT) and Buss and Warren's Aggression Questionnaire (BWAQ) were used to measure IA and aggression, respectively. ResultsThe prevalence of IA and total aggression was 16.8 % and 25.0 %, respectively. Binary logistic regression analysis indicated that IAT score was significantly associated with total and five sub-types of aggression (P < 0.001). However, scores of physical aggression, hostility, and indirect aggression were positively associated with IA (P < 0.001), while verbal aggression and anger were not significant (P > 0.05). Moreover, the interaction of sex and IA was significant for aggression. Specifically, females with IA had higher risks of anger and indirect aggression but had lower risks of physical and verbal aggression compared to males with IA. LimitationsCross-sectional design, self-reported information, and only Chinese rural adolescents. ConclusionsIA is a strong risk factor of total and five sub-types of aggression, while not all sub-types of aggression are predictors of IA. Prevention programs for adolescents' IA and aggression should consider different aggression sub-types and sex.

Abstract 5892: Factors associated with longitudinal changes in mammographic density in a multiethnic breast screening cohort of postmenopausal women

Abstract Mammographic density is an important risk factor for breast cancer and is known to differ in women by characteristics such as age and race/ethnicity. Women who experience longitudinal decreases in breast density have a reduced risk of breast cancer; however, besides age, which correlates with decreases in breast density, it is unclear what other factors contribute to changes in breast density over time. Understanding factors associated with density changes may enable a better understanding of breast cancer risk and potential strategies for prevention. This study investigated factors associated with changes in mammographic density in a cohort of 3,392 postmenopausal women (mean age=61.3±8.8 years) with no history of breast cancer who had at least two mammograms spaced at least three months apart at a University of California, Irvine Health breast imaging facility between 2011-2017. Self-reported information on demographics, breast and reproductive history, and lifestyle factors, including body mass index (BMI), alcohol intake, smoking, and physical activity, was collected by an electronic intake form, and Breast Imaging Reporting and Database System (BI-RADS) mammographic density scores were obtained from electronic medical records. 7.9% of women exhibited a longitudinal decrease in mammographic density, 6.7% exhibited an increase, and 85.4% exhibited no change. Longitudinal changes in mammographic density were statistically significantly correlated with age, race/ethnicity, and age at menopause by univariate analysis using the Fisher’s exact test. Multivariate conditional logistic regression using baseline mammographic density as strata was performed to identify factors associated with a longitudinal increase or decrease in mammographic density. Variables were selected if they were nominally significant (p &amp;lt; 0.10) in the initial univariate analyses of women who exhibited a longitudinal change in mammographic density (race/ethnicity, age at baseline, menopause age) or were otherwise selected a priori based on previous literature showing an association with mammographic density (alcohol, physical activity, BMI). Asian women were more likely to exhibit a longitudinal increase in mammographic density (OR=1.78, 95% CI=1.02-3.09, p=0.04) and less likely to exhibit a decrease (OR = 0.58, 95% CI = 0.40-0.83, p=0.003) compared to white women. On the other hand, overweight and obese women were less likely to exhibit an increase compared to normal weight women (OR = 0.52, 95% CI = 0.31-0.87, p=0.01; OR = 0.41, 95% CI = 0.23-0.75, p=0.004, respectively). Other lifestyle factors (alcohol intake, smoking, and physical activity) were not associated with longitudinal changes in mammographic density. The potential interactions of Asian race and BMI with longitudinal breast density changes in influencing breast cancer risk should be further studied. Citation Format: Roza L. Kirmizi, Christie J. Lee, Hannah Lui Park, Argyrios Ziogas, Andrea Alvarez, Rachel M. Lucia, Deborah Goodman, Kathryn M. Larsen, Richard Kelly, Hoda Anton-Culver, Stephen A. Feig. Factors associated with longitudinal changes in mammographic density in a multiethnic breast screening cohort of postmenopausal women [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5892.

Psychometric Evaluation of the Affect Regulation Checklist: Clinical and Community Samples, Parent-Reports and Youth Self-Reports.

The Affect Regulation Checklist (ARC) was designed to capture affect dysregulation, suppression, and reflection. Importantly, affect dysregulation has been established as a transdiagnostic mechanism underpinning many forms of psychopathology. We tested the ARC psychometric properties across clinical and community samples and through both parent-report and youth self-report information. Clinical sample: Participants included parents (n = 814; Mage = 43.86) and their child (n = 608; Mage = 13.98). Community sample: Participants included independent samples of parents (n = 578; Mage = 45.12) and youth (n = 809; Mage = 15.67). Exploratory structural equationmodeling supported a three-factor structure across samples and informants. Dysregulation was positively associated with all forms of psychopathology. In general, suppression was positively associated with many forms of psychopathology, and reflection was negatively associated with externalizing problems and positively associated with internalizing problems.

Use of permethrin and other pyrethroids and mortality in the Agricultural Health Study

ObjectivesPyrethroid insecticides have been linked with multiple health outcomes. One study reported an association with increased all-cause and cardiovascular mortality. Given the widespread use of pyrethroids, these findings warrant confirmation....

Self-monitoring of psychological stress-induced blood pressure in daily life using a wearable watch-type oscillometric device in working individuals with hypertension

This study investigated psychological stress-induced blood pressure (BP) elevation according to self-measured data obtained by a wearable watch-type oscillometric device for multiple days in 50 working hypertension patients (mean ± SD age: 60.5 ± 8.9 years; 92.0% men; 96% treated for hypertension). Participants were asked to self-measure their BPs at five predetermined times as well as at any additional time points at their own discretion under ambulatory conditions for a maximum of 7 days. At the time of each BP measurement, participants self-reported their location, emotion, and degree of stress. A total of 1220 BP readings with self-reported situational information were obtained from 50 participants over 5.5 ± 1.2 days. Systolic BP (SBP) and diastolic BP (DBP) measured during moments of self-reported negative emotions (i.e., anger, tension, anxiety, or sadness) were significantly higher (5.0 ± 1.3 and 2.0 ± 0.8 mmHg, both p < 0.05) than those during moments of self-reported positive emotions (i.e., happiness or calm). SBP/DBP were significantly increased under a moderate or high degree of stress by [4.5 ± 1.1]/[2.5 ± 0.7] and [10.2 ± 3.0]/[4.7 ± 1.8] mmHg, respectively. As a result, it was estimated that SBP/DBP increased 15.2/8.5 mmHg in the presence of highly stressful negative emotions. In conclusion, self-measurement of BP monitoring with a wearable device for multiple days is a feasible method to detect daily stress-induced BP elevation in working adults.

An Investigation of Longitudinal Associations Between Psychological Distress and Student Victimization by Teachers.

Previous research has suggested that psychological distress (i.e., anxiety, depression, and somatization) is associated with student victimization by teachers. The direction and causality of this relationship have not yet been empirically supported. This study examined longitudinal associations between adolescent psychological distress (anxiety, depression, and somatization) and student victimization by teachers among 419 adolescents in grades 7-9 of secondary schools in Hong Kong. A self-administered questionnaire was conducted to collect student self-reported information about their experiences of victimization by teachers and their psychological distress, including depression, anxiety, and somatization, at two time points separated by a 9-month interval. A cross-lagged panel analysis provided evidence for the contribution of depression, anxiety, and somatization to later victimization by teachers. These findings were also relevant for male and female adolescents. The findings suggest that psychological distress, such as depression, anxiety, and somatization, is a risk factor predicting student victimization by teachers rather than the consequences of exposure to teacher violence. The results support the importance of reducing adolescent depression, anxiety, and somatization symptoms in future intervention programs to prevent them from being victimized by teachers.

Influenza Vaccination and COVID-19 Outcomes in People Older than 50 Years: Data from the Observational Longitudinal SHARE Study.

Existing literature on the association between influenza vaccination and COVID-19 infection/outcomes is conflicting. Therefore, we aimed to investigate the association between influenza vaccination and COVID-19 outcomes in a large cohort of adults who participated in the SHARE (Survey of Health, Ageing, and Retirement in Europe). Information regarding influenza vaccination in the previous year, and medical and demographic characteristics, were self-reported. Positivity for COVID-19, symptomatology, and hospitalization were also ascertained using self-reported information. An adjusted logistic regression analysis (including 15 baseline factors or propensity score) was used to assess the association between influenza vaccination and COVID-19 outcomes. A total of 48,408 participants (mean age 67 years; 54.1% females) were included. The prevalence of influenza vaccination was 38.3%. After adjusting for 15 potential confounders, influenza vaccination was significantly associated with a lower risk of positivity for COVID-19 (OR = 0.95; p < 0.0001), symptomatic forms (OR = 0.87; p < 0.0001), and hospitalization for COVID-19 (OR = 0.95; p < 0.0001). The results were similar when using a propensity score approach. In conclusion, influenza vaccination may be beneficial for the prevention of COVID-19, as the present study found that influenza vaccination was associated with a small/moderate lower risk of COVID-19 infection and adverse outcomes.

Intracellular Nutritional Biomarker Differences in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Subjects and Healthy Controls

ObjectivesA comparison of the nutritional biomarkers between ME/CFS subjects and healthy controls (HC) was undertaken on secondary data collected from an IRB approved cross-sectional study in ME/CFS patients.MethodsME/CFS participants were recruited per the 2018 revised Canadian Clinical Case Definition for ME/CFS along with age matched HCs. Self-reported information on demographics and supplement use was collected, and body mass index calculated. HEI was calculated from Willet FFQ and multiple day 24-hour recall data, and severity of fatigue measured by Multidimensional Fatigue Inventory (MFI). Lymphocyte transformation assay by SpectraCell Lab (Houston, TX) was employed for intracellular micronutrient status. A series of two-tailed Mann-Whitney U tests (ɑ = 0.05) were performed for the non-parametric data expressed as mean ± standard error of the mean. All statistical analyses were conducted in IBM SPSS Statistics version 25 (Armonk, NY).ResultsOut of the 21 participants (11 ME/CFS and 10 HC), 82% of ME/CFS and 50% of HC were female. Higher fatigue scores were observed in ME/CFS (16.64 ± 1.36) than HC (10.78 ± 2.14). ME/CFS had better HEI scores (63.36 ± 13.44) than the HC (38.55 ± 12.29). However, despite better diet quality and supplementation, ME/CFS group showed lower intracellular Vitamin B3 and manganese (Mn) (86.3 ± 2.42 and 53.6 ± 2.81 respectively) but higher calcium (Ca) (57.5 ± 3.55) as compared to HC (97.2 ± 2.31, 64.5 ± 1.87 and 46.5 ± 0.96 respectively).ConclusionsThe results align with the current literature on indications of mitochondrial dysfunction in ME/CFS. Reduced intracellular vit B3 provides suboptimal production of the NAD(P)(H)-cofactor family, thus affecting mitochondrial function and consequently energy production. The aberration in energy metabolism is compounded by other factors, such as reduced Mn but higher Ca intracellular levels seen in this study indicating disruptions in oxidative stress pathways, resulting in debilitating fatigue experienced by individuals with ME/CFS.Funding SourcesNSU Presidential Faculty Research and Development Grant.

Shift work and job satisfaction among Palestinian nurses: a cross-sectional study

BackgroundRotating shift work is associated with job dissatisfaction, sleeping disturbances, and health problems compared with working only in the daytime. Whether the relationship between rotating shift work and job satisfaction differs between the sexes among nurses in occupied Palestinian territory is unclear. We investigated this relationship and compared it with that among regular day workers. MethodsWe did a cross-sectional study in Hebron district in August to October, 2008, involving all registered nurses with at least 1 year of practice. Those who worked fixed evening or night shifts or who were on leave were excluded. Job satisfaction was assessed with the Generic Job Satisfaction scale, containing ten items with scores from 1 to 5; a higher score indicated a higher (better) job satisfaction. Associations were assessed with β coefficients and 95% CIs and χ2 tests in linear regression analyses. Statistical analyses were done with Stata (version 10). The threshold for significance was set at p=0·05. The study was approved by the Palestinian Ministry of Health. Written informed consent was obtained from all participants. FindingsOf 472 eligible nurses, 426 (90%) were included in the study: 259 women and 167 men, among whom 217 worked shifts and 209 who worked only during the daytime. The mean job satisfaction score among female nurses was 32·6 (SD 6·4) and among male nurses was 31·7 (SD 7·0). Crude analyses showed that male and female shift workers reported lower job satisfaction than those working day shifts (mean score 30·8 [SD 6·5] vs 33·8 [6·4]). After adjustment for age, number of children, years of education, and job title, this effect remained statistically significant only among male nurses, as the men with rotating shift-work reported job scores 3·5 points lower than those working only during the daytime (β coefficient –3·5, 95% CI –5·9 to –1·1; p=0·005) whereas for women the β coefficient value was 0·10 (95% CI –1·8 to 2·1, p=0·90). InterpretationMale nurses working rotating shift patterns reported lower job satisfaction than men working only during the daytime, whereas no difference was found for female nurses. Because both exposure and outcome were measured using self-reported information and the study design was cross-sectional, interpretation of the results should be made with caution. However, further studies should investigate whether shift work affects the quality of patients’ care. FundingNorwegian Programme for Development, Research and Education.

A Comparison of Methods to Adjust Risk Models for Measurement Error in Dietary Exposure

ObjectivesTo compare approaches to adjust for measurement error when exploring the relationship between the sodium-to-potassium ratio and hypertension and blood pressure.MethodsUsing National Health and Nutrition Examination Survey (NHANES) data from 2005–2010, Zhang et al. (2013) examined relationships between the sodium-to-potassium ratio (Na:K) and hypertension and blood pressure. They used the Iowa State University (ISU) Method to account for measurement error assuming the dietary intakes assessed with up to two 24-hour recalls (24 HR) per person were unbiased for long-term (usual) intake. We replicated their analytic dataset (n = 10,467 adults ³20 y). Systolic and diastolic blood pressure values were calculated as the mean of three readings; a binary variable for hypertension status was derived from blood pressure values and self-reported health information. Logistic (hypertension) and linear (blood pressure) models were adjusted for age, sex, and race/ethnicity. The primary exposure variable, Na:K, was obtained from calibration models that adjusted for random variation in the 24 HR. The National Cancer Institute (NCI) Method used regression calibration from a joint model - fit with two methods, maximum likelihood and Markov Chain Monte Carlo (MCMC) - for sodium and potassium. A third model used the ISU Method to univariately model each component. All calibration models adjusted for the same covariates as the regression models plus nuisance effects. Standard errors for estimates and differences (e.g., MCMC - ISU) were computed using Balanced Repeated Replication to account for NHANES’ survey design.ResultsBoth NCI implementations gave nearly equivalent results that sometimes differed from the ISU results. A one-unit increase in Na:K was associated with a mean systolic blood pressure increase of 2.82 mmHg, se .57 (ISU) vs. 3.87 mmHg, se .87 (MCMC) (t-test pdiff = 0.005), and a mean diastolic blood pressure increase of 0.80 mmHg, se .43 (ISU) vs. 0.61, se .68 (MCMC) (pdiff = 0.495). A one-unit increase in Na:K was associated with an increase of 0.41, se .11 (ISU) vs. 0.63, se .18 (MCMC) (pdiff = 0.008) in the log odds of hypertension.ConclusionsThe choice of modeling approaches for 24 HRs may affect estimated error-corrected relationships between health outcomes and dietary intake.Funding SourcesVanier Canada Graduate Scholarship.

Factors Associated with Obesity Adjusting for Self-Reported Skin Color-Ethnicity Versus Genomic Ancestry in Admixed Brazilian Population

ObjectivesTo evaluate differences in factors associated with obesity, considering self-reported color-ethnicity information in comparison with genomic ancestry in admixed Brazilian population.MethodsData from 563 free-living unrelated individuals aged ≥12 years (mean = 47; min. = 12; max = 93) of cross-sectional population-based Health Survey of São Paulo with Focus on Nutrition (2015 ISA-Nutrition) were evaluated, including self-reported skin color-ethnicity, blood samples and other information collected in 2015. Genotyping was accessed from blood using Axiom™ PMR Array, resulting in 555,064 high-performing markers, after quality control and merging with 1000 Genomes Project data. Population structure was evaluated using principal component analysis (PCA). Factors associated with obesity were assessed using two logistic regression models: 1) using self-reported skin color-ethnicity (white, black, mixed, or other), and 2) using the first four components of PCA. Other variables included in models were sex, age, age squared, income, education, marital status, smoking status, physical activity, diet quality, high blood pressure, diabetes, and dyslipidemia.ResultsPrevalence of obesity in the sample was 24.9%. In model 1, factors positively associated with obesity were: female (OR = 2.1; 95%CI = 1.3–3.3, ref. = male), educational level adequate for age (OR = 1.7; 95%CI = 1.0–2.9, ref. = lower education level for age), being divorced (OR = 2.8; 95%CI = 1.4–5.6, ref. = married), and having high blood pressure (OR = 2.4; 95%CI = 1.4–3.9, ref. = normal pressure), whilst income was negatively associated (OR = 0.99; 95%CI = 0.997–0.999). Variables associated with obesity in model 1 remained significant in model 2, with similar OR and 95%CI. Other variables were also significant in model 2: age (OR = 1.07; 95%CI = 1.0–1.14), age squared (OR = 0.99; 95%CI = 0.998–0.999), being widow/er (OR = 0.47; 95%CI = 0.22–0.99, ref. = married), having diabetes (OR = 1.8; 95%CI = 1.02–3.0, ref. = without diabetes). Post-estimation statistics showed that both models performed similarly, with model 2 presenting slightly better results.ConclusionsThe use of genomic ancestry data added important information in the investigation of obesity in this admixed population.Funding SourcesSão Paulo Municipal Health Department, FAPESP, and CNPq.

Association between autistic traits and binge drinking: Findings from Japan.

Substance misuse may be elevated in some individuals with autism spectrum disorder (ASD). As yet, however, little is known about the association between autistic traits (AT) and substance use/misuse in adults. This study examined the association between AT and binge drinking (BD) among individuals in Japan. Data were analyzed from 1452 individuals aged 18 and above collected during an online survey in February 2021. Self-reported information was obtained on BD assessed as consuming 5 or more (males) or 4 or more (females) drinks containing any kind of alcohol within a 2-h period. AT were assessed with the Japanese version of the Autism Spectrum Quotient - the AQ-J-10. Logistic regression analysis was used to examine associations. The prevalence of past-month BD was significantly higher in individuals with AT compared to those without AT (42.7% > 27.6%). In a fully adjusted analysis that controlled for mental health (anxiety, depression) and attention-deficit/hyperactivity disorder symptoms, individuals with AT had significantly higher odds for BD once a week or more often (OR: 1.54, 95%CI: 1.04-2.29). AT were also associated with significantly higher odds for BD among women (OR: 2.27, 95%CI: 1.08-4.76), and those aged 18-34 (OR: 2.37, 95%CI: 1.09-5.18) and aged 60 and above (OR: 2.15, 95%CI: 1.02-4.53). Individuals with AT have higher odds for BD. Increased efforts to detect alcohol use/misuse in adults with AT and AT in adults misusing alcohol may be efficacious in efforts to manage symptoms and eliminate harmful alcohol misuse.

Association between parental absence during childhood and depressive symptoms in adulthood in rural Vietnam

BackgroundWhile parental absence during childhood has been linked to depression/depressive symptoms in adulthood, no research has been conducted on this association in Vietnam, where many children were separated from their parents during and after the Vietnam War (1955–1975). We examined the association between parental absence in childhood and depressive symptoms among rural community dwellers in Khanh Hoa Province, Vietnam. MethodsData came from 3000 individuals aged 40–60 years old who participated in the baseline survey of the Khanh Hoa Cardiovascular Study. Depressive symptoms were assessed with the 11-item Center for Epidemiologic Studies Depression Scale. Self-reported information on parental absence due to death, divorce, or outmigration to other locations before the age of 15 was also obtained. A Poisson regression analysis with a robust variance estimator was used to examine associations. ResultsExperiencing parental absence at 3 - < 15 years old and before 3 years old was associated with a 1.21 times (95% confidence interval [CI] = 1.02–1.43) and 1.41 times (95% CI = 1.15–1.73) higher prevalence of depressive symptoms, respectively (p trend <0.001). When examining the associations by the different reasons for the parental absence, the strongest association was found for parental absence due to outmigration to other locations. LimitationsWe had no information on who respondents lived with after they experienced parental absence. In addition, self-reported information on childhood experiences was subject to recall bias. ConclusionsIn rural Vietnam, parental absence during childhood was associated with a significantly increased prevalence of depressive symptoms in middle adulthood.

Can Lower Levels of Classroom Victimization be harmful? Healthy Context Paradox Among Chinese Adolescents.

The healthy context paradox is defined as the phenomenon that victims' psychological adjustment worsens in a context with a lower rate of victimization. The unexpected pattern was primarily confirmed in children and adolescents from western societies, and it is unclear whether classroom-level victimization could moderate the link between peer victimization and psychological adjustment in the Chinese cultural context, where Confucian philosophies and collectivism are highly valued. Furthermore, most existing research used a single method to assess peer victimization. The current study attempted to examine classroom-level peer victimization as a moderator in the association between individual-level peer victimization and depression, self-esteem, and well-being among 2613 Chinese seventh graders (1237 girls, Mage = 13.00±.61) from 47 classrooms (Mclassroom size = 55.60, range from 45 to 65) using both self-reported and peer-reported information on peer victimization. At the individual level, the results revealed that both self- and peer-reported victimization were positively related to depression and negatively related to self-esteem and well-being. Most importantly, consistent with past findings documenting the healthy context paradox, self-reported victimized youth experienced a higher level of depression and lower level of self-esteem and well-being in classrooms where the overall level of victimization was relatively low. However, the healthy context paradox was not replicated in the nominated data of peer victimization. These results confirmed the healthy context paradox in Chinese culture to some extent. The findings emphasize the importance of measuring peer victimization from multiple sources and suggest there is a need for additional support to victimized middle school students where the classroom context was relatively healthy.

A metamodel-based flexible insulin therapy for type 1 diabetes patients subjected to aerobic physical activity

Patients with type 1 diabetes are subject to exogenous insulin injections, whether manually or through (semi)automated insulin pumps. Basic knowledge of the patient’s characteristics and flexible insulin therapy (FIT) parameters are then needed. Specifically, artificial pancreas-like closed-loop insulin delivery systems are some of the most promising devices for substituting for endogenous insulin secretion in type 1 diabetes patients. However, these devices require self-reported information such as carbohydrates or physical activity from the patient, introducing potential miscalculations and delays that can have life-threatening consequences. Here, we display a metamodel for glucose-insulin dynamics that is subject to carbohydrate ingestion and aerobic physical activity. This metamodel incorporates major existing knowledge-based models. We derive comprehensive and universal definitions of the underlying FIT parameters to form an insulin sensitivity factor (ISF). In addition, the relevance of physical activity modelling is assessed, and the FIT is updated to take physical exercise into account. Specifically, we cope with physical activity by using heart rate sensors (watches) with a fully automated closed insulin loop, aiming to maximize the time spent in the glycaemic range (75.5% in the range and 1.3% below the range for hypoglycaemia on a virtual patient simulator).These mathematical parameter definitions are interesting on their own, may be new tools for assessing mathematical models and can ultimately be used in closed-loop artificial pancreas algorithms or to extend distinguished FIT.

Maternal thyroid disease in pregnancy and timing of pubertal development in sons and daughters

To study whether maternal thyroid disease in pregnancy is associated with pubertal timing in sons and daughters. Cohort study. National birth cohort and health registers. A total of 15,763 mothers and children from the Danish National Birth Cohort and its Puberty Cohort. Register-based and self-reported information on maternal thyroid diseases during pregnancy (hyperthyroidism, hypothyroidism, benign goiter, or no thyroid disease [reference group]). The adjusted mean age difference (months) at attaining several self-reported pubertal milestones collected every 6 months using an interval-censored regression and the average difference in age at attaining all pubertal milestones using the Huber-White robust variance estimation (primary outcome). Sons of mothers with hyperthyroidism had earlier pubertal development (average difference, -2.9 [95% confidence interval (CI), -5.0 to -0.7] months) than unexposed sons. Maternal hypothyroidism was not associated with pubertal development in sons (average difference, -1.2 [95% CI, -5.1 to 2.7] months). We observed nonstatistically significant indications of earlier pubertal development in sons of mothers with benign goiter (average difference, -1.9 [95% CI, -4.6 to 0.9] months). Maternal thyroid disease was not associated with pubertal development in daughters (average difference (months), hyperthyroidism, -0.8 [95% CI, -2.8 to 1.2]; hypothyroidism, 0.3 [95% CI, -3.1 to 3.8]; and benign goiter, 0.7 [95% CI, -2.0 to 3.4]). We found indications of earlier pubertal development in sons of mothers with hyperthyroidism. More research is needed to further investigate the observed sex-specific association.

Dietary patterns among Saudis with type 2 diabetes mellitus in Riyadh: A cross-sectional study.

We investigated dietary patterns and their associations with sociodemographic and lifestyle factors in Saudi adults with type 2 diabetes mellitus (T2DM). A total of 297 participants (154 men and 143 women) with a mean age (standard deviation) of 54.0 (7.0) years were enrolled in the current study. Self-reported information on sociodemographic and lifestyle characteristics, eating behavior, and frequency of consumption was collected from all participants. Principal component analysis was used to determine dietary patterns. Multiple linear regressions were used to examine the associations between dietary patterns and sociodemographic and lifestyle factors. We identified five dietary patterns: “Vegetables and olive oil,” “Refined grains and sweets,” “Dairy products and legumes,” “Dates and beverages,” and “Fruit.” Age was inversely associated with the pattern “Refined grains and sweets” (β = -0.036, p <0.001). Females were more likely to have higher scores with the “Fruit” pattern (β = 0.410, p = 0.011). Smoking was associated with “Vegetables and olive oil” (β = 0.919, p = 0.001) and “Dates and beverages” (β = -0.947, p = 0.001) patterns. The level of physical activity was associated with “Dates and beverages” (β = 0.104, p = 0.048) and “Vegetables and olive oil” (β = -0.102, p = 0.048) patterns. The number of snacks consumed was associated with “Dates and beverages” pattern (β = -0.241, p = 0.005), and the frequency of meals eaten in fast food locations and restaurants per month was associated with “Vegetables and olive oil” pattern (β = -0.043, p = 0.034). Each dietary pattern was associated with different sociodemographic and lifestyle factors and eating behaviors. This study provides insights into the underlying nutritional habits of Saudi Arabian patients with T2DM. Future studies are necessary to assess these associations in representative samples.

Data misrepresentation detection for insurance underwriting fraud prevention

Premium fraud concerns data misrepresentation committed by an insurance customer with the intent to benefit from an unduly low premium at the underwriting of a policy. In this paper, we propose a novel approach for evaluating the risk of underwriting premium fraud at the time of application in the presence of potentially misrepresented self-reported information. The aim of the approach is to support insurance companies in identifying fraudulent applications and their decisions to underwrite insurance contract propositions. Likewise, it can be use to make straight-through processing (i.e. automated) underwriting systems more fraudproof, by e.g., triggering a validation on applications prone to misrepresentations. Our approach is based on conditional density estimates for a set of validated contracts. The proposed approach does not require historical fraud labels and can adapt to changes in pricing policy. Moreover, the approach can be used to detect outliers in addition to predicting underwriting fraud and is extended to multivariate self-reported data. We further demonstrate a link between Shapley values in common conditional expectation problems and conditional density estimations to make our approach explainable. We report a case study involving motor insurance underwriting, in which a driver's identity and driving record can be misrepresented to benefit from an unduly low premium; the results indicate the effectiveness of the proposed approach for detecting and preventing underwriting fraud.