Stepwise Linear Regression Analysis Research Articles

The Chinese version of the Ohkuma questionnaire: reliability analysis and diagnostic value.

While the Ohkuma questionnaire is a simple, reliable, and easy-to-use tool to assess dysphagia, none of its versions can be used by the Chinese population. The purpose of this study was to evaluate the internal consistency, reliability and clinical validity of a newly made Chinese version of the Ohkuma questionnaire, and to provide some objective basis for its application in screening dysphagia. From September 21 to June 2022, 96 patients with dysphagia and 89 asymptomatic subjects were recruited from three hospitals in China to form an observation and a control group, respectively. All subjects completed the Ohkuma questionnaire, Eating Assessment Tool-10, and a Video Fluoroscopy Study of Swallowing. The Cronbach's α coefficient measured in the questionnaire was 0.867, indicating acceptable internal reliability. The analysis of variance generated four main factors to be assessed, showing a good aggregation effectiveness of the questionnaire. The AVE square root values of three factors were greater than the maximum absolute value of the correlation coefficients between factors, indicating good differentiation effectiveness. The sensitivity and specificity scores, together with the positive and negative likelihood as well as diagnostic odds ratios indicate a good reactivity of the questionnaire. Lastly, after adjusting for age and sex, the results of the stepwise linear regression analysis showed that there was a significant positive correlation between the Ohkuma questionnaire and the penetration aspiration scale. The Chinese version of the Ohkuma questionnaire has good reliability and validity, and can be used as a rapid and effective screening tool for dysphagia.

Presence of Self-Reported Sleep Alterations After Stroke and Their Relationship With Disability: A Longitudinal Study.

Sleep disorders have a prevalence of 30% to 70% in post-stroke individuals. The presence of sleep disorders and poor sleep quality after stroke can affect important functions and lead to worse outcomes. However, most studies are restricted to the acute post-stroke stage only. To investigate the frequency of self-reported sleep alterations in a sample of chronic stroke individuals and to identify which self-reported sleep alterations were associated with disability. Prospective exploratory study. Self-reported sleep alterations were measured by the Pittsburgh Sleep Quality Index, Insomnia Severity Index, Epworth Sleepiness Scale, and STOP-Bang Questionnaire. The dependent variable was measured 3 years after the first contact by the Modified Rankin Scale (mRS). Step-wise multiple linear regression analysis was employed to identify which sleep alterations were associated with disability. Sixty-five individuals with stroke participated. About 67.7% of participants had poor sleep quality, 52.4% reported insomnia symptoms, 33.9% reported excessive daytime sleepiness, and 80.0% were classified as intermediate or high risk for obstructive sleep apnea. Only risk for obstructive sleep apnea was significantly associated with disability and explained 5% of the variance in the mRS scores. Self-reported sleep alterations had a considerable frequency in a sample of chronic stroke individuals. The risk of obstructive sleep apnea was associated with disability in the chronic stage of stroke. Sleep alterations must be considered and evaluated in the rehabilitation process even after a long period since the stroke onset.

Quantitative ultrasound techniques and biochemical markers to assess liver steatosis and fibrosis in newly diagnosed acromegaly.

The liver is known to be protected from steatosis under the influence of high GH/IGF-1. Cytokeratin 18 (CK18) and insulin-like growth factor binding protein 7 (IGFBP7) increase in liver steatosis and fibrosis. The aim of this study was to use quantitative ultrasound techniques and biochemical markers to assess liver steatosis and liver fibrosis in newly diagnosed acromegaly. This single-center, cross-sectional study included 23 patients with newly diagnosed acromegaly and 46 age, sex, body mass index (BMI) and waist circumference (WC)-matched controls. Liver steatosis was assessed using tissue attenuation imaging (TAI), and stiffness, indicative of fibrosis, was assessed by shear wave elastography (SWE). Serum IGFBP7 and CK18 were studied by ELISA. The acromegaly group had significantly lower liver steatosis (p = 0.006) and higher liver stiffness (p = 0.004), serum IGFBP7 (p = 0.048) and CK18 (p = 0.005) levels than the control group. The presence of fibrosis (p = 0.012) was significantly higher in the acromegaly group than in the control group. Moreover, CK18 was positively correlated with liver stiffness, WC, HOMA-IR, HbA1c, and triglyceride. In the acromegaly group, liver steatosis was negatively correlated with GH level. Stepwise multiple linear regression analysis revealed that BMI (p = 0.008) and CK18 (p = 0.015) were independent risk factors for increased liver stiffness. This study showed that there was an increased presence of liver fibrosis independent of liver steatosis in newly diagnosed acromegaly. Serum CK18 appears to be a potential marker of increased liver fibrosis in acromegaly.

Dietary patterns and the risk of diabetes in Korean adults: a cross-sectional and prospective cohort study

ObjectiveThis study aims to identify dietary patterns associated with diabetes in Korean adults and to investigate their association with diabetes risk in both a cross-sectional and prospective study. MethodsPredefined food groups collected by the Korea National Health and Nutrition Examination Survey (KNHANES 2015–2018, n = 19,721) were entered in a reduced rank regression (RRR) model, followed by stepwise linear regression analyses to identify the most predictive dietary patterns. We evaluated the construct validity of dietary patterns in two independent samples from KNHANES 2019−2021 (n = 14,223) and the Health Examinees (HEXA) cohort study (n = 30,013). Associations between dietary patterns and diabetes risk were examined using multivariable regression and multivariable-adjusted Cox proportional hazard models, respectively. ResultsA dietary pattern was identified with high positive loadings for refined white rice, kimchi and salted vegetables, wheat flour and bread, and seasonings, and high negative loadings for whole grains, legumes with tofu and soymilk, poultry, eggs, and plant oils. The higher pattern scores were significantly associated with diabetes risk in KNHANES 2015–2018 (male: odds ratio [OR]: 1.59; 95% confidence interval [CI]: 1.35, 1.88; female: OR: 1.37; 95% CI: 1.18, 1.52), KNHANES 2019−2021 (male: OR: 1.47; 95% CI: 1.01, 1.69; female: OR: 1.37; 95% CI: 1.18, 1.54), and HEXA study (male: hazard ratio [HR]: 1.10; 95% CI: 1.01, 1.34; female: HR: 1.24; 95% CI: 1.02, 1.52). ConclusionsDietary patterns derived by RRR followed by stepwise linear regression analyses were associated with increased risks of diabetes among Korean adults.

Association of anhedonia with brain-derived neurotrophic factor and interleukin-10 in major depressive disorder

BackgroundAnhedonia, a core symptom of major depressive disorder (MDD), manifests in two forms: anticipatory and consummatory, reflecting a diminished capacity to anticipate or enjoy pleasurable activities. Prior studies suggest that brain-derived neurotrophic factor (BDNF) and interleukin-10 (IL-10) may play key roles in the emergence of anhedonia in MDD. The specific relationships between these biomarkers and the two forms of anhedonia remain unclear. This study investigated the potential links between BDNF, IL-10, and both forms of anhedonia in MDD patients. MethodsThis study included 43 participants diagnosed with MDD and 58 healthy controls. It involved detailed assessments of depression and anxiety levels, anticipatory and consummatory pleasure, cognitive functions, and a broad spectrum of plasma biomarkers, such as C-reactive protein, various interleukins, and BDNF. Using partial correlation, variables related to pleasant experiences were identified. Stepwise multiple linear regression analysis was applied to pinpoint the independent predictors of anhedonia in the MDD group. ResultsDemographically, both groups were comparable in terms of age, sex, body mass index, educational year, and marital status. Individuals with MDD displayed markedly reduced levels of anticipatory and consummatory pleasure, higher anxiety, and depression scores compared to healthy controls. Additionally, cognitive performance was notably poorer in the MDD group. These patients also had lower plasma diamine oxidase levels. Analysis linked anhedonia to impaired delayed memory. Regression results identified IL-10 and BDNF as independent predictors of anticipatory and consummatory anhedonia, respectively. ConclusionThese findings demonstrate that anticipatory and consummatory anhedonia are influenced by independent factors, thereby providing critical insights into the distinct neuroimmunological mechanisms that underlie various forms of anhedonia.Clinicl Trial Registration Number: NCT03790085

Analysis of the Correlation Between Visceral Fat Area and Insulin Resistance in Patients with Type 2 Diabetes and Abdominal Obesity

Objective: To analyze the correlation between visceral fat area and insulin resistance index (HOMA-IR) in patients with type 2 diabetes mellitus (T2DM) and abdominal obesity and to provide a reference for screening and related research of such patients. Methods: Two hundred patients with T2DM admitted to Guandu People’s Hospital of Kunming were included. The study was carried out from October 2022 to December 2023. The patients were divided into three groups according to different abdominal visceral fat areas (VFA): Group A (n = 65) was less than 75cm2, Group B (n = 75) was 75–100 cm2, and Group C (n = 60) was greater than 100 cm2. The subjects in the three groups were all tested for glycated hemoglobin (HbA1c), fasting insulin (FINS), and fasting blood glucose (FPG). Height and weight were measured to calculate body mass index (BMI). The HOMA-IR and TYG (fasting triglyceride and glycemic index) were also calculated. Changes in the BMI, VFA, HOMA-IR, and TYG levels were observed in the three groups. Results: The VFA, BMI, HbA1c, FPG, FINS, HOMA-IR, and TYG of the patients all increased, with a more significant increase in the BMI, FINS, HOMA-IR, and TYG levels (P < 0.01). Multiple linear stepwise regression analyses used visceral fat area (VFA) as the dependent variable. The results showed that VFA was closely related to BMI, FINS, HOMA-IR, and TYG. Conclusion: Early reduction of VFA to reduce insulin resistance may be a better treatment and effective method for T2DM, providing powerful measures and new strategies for effective blood sugar control and early prevention in the treatment of metabolic diseases.

Repeated-sprint sets test: a new method for evaluating and forecasting fitness in elite young male soccer players

The objective of the current study was to explore the correlation between repeated sprint sets (RSS) ability and several physical attributes, including maximum sprint speed, maximal aerobic speed, maximal anaerobic speed, aerobic capacity, and explosive strength. Moreover, the aim was to assess the suitability of RSS as a comprehensive evaluation tool for physical qualities and to determine which physical field tests most accurately predict RSS in elite young male soccer players. A total of thirty-two young elite male soccer players (mean age 14.6 ± 0.3 years; predicted years from peak height velocity (PHV): − 0.4 ± 0.3; years in training: 3.7 ± 0.5) voluntarily participated in the study. The players participated in eight consecutive specific physical tests, with a minimum 72-h recovery between each session to minimize the impact of fatigue during the second trial. The participants completed the tests in the following order: RSS test, Vam-Eval test, a constant velocity test performed until exhaustion at 100% of vVO2max (tlim100), 20-m Multi-Stage Shuttle Run test (VMSRT), Yo-Yo Intermittent Recovery Test level 1 (Yo-Yo IR1), Maximal Anaerobic Shuttle Running Test (VMASRT), Maximal Sprinting Speed Test (20-m flying sprint), Countermovement Jump (CMJ), and Standing Long Jump test (SLJ). The results of the study showed that there were very large negative correlations between tlim100 and SST (sum of sprint times), and large negative correlations between Yo-Yo IR1, Vam-Eval, and SST during RSS in young elite male soccer players (p < 0.05). Additionally, VMASRT and SLJ demonstrated a moderate negative correlation with SST (p < 0.05). In contrast, significant positive correlations were found between 20-m flying sprint and the SST (p < 0.05). According to the stepwise multiple linear regression analysis, the primary predictors of SST, ranked by importance, were tlim100 and Yo-Yo IR1. These two predictors collectively accounted for 72% of the variance in players’ SST (p < 0.0001). Due to the importance of aerobic capacity and short repeated accelerations/sprint sets for overall competitive performance in soccer, in conclusion, our results suggest that elite young male soccer players should perform both high intensity interval training and aeorobic capactity exercises as part of soccer training if the primary outcome is to improve repeated sprint ability performance.

On critical levels of ecological status for macrozoobenthic communities in Peter the Great Bay of the Japan Sea: field studies

Relationship between the environmental stress index (PES) and the mean total explained variance of biotic parameters (MEV, as a measure of the environmental factors influence on macrozoobenthic communities) is determined using the methods of multiple linear stepwise regression analysis and non-linear estimation. The relationship is S-shaped, with the points of beginning and end of linear growth confined to the PES ≈ 15–16 % and 30 %. These levels should be considered as boundary criteria for the status of macrozoobenthic communities. Under favorable environmental conditions, PES does not exceed 15 % (the first critical level), that is close to a «biologically balanced» state of the communities. The PES values in the range of 15–30 % indicate an increased influence of limiting factors, but this influence is not destructive. The PES values &gt; 30 % (the second critical level) indicate extreme deterioration of habitat conditions and transition to a «physically controlled» state of the communities.

Areas of professional life and job satisfaction of nurses.

Job satisfaction among nurses is closely related to work environment as well as organizational and professional commitment. Satisfaction is a concept derived from Latin, where "satis" means "enough," as much as is needed to fully satisfy expectations, needs, aspirations, in such a way that there is no room for complaint. Job satisfaction, on the other hand, is formulated as a positive attitude of employees toward the duties of the job, the work environment and other employees. The aim of this paper was to demonstrate how the different areas of nurses' professional life, i.e., workload, control, rewards, community, sense of justice and values, correlate with their perceived job satisfaction. A cross-sectional study was conducted in a group of 509 nurses working in a public hospital in Poland. Data were collected using a survey questionnaire, which consisted of a section containing sociodemographic data and standardized instruments: The Minnesota Satisfaction Questionnaire (MSQ) and The Areas of Worklife Survey (AWS) developed by Maslach and Leiter. Correlations were made using Spearman's rho coefficient. The calculations also used stepwise linear regression analysis after checking certain assumptions, including checking the assumption of normality of residuals and the Durbin-Watson Test. The mean score for the 20 items of the MSQ questionnaire ranged from 3.05 to 3.43 on a 5-point Likert scale. Support from the interdisciplinary team, which concerned assessing the quality of the social environment in the workplace, cooperation and showing positive feelings received the highest rating among respondents (3.51 ± 0.76). The sense of fair treatment at work averaged 3.26 ± 0.58. The area of value conflict within the organization itself or between the employee's values and those of the organization, respondents rated an average of 3.26 ± 0.65. The mean score for all areas of professional work in the surveyed group was 3.09 ± 0.45. As satisfaction in particular areas of work life increases, so does the level of satisfaction in such aspects of work as achievement and a sense of fairness. The higher the level of satisfaction in the area of control, the more the sense of satisfaction with independence increases. The higher the satisfaction of respondents in the areas of values, workload and control, the higher the level of satisfaction with working conditions occurs.

Antimicrobial Properties Of Pyrazolone Compounds With Their Qsar Investigations

The present paper reports the analysis and the antimicrobial activity viz. antifungal activity of some pyrazolone compounds which were performed against Alternaria solani using disc diffusion method on nutrient agar and nutrient broth media. The compounds were characterized by elemental analysis and spectral studies. Result of antimicrobial screening indicated that compounds 4-Amino antipyrine thiosemicarbazone, 1-(2-Chloro-5-sulfophenyl)-3-methyl-5-pyrazolone and 1-(4 -Sulfoamidophenyl)-3-methyl-5-pyrazolone were found to be the most potent/active against A. solani. Correlation studies between different computed properties of the compounds with their biological activity, QSAR (Quantitative Structure Activity Relationship) investigations with a stepwise linear regression analysis were conducted. The studies are carried out using Hyperchem 8.0 version software using AM1, PM3, MNDO and ZINDO methods. Selected QSAR/ 3D-QSAR equations including different physical parameters of these series are reported.

Effects of stigma on the quality of life in patients with epilepsy

BackgroundThis study was aimed to evaluate the stigma and quality of life (QoL) in adult patients with epilepsy (PWEs) and explore the relationship between stigma and QoL.MethodsTwo hundred and ninety-eight PWEs admitted to the Epilepsy Center of the First Affiliated Hospital of Chongqing Medical University during September 2020 and March 2021 were enrolled in this study. All participants completed self-reported questionnaires including the Stigma Scale for Epilepsy and the Quality of Life in Epilepsy Inventory-31 (QOLIE-31).ResultsA total of 146 (49%) PWEs reported an experience of stigma. The total score of QOLIE-31 and the individual scores of seven subscales (worry about new seizures, emotion, well-being, energy and fatigue, cognitive impairment, medication effect, and social function) were significantly decreased in these patients (P < 0.001). Multivariate stepwise linear regression analysis showed that the annual household income per capita, the number of antiseizure medications and stigma had statistically significant effects on QoL (P < 0.05). Among them, stigma had the most significant negative effect.ConclusionsNearly half of PWEs have experienced stigma. Stigma, lower household income per capita, and polypharmacy treatment are associated with poorer QoL. Stigma has the most obvious negative impact.

The effect of perioperative sequential application of multiple doses of tranexamic acid on postoperative blood loss after PLIF: a prospective randomized controlled trial.

Tranexamic acid (TXA) has been utilized in spinal surgery to effectively reduce intraoperative blood loss (IBL) and allogeneic blood transfusion rates. However, the traditional TXA regimen might last the entire duration of hyperfibrinolysis caused by surgical trauma, resulting in its limited ability to reduce postoperative blood loss (PBL). Therefore, the aim of this study was to investigate the effectiveness of perioperative sequential administration of multiple doses of TXA in reducing PBL in patients who underwent posterior lumbar interbody fusion (PLIF). From October 2022 to June 2023, 231 patients who were diagnosed with lumbar degenerative disease and scheduled to undergo PLIF were prospectively enrolled in the present study. The patients were randomly divided into three groups. Moreover, all patients received an intravenous injection of TXA at a dose of 15mg/kg 15min before the surgical skin incision. Patients in Group A received a placebo of normal saline after surgery, while patients in Group B received three additional intravenous injections of TXA at a dose of 15mg/kg every 24h. Patients in Group C received three additional intravenous injections of TXA at a dose of 15mg/kg every 5h. The primary outcome measure was PBL. In addition, this study assessed total blood loss (TBL), IBL, routine blood parameters, liver and kidney function, coagulation parameters, fibrinolysis indexes, inflammatory indicators, drainage tube removal time (DRT), length of hospital stay (LOS), blood transfusion rate, and incidence of complications for all subjects. The PBL, TBL, DRT, and LOS of Group B and Group C were significantly lower than those of Group A ( P <0.05). The level of D-dimer (D-D) in Group C was significantly lower than that in Group A on the first day after the operation ( P =0.002), and that in Group B was significantly lower than that in Group A on the third day after the operation ( P =0.003). The interleukin-6 levels between the three groups from 1 to 5 days after the operation were in the order of Group A > Group B > Group C. No serious complications were observed in any patient. The results of multiple stepwise linear regression analysis revealed that PBL was positively correlated with incision length, IBL, smoking history, history of hypertension, preoperative fibrinogen degradation product level, and blood transfusion. It was negatively correlated with preoperative levels of fibrinogen, red blood cells, blood urea nitrogen, and age. Compared to female patients, male patients had an increased risk of PBL. Finally, the incidence of PBL was predicted. Sequential application of multiple doses of TXA during the perioperative period could safely and effectively reduce PBL and TBL, shorten DRT and LOS, reduce postoperative D-D generation, and reduce the postoperative inflammatory response. In addition, this study provided a novel prediction model for PBL in patients undergoing PLIF.

The Influence of Chemical Fertilizers on the Effectiveness of Biochar in Mitigating Cadmium Mobility in Soil

The focus of this study was to explore how various fertilizers influence the movement of cadmium in soil treated with biochar. The research utilized a strong acid sandy loam soil from Chanthaburi Province, naturally rich in organic matter with moderate cation exchange capacity and low nitrogen, potassium, phosphorus, sulfate, salinity and chloride levels. The soil was purposely contaminated with 50 mg kg-1 of cadmium and treated with biochar derived from water hyacinth through pyrolysis at 450°C for an hour. This biochar displayed moderate alkalinity, high organic matter, phosphorus, potassium, and cation exchange capacity, but low nitrogen content. Analytical techniques like Scanning Electron Microscopy and Fourier-Transform Infrared Spectroscopy were employed to study the surface characteristics of the biochar. The cadmium adding soil was blended with 10% biochar and various chemical fertilizers at a 0.04% ratio. Diethylenetriamine pentaacetate (DTPA) extraction was used to assess the bioavailability of cadmium to plants in the soil, while sequential extraction was conducted to identify the different forms of cadmium present in the soil. The study revealed distinct effects of different fertilizers on cadmium mobility. Fertilizers like 46-0-0 and 0-3-0 caused a transformation of cadmium from stable to less stable forms, increasing the bioavailability of cadmium to plants. Conversely, fertilizers such as 15-15-15, 0-0-50, 0-0-60, and 0-52-34 shifted cadmium from less stable to more stable forms, resulting in decreased cadmium extracted by DTPA. Other fertilizers showed no significant impact on cadmium mobility in the soil. A stepwise linear regression analysis highlighted that nitrogen content, potassium content, and electrical conductivity were influential factors affecting cadmium mobility.

Socio-demographic factors and parental feeding practices predicted body mass index of Malaysian children with learning disabilities

Introduction: Overweight and obesity have emerged as significant global health concerns among children. Previous studies have provided evidence that children with intellectual and learning disabilities (LD) are at a higher risk of obesity compared to their peers without disabilities. Methods: This study aimed to predict body weight status of children with LD who attended Special Education Integration Program in Kelantan, located on East Coast of Peninsular Malaysia. Parents completed a self-administered questionnaire in Malay language, which included “Screening Tool of Feeding Problems” children’s version (STEP-CHILD) and Comprehensive Feeding Practice Questionnaire (CFPQ). The children’s body weight and height were measured to determine body mass index (BMI). Research hypothesis was tested through stepwise multiple linear regression analysis. Results: This study recruited 245 subjects with mean age of 10.5±1.7 years and mean BMI of 18.5±4.9 kg/m2. Prevalence of underweight, thinness and severe thinness was 12.2%, while overweight and obesity was 29.0%. Male children with LD (β=0.109, p&lt;0.044), older age (β=0.226, p&lt;0.001), higher child birth weight (β=0.119, p&lt;0.029), lack of parental modelling (β=-0.170, p=0.004), lower parental pressure (β=-0.266, p&lt;0.001), and higher restriction for weight control (β=0.361, p&lt;0.001) were found to predict higher BMI values. Conclusion: Positive parental feeding practices during mealtime are crucial for addressing the poor nutritional status of children with LD.

The impact of mental health on health-related quality of life in patients with NF2-related Schwannomatosis

NF2-related schwannomatosis (NF2-SWN) is a rare genetic disorder and is associated with progressive morbidities. This study aimed to investigate the relationship between NF2-SWN disease severity, health-related Quality of Life (QoL), and mental health aspects of patients. Standardised questionnaires assessing mental health problems (symptoms of depression, anxiety, and somatic burden), psychological factors (resilience, loneliness, and personality functioning), and health-related QoL were administered to 97 patients with NF2-SWN. The results of these questionnaires were compared with physician-rated disease severity. Questionnaires were completed by 77 patients. Physician-rated disease severity scores were available for 55 patients. NF2-SWN patients showed a high prevalence of clinically relevant symptoms of depression (30%), anxiety (16%), and somatic burden (32%). Almost all variables showed moderate to high correlations with NF2-SWN-related QoL. NF2-SWN-related QoL was associated with physician-reported disease severity (r = 0.614). In the stepwise hierarchical linear regression analysis, a significant model with four predictors (disease severity type, depression symptoms, personality functioning, and gender) explained 64% of the variance in NF2-SWN-related QoL. Our results showed a strong association between NF2-SWN-related QoL and depression symptoms. Moreover, personality functioning is an important influencing factor, representing a modifiable construct that can be targeted by prevention programs or psychotherapy.

Parental knowledge and attitude of postoperative paediatric pain: stepwise linear regression analysis.

Despite the fact that mothers care for their children's pain in most cases, it has been noted that mothers have limited knowledge and attitude about paediatric pain. This study aims to assess parental knowledge and attitude of postoperative paediatric pain (POPP). This is institutional based cross sectional study conducted with 102 parents at Nigist Eleni Mohamed Memorial Comprehensive Specialized Hospital (NEMMCSH). A convenience sampling technique was used to select parents. This study has used a questionnaire (Parental Pain Expression Perception (PPEM), examine parents' attitudes and knowledge about how their children exhibit their pain and Medication Attitude Questioner (MAQs), focuses on how parents feel about giving their child analgesic medication to alleviate post-operative pain). Descriptive statistics were utilized to analyse the parent's response and presented with frequency and percentage. Factor analysis to analyze factor structure and stepwise linear regression analysis to examine the impact of socio-demographic factors in predicting parental knowledge and attitude about POPP were done. The statistical tests were performed at 95% confidence interval and 5% significance level. A total of 102 parents fulfilling the inclusion criteria were included. About 78% of parents agreed that children always express pain by crying or whining. The majority of parents (75.6%) believe children who are playing are not in pain. Regarding parental attitudes about pain medications, majority of parents (61%) believe that children should be given pain medication as little as possible because of its side effects. According to about 26.8% of parents, giving children pain medication for pain might teach them to use drugs for other issues. On the other hand, 63.4% of parents say that giving children pain medication as little as possible is the most effective way to manage their pain. Parents of younger children and parents from rural area are more likely to score higher in attention seeking sub-score of PPEP while parents from urban residence and those parents who are employed are more likely to perceive about the side effects of pain medications (Side effects factors). The overall knowledge and attitude of parents about postoperative pain and pain medications were poor.

Differences in kinetic factors affecting gait speed between lesion sides in patients with stroke.

The differences in kinetic mechanisms of decreased gait speed across brain lesion sides have not been elucidated, including the arrangement of motor modules reflected by kinetic interjoint coordination. The purpose of this study was to elucidate the differences in the kinetic factors of slow gait speed in patients with stroke on the lesion sides. A three-dimensional motion analysis system was employed to assess joint moment in the lower limb and representative gait parameters in 32 patients with right hemisphere brain damage (RHD) and 38 patients with left hemisphere brain damage (LHD) following stroke as well as 20 healthy controls. Motor module composition and timing were determined using principal component analysis based on the three joint moments in the lower limb in the stance phase, which were the variances accounted for principal components (PCs) and the peak timing in the time series of PCs. A stepwise multiple linear regression analysis was performed to identify the most significant joint moment and PC-associated parameter in explaining gait speed. A negligible difference was observed in age, weight, height, and gait speed among patients with RHD and LHD and controls. The following factors contributed to gait speed: in patients with RHD, larger ankle plantarflexion moment on the paretic (p = 0.001) and nonparetic (p = 0.002) sides and ankle dorsiflexion moment on the nonparetic side (p = 0.004); in patients with LHD, larger ankle plantarflexion moment (p < 0.001) and delayed peak timing of the first PC (p = 0.012) on the paretic side as well as ankle dorsiflexion moment on the nonparetic side (p < 0.001); in the controls, delayed peak timing of the first PC (p = 0.002) on the right side and larger ankle dorsiflexion moment (p = 0.001) as well as larger hip flexion moment on the left side (p = 0.023). The findings suggest that the kinetic mechanisms of gait speed may differ among patients with RHD following patients with stroke with LHD, and controls.

Blood glucose control and metabolic dysfunction-associated steatotic liver disease in people with type 1 diabetes.

Metabolic dysfunction-associated steatotic liver disease (MASLD) may have distinctive pathophysiological features in type 1 diabetes (T1D). We evaluated the independent role of blood glucose control on MASLD in T1D. In a cross-sectional study on 659 T1D adult patients, MASLD was assessed by the Fatty Liver Index (FLI) and the Hepatic Steatosis Index (HSI). Anthropometric, biochemical, and clinical parameters were retrieved from electronic records. Blood glucose control status was evaluated by dividing participants into subgroups according to the median value of HbA1c [7.6% (60mmol/mol)], and this analysis was repeated excluding overweight/obese patients. Patients with HbA1c above 7.6% (60mmol/mol) showed significantly higher MASLD indices (HSI 38 ± 6 vs. 36 ± 5, p < 0.001; FLI 26 ± 26 vs.19 ± 19, p < 0.001), and higher proportions of MASLD identified by HSI (57 vs. 44%, p < 0.001) and FLI (14 vs. 7%, p < 0.001) than patients with HbA1c below 7.6% (60mmol/mol). Similar results were obtained for HSI after the exclusion of overweight/obese patients. Stepwise linear regression analysis confirmed that HbA1c was independently associated with HSI (r = 0.496, p = 0.009) and FLI (r = 0.722, p = 0.007); waist circumference with HSI (r = 0.492, p < 0.001); and waist circumference (r = 0.700, p < 0.001), HDL cholesterol (r = 0.719, p < 0.001), and LDL cholesterol (r = 0.712, p < 0.001) with FLI. Blood glucose control is a main factor associated with MASLD in adults with T1D, also independently of overweight and obesity. Appropriate therapeutic strategies focused on tight blood glucose control may also be needed for the prevention and treatment of MASLD in T1D.

Dermatological patients with itch report more stress, stigmatization experience, anxiety and depression compared to patients without itch: Results from a European multi-centre study.

Itch as the most common symptom in dermatology has been shown to be related to psychological factors such as stress, anxiety and depression. Moreover, associations were found between perceived stigmatization and itch. However, studies investigating the differences between patients with dermatoses with and without itch regarding perceived stress, stigmatization, anxiety and depression are missing. Therefore, one of the aims of the second study of the European Society for Dermatology and Psychiatry (ESDaP study II) was to investigate these relationships in a large cohort of patients with different itchy dermatoses. 3399 patients with 14 different itchy dermatoses were recruited at 22 centres in 17 European countries. They filled in questionnaires to assess perceived stigmatization, stress, signs of clinically relevant anxiety or depression, itch-related quality of life, the overall health status, itch duration, frequency and intensity. The most significant association between the severity of itching and the perception of stress was observed among individuals with rosacea (correlation coefficient r = 0.314). Similarly, the strongest links between itch intensity and experiences of stigmatization, anxiety, and depression were found in patients with seborrheic dermatitis (correlation coefficients r = 0.317, r = 0.356, and r = 0.400, respectively). Utilizing a stepwise linear regression analysis, it was determined that within the entire patient cohort, 9.3% of the variation in itch intensity could be accounted for by factors including gender, levels of anxiety, depression, and perceived stigmatization. Females and individuals with elevated anxiety, depression, and perceived stigmatization scores reported more pronounced itch intensities compared to those with contrary attributes. This study underscores the connection between experiencing itch and its intensity and the psychological strain it places on individuals. Consequently, psychological interventions should encompass both addressing the itch itself and the interconnected psychological factors. In specific cases, it becomes imperative for dermatologists to direct individuals towards suitable healthcare resources to undergo further psychological assessment.

Socioeconomic disparities in diet and physical activity in children: evidence from well-child visit electronic health records in the Canary Islands, Spain

BackgroundDiet and physical activity (PA) in childhood are heavily influenced by the living environment. While diet quality follows a socioeconomic pattern, limited evidence is available in relation to PA in...