Stepwise Regression Research Articles

Digital and social media use among adolescents in Arctic Norway: Exploring risk and protective factors in Finnmark County.

Digital and social media use among adolescents in Arctic Norway: Exploring risk and protective factors in Finnmark County.

Factors Associated With Social Participation Among Young and Middle-Aged Patients After Cardiac Surgery: A Cross-Sectional Study.

This study aimed to investigate the level of social participation among young and middle-aged patients after cardiac surgery and its influencing factors by using a cross-sectional design. Participants were recruited from the Department of Cardiac Surgery of Guangdong Provincial People's Hospital through convenience sampling, and 237 young and middle-aged patients after cardiac surgery completed the Questionnaire on Participation and Autonomy (IPA). Data were analyzed using descriptive statistics, independent t-test, one-way analysis of variance, Pearson's correlation coefficients, and multiple stepwise linear regression analysis. A total of 237 participants, with a mean (SD) age was 47.2 (9.2). The total score (SD) of social participation among young and middle-aged patients after cardiac surgery was 52.0 (6.7), indicating a moderately low level of social participation. The results of multiple stepwise regression analysis showed that gender, age, number of comorbidities, social support, self-efficacy, kinesiophobia, and pain were the influencing factors of social participation (p < 0.05), which variables accounted for approximately 59.6% of the variance in the social participation. The social participation among young and middle-aged patients after cardiac surgery needs to be improved. TRIAL REGISTRATION: This study has been approved by the Chinese Clinical Trial Registry. (registration number: ChiCTR2400083390).

Injury, child and family/contextual factors predict neurodevelopment outcomes after abusive head trauma.

Injury, child and family/contextual factors predict neurodevelopment outcomes after abusive head trauma.

TIAMAT- towards an interdisciplinary automated malnutrition screening tool.

TIAMAT- towards an interdisciplinary automated malnutrition screening tool.

Impact of clinical trial treatment and area deprivation index in the outcomes of adolescent and young adult patients with acute myeloid leukemia.

6550 Background: Socioeconomic status (SES) is an independent prognostic factor in patients (pts) with acute myeloid leukemia (AML). Adolescent and young adult (AYA, age 15-39) pts with AML traditionally have better outcomes than older adult pts. Prior studies have shown that SES adversely impacts outcomes in AYA pts. Area Deprivation Index (ADI) is one of the most advanced SE tools, incorporating 17 SE factors to rank neighborhoods based on disadvantaged status. Higher ADI score corresponds to more disadvantaged neighborhoods. Here, we report the largest cohort of AYA pts with AML treated at a single institution with molecular, cytogenetic (CG) and ADI data. Methods: AYA pts with AML treated at MD Anderson Cancer Center from 3/2013 to 3/2023 were included. ADI data was downloaded from https://www.neighborhoodatlas.medicine.wisc.edu . Backward elimination was applied to the multivariable model, removing variables sequentially until only variables with p&lt;0.1 remained. Results: 190 AYA pts were included (non-Hispanic White, NHW-139, non-Hispanic Black-24, Hispanic-16, Asian-11). Median age was 31 years (17-39). 81 pts (43%) had adverse risk by ELN 2022 and 135 (71%) were treated in clinical trials. Both median overall survival (OS) and relapse-free survival (RFS, not censored for transplant (SCT)) was 85.4 months, respectively. ADI national rank 61-100 (HR 1.906, 1.069-3.396, p=0.029), complex CG (HR 2.854, 1.530-5.324, p=0.001), intermediate risk (HR 2.514, 1.160-5.449, p=0.020), and adverse risk (HR 4.257, 1.975-9.177, p&lt;0.001) adversely affected OS. Notably, treatment in clinical trials (HR 0.499, 0.309-0.806, p=0.005) and SCT (HR 0.499, 0.288-0.862, p=0.013) led to longer OS. Only complex CG and adverse risk negatively impacted RFS. Conclusions: AYA pts from disadvantaged neighborhoods (ADI national rank 61-100) had an inferior OS. Our data showed that treatment in clinical trials and SCT led to longer OS. These results underscore the importance of treatment in clinical trials and SCT for improving OS in AYA, particularly for AYA pts from disadvantaged neighborhoods. Efforts to improve access to clinical trials and SCT, especially for AYA pts from disadvantaged neighborhoods are needed. Results of Cox regression analysis for overall survival (p value cutoff 0.100 for MVA). Univariate Multivariate HR 95% CI P HR 95% CI P ADI state1-6 ref ref ref ref ref ref 7-10 1.558 0.964-2.517 0.070 1.178 0.625-2.221 0.612 ADI national 1-60 ref ref ref ref ref ref 61-100 1.918 1.232-2.986 0.004 1.906 1.069-3.396 0.029 CG: Complex 5.046 3.021-9.428 &lt;0.001 2.854 1.530-5.324 0.001 Favorable ref ref ref ref ref ref Intermediate 2.162 1.005-4.650 0.049 2.514 1.160-5.449 0.020 Adverse 4.640 2.347-9.175 &lt;0.001 4.257 1.975-9.177 &lt;0.001 Clinical trial 0.495 0.315-0.779 0.002 0.499 0.309-0.806 0.005 SCT (time-dependent) 0.643 0.389-1.062 0.085 0.499 0.288-0.862 0.013

Environmental impact and economic performance of Norwegian dairy farms.

Environmental impact and economic performance of Norwegian dairy farms.

Patient Navigators Improve In-Office Eye Exam Adherence After Community Eye Screenings in a Randomized Clinical Trial: NYC-SIGHT Study.

Patient Navigators Improve In-Office Eye Exam Adherence After Community Eye Screenings in a Randomized Clinical Trial: NYC-SIGHT Study.

AI-driven prediction of post-transplant survival and stratification of HCC recurrence risk.

4114 Background: Traditional selection criteria (e.g., Milan, UCSF) and scoring systems (MELD/PELD) for liver transplant eligibility in hepatocellular carcinoma (HCC) often fail to capture the complex interplay of tumor biology, patient factors, and bridging therapies. Although Milan and UCSF yield similar 1-, 3-, and 5-year survival rates, the debate over expanded criteria highlights the need for refined, individualized risk-stratification tools. Methods: We retrospectively analyzed 21,182 HCC patients from the UNOS database to develop deep learning and Cox regression models for overall survival (OS). Models incorporated demographic (e.g., age, race), clinical (e.g., diabetes, MELD differences), and tumor-specific variables (e.g., tumor count, size tiers). Performance was compared to standard MELD-based calculations using 5-fold cross-validation, with primary endpoints of 1-, 3-, and 5-year survival. For recurrence risk, we used 15,801 records to train gradient boosting (XGBoost) and Cox models. Key variables included tumor characteristics (size levels, vascular invasion), recipient factors (insurance type, functional status, initial MELD/PELD), and alpha-fetoprotein (when available). Model performance was evaluated via area under the curve (AUC) and concordance index (c-index); external validation was performed for the recurrence model. Results: Cox Regression (time-to-event): Final multivariable models achieved c-indices of 0.611 for OS and 0.601 for progression-free survival (PFS). Stepwise Logistic Regression (mortality): Mean AUCs were 0.664 (1-year), 0.705 (3-year), and 0.758 (5-year). Random Forest Classifier: Slightly higher AUCs than logistic regression (0.663 at 1-year, 0.714 at 3-year, 0.762 at 5-year). Gradient Boosting (recurrence): 1-year recurrence predictions achieved AUC &gt; 0.80, with microvascular invasion emerging as a key risk factor (p&lt;0.001). Across approaches, incorporating multiple clinical and tumor-specific factors outperformed MELD-based models, consistently showing improved predictive accuracy. Conclusions: Machine learning–based models, including deep learning, random forests, and gradient boosting, offer enhanced risk prediction for post-transplant survival and HCC recurrence beyond traditional scoring criteria. These advanced tools enable more nuanced transplant selection, surveillance, and early intervention strategies, potentially improving long-term outcomes for HCC patients undergoing liver transplantation.

Impact of pressure-related injury on hospitalized patients with colorectal cancer: A United States population-based cohort study.

e15688 Background: Colorectal cancer is the third most common cancer worldwide. Newer treatment options have significantly helped improve quality of life, albeit with the potential for more adverse effects. Pressure-related injuries, including pressure ulcers, sacral wounds, heel ulcers, and full-thickness wounds, continue to be significant comorbidity in hospitalized patients. Patients with underlying malignancy are more prone to developing pressure-related injury, especially in cases with poor performance status. Our study aims to explore the impact of pressure-related injury on hospitalized patients with colorectal cancer. Methods: We utilized the 2020 National Inpatient Sample (NIS) Database in conducting this retrospective cohort study. We identified patients with colorectal cancer and pressure-related injury using appropriate ICD-10 diagnostic codes. We stratified patients with colorectal cancer based on the presence or absence of pressure-related injury. A survey multivariable logistic and linear regression analysis was used to calculate adjusted odds ratios (ORs) for the primary and secondary outcomes. A p value of &lt; 0.05 was considered statistically significant. Results: We identified a total of 77130 hospitalized patients with colorectal cancer, of which 0.26% (205/77130) had comorbid pressure-related injury. The overall in-hospital mortality among patients with colorectal cancer was 2.74% (2115/77130). Among those with concomitant pressure-related injury, the mortality rate was significantly higher at 12.20% (25/205, p&lt;0.001). Utilizing a stepwise survey multivariable logistic regression model that adjusted for patient and hospital level confounders, pressure-related injury was found to be an independent predictor of increased in-hospital mortality (adjusted OR 3.22; 95% (confidence interval [CI] 1.22-8.51; p= 0.018), longer LOS (coefficient 7.41 days; CI 2.15-12.66; p= 0.006), but not higher total hospitalization charge ($25963; CI -$4867-$56794; p=0.099) or increased need for mechanical ventilation (adjusted OR 3.27; CI 0.95-11.23; p= 0.059). Conclusions: Our analysis demonstrated that pressure-related injury was prevalent in hospitalized patients with colorectal cancer. It was associated with significantly worsened in-hospital mortality and longer LOS. Efforts should be made for early diagnosis and accurate documentation of pressure-related injuries. Strategies focused on establishing institutional protocols for preventing and managing pressure-related injuries, including wound care teams as indicated, may help improve clinical outcomes. Further prospective studies are needed to describe these associations better.

A novel method to determine background concentrations and spatial distributions of heavy metals in soil at large scale using machine learning coupled with remote sensing-terrain attributes.

A novel method to determine background concentrations and spatial distributions of heavy metals in soil at large scale using machine learning coupled with remote sensing-terrain attributes.

Severity Indices of Diquat Poisoning for Triage and Prognosis in Acute Diquat Poisoning: A Multicenter Prospective Cohort Study.

Severity Indices of Diquat Poisoning for Triage and Prognosis in Acute Diquat Poisoning: A Multicenter Prospective Cohort Study.

Vortioxetine versus SSRI/SNRI with Pregabalin Augmentation in Treatment-Resistant Burning Mouth Syndrome: A Prospective Clinical Trial.

The treatment of Burning Mouth Syndrome (BMS) represents a challenge in tailoring appropriate medication for individual patients. The augmentation of pregabalin to conventional treatment has shown promising outcomes in relieving pain and improving the quality of life in chronic pain conditions. This study aimed to compare the efficacy of vortioxetine with other antidepressants (SSRIs/SNRIs) in combination with pregabalin in a cohort of unresponsive BMS patients and to predict treatment response by using clinical data. A 52-week randomized, open-label, comparative clinical study was conducted, enrolling 203 BMS patients previously treated with one antidepressant for 12 weeks and non-responders to the treatment (clinical trial registration: NCT06025474). The study sample included two groups: Group A (136) received vortioxetine, while Group B (67) received SSRIs/SNRIs. Pregabalin (75 mg/day) was added to both groups, with a potential dosage increase to 150 mg/day for inadequate responders after 12 weeks. Treatment response was assessed with VAS and SF-MPQ, HAM-A, and HAM-D scores at 12, 24, 36, and 52 weeks. Stepwise logistic regression analysis was used to predict treatment response. A total of 84 (61.8%) BMS patients in Group A and 39 (58.2%) in Group B showed treatment response. Group A reported a faster onset of action compared to Group B (44.8% versus 22.4% at time 1; p:0.002**) and lower adverse event rates (8.8% versus 20.8%; p:0.001). The addition of pregabalin to vortioxetine may be considered a potential treatment option for BMS. Further research is required to corroborate these findings and optimize personalized treatment approaches for BMS patients. ClinicalTrials.gov (NCT06025474).

Comparative immobilization of 30 PFAS mixtures onto biochar, clay, nanoparticle, and polymer derived engineered adsorbents: Machine learning insights into carbon chain length and removal mechanism.

Per- and polyfluoroalkyl substances (PFAS) are a group of fluorinated chemicals that cause potential risk in PFAS-impacted soil and water. The adsorption efficiency of 30 PFAS mixtures using different adsorbents in environmentally relevant concentrations was investigated. Different meso/microporous designed adsorbents (n = 7) were used for PFAS adsorption and their interfacial interactions. The adsorbents were tested for their ability to remove PFAS mixtures, including perfluoroalkyl sulfonic acids (PFSAs, n = 7, C4-C10), perfluoroalkyl carboxylic acids (PFCAs, n = 11, C4-C14), fluorotelomer sulfonic acids (FTSs, n = 4), perfluoroalkane sulfonamido acetic acids (FASAAs, n = 3, C8), perfluoroalkane sulfonamides (FASAs, n = 3, C8) and perfluoroalkane sulfonamidoethanols (FASEs, n = 2, C8). The overall removal rate of 30 PFAS was recorded as 86.20-89.29 %, 87.63-90.33 %, and 67.07-93.61 % for microporous biochar/modified biochar, halloysite nanoclays, and mesoporous polymer composites-based adsorbents, respectively. The presence of sugarcane bagasse-derived biochar, iron nanoparticles, and β-cyclodextrin in the composite adsorbents enhances the sorption of PFAS. Higher adsorption efficiency was observed for long-chain PFCAs, PFSAs, FTSs, FASAAs, FASAs, and FASEs, whereas, complete removal of short-chain PFCAs, PFSAs, and FTSs is still challenging by using all the studied adsorbents. The carbon chain length and head groups of PFAS play a vital role in removing PFAS. The correlation coefficient (R2) values between removal rate and carbon chain length, for PFCAs (n = 11), and PFSAs (n = 7) were found as 0.73, and 0.31 respectively. Appropriate machine learning tools including efficient linear least squares, Gaussian process regression, and stepwise linear regression, were applied to fit experimental data and assess model accuracy.

Investigation on the association between Osteopontin and Apolipoprotein E gene polymorphisms and vancomycin-induced acute kidney injury: A pharmacokinetic/pharmacogenetic study in critically ill patients.

Investigation on the association between Osteopontin and Apolipoprotein E gene polymorphisms and vancomycin-induced acute kidney injury: A pharmacokinetic/pharmacogenetic study in critically ill patients.

Understanding urbanization development process and the associated PCBs concentration in urban soils - A genetic algorithm-based urbanization index approach.

Understanding urbanization development process and the associated PCBs concentration in urban soils - A genetic algorithm-based urbanization index approach.

Evidence-Based Nursing Competence in Pediatrics: A Cross-Sectional Examination of Current Practices and Influencing Factors.

It is necessary to explore the current status and determinants of evidence-based nursing (EBN) competencies among pediatric nurses, thereby offering valuable insights for clinical practice and patient care. A cross-sectional survey was conducted among pediatric nurses employed at a pediatric hospital in May 2024. Pearson correlation and multiple stepwise linear regression were used to ascertain the predictors of EBN competencies. The survey included 422 pediatric nurses. The mean EBN competency score was 70.66 ± 15.04, indicating a moderate level of EBN proficiency. Correlational analysis revealed significant associations between EBN competencies and nurses' age (r = 0.465), educational level (r = 0.534), professional title (r = 0.507), and prior EBN training (r = 0.528) (all p < .05). Multiple linear regression analysis confirmed that age, educational level, professional title, and prior EBN training are influencing factors (all p < .05). It is essential for nursing administrators to implement more rigorous and targeted EBN training programs to enhance the competencies of pediatric nurses. [J Contin Educ Nurs. 2025;56(6):237-244.].

In silico screening to search for selective sodium channel blockers: When size matters.

In silico screening to search for selective sodium channel blockers: When size matters.

Outcomes of therapy-related AML (T-AML) with venetoclax-based therapies.

6549 Background: T-AML refers to AML in patients (pts) with prior exposure to cytotoxic chemotherapy (CT) and/or radiotherapy (RT) and is often associated with adverse risk (AR) genomics. Evaluation of outcomes of T-AML with respect to type of prior therapy exposure, AML genomics, and contemporary AML therapy, especially with venetoclax (VEN), is warranted. Methods: We retrospectively analyzed pts aged ≥18 years with newly diagnosed T-AML. Pts with an antecedent myeloid disorder (MDS/CMML) prior to AML diagnosis were excluded; thus, including only pure T-AML. Composite complete response (CRc) included CR and CRi and overall response (OR) included CRc + morphologic leukemia free state. Results: From 1/2012 to 12/2023, 317 pts were included; median (med) age was 69 years (range 21-92). Overall, 120 (38%) received prior CT alone, 77 (24%) received prior RT alone (RT), and 114 (36%) received both (CRT). The most common prior malignancy was non-Hodgkin lymphoma (37%) in the CT group, prostate cancer (60%) in the RT group, and breast cancer (45%) in the CRT group.Among 286 pts with complete cytogenetic data, 180 (63%) were adverse, of whom 132 (46%) had complex karyotype (CK; 42% of CT, 48% of RT, and 61% of CRT groups). TP53 was mutated in 113/286 patients (40%) tested (36% of CT, 35% of RT, and 47% of CRT groups). Stratified by type of CT received, CK and TP53 mutation were seen in 5/5 (100%) and 3/5 (60%) of PARP inhibitor-exposed, 98/184 (53%) and 78/183 (43%) of alkylator-exposed, and 21/36 (58%) and 16/37 (43%) of topoisomerase inhibitor-exposed. Overall, 217/304 (71%) were ELN 2017 AR. In total, 251 pts (79%) received low-intensity AML therapy (LIT). CRc and OR was achieved in 122 (49%) and 146 (58%) pts treated with LIT (vs 58% and 65% with LIT+VEN). In pts treated with intensive chemotherapy (IC), the CRc and OR rate was 64% and 68% (vs 68% and 73% with IC+VEN). Overall, med RFS was 7.2 months (mos; 95% CI 5.6-8.9), and med OS was 11.8 mos (10.0-13.7). Med OS was 5.7 vs 9.0 mos (p=0.02) with LIT and LIT+VEN, respectively (resp), and med OS was 10.9 vs 48.9 mos (p=0.03) for IC vs IC+VEN, resp. Among pts treated with LIT+VEN, med OS was 14.0, 12.4, and 9.6 mos in those who had received prior CT, RT and CRT, resp; when stratified by ELN 2017 criteria, med OS was 24.6, 9.4 and 4.8 mos in the favorable, intermediate and AR groups, resp. Sixty-seven (21%) pts underwent HSCT with a landmarked comparison showing improved OS with HSCT (28.5 months vs 9.4, p&lt;0.001). On multivariate Cox analysis in the LIT+VEN group, with forward model selection, using variables age &lt;/≥ 60, adverse cytogenetics, ASXL1, IDH1/2, FLT3-ITD, RAS, RUNX1, TP53 status , HSCT, and prior therapy group, HSCT was favorable (HR=0.19, 95% CI 0.01-0.37), along with IDH2 and NPM1 mut, while RAS and TP53 mut was associated with higher hazards of death. Other factors were not significant. Conclusions: Venetoclax improves outcomes in T-AML. In LIT+VEN treated patients, ELN 2024 risk stratification is prognostic.

Factors Influencing Occupational Burnout Among Palliative Care Practitioners in China.

Factors Influencing Occupational Burnout Among Palliative Care Practitioners in China.

Unraveling antipsychotic induced weight gain in schizophrenia - A proof-of-concept study exploring the impact of the cumulative historical occupancy of different receptors by antipsychotics.

Unraveling antipsychotic induced weight gain in schizophrenia - A proof-of-concept study exploring the impact of the cumulative historical occupancy of different receptors by antipsychotics.