Stepwise Binary Logistic Regression Research Articles

Factors Affecting the Individual Interest of Secondary School Students in Natural Science Lessons

Individual interest in learning natural sciences is a complex process influenced by multiple internal and external factors. The research reflects the need to determine the factors that affect individual interest in learning natural sciences in secondary school students. Two duly validated questionnaires were used, one of 18 factors that records the students' perceptual assessments and the other that measures individual interest. The questionnaires were applied to 741 students in the 3rd, 4th and 5th grades of secondary education. By means of a backward stepwise binary logistic regression, a significant model was found that explains 55.4% of the individual interest in learning natural sciences. Family problems is the factor with the highest importance (55 %), followed by study techniques (47.9 %), didactic material (47.3 %), selective attention (42 %), teaching methods and techniques (41 %), family assessment (41 %), scientific language (32.9 %), academic self-concept (31.8 %), peer bullying (26.5 %), study habits (26.4 %) and Chat in social networks (25.4 %). It is concluded that the model is composed of a broad set (11) of internal and external factors, provides a valid conceptual framework as empirical support to explain individual interest in learning the natural sciences.

Identifying factors associated with increased rate of mortality of COVID-19 patients among Jordanian population: A multicenter case-controlled retrospective study

Coronavirus 2019 (Covid-19) is a serious infectious disease that affects humans globally. Identifying factors that increase the prevalence of mortality are of interest for the healthcare providers. Therefore, the present study aimed to evaluate many risk factors and its association with mortality among COVID-19 patients.
 A total of 353 patients enrolled in this multicentered case-controlled retrospective study that was conducted in two designated hospitals in Amman, Jordan on patients admitted between 25 October 2020 to 26 September 2021. According to a stepwise binary logistic regression analysis found that patients who took Meropenem (p<0.001) and beta blockers (p=0.004) had lower incidence to be discharge during hospitalization. Also, diabetic patients (p<0.001) had lower discharge rate. We concluded that patients with secondary bacterial infection during the course of hospitalization, patients who needed to take beta blockers and diabetic patients are at higher risk of mortality.

Acceptability for the influenza virus vector COVID-19 vaccine for intranasal spray: A cross-sectional survey in Beijing, China

ABSTRACT The intranasal spray COVID-19 vaccine was made available for the first time in China, it is necessary to understand receivers’ satisfaction and experience toward the vaccine to help optimize vaccination service. A self-administered multicenter cross-sectional questionnaire survey was conducted in Beijing, China, in December 2022. The vaccination experience was evaluated through three dimensions: immediate tolerance, smooth progress, and time-saving. Vaccine acceptability was measured by receivers’ preference for the intranasal spray over intramuscular injection after vaccination and their recommendation willingness. Stepwise multinomial and binary logistic regression models were applied to investigate factors associated with vaccine acceptability. Among 10,452 participants included in the analysis, 92.6% felt no discomfort during the inoculation, 99.8% thought the vaccination process went well, and 89.4% deemed it a time-saving option. For vaccine acceptability, 5566 (53.3%) participants were willing to recommend the vaccine to others, 534 (5.1%) refused, and 4352 (41.6%) had not decided yet; 6142 (58.8%) participants preferred the intranasal spray, 873 (8.4%) preferred the intramuscular injection, and 3437 (32.9%) had no preferences. The most concerned aspects of the intranasal spray vaccine were vaccine effectiveness and safety. Receivers who perceived higher vaccine effectiveness or safety were more likely to recommend it to others (OR, 95%CI: 4.41, 3.24–6.00; 6.11, 4.52–8.27) or prefer it over intramuscular injection after vaccination (OR, 95%CI: 5.94, 4.62–7.65; 8.50, 6.70–10.78). Receivers showed good acceptability and experience toward the intranasal spray COVID-19 vaccine. Vaccine effectiveness and safety were the most concerned aspects, and corresponding publicity and education efforts may help improve vaccine acceptability.

Risk factors associated with arterial hypertension in university students in southern Sonora

The aim of this study was to identify the risk factors associated with hypertension (HT) using a logistic regression model in university students from southern Sonora. A total of 296 students took part (60.1 % female sex, 18.7 ± 0.8 years, 69.5 ± 12.5 kg) who had their blood pressure evaluated for preclinical (≥120-140/<90) and clinical (≥140/≥90) range classification and were administered the risk factor questionnaire participated. The association between explanatory factors and HT was performed by stepwise binary logistic regression. The model developed indicated that the probability of preclinical and clinical HT was 4.65 times in overweight and obese students, 7.94 times those who reported one to two histories of chronic noncommunicable diseases (NCD), 8.29 times those who indicated three to four family histories of NCD, 2.66 times those who indicated intermittent sleep, and as a protective factor a lower probability of 2.89 times those who drink coffee regularly at breakfast. It is concluded that overweight and obesity in combination with family history, poor sleep quality, and non-consumption of coffee are risk factors for HT in university students.

Personality dimensions of compulsive sexual behavior in the Sex@Brain study

AbstractBackground and aimsHypersexual disorder is characterized by recurrent and intense sexual fantasies, sexual urges, or sexual behaviors that can lead to clinically relevant levels of distress and adverse consequences for affected individuals. Earlier research has established a connection between sexual phenomena, such as compulsive sexual behavior, and personality features. The aim of the present study was to gain further insights into the associations of personality maladjustment and HD.MethodsThe present study applied the dimensional approach of personality maladjustment presented in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to connect compulsive sexual behavior to personality maladjustment. We investigated 47 men suffering from HD (age: M = 36.51, SD = 11.47) and 38 matched men without HD (age: M = 37.92, SD = 12.33) regarding personality maladjustment using a 100-item version of the Personality Inventory for DSM-5 (PID-5-BF).ResultsThe men with HD showed higher levels of personality maladjustment regarding all PID-5-BF domains (negative affect, detachment, psychoticism, antagonism, and disinhibition) and significantly differentiated from men without HD in the level of subordinate facets. However, no domain of personality differentiated significantly between groups using a binary stepwise logistic regression analysis.Discussion and conclusionsIn sum, the findings of the study underline the extent of personality maladjustment in men with HD. Interpersonal difficulties which men with HD frequently experience can contribute to clinically relevant levels of distress and adverse consequences reported by affected individuals.

High Prevalence of Superficial and Deep Medial Collateral Ligament Injuries on Magnetic Resonance Imaging in Patients With Anterior Cruciate Ligament Tears

To assess the prevalence of and factors associated with medial collateral ligament (MCL) complex injuries on magnetic resonance imaging (MRI) in patients with anterior cruciate ligament (ACL) tears. Data were extracted from the Natural Corollaries and Recovery After ACL Injury (NACOX) multicenter longitudinal cohort study. Between May 2016 and October 2018, patients who presented to 1 of 7 health care clinics across Sweden with an ACL tear sustained no more than 6 weeks earlier and who were aged between 15 and 40 years at the time of injury were invited to participate. All the patients included in this study underwent MRI. The mean time from injury to MRI was 19.6 ± 15.2 days. An orthopaedic surgeon specializing in knee surgery and a musculoskeletal radiologist reviewed all MRI scans. Injuries to the superficial MCL (sMCL), deep MCL (dMCL), and posterior oblique ligament were identified. Stepwise forward multiple binary logistic regression analyses were used to evaluate patient characteristics (age, sex, body mass index, preinjury Tegner activity level, and activity at injury) and injuries on MRI (lateral meniscus [LM] injury, medial meniscus [MM] injury, pivot shift-type bone bruising, medial femoral condyle [MFC] bone bruising, and lateral femoral condyle [LFC] impaction) associated with the presence of MCL complex tears. In total, 254 patients (48.4% male patients) with a mean age of 25.4 ± 7.1 years were included. The overall prevalence of MCL (sMCL and dMCL) injuries and isolated dMCL injuries was 16.5% (42 of 254) and 24.8% (63 of 254), respectively. No isolated sMCL injuries were found. Posterior oblique ligament injuries were found in 12 patients (4.7%) with MCL (sMCL and dMCL) injuries. An LM injury (odds ratio [OR], 3.94; 95% confidence interval [CI], 1.73-8.94; P= .001) and LFC impaction (OR, 2.37; 95% CI, 1.11-5.07; P= .02) increased the odds of having an MCL injury, whereas an MM injury (OR, 0.26; 95% CI, 0.12-0.59; P= .001) reduced the odds. Isolated dMCL injuries were significantly associated with MFC bone bruising (OR, 4.21; 95% CI, 1.92-9.25; P < .001) and LFC impaction (OR, 3.86; 95% CI, 1.99-7.49; P < .001). The overall combined prevalence of MCL (sMCL and dMCL) injuries and isolated dMCL injuries in patients with ACL tears was high (16.5%+ 24.8%= 41.3%). The presence of an LM injury and LFC impaction increased the odds of having an MCL injury, whereas the presence of an MM injury reduced the odds. MFC bone bruising and LFC impaction were associated with the presence of isolated dMCL injuries. Level III, retrospective cohort study.

Clonazepam Loading Dose in Status Epilepticus: Is More Always Better?

Benzodiazepines are the first treatment line in status epilepticus (SE). Despite their well-established benefit, benzodiazepines are frequently underdosed with potential detrimental consequences. In some European countries, clonazepam (CLZ) is commonly used as the first line treatment. The aim of this study was to explore the correlation between CLZ loading doses and SE outcome. This study included a retrospective analysis of a prospective registry in Lausanne, Switzerland (CHUV Lausanne University Hospital), including all SE episodes treated between February 2016 and February 2021. Only adults (>16 years old) were included with CLZ used as the first treatment line. Post-anoxic SE were excluded because of significant differences in physiopathology and prognosis. Patient characteristics, SE features, the validated SE severity score (STESS), and treatment characteristics were prospectively recorded. We considered loading doses of 0.015 mg/kg or higher (following commonly recommended loading doses)as high doses. We analyzed outcome in terms of number of treatment lines after the CLZ, proportion of refractory episodes, intubation for airways protection, intubation for SE treatment, and mortality. We performed univariable analyses to investigate the association between loading doses and clinical response. A multivariable stepwise backward binary logistic regression was applied for adjusting for potential confounders. Multivariable linear regression was similarly used to analyze CLZ dose as a continuous variable. We collected 251 SE episodes in 225 adult patients. Median CLZ loading dose was 0.010 mg/kg. CLZ high doses were used in 21.9% of SE episodes (in 43.8% for >80% of the high dose). Thirteen percent of patients with SE were intubated for airways control, while intubation was needed in12.7% for SE treatment. High CLZ loading doses were independently associated with younger age (median 62 versus 68 years old, p = 0.002), lesser weight (65kg versus 75kg, p = 0.001) and more frequent intubation for airways protection (23% vs 11%, p = 0.013), but differing CLZ dose was not associated with any outcome parameter. CLZ high doses were more frequently used for SE treatment in younger patients with healthy weight and were more often associated with intubation for airways protection, probably as an adverse event. Varying CLZ dose did not alter outcome in SE, raising the possibility that commonly recommended doses are above what is needed, at least in some patients. Our results suggest that CLZ doses in SE may be individualized depending on the clinical setting.

Symptoms and risk factors for long COVID in Tunisian population

BackgroundThe COVID-19 pandemic has presented various challenges, one of which is the discovery that after the acute episode, around 30% of patients experience persistent symptoms or develop new ones, now known as long COVID. This new disease has significant social and financial impacts. The objective is to determine the prevalence of long COVID in the Tunisian population and identify its predictive factors.MethodsThis was a cross-sectional study conducted among Tunisians who were infected with COVID-19 between March 2020 and February 2022. An online self-administered questionnaire was distributed through social media, radio, and television channels over the course of one month (February 2022). Long COVID was defined as the persistence of existing symptoms or the development of new symptoms within three months after onset, lasting for at least two months, and with no differential diagnosis. We performed univariate and multivariate analyses using binary stepwise logistic regression with a significance level set at 5%.ResultsA total of 1911 patients participated in our study, and the prevalence of long COVID was 46.5%. The two most frequent categories were general and neurological post-COVID syndrome, with a prevalence of 36.7% each. The most commonly observed symptoms were fatigue (63.7%) and memory problems (49.1%). In the multivariate analysis, the predictive factors for long COVID were female gender and age of 60 years or older, while complete anti-COVID vaccination was found to be a protective factor.ConclusionsOur study found that complete vaccination was a protective factor against long COVID, while female gender and age of 60 years or older were identified as the main risk factors. These findings are consistent with studies conducted on other ethnic groups. However, many aspects of long COVID remain unclear, including its underlying mechanisms, the identification of which could guide the development of potential effective treatments.

Leucine-Rich Alpha-2-Glycoprotein: A Novel Predictor of Diastolic Dysfunction

Leucine-rich α2-glycoprotein (LRG1) mediates cardiac fibrocyte activation. It is upregulated in inflammatory conditions, atherosclerosis, and fibrosis. Diastolic dysfunction (DD) is due to myocardial fibrosis. This cross-sectional study examined the relationship between LRG1 and DD. Patients with symptoms of chronic coronary ischemia were recruited. Patients with symptoms of overt heart failure, ejection fraction (EF) < 55%, impaired renal function, infection, and recent trauma were excluded from the study. Clinical parameters examined were SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery (SYNTAX) score, echocardiographic assessment, and LRG1 levels. Binary stepwise logistic regression was used to evaluate the association between LRG1 and DD. Receiver Operating Characteristic (ROC) analysis was used to determine optimal cut-off values and predictive performance of LRG1. A total of 94 patients were enrolled in the study, with 47 having a clinical diagnosis of DD. Plasma LRG1 was significantly (U = 417.00, p < 0.001) higher in the DD group (M = 14) compared to the No-DD group (M = 8) by Mann-Whitney U test. There were higher SYNTAX scores in the DD group (M = 24.5) compared with No-DD (M = 7). LRG1 had significant predictability of DD (OR = 1.32 (95% CI: 1.14-1.53)). The ROC showed an AUC = 0.89 (95% CI: 0.82-0.95). LRG1 had a 78% sensitivity (95% CI: 65.3-87.7) and 72.3% specificity (95% CI: 57.4-84.4) for predicting DD at a cut-off value of "9". In conclusion, we identified LRG1 as a novel independent predictor of DD. Further studies are warranted to validate the utility of LRG1 in predicting DD.

Abstract P257: Self-Perception of Mental and Physical Health Are Significant Predictors of Activities of Daily Living

Background: Stroke is a leading cause of long-term disability and death worldwide. Stroke results in impaired physical, psychological, and social functions. This study examined the extent to which self-perception of physical and mental health, conditions manageable by behavioral intervention (MBI), and medical conditions contribute to activities of daily living (ADL) performance post-stroke among adults aged 65 and above. Methods: Data from the 2017 Medicare Health Outcomes Survey Cohort 19 were analyzed. The outcome variable was defined as, being able to independently perform basic ADL such as bathing, dressing, eating, getting in and out of the chair, walking, and using the toilet. Stepwise binary logistic regression was used to identify risk factors that predict overall ADL performance. Results: A total of 9,531 older adults with stroke were included in the study, 56.97% of whom were females. Overall, 58.6% had some difficulty or were unable to perform ADLs post-stroke. In the final model, self-perception of physical (OR=0.89, 95% CI=0.883, 0.896) and mental (OR=0.961, 95% CI=0.954, 0.968) health and older (74+) age (OR=1.7, 95% CI=1.452,1.895) were associated with difficulty in self-perception of ADL. A 12.2% increase in explained variance after adding medical conditions such as diabetes, hypertension, cancer, etc. to demographic factors; a 13.6% increment in explained variance after adding conditions MBI such as obesity, smoking, pain, etc.; and a 10.5% increment after adding self-perception of mental and physical health was obtained. The final model explained 39.4% of the total variance in the self-perception of ADL. Conclusion: Not only conditions manageable by behavior interventions, and medical conditions predict performance, but self-perceptions of mental and physical health have an impact on ADL. The significant association between self-perception and ADL found in this study signals the need for new avenues for interventions for persons with stroke with respect to their ability to perform self-care activities. These findings can inform future work that identifies and addresses psychosocial and behavioral risk factors that contribute to ADL.

The Role of Change in Self-efficacy in Maintaining Exercise-Associated Improvements in Mood Beyond the Initial 6 Months of Expected Weight Loss in Women with Obesity.

Although mechanisms are unclear, there is a robust association between exercise and mood improvements. However, beyond ~ 6months of expected weight loss, weight-management behaviors such as exercise wane as weight gradually regains in most adults. The amount of exercise required to maintain mood improvement is unknown, as is the possible role of theory-based psychosocial changes associated with treatment such as in self-efficacy. Women who volunteered for a community-based cognitive-behavioral obesity treatment emphasizing exercise and building self-efficacy via self-regulating through lifestyle challenges/barriers, and were of the 86% who reduced their negative mood during its initial 6months, were allocated into groups who either maintained their negative mood reduction (Sustain group, n = 43) or reverted toward initial levels of negative mood (Revert group, n = 73) during months 6-24. A binary stepwise logistic regression analysis assessed whether exercise amount and/or change in self-efficacy significantly classified Sustain vs. Revert group membership. Change in exercise amount was not significantly associated with group membership. However, after additional entry of change in exercise self-efficacy, a significant association was found - successfully classifying 70% and 42% of the Revert and Sustain group participants, respectively. When self-efficacy change was entered as the sole independent variable, group membership was classified with 62% accuracy, overall (96% in the Revert group). Consistent with behavioral explanations of the exercise-mood change relationship, it was interpreted that self-efficacy, rather than exercise amount, was an important correlate of mood change beyond month 6. Suggestions for bolstering self-efficacy later in behavioral obesity treatments were provided.

Modeling the risk factors of women with very severe menopausal symptoms.

Individual differences and sociodemographic, gynecological, and cultural characteristics affect the severity of menopausal symptoms. This study aimed to reveal the severity of menopausal symptoms experienced by Turkish women and the risk factors that cause women to experience very severe menopausal symptoms. This cross-sectional and descriptive study was conducted with 435 women in menopause. The Personal Information Form and the Menopause Rating Scale were used to collect data. In logistic regression analysis, backward stepwise Wald binary logistic regression method was used. In the logistic regression analysis, there were 30 independent variables. The dependent variable was determined as the total MRS score. The mean score of the somatic symptoms sub-dimension was 3.14 ± 2.12, the mean score of the psychological symptoms sub-dimension was 10.11 ± 5.66, and the mean score of the urogenital symptoms sub-dimension was 3.58 ± 2.90. The total mean score of the Menopause Rating Scale was 16.83 ± 9.31. Menopausal age between 44 and 50 years old (OR=10.681), having a chronic illness (OR=6.432), having more than 5 pregnancies (OR=5.372), and spouse's primary school or below education level (OR=4.02) increase the severity of menopausal symptoms. It is recommended that healthcare professionals evaluate the symptoms of women in the menopause period to provide them with psychological and social support and to help the spouse and family cooperate with women in menopause in compliance with the process.

Risk factors of postoperative neurodevelopmental abnormalities in neonates with critical congenital heart disease.

To investigate the risk factors of postoperative neuro-developmental abnormalities in neonates with critical congenital heart disease (CCHD). Clinical data of 50 neonates with CCHD admitted in the Cardiac Intensive Care Unit, The Children's Hospital, Zhejiang University School of Medicine from November 2020 to December 2021 were retrospectively analyzed. Neurological assessment was performed with cranial ultrasonography, CT/MRI, video electroencephalogram and clinical symptoms before and after surgical treatment for all patients, and neurodevelopmental abnormalities were documented. Binary logistic stepwise regression was used to analyze risk factors of postoperative new-onset neurodysplasia in children with CCHD, and the predictive value of the risk factors on postoperative neurodevelopmental abnormalities were evaluated using the receiver operating characteristic (ROC) curve. Neurodevelopmental abnormalities were detected in 22 cases (44.0%) and not detected in 28 cases (56.0%) before surgery. There were no significant differences in gender, birth weight, age at admission, gestational age, preoperative SpO2 level, prematurity, cyanotic congenital heart disease, and ventilator support between the two groups (all P>0.05). After surgery, there were 22 cases (44.0%) with new-onset neurological abnormalities and 28 cases (56.0%) without new-onset abnormalities. Multivariate logistic regression analysis showed that postoperative 24 h peak lactic acid (OR=1.537, 95%CI: 1.170-2.018, P<0.01) and postoperative length of ICU stay (OR=1.172, 95%CI:1.031-1.333, P<0.05) were independent risk factors for postoperative new-onset neurodevelopmental abnormalities. The area under ROC curve (AUC) of the postoperative 24 h peak lactic acid for predicting the new-onset neurological abnormalities after operation was 0.829, with cut-off value of 4.95 mmol/L. The diagnostic sensitivity and specificity were 90.0% and 64.3%, respectively. The AUC of postoperative length of ICU stay for predicting the new-onset neurological abnormalities after operation was 0.712, with cut-off value of 18.0 d. The diagnostic sensitivity and specificity were 50.0% and 96.4%, respectively. The AUC of the combination of the two indicators was 0.917, the diagnostic sensitivity and specificity were 95.5% and 64.3%, respectively. The incidence of neurodysplasia in neonatal CCHD is high, and new neurological abnormalities may occur after surgery. The postoperative 24 h peak lactic acid and postoperative length of ICU stay are risk factors for new-onset neurodysplasia after surgery. The combination of the two indicators has good predictive value for neurodevelopmental outcomes after surgery in CCHD infants.

Abstract 54: Incidence And Predictors Of Dural Arteriovenous Fistulae After Cerebral Venous Sinus Thrombosis: Analysis Of ACTION-CVT

Background: Intracranial dural arteriovenous fistulae (DAVF) are uncommon vascular anomalies with a reported incidence of 0.2 per 100,000 person years. An association between cerebral venous thrombosis (CVT) and DAVF has been reported; however, the direction of causality between the two remains uncertain. We aimed to identify the incidence and predictors of development of DAVF among patients with CVT. Methods: This is a post-hoc analysis of Anticoagulation in the Treatment of Cerebral Venous Thrombosis (ACTION-CVT), a multicenter retrospective study comparing outcomes of CVT patients treated with warfarin versus direct oral anticoagulants (DOACs) from 2015 to 2020. Patients were included in this analysis if they did not have DAVF on initial imaging and had follow-up vascular imaging during the study. Clinical, imaging, and anticoagulation characteristics of patients who developed DAVF were compared to those who did not. Stepwise binary logistic regression including important variables (achieving p&lt;0.1 on univariate analyses) was used to determine predictors of DAVF development. Results: A total of 751 patients (median age 43, 66% female) met inclusion criteria of whom 13 (1.7%) developed DAVF with an estimated rate of 2.40 per 100 patient years. Patients with DAVF were less likely to have headache at presentation (53.8% vs 79.3%, p=0.037), but more likely to have no venous recanalization on follow-up imaging (46.2% vs 14.8%, p=0.008), baseline cortical vein thrombosis (15.4% vs 2.7%, p=0.053), and received warfarin (vs. DOACs) as initial oral anticoagulant (84.6% vs 58.7%, p=0.085) but the latter two missed the statistical significance threshold. In stepwise binary logistic regression analysis, cortical vein thrombosis (OR 7.98, 95% CI 1.40-45.35, p=0.02) and lack of venous recanalization (OR 4.93, 95% CI 1.48-16.39, p=0.01) were associated with development of DAVF. Conclusion: In this large multicenter study of CVT, the incidence of DAVF development was higher than the previously reported rate in the general population. The presence of cortical vein thrombosis and lack of venous recanalization were associated with increased risk of development of DAVF.

Prevalence and risk factors for anxiety and depression among community dwelling patients with cervical spondylosis during the COVID-19 pandemic

BackgroundThe emergence of COVID-19 and its unfavorable consequences lead to disease fear and other related mental health problems for individuals worldwide. This study aimed to analyze the prevalence and relevant factors of anxiety and depression among community dwelling cervical spondylosis (CS) patients, and to explore the relationship between fear of COVID-19 and anxiety and depression, so as to provide scientific basis for improving their mental health. MethodsA community-based cross-sectional study was conducted among a cohort of 556 CS patients by using convenient sampling. These participants were asked to complete a demographic questionnaire, the Hospital Anxiety and Depression Scale (HADS), and the Fear of COVID-19 Scale (FCV-19S). The Chi-square test was used to determine the differences among categorical variables. Binary stepwise logistic regression was used to determine predictors of anxiety and depression. ResultsThe median HADS-A score was 5 (interquartile interval 2–7), and the median HADS-D score was 4 (interquartile interval 2–8). In this study, the prevalence of anxiety and depression was 25.0% and 26.6%, respectively. Gender and comorbid chronic diseases were predictors of depressive symptoms. In addition, fear of COVID-19 was related to depression and anxiety among community dwelling CS patients. ConclusionApproximately one quarter of community dwelling CS patients were suffering depression or anxiety. Our findings could provide a basis for the development of psychological crisis intervention strategies for CS patients under public health emergencies in the future.

Impact of pandemic COVID-19 lockdown on penetrating keratoplasty patients.

To study the impact of the COVID-19 lockdown on the regular follow-up of keratoplasty patients. This retrospective interventional case series included 30 patients who had immunological corneal endothelial rejection out of 190 patients who came for post-PKP follow-up between September 15, 2019, and September 30, 2020. The demographics, primary diagnosis, surgical technique, time of presentation, recovery of graft, associated ocular problems, and visual acuity at 1 month were analyzed. Forward stepwise (likelihood ratio) binary logistic regression was used to find significant variables. The study population had 19 males (63.33%) and 11 females (36.67%). The mean age of the study group was 42.83 ± 18.89 (8-80) years. Of 30 patients, 19 (63.3%) presented before and 11 (36.7%) after the COVID-19 lockdown. Overall, 23 (77%) showed a reversal of graft rejection. Logistic regression showed that preoperative indications, large-sized grafts, and deep corneal vascularization were significant risk factors for non-resolution of graft rejection. It was noted that patients who presented to the hospital late had poor recovery (P = 0.002). The delay in the presentation was a significant risk factor for non-resolution of graft rejection (P < 0.01). Z-test for proportions revealed that the difference in the non-resolution of rejection on immediate or delayed treatment in patients presenting during lockdown (P = 0.002) was significant. This article is to highlight the impact of the COVID-19 lockdown on graft rejection recovery of PKP patients due to delays in follow-up. Early treatment helps in the recovery of graft transparency and the reversal of immunological graft rejection. Also, primary diagnosis, deep vascularization, and large-sized grafts were significant risk factors for non-resolution of graft rejection.

Pancreas fat content, insulin homeostasis and circulating endothelial microparticles inmale essential hypertensive patients.

Thepancreas fat contenthas been poorly investigated in essential hypertension. The authors aim to relatepancreas and liver fat contentwith parameters measuring insulin resistance, beta-cell function and also withmarkers ofendothelial dysfunction and platelet or endothelial cell destruction. The authors studied a group of 40malehypertensive patients with well-controlled blood pressure, maintaining a stable weight, and having not changed their medication during the last year. Pancreas fat content was correlated with HOMA-IR (r=.616, p<.001), HOMA-S (r=-.439, p<.005), beta cell function parameter (r=.457, p<.005), and QUICKI (r=.412, p<.01), whereas liver fat was not patients in thehighest quartileof pancreas fat content had more circulating endothelial microparticles than patients in the other quartiles (median 129 [94.3-200] vs. 60.9 [49.4-88.8], p=.002).However, patients in the highest quartile of the pancreas fat content distribution did not differ from the lowest in hyperemic response after ischemia nor circulating platelet microparticles count. Liver fat content was not related to any of the parameters studied. In a multivariate stepwise binary logistic regression analysis (Wald Method) circulating endothelial microparticles remain significantly associated with pancreas fat content after adjusting for confounding factors, such as tobacco, diabetes mellitus, hypercholesterolemia, or metabolic syndrome. Our results reflect that in essential hypertension,pancreas fat contentis superior toliver fatto study beta-cell functionality and insulin resistance. Moreover, the authors described for the first time thatpancreas fat content isrelated to endothelial cell destruction. Further studies are needed to confirm this point.

Prevalence and predictors of medication non-adherence in children with inflammatory bowel disease in China: A cross-sectional study.

Background: Non-adherence to physician-prescribed medications, especially oral medications, is common in children with inflammatory bowel disease (IBD), and medication non-adherence is associated with poorer outcomes in IBD. Therefore, understanding and improving medication adherence in children with IBD is critical for optimizing treatment and improving treatment outcomes. Despite the relatively high prevalence of IBD in children in China, to date, very little is known about medication adherence in these patients. Objective: The aim of this study was to investigate the prevalence of medication non-adherence and its risk factors in children with IBD in China to provide a basis for developing adherence improvement strategies. Methods: A cross-sectional design was employed. Children (aged <18years) with IBD who visited the Children's Hospital, Zhejiang University School of Medicine, from September 2020 to December 2021 were included. Data were collected by a general information questionnaire, the 4-item Medication Adherence Report Scale (MARS-4) and Crohn's and Colitis Knowledge (CCKNOW) questionnaire. Subsequently, forward stepwise binary logistic regression analysis was performed to determine independent predictors of medication non-adherence. Results: A total of 119children were included in this study. The results showed that 33 (27.73%) and 86 (72.27%) children had poor and good medication adherence, respectively. Of these, 83 (69.75%) had forgotten to take their medications sometimes, often, or always. On binary logistic regression, we found that the incidence of medication non-adherence in children with IBD course of 3years and above [OR 4.82 (95%CI: 1.47-15.88); p = 0.01] was significantly higher than that in children with course of 3 months to 1year, whereas children with higher parental CCKNOW scores [OR 0.77 (95%CI: 0.67-0.88); p = 0.00] had significantly lower incidence of medication non-adherence than those with lower parental CCKNOW scores, and the results of the correlation between parental knowledge scores of the four categories and children's medication adherence showed that drug knowledge scores (r = 0.36, p < 0.00) and complication knowledge scores (r = 0.24, p = 0.01) were positively correlated with medication adherence. Conclusion: Poor medication adherence in children with IBD in China was common, and forgetting to take medication was the main barrier. Longer disease duration (3years and above) in children could act as a risk factor for medication adherence, whereas higher level of parental knowledge about IBD could act as a protective factor, and one interesting novel finding was that the level of parental knowledge about drug and complication were significantly correlated with medication adherence in children with IBD. Our results may inform on the design and implementation of medication adherence interventions for children with IBD.

The prevalence and associated factors of prenatal depression and anxiety in twin pregnancy: a cross-sectional study in Chongqing, China

BackgroundPregnant women expecting twins are more likely to experience stress, which can lead to anxiety and depression. Our aim was to investigate the prevalence of prenatal anxiety and depressive symptoms in women with twin pregnancies and the associated factors.MethodsIn a cross-sectional survey, 210 women with twin pregnancies who satisfied the inclusion and exclusion criteria in two tertiary centers in Southwestern China were asked to complete a basic information form, the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS). To compare statistics with normal distribution in distinct characteristic groups, a paired t-test, and one-way ANOVA were utilized. Binary logistic step regression was used to analyze the associated factors of antenatal anxiety and depressive symptoms.ResultsThe 210 women with twin pregnancies (age = 30.8 ± 4.2 years) were between 7 and 37 gestational weeks (29.2 ± 1.2 weeks), were typically well-educated (72.4% had a post-high-school degree), and reasonably affluent (88.1% were above the low-income cutoff). Among them, 34.8% had symptoms associated with clinical levels of anxiety, and 37.1% had symptoms indicating possible depression. The prevalence of co-morbid anxiety and depressive symptoms was 24.3%. Binary stepwise logistic regression analysis showed that previous health status and sleep disturbance during pregnancy were the associated factors of anxiety symptoms in women with twin pregnancies (P < 0.05), whereas age, previous health status, negative life events, and physical activity during pregnancy were the associated factors of depressive symptoms in women with twin pregnancies (P < 0.05).ConclusionAbout one-third of women with twin pregnancies had symptoms of anxiety or depression; these were most strongly predicted by some modifiable factors, suggesting that early preventive mind-body interventions may be a promising strategy to protect against mental health issues for women with twin pregnancies.

Prevalence, demographics, and clinical correlates of antisocial personality disorder in Chinese methamphetamine patients.

Antisocial personality disorder (ASPD) is very common among methamphetamine (MA) patients, but very few studies have been conducted in China. This study aimed to investigate the prevalence and clinical correlates of ASPD among Chinese MA patients. We recruited 627 MA patients and collected demographic and MA use data through one-on-one semi-structured interviews. ASPD was measured by the Mini International Neuropsychiatric Interview (M.I.N.I.). The Desires for Drug Questionnaire (DDQ) and visual analog scale (VAS) were used to assess drug cravings. The prevalence rate of ASPD among MA patients was 27.59% (173/627). Patients with ASPD had greater age at the first onset, duration of MA use, length of abstinence, VAS, DDQ desire and intention, negative reinforcement, and total DDQ scores than patients without ASPD. Stepwise binary logistic regression analysis revealed that age, age at the first onset, length of abstinence, and DDQ-negative reinforcement were independently associated with ASPD in MA patients. Our findings suggest that the prevalence of ASPD is high among Chinese MA patients. Furthermore, some demographic and clinical variables are associated with ASPD in MA patients. We focused our study on the clinical profile of ASPD and the reasons for its high prevalence in Chinese methamphetamine patients. We identified several demographic and clinical variables as correlates of the occurrence of ASPD in methamphetamine patients, which provides evidence for ASPD comorbidity in methamphetamine patients.