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Background: Calls to action addressing the interconnections between physical (in)activity and the climate crisis are increasing. The current study aimed to investigate public support for policy actions that potentially have co-benefits for physical activity promotion and climate change mitigation. Methods: In 2023, a survey through the Angus Reid Forum was completed by 2507 adults living in Canada. Binary logistic regressions were conducted. Separate models were created to reflect support or opposition to the 8 included policy items. Several covariates were included in the models including age, gender, political orientation, physical activity levels, income, urbanicity climate anxiety, and attitudes surrounding physical activity and climate change. The data were weighted to reflect the gender, age, and regional composition of the country. Results: Most individuals living in Canada strongly or moderately supported all actions (ranging from 71% to 85%). Meeting the physical activity guidelines, higher self-reported income, and scoring high on personal experience of climate change were associated with higher odds of supporting the policy actions related to climate actions. Conclusions: Most adults living in Canada support policies that align with the recommended policy actions related to physical activity and climate change. National campaigns enhancing awareness and understanding of the bidirectional relationship between physical activity and climate change are warranted, and these should consider the consistent demographic differences (eg, gender, age, and political orientation) seen in public support for physical activity-related policies. [ABSTRACT FROM AUTHOR]

Background: The built environments in which we work, live, and play can influence physical activity behaviors, and perceptions of these environments are associated with walking behavior. This study's objective is to compare national-level data on perceptions of the near-home walking environment from the 2015 and 2020 National Health Interview Survey. Methods: Adults in 2015 (n = 30,811) and 2020 (n = 29,636) reported perceptions of walkable supports (roads, sidewalks, paths, or trails; sidewalks on most streets), destinations (shops, stores, or markets; bus or transit stops; movies, libraries, or churches; places that help you relax, clear your mind, and reduce stress), and barriers to walking (traffic; crime; animals). Age-adjusted prevalence estimates, prevalence differences, and 95% confidence intervals were calculated overall and by demographic characteristics. Results: The reported prevalence of roads, sidewalks, paths, or trails for walking increased overall (85.3% in 2015 to 88.0% in 2020) and for many subgroups. Perceived places to walk to for relaxation, to clear your mind, and to reduce stress increased overall (72.1% in 2015 to 77.1% in 2020) and for all subgroups. Perceptions of crime as a barrier to walking decreased overall (12.5% in 2015 to 11.2% in 2020) and for some subgroups. From 2015 to 2020, the proportion of adults perceiving roads, sidewalks, paths, or trails; places to relax; and crime as a barrier to walking improved. Conclusions: Continuing to monitor perceptions of the walking environment could contribute to progress toward national walking and walkability goals in the United States. [ABSTRACT FROM AUTHOR]

The authors conducted a survey containing the Copenhagen Burnout Inventory to explore the degree and type of burnout experienced by academic librarians in the spring of 2023. The average burnout score of the respondents (N = 267) was found to be middling (M = 45.68142). When subtypes of burnout were explored, academic librarians showed the most personal burnout, followed closely by work-related burnout. Client-related burnout was low. Analyses were conducted to explore differences due to demographic or workplace characteristics; however, the only significant relationship observed was between the duration of a librarian's career and their degree of client-related burnout. [ABSTRACT FROM AUTHOR]

Purpose: To examine the relationship between socioeconomic inequalities and oral health among adults in the Guangxi province of China. Materials and Methods: The present work was designed as a cross-sectional study, and comprises a secondary analysis of the Fourth National Oral Health Survey from 2015–2016. A multistage cluster sampling method was adopted for this survey, conducted in three urban and three rural districts Guangxi province. Dental examinations were conducted to determine oral health indicators: decayed teeth (DT), clinical attachment loss (CAL) and missing teeth (MT). The outcome measures were DT, CAL and MT. A structured questionnaire was used to collect data on demographic characteristics and socioeconomic status (SES). Multiple logistic regression models were used to analyse the relationship between SES and oral health by adjusting covariates. Results: The sample consisted of 651 participants aged 35–74 years. Logisitic analysis showed a statistically significant association between SES and oral health indicators. In the fully adjusted model, participants with primary education were more likely to suffer more DT (OR = 2.67, 95% CI: 1.17–6.10), teeth with CAL ≥ 4 mm (OR = 2.15, 95% CI: 1.25–3.67) and MT (OR = 3.04, 95% CI: 1.65–5.60) compared to the higher education group. Participants with secondary education exhibited a higher likelihood of experiencing increased MT compared to those in the higher education group in the fully adjusted model (OR = 3.21, 95% CI: 1.78–5.76). Household income was associated with DT and MT in the unadjusted model only. Conclusions: There was strong relationship between SES and oral health of adults. The survey suggested a relationship between low educational attainment and oral health. [ABSTRACT FROM AUTHOR]

During the 2022 National Collegiate Athletic Association (NCAA) college football season, eight of the 65 Power-5 head coaches were Black. The racial composition of assistant coaches, however, was nearly 50% Black and 50% White. While the head coach of a Power-5 football team serves as the leader of the program, the 10 assistant coaches permitted by the NCAA oversee a variety of critical roles; the most valuable of which is recruiting. This study extends previous work by examining the racial composition of Power-5 football coaching staffs and recruiting responsibilities through the lens of racial tasking. An analysis of Power-5 football recruiting classes from 2019 and 2020 illustrates that assistant coaches are tasked with recruiting prospective athletes racially similar to themselves 58% of the time. Furthermore, Black assistant coaches are disproportionately tasked with recruiting Black recruits and higher rated recruits (i.e., five- and four-star) compared to their White counterparts. We contend such racialized responsibilities and expectations may affect opportunities for advancement among Black assistant coaches. [ABSTRACT FROM AUTHOR]

This paper develops a distance score that measures the extent to which college graduates work in jobs requiring knowledge that is related to their college major. For a given individual, this distance score is estimated by taking the Euclidean distance between the knowledge requirements of an individual's occupation, and the knowledge requirements of the perfectly matching occupations that their major trains individuals for. Using this measure, it is documented that non-perfectly matched graduates of majors with high perfect match rates tend to use major-related knowledge in their jobs to a greater extent than non-perfectly matched graduates of majors with low perfect match rates. This indicates that cross-major differences in perfect match rates tend to understate cross-major differences in major-related knowledge use. Furthermore, average hourly earnings are found to be continuously decreasing in the value of the distance score. This earnings penalty persists when controlling for an individual's demographic characteristics, as well as their college major. [ABSTRACT FROM AUTHOR]

Objective: To assess reporting practices of sociodemographic data in Upper Aerodigestive Tract (UAT) videomics research in Otolaryngology-Head and Neck Surgery (OHNS). Study design: Narrative review. Methods: Four online research databases were searched for peer-reviewed articles on videomics and UAT endoscopy in OHNS, published since January 1, 2017. Title and abstract search, followed by a full-text screening was performed. Dataset audit criteria were determined by the MINIMAR reporting standards for patient demographic characteristics, in addition to gender and author affiliations. Results: Of the 57 studies that were included, 37% reported any sociodemographic information on their dataset. Among these studies, all reported age, most reported sex (86%), two (10%) reported race, and one (5%) reported ethnicity and socioeconomic status. No studies reported gender. Most studies (84%) included at least one female author, and more than half of the studies (53%) had female first/senior authors, with no significant differences in the rate of sociodemographic reporting in studies with and without female authors (any female author: p = 0.2664; first/senior female author: p > 0.9999). Most studies based in the US reported at least one sociodemographic variable (79%), compared to those in Europe (24%) and in Asia (20%) (p = 0.0012). The rates of sociodemographic reporting in journals of different categories were as follows: clinical OHNS: 44%, clinical non-OHNS: 40%, technical: 42%, interdisciplinary: 10%. Conclusions: There is prevalent underreporting of sociodemographic information in OHNS videomics research utilizing UAT endoscopy. Routine reporting of sociodemographic information should be implemented for AI-based research to help minimize algorithmic biases that have been previously demonstrated. Level of evidence: 4. [ABSTRACT FROM AUTHOR]

Considering that an eco-friendly image is an important factor that influences the purchase of eco-friendly products, and that demographic characteristics of consumers may affect this purchase behavior, the importance of examining how these characteristics influence repurchase intention of "green" products cannot be overstated. Therefore, the purpose of this study was to understand the structural relationship between a shop's "eco-friendly" image, consumers' demographic characteristics (gender, age, income, education), as well as customer satisfaction, customer trust, and repurchase intention. A total of 360 samples were analyzed using SPSS 25.0 and AMOS 22.0 statistical programs. The results of this study are as follows. First, it was found that the eco-friendly image had a positive effect on customer satisfaction and customer trust. Second, customer satisfaction was found to have a positive effect on customer trust. Third, customer satisfaction and customer trust had a positive effect on repurchase intention. Finally, this study confirmed the moderating effect of demographic characteristics on the relationship between customer satisfaction, customer trust, and repurchase intention. [ABSTRACT FROM AUTHOR]

Background and Objective: Uncontrolled asthma in patients treated for mild/moderate disease could be caused by non‐pulmonary treatable traits (TTs) that affect asthma control negatively. We aimed to identify demographic characteristics, behavioural (smoking) and extrapulmonary (obesity, comorbidities) TTs and the risk for future exacerbations among patients with uncontrolled asthma prescribed step 1–3 treatment according to the Global Initiative for Asthma (GINA). Methods: Twenty‐eight thousand five hundred eighty‐four asthma patients (≥18 y) with a registration in the Swedish National Airway Register between 2017 and 2019 were included (index‐date). The database was linked to other national registers to obtain information on prescribed drugs 2‐years pre‐index and exacerbations 1‐year post‐index. Asthma treatment was classified into step 1–3 or 4–5, and uncontrolled asthma was defined based on symptom control, exacerbations and lung function. Results: GINA step 1–3 included 17,318 patients, of which 9586 (55%) were uncontrolled (UCA 1–3). In adjusted analyses, UCA 1–3 was associated with female sex (OR 1.34, 95% CI 1.27–1.41), older age (1.00, 1.00–1.00), primary education (1.30, 1.20–1.40) and secondary education (1.19, 1.12–1.26), and TTs such as smoking (1.25, 1.15–1.36), obesity (1.23, 1.15–1.32), cardiovascular disease (1.12, 1.06–1.20) and depression/anxiety (1.13, 1.06–1.21). Furthermore, UCA 1–3 was associated with future exacerbations; oral corticosteroids (1.90, 1.74–2.09) and asthma hospitalization (2.55, 2.17–3.00), respectively, also when adjusted for treatment step 4–5. Conclusion: Over 50% of patients treated for mild/moderate asthma had an uncontrolled disease. Assessing and managing of TTs such as smoking, obesity and comorbidities should be conducted in a holistic manner, as these patients have an increased risk for future exacerbations. Uncontrolled asthma in patients treated for mild to moderate disease is associated with treatable traits such as smoking, obesity and comorbidities. Moreover, these patients have an increased risk for future exacerbations. These findings highlight the importance of assessing and managing treatable traits in asthma, in a holistic manner. See relatededitorial [ABSTRACT FROM AUTHOR]

Purpose: To assess the accuracy of preoperative sonographic staging in patients with primary invasive breast cancer. Methods: We retrospectively analyzed a prospectively kept service database of patients with newly diagnosed, unifocal, cT1-3, invasive breast cancer. All patients were diagnosed at a single center institution between January 2013 and December 2021. Clinical T stage was assessed preoperatively by ultrasound and correlated with the definite postoperative pathologic T stage. Demographics, clinical and pathological characteristics were collected. Factors influencing accuracy, over- and underdiagnosis of sonographic staging were analyzed with multivariable regression analysis. Results: A total of 2478 patients were included in the analysis. Median patients' age was 65 years. 1577 patients (63.6%) had clinical T1 stage, 864 (34.9%) T2 and 37 (1.5%) T3 stage. The overall accuracy of sonography and histology was 76.5% (n = 1896), overestimation was observed in 9.1% (n = 225) of all cases, while underestimation occurred in 14.4% (n = 357) of all cases. Accuracy increased when clinical tumor stage cT was higher (OR 1.23; 95% CI 1.10–1.38, p ≤ 0.001). The highest accuracy was seen for patients with T2 stage (82.8%). The accuracy was lower in Luminal B tumors compared to Luminal A tumors (OR 0.71; 95% CI 0.59–0.87, p ≤ 0.001). We could not find any association between sonographic accuracy in HER2 positive patients, and demographic characteristics, or tumor-related factors. Conclusion: Our unicentric study showed a high accuracy of sonography in predicting T stage, especially for tumors with clinical T2 stage. Tumor stage and biological tumor factors do affect the accuracy of sonographic staging. [ABSTRACT FROM AUTHOR]

Background and purpose: Wilson's disease (WD) is a rare autosomal recessive disorder causing excessive copper deposition and a spectrum of manifestations, particularly neurological and hepatic symptoms. We analysed the clinical characteristics of patients with WD admitted to the country's only reference centre, which provided long‐term care to most adult patients in Poland over seven decades (pre‐1959 to 2019). Methods: Electronic prospective data collection began in the 2000s and, for prior years, medical records were analysed retrospectively. Demographic and clinical characteristics, treatment and outcomes were analysed by decade of diagnosis. Life‐years lost were estimated in patients with WD compared with the general population. Kaplan–Meier curves were used for a time‐to‐death analysis using 2000–2009 as a reference. Results: In total, 929 patients were analysed. The number of patients increased from 21 before 1959 to 315 for 2000 to 2009 period. Mostly males were diagnosed before the 1990s, but the numbers of female patients diagnosed increased thereafter. Initially, most patients presented with neurological manifestations; however, the incidence of hepatic manifestations and asymptomatic presentations increased over time as patients were diagnosed early and consequently were more independent at diagnosis. Fewer Kayser‐Fleischer rings were detected recently. Prior to 1970, patients were treated with D‐penicillamine (DP); however, since the introduction of zinc, both therapies have been used as often. Since the 1990s, switches between DP and zinc were recorded in 6%–7% of patients. Consistent improvement in survival has been observed over the years. Conclusions: This is the largest cohort of patients with WD reported in Poland, with the longest follow‐up. Earlier diagnosis and prognosis have improved over seven decades. [ABSTRACT FROM AUTHOR]

The number of U.S. adults who own and carry a firearm for self-defense is rising. Research has established that owning or carrying a firearm increases the risk of injury and death for firearm owners and the people in their lives. This study sought to better understand this paradox by estimating associations of perceived specific and diffuse threats with firearm behaviors among U.S. adults. The authors used data from the 2023 National Firearm Attitudes and Behaviors Study, a nationally representative cross-sectional survey of U.S. adults. Binary and ordinal logistic regression estimated associations of perceived specific (fear of attack in the community, fear of someone breaking into the home) and diffuse threats (belief in a dangerous world) with firearm ownership and carriage frequency, overall and stratified by gender. Adjusted models controlled for violence exposures and demographic characteristics. The authors conducted analyses in 2024. Among all U.S. adults, the perceived specific threat of someone breaking into the home was associated with firearm ownership (AOR: 1.09 [0.98, 1.23]). Among firearm-owning adults, the diffuse threat of belief in a dangerous world was associated with firearm carriage frequency (1.11 [0.98, 1.25]). Both the associations persisted among men (AORs = 1.27 [1.05–1.52] and 1.15 [1.01–1.31], respectively), but analyses found no associations between perceived threats and firearm behaviors among women. Perceived threats are associated with firearm behaviors among U.S. men, even after accounting for the actual violence they report experiencing or witnessing. [ABSTRACT FROM AUTHOR]

A person-centered approach identified five empirically unobserved student profiles of first-time full-time university students who shared similar academic patterns, performance measures, and demographic characteristics. Honors and Flourishing classes tended to graduate within 6 years of attempting their first-college mathematics course, earned a high grade in that course, and made continued degree progress. The Flourishing class had lower semester and first-college mathematics GPAs than the Honors class but higher GPAs than the Tenacious class. Placement in remedial mathematics alone did not determine class membership. The Honors class had an overrepresentation of White women, and an underrepresentation of Black men. Hispanic students were most prevalent in the Flourishing group while Black men were more prevalent in the Tenacious group. As a whole, men fared worse on outcomes than women. [ABSTRACT FROM AUTHOR]

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Financial literacy is crucial to the growth and development of any enterprise. This study investigates the impact of microentrepreneurs' demographic characteristics on financial literacy by breaking it down into three components: financial knowledge, financial behavior, and financial attitude. The study data were collected from 132 microentrepreneurs through a survey questionnaire using a snowball sampling technique. An ordinary least square regression was used to analyze how entrepreneurs' demographic characteristics are related to financial knowledge, financial behavior, financial attitude, and financial literacy. The study revealed that being male, having higher education and more experience, and operating in urban areas have a significant impact on financial literacy and its three components. However, age was found to have no significant impact on financial literacy. This study will help in designing targeted strategies and specialized programs for entrepreneurs looking at the significant impact of their diverse characteristics on financial literacy. [ABSTRACT FROM AUTHOR]

Today, more people than ever live in one-person households (OPHs). Sweden’s OPH population started to grow in the 1960s, and today the country has one of the highest proportions in the world, reaching almost 40% of all households. However, despite an internationally high share of OPHs, little is known about the long-term changes in the Swedish OPH population’s composition. By utilizing register data covering the entire Swedish population at 5-year intervals the current study elucidate changes in the demographic characteristics and socioeconomic status (SES) of the working-age (30–64) OPH population from 1960 to 2018. Our findings show that there have been substantial changes over time in the associations between gender, civil-status and SES and the probability of living alone. A sharp increase in divorce rates in the 1970s was an important driver in the increased share of OPHs in working-age, especially for men aged 30–45 years. We also found a shift in the trends of associations between SES and the probability of living alone, from a positive to a negative association for women and an increasingly negative association for men. Today, low-SES men and women in Sweden are increasingly selected into OPHs, and the SES patterns across the sexes have converged. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodResultsConclusionCertain client characteristics are associated with early working alliance difficulties in psychotherapy. However, there is limited quantitative evidence on whether combinations of these characteristics (e.g., intersectional identities, prior treatment experiences) are related to alliance development. The present study leveraged a person-centered research approach to examine profiles of early alliance development and differences in the latent class structure of client characteristics among alliance development profiles.Individual psychotherapy clients (N = 2,579) rated the working alliance for their first four sessions and self-reported demographics, treatment history, and psychological distress. Therapists provided their assessment of clients’ primary presenting concerns at baseline.Latent profile analysis revealed three profiles of working alliance development: high and stable, moderate and increasing, and low and stable. Follow-up person-centered analyses (multigroup confirmatory latent class analysis) indicated that clients in the alliance profiles differed in their combinations of clinical and demographic characteristics. For example, women of color with high baseline distress and a history of prior psychotherapy were over-represented in the low and stable alliance profile.These results are consistent with recommendations to holistically consider how clients’ characteristics and experiences shape psychotherapy processes. Results also highlight the utility of person-centered quantitative methods in psychotherapy research. [ABSTRACT FROM AUTHOR]

The possible pathway in which traumatic life events influence the likelihood of marriage dissolution has not been fully explored. In this study a case study of various countries were chosen to maximize the diversity. We examined the effects of various traumatic life events on the likelihood of divorce, while controlling demographic and psychological factors. We employed a mixed probit model on data collected from various countries, such as Turkey, Thailand during the period of 2015–2016. The considered variables in this study were divided into mental health, traumatic life events, and demographic characteristics along with other characteristics. Our results showed that factors such as traumatic life events, e.g., being cheated on, being emotionally or sexually abused, or being disabled, and having divorced parents are positively associated with a higher likelihood of divorce. On the other hand, factors such as better subjective life conditions, older age, and previous divorce are negatively associated with the likelihood of divorce. The results also revealed some interaction effects between different factors. The results emphasize the importance of supporting those who have undergone traumatic life events, by helping them not only with the related traumas, but also preparing them for having a successful marriage. The impacts are expected to be due to shattered assumption theory. This is one of the earliest studies to consider the impact of traumatic life events on the likelihood of divorce. [ABSTRACT FROM AUTHOR]

Objective: The primary goal of this study is to discern the optimal adjuvant treatment for patients diagnosed with bacterial vaginosis, focusing on reducing recurrence rates. Methods: This study is a double-blind clinical trial with no previous similar trials conducted to date. The study population consisted of non-pregnant, married women visiting teaching hospitals' clinics in Mashhad, complaining of vaginal discharge. After informed consent and questionnaire completion, samples were obtained from vaginal discharge surrounding the cervix of clinically diagnosed bacterial vaginosis patients. Using Gram staining, a gold standard method for bacterial vaginosis diagnosis, samples were examined under a microscope according to the Nugent score. After initial treatment with metronidazole, patients were divided into two groups receiving either vaginal or oral probiotics. Results: Of the 55 participating women, 20 were in the vaginal probiotic group and 35 were in the oral probiotic group. No significant demographic or clinical differences existed between groups at baseline. The Nugent score decreased from 8.5 to 3 in the vaginal group and from 9 to 3 in the oral group, suggesting the effectiveness of both treatments. While the difference between groups was not statistically significant, each group showed significant improvements from their initial states (p-value < 0.001). Conclusion: No significant difference was observed in the effectiveness of oral versus vaginal probiotics in reducing the recurrence of bacterial vaginosis after routine treatment. Therefore, the type of probiotic to be used could be chosen based on patient preference. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion Peripartum hysterectomy (PH), the surgical removal of the uterus during or shortly after childbirth, is a critical procedure in maternal health care. Definitions of PH vary globally, leading to challenges in understanding its occurrence. Our study aimed to provide comprehensive insights into PH in a South African context, investigating indications, demographic characteristics, clinical and histopathological diagnoses, complications, and outcomes.A retrospective record review study design was used, focusing on PH cases at a tertiary facility in Johannesburg, South Africa (SA), between January 2018 and December 2020. Medical records were systematically examined to identify trends, indications, and outcomes associated with PH. Data collection encompassed demographic characteristics, obstetric history, clinical indications, clinical and histopathological diagnoses, and complications. Data analysis used descriptive statistics, interrater reliability tests, and comparative findings with previous SA studies.The study included 56 pregnant women with a median age of 32 years (interquartile range: 25–35) who underwent PH between January 2018 and December 2020 at Charlotte Maxeke Johannesburg Academic Hospital in South Africa. We found that pregnancy‐related sepsis (PRS) emerged as the most common indication of PH, as reported among 18 (32.1%) of the women, with an 88.8% histopathological confirmation rate. Abnormal placentation (14/56, 25%) and PPH (8/56, 14%) were other common indications. Clinical and histopathological diagnoses exhibited a strong level of agreement (70.9%), emphasizing the importance of accurate diagnostics.Our study found a shift in the primary historical indications, such as uterine atony and uterine rupture in South Africa, with PRS emerging as the primary indication in recent years(2009‐2020). Clinical assessment complemented by histopathological findings remains critical for improved obstetric complication management. [ABSTRACT FROM AUTHOR]

Background and Aims Methods Key Results Conclusions & Inferences The group of disorders known as Disorders of Gut Brain Interaction (DGBI) were originally labeled functional GI disorders and were thought to be disorders of the gastrointestinal tract that had several psychological conditions as comorbidities. Despite mounting evidence that psychological morbidity plays an innate role in the etiology and maintenance of DGBI, none of the Rome IV criteria include any measure of psychological symptoms.This study tested the hypothesis that individuals would cluster differently if GI symptoms alone were considered versus GI symptoms combined with measures of psychological symptoms.Data were obtained from the Rome Foundation Global Epidemiology Study measuring Rome IV GI symptoms, psychological measures and demographic characteristics. Latent profile models were used to cluster individuals based on (i) GI symptoms only (GI only) and then (ii) GI and psychological measures (GI + Psych).Individuals clustering into the same group of individuals whether formed via GI only or GI + Psych, ranged from 96% for a 2‐class solution (the most simplistic) to 76% with 6 classes (the parsimonious system) and 59% with twenty‐two classes (mimicking Rome IV). The generalisability of this finding between six geographic regions was confirmed with agreement varying between 95%–97% for 2 clusters and 71–79% for 6 classes and 51%–63% for 22 classes. These findings were also consistent between DGBI (range 94% with 2 classes to 50% with 22 classes) and non‐DGBI (range 97% with 2 clusters to 65% with 22 classes) groups.Our data suggest that considering psychological as well as gastrointestinal symptoms would lead to a different clustering of individuals in more complex, and accurate, classification systems. For this reason, future work on DGBI classification should consider inclusion of psychological traits. [ABSTRACT FROM AUTHOR]

Introduction: Non-consensual condom removal (NCCR) refers to the act of removing a condom during sex without the other person's permission. It poses physical and psychological risks to women's health. Views and attitudes regarding this sexual practice are not well understood in the UK. This study aimed to explore young people's views on the morality and criminality of NCCR and how their views are affected by negative health outcomes, relationship status, and socio-demographic characteristics. Methods: A quantitative online survey of people aged 18–25 living in the UK was conducted. The survey consisted of two NCCR scenarios, varied by health outcome and relationship status, followed by questions about the morality and criminality of NCCR and respondents' socio-demographic characteristics. Statistical analysis included Chi-square testing and logistic regression modelling. Results: Most of the 1729 respondents considered NCCR to be a violation of consent to sex (97.4%-98.1%), to be wrong (99.3%-99.5%), and to be sexual assault (86.3%-89.2%). Respondents were more likely to support prison time for NCCR if the victim got pregnant (52.1%) (rather than depressed (41.6%)) or was part of a casual hook-up (53.9%) (as opposed to a long-term dating relationship (47.2%). Respondents who were female or non-heterosexual were more likely to view NCCR as sexual assault and support prison as a penalty for NCCR. Conclusion: The majority of young UK adults in this survey considered condom removal during sex without the other person's permission to be a violation of consent, morally wrong, and a form of sexual assault. Support for prison as a penalty was lower. These findings can inform future campaigns on consent in sexual relationships and legislation to provide support for women affected by NCCR. [ABSTRACT FROM AUTHOR]

Although the term "diversity" is ubiquitous in modern day society, the meaning of the term is not well understood, and it is unclear when people perceive groups to be more or less diverse. Across five experiments, we examined perceptions of racial diversity and preferences for living in diverse contexts related to visual representations of groups. While recent theorizing suggests that a greater number of low-status racial minorities may contribute to perceiving more diversity and determine living preferences, our findings indicate the importance of the race of the perceiver in these processes. Although White and Black participants rated majority Black compared to majority Asian groups as more diverse, followed by majority White targets (cf. Experiment 4), Asian participants did not differ in their diversity ratings across the different racial compositions. Notably, White and Asian participants rated majority White and majority Asian compared to majority Black neighborhoods as more desirable. Black participants, in contrast, consistently rated majority Black compared to majority White and majority Asian neighborhoods as more desirable and did not distinguish between the latter two contexts. Together these findings provide new evidence about how people define diversity and the importance of target-level factors, perceiver-level factors, and the interplay between these factors on perceptions of racial diversity and inclusivity. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Transfusion‐transmissible infection (TTI) prevalence among US blood donors has been widely documented. Here we estimate the prevalence of donors presenting with ≥2 TTIs (multiple infections past or present referred to as coinfections) and describe their demographics and associations.Data from the Transfusion‐Transmissible Infections Monitoring System were compiled for October 2020–September 2023 (3 years). Prevalence per million donations (pmd) was calculated for each TTI coinfection combination with demographic characteristics summarized. The odds of each TTI coinfection combination were estimated using logistic regression. Reactivity by NAT and/or serology (HIV, HBV, and HCV) defined donors as consensus positive (CP) for each infection while serology‐based algorithms defined syphilis CP and the subset with active syphilis infections (ASIs).About 22 million donations were included, with 212 coinfections (9.7 pmd). Around 2% of donations positive for any TTI (n = 10,516) were coinfections. Coinfection prevalence per TTI combination ranged from 0.3 pmd for HIV CP and HCV CP, to 4.3 pmd for HIV CP and syphilis CP. There were high proportions of coinfections from donors who were male, aged 25–54 years, white or black, first time, and residing in the southern US Census Region. The odds of a second TTI occurring in an individual donor with a TTI ranged from 23 (95% CI: 13, 41) times more likely for HBV CP and ASI to 395 (95% CI: 298, 524) times more likely for HIV CP and ASI.Coinfections are relatively uncommon among blood donors in the United States; however, associations exist among HIV, HBV, HCV, and syphilis infections. [ABSTRACT FROM AUTHOR]

Objective: Hematological indicators in the early stage of PD-1 inhibitor treatment may show superior predictive ability of the occurrence of immune related adverse event (irAE) compared to the pre-treatment indicators, as the immune response is modulated during the PD-1 inhibitor treatment. The objective of this study was to investigate the predictive capabilities of biomarkers in the early treatment stage for immune related thyroid dysfunction (irTD), and explore the potential predictive cytokines. Methods: Medical records and blood test results of cancer patients treated with PD-1 inhibitor at a certain medical institution were collected. Logistic regression analysis was utilized to identify the predictive factors of irTD, ROC curves were plotted and the area under the curves (AUC) was calculated. Serum samples were collected before and during early treatment phase, cytokine detection was performed to explore potential predictive cytokines. Results: A total of 264 patients were enrolled, 58 developed irTD (21.97%), including 31 patients with thyrotoxicosis and 27 with hypothyroidism. There were no significant differences in demographic characteristics, tumor types and PD-1 inhibitors between patients with and without irTD. Multivariate logistic analysis showed that anti-thyroglobulin antibody (TgAb) (OR=2.831, 95%CI: 1.077-7.443, P=0.035) and anti-thyroperoxidase antibody (TPOAb) (OR=9.565, 95%CI: 3.399-26.921, P=0.000) in the early treatment phase were independent predictive factors for irTD, the AUC of early-stage biomarkers was larger than that of pre-treatment (0.655 vs 0.571); low level of TSH at the early stage (OR=0.162, 95%CI: 0.077-0.341, P=0.000)was significantly correlatedwith thyrotoxicosis; female (OR=3.889, 95%CI: 1.457-10.380, P=0.007) and positive TPOAb (OR=8.678, 95%CI: 2.656-28.357, P=0.000) at the early stage were significantly correlated with hypothyroidism. The AUCs of early-stage biomarkers were larger than that of pre-treatment both in thyrotoxicosis (0.812 vs 0.637) and hypothyroidism patients (0.728 vs 0.710). The increase of IL-16 (adjusted P=0.004), IL-12p70 (adjusted P=0.014), IL-17 (adjusted P=0.014), CCL-15 (adjusted P=0.014) and IL-1a (adjusted P=0.021) in the early treatment phase were positively correlated with irTD. Conclusions: Biomarkers at the early stage of PD-1 inhibitor treatment could predict irTD, and demonstrated stronger predictive ability compared to pretreatment biomarkers. IL-16, IL-12p70, IL-17, CCL-15 and IL-1a could serve as potential predictive biomarkers for irTD. [ABSTRACT FROM AUTHOR]

This study employs the Standard International Trade Classification (SITC rev.3) to categorize agricultural products and examines the overall and each type of agricultural trade networks in China. It utilizes Social Network Analysis and the Quadratic Assignment Procedure to explore pattern changes and identify influencing factors. The findings indicate that between 2000 and 2019, China's agricultural trade networks experienced expansion in scale and density, with China positioned at the network's centre. However, challenges exist, such as insufficient control and over-reliance on specific trading partners. Key factors influencing the networks include the business environment (BUE), regional trade agreements (RTA), and government governance capacity (GOC). Differences in BUE and GOC are negatively associated with the development of trade networks, while RTAs are positively associated with trade network connectivity. Economic and demographic differences are also positively associated with the closeness of trade networks. Based on these findings, policy recommendations are proposed to address the identified issues. [ABSTRACT FROM AUTHOR]

BackgroundMethodsResultsConclusionThough the measurement of social norms is important for evaluating entertainment-education interventions, there is a dearth of validity evidence for measuring tools to assess different social norm constructs.Identical survey items were used to assess family planning norms among married Zambian women in 2019 and 2022 following an entertainment-education radio program intervention. Confirmatory Factor Analysis was used for confirmation of the internal structure of several subscales used to measure social norms found in a previous study.There were no statistically significant demographic differences between participant groups at T1 and T2. CFA supported a five-factor model at T2 comprising descriptive norms (4 items), outcome expectations (3 items), and 3 different constructs capturing injunctive norms (3 items each).Results indicate good structural validity evidence for measuring social norms in entertainment-education using existing tools. [ABSTRACT FROM AUTHOR]

Background: Individual preferences have preceded the use of health care services, and it has been affected by different hospital attributes. This study aimed to elicit the Iranians' preferences in choosing hospitals using a discrete choice experiment. Methods: A discrete choice experiment (DCE) was conducted through face to face interviews with 301 participants. The DCE was constructed by six attributes were included based on a literature review, qualitative interviews, Focus Group Discussion (FGD) and consensus development approach: waiting time, quality of care, travel time, hospital type, provider competency, and hospital facilities. individuals' preferences for hospital attributes were analyzed using a mixed logit model, and interaction terms were used to assess preference heterogeneity among individuals with different sociodemographic characteristics. Results: Participants had strong and significant preferences for care delivered in hospitals with 'full' (β = 0.6052, p<0.001) or 'moderate' (β = 0.5882, p<0.001) hospital equipment and with 'excellent' provider competency (β = 0.2637, p<0.001). The estimated coefficients for the "waiting time of 120 minutes" (β = −0.1625, p<0.001) and the "travel time of 30 minutes" (β = −0.1157, p<0.001) were negative and significant. The results also show that the personal characteristics such as age, education level, and income significantly affected individual preferences in choosing a hospital. Conclusion: Considering people's preferences can be important given the more active role of today's patients in decision-making about their treatment processes. The results of this study should be taken into consideration by health policymakers and all stakeholders to be aware of differences in preferences of people and maximize their satisfaction. In this case, it is important to continuously involve people and consider their preferences in the design, topology, construction, and equipment of hospitals. [ABSTRACT FROM AUTHOR]

Background: Older adults account for a large proportion of hospital admissions. In this study we aim to bridge a gap between medical and psychosocial factors in predicting hospitalisation. Methods: Demographic and social characteristics of community-dwelling pre-frail and frail older people were collected by questionnaires every six months during a two year follow-up. Hospital admission within this period was dichotomised as yes/no. To define pre-frailty and frailty the Fried frailty criteria were used. Analysis of risk factors for hospitalisation was performed using multivariable logistic regression. Results: Hospitalised participants (n = 1803) were more often male and frail in comparison to not-hospitalised participants. They also experienced more chronic diseases (54.5% ≥ 4 chronic diseases), poorer self-perceived health (SPH) (76.4% fair to very poor) and lack of informal care (20.1%). In multivariable logistic regression male gender (Odds ratio (OR) 1.65, p < 0.001), frailty (vs. pre-frailty) (OR 1.66, p = 0.002), reporting lower SPH (OR 3.12, p < 0.001) and lacking informal care (OR 1.69, p < 0.001) showed significant associations with hospital admission. Subgroup analysis of pre-frail and frail participants, showed consistent associations between male gender (respectively OR 1.61, p < 0.001 ; OR 1.72, p = 0.085), lower SPH (OR 2.23, p = 0.001; OR 31.16, p < 0.001), lack of informal care (OR 1.64, p = 0.005; OR 2.63, p = 0.012) and hospitalisation. Conclusion: Frailty, male gender, lower SPH and lack of informal care are risk factors for hospitalisation within community-dwelling older people, showing the need of a holistic approach to possibly prevent hospitalisation. Further research should focus on evaluating individual factors for hospitalisation, particularly targeting pre-frail individuals. Key points: - Frail older adults are at higher risk for hospitalisation compared to pre-frail. - Associations with hospitalisation: male gender, frailty, lower SPH, no informal care. - Psychosocial factors emerge as important determinants for hospitalisation. - Understanding medical and psychosocial factors of frailty is key for effective care planning. [ABSTRACT FROM AUTHOR]

Background: Several studies pointed out the importance of genetic risk factors such as parental consanguinity (PC) and familial multiple sclerosis (FMS) in the risk of MS. This study aimed to investigate the PC and FMS among people with MS (pwMS) in Isfahan, Iran. Methods: This case–control study was conducted on pwMS from the MS clinic of Kashani Hospital, Isfahan, Iran, in October 2023. A group of healthy controls (HC) were also recruited. Data on demographic and clinical characteristics and history of PC and FMS were collected from participants. The relationships between PC, FMS, and developing MS were assessed using multinomial logistic regression analysis. The odds ratio (OR) with a 95% confidence interval (CI) was computed. Results: A total number of 4264 pwMS and 400 HCs were included. The prevalence of PC and FMS among pwMS were 29.3% and 24%, respectively. Multinomial logistic regression adjusted for age and sex indicated that the odds of developing MS were significantly associated with a history of PC (OR = 3.03, 95% CI 2.23 to 4.13, p < 0.001) and FMS (OR = 5.42, 95% CI 3.51 to 8.38, p < 0.001). Conclusion: PC and FMS can increase the risk of developing MS. They should be considered along with other risk factors for developing MS. A comprehensive conclusion requires further research. [ABSTRACT FROM AUTHOR]

Introduction: Suicide in children is a significant and unacceptable global phenomenon. This paper provides a descriptive overview of the children presenting in the first five years (2016-2021) of the implementation of the Zero Suicide Framework (ZSF) and Suicide Prevention Pathway (SPP) at a Child and Youth Mental Health Service in Queensland, Australia. Methods: Basic demographic variables (sex, age, socioeconomic status), and changes in presentations over time, are presented for 1,048 children. Completeness of selected SPP components relating to care planning and universal interventions are examined as an indicator of fidelity to the SPP model of care. The paper then focuses on the cohort of children who received care through the SPP in 2020, describing their demographic characteristics and baseline clinical scores. Result: There was an increase in admissions each year and children presented with a diverse range of clinical needs. The SPP greatly increased the provision of first line interventions for patients. Discussion: A standardized approach to suicide prevention improves consistency in management. These findings may inform the use of the ZSF/SPP in child mental health settings globally. [ABSTRACT FROM AUTHOR]

Background: Hereditary transthyretin-related amyloidosis is a clinically heterogeneous autosomal dominant disease caused by pathogenic variants in the TTR gene (hATTR amyloidosis). Objective: The current study describes the demographic, clinical, and genetic characteristics of patients with suspected hATTR amyloidosis. Methods: This study is part of the "Hereditary transthyretin-related amyloidosis and longitudinal monitoring of TTR-positive patients" (TRAMmoniTTR) study. This study included 3167 participants, along with their clinical details. Principal component (PC) analysis was used to analyze their clinical symptomatology. Next-generation sequencing of the TTR gene was performed and genotype–phenotype relationships were investigated. We compared the demographic and clinical characteristics using the principal components (PCs) and also compared participants with and without the TTR pathogenic variants. Results: We identified five main clinical phenotypes out of 22 single symptoms that explained 49% of the variation. The first two PCs referred to polyneuropathy and cardiomyopathy. We found significant differences between gender and PC-polyneuropathy and PC-cardiomyopathy, with male over-representation in the higher quantiles of PC-polyneuropathy and male under-representation in the lowest quantiles of PC-cardiomyopathy. We identified 92 participants with hATTR (3%), exhibiting 17 unique heterozygous TTR variants. The p.Val50Met variant was the most frequent. Furthermore, 503 participants (20%) were identified with ATTR and no relevant TTR variants (ATTRwt). We detected significant differences between the ATTRwt and hATTR groups, with male gender predominance in only the ATTRwt group and a positive family history of polyneuropathy and/or cardiomyopathy among the hATTR participants. Conclusions: The current clinical and genetic characterization of this cohort serves as a foundation for further longitudinal monitoring and assessment. [ABSTRACT FROM AUTHOR]

Background: The early detection of transthyretin cardiac amyloidosis (ATTR-CM) is essential, with Tc-99m pyrophosphate scintigraphy (PYP scan) being a key diagnostic tool. Although a previously validated score has shown promise in predicting PYP scan positivity among patients with HFpEF, further evaluation in diverse cohorts is necessary. Objectives: To assess the effectiveness of the ATTR-CM score in predicting PYP scan positivity within our patient population. Methods: We analyzed patients referred for PYP with SPECT at the Cleveland Clinic from January 2012 to January 2020, all of whom had undergone echocardiography within the previous year. The ATTR-CM score was determined using the following criteria: Age (60–69, +2; 70–79, +3; ≥80, +4), sex (male, +2), hypertension (present, −1), left ventricular ejection fraction (LVEF <60%, +1), posterior wall thickness (≥12 mm, +1), and relative wall thickness (>0.57, +2). A score of ≥6 indicated high risk. Results: Among the 540 patients (32% female, 33% black), 27% had an LVEF <40%. The score demonstrated good discrimination by AUC, with consistent performance across different racial groups, sexes, and LVEF categories. For scores ≥6, sensitivity was lower in women and black patients; however, lowering the cutoff to 5 markedly improved sensitivity. Conclusions: The ATTR-CM score displayed consistently good performance by AUC across our cohort, including patients with HFrEF. Nevertheless, its sensitivity was reduced in black patients and women. Efforts to scale ATTR-CM diagnosis tools should be mindful of demographic differences in risk prediction models. [ABSTRACT FROM AUTHOR]

Background: The association between weight-adjusted waist index (WWI) and disability is unclear. This study aimed to assess the relationship between WWI and disability in middle-aged and elderly Chinese individuals and provide more predictive indicators for disability prevention. Methods: In this study, 13,015 middle-aged and older adults aged 45 years and above who were surveyed in 2011 by the China Health and Aging Tracking Survey (CHARLS) database were selected, and 8344 respondents with complete data were included for cohort analysis after seven years of follow-up. Information on clinical demographic characteristics, anthropometric indices, assessment of disability, and related covariates were collected, and the presence or absence of disability was assessed by the disability scale. WWI was calculated by dividing the waist circumference (cm) by the square root of the body weight (kg). Cox proportional hazards model was used to analyze the association between WWI and disability after follow-up. Results: Our study found that 2912 of 8344 participants had disability after seven years of follow-up, and disability incidence was approximately 34.9%. Age, sex, place of residence, chronic disease, depression, waist circumference, and WWI were significantly associated with disability in univariate analysis. Among them, there was a positive association between WWI as a continuous variable and incidence of disability (hazard ratio (HR) = 1.26, 95% CI: 1.22–1.31, p < 0.001). WWI was transformed into categorical variables using quartiles as cutoffs for disability regression analysis. After adjusting covariates, HR values in the 2nd, 3rd and 4th quantile showed an increasing trend compared with the 1st quantile, and the risk of disability among WWI subjects in the 4th quantile increased by 43% (95% CI: 1.24–1.64). P values for the trend test in the model were all < 0.001. In subgroup analyses, the positive association between WWI and risk of disability remained robust for sex, age, alcohol consumption, smoking status, education level, marital status, and place of residence after adjusting for all covariates considered in this study. Conclusions: WWI is a new and reliable obesity-related indicator that can be used for disability prevention. WWI can be detected and controlled for reducing the risk of disability. [ABSTRACT FROM AUTHOR]

Background: The research community has historically failed to enroll diverse groups of participants in dementia clinical trials. A unique aspect of dementia care research is the requirement of a study partner, who can attest to the care recipient's clinical and functional capacity. The aim of this study is to assess racial and ethnic differences and the importance of various trial considerations among dementia caregivers, in their decision to participate in clinical research as study partners. Method: We embedded a vignette about a hypothetical dementia clinical trial in a nationally representative survey of U.S. dementia caregivers, oversampling non-Hispanic Black and Hispanic caregivers. Dementia caregivers were asked about their willingness to participate in the trial with their care recipient and rated the importance of nine considerations in hypothetical decisions to participate. Caregiver demographic characteristics were analyzed as predictors of trial participation in a base demographic model. In a second reasons model caregiver demographic characteristics and the rated importance of the nine considerations were separately analyzed as predictors; both models used survey-weighted logistic regression. Result: The sample consisted of 610 dementia caregivers, including 156 non-Hispanic Black and 122 Hispanic caregiver participants. In the base demographic model, hypothetical trial participation was negatively associated with older caregiver age (OR (odds ratio) = 0.72, p = < 0.001). In the reasons model, the rated importance of a social responsibility to help others by participating in research was significantly associated with participation (OR = 1.56, p = 0.049), while the importance of the possibility of the care recipient experiencing serious side effects was negatively associated with participation (OR = 0.51, p = 0.003). In both models there was no significant difference in hypothetical participation between non-Hispanic Black and non-Hispanic White caregivers, or between Hispanic and non-Hispanic White caregivers. Conclusion: Hispanic and non-Hispanic Black dementia caregivers were not less likely than non-Hispanic White dementia caregivers to participate in a hypothetical dementia clinical trial. Our study suggests that failures to recruit diverse populations in dementia clinical research are not attributable to less willingness among members of underrepresented groups but may instead reflect structural barriers and historic exclusion from trial participation. [ABSTRACT FROM AUTHOR]

Background: With the increasing global aging population, the health and welfare of elderly individuals, especially individuals with prevalent mild cognitive impairment (MCI) living in nursing homes, have become critical concerns. These concerns highlight the urgency of developing effective interventions to address the cognitive and psychological needs of elderly individuals, ensuring their well-being and alleviating the burden on their caregivers. Objective: This study investigates the impact of wooden toy training on mitigating cognitive decline in elderly individuals with cognitive impairment. It evaluates how this training influences cognitive functions and psychological well-being, exploring whether it can slow or reverse the progression of cognitive decline. This outcome will be assessed in a randomized controlled trial, in which changes in cognitive ability and psychological health indicators among the participants will be measured. Design: A two-arm, open-label, cluster-randomized controlled trial. Setting(s): The study was conducted in two nursing homes, which served as both the recruitment sites for participants and the intervention locations. These nursing homes were selected for their ability to facilitate the intervention and for their representative demographic characteristics of the elderly population. The settings provided a controlled environment that was conducive to implementing the wooden toy training program and observing its effects on the participants. Participants: A total of 76 elderly participants with mild cognitive impairment but functional independence were recruited. Methods: Participants were randomized into an intervention group and a control group. The intervention group engaged in an 8-week wooden toy training program, whereas those in the control cohort received customary nursing care. Standardized cognitive and psychological well-being measures were used to assess improvements in cognitive performance and mental health. Results: Significant improvements were observed in the cognitive functions of the intervention group from a baseline score of M = 13.11 to M = 16.29 postintervention (95% CI [-4.44, -1.93]), along with reductions in depressive symptoms from a baseline score of M = 8.63 to M = 7.18 (95% CI [0.38, 2.51]). Additionally, engagement in activities with wooden toys significantly satisfied their need for competence, increasing from a baseline of M = 16.29 to M = 20 postintervention (95% CI [-5.92, -1.51]), and relatedness, which improved from a baseline of M = 20.32 to M = 22.95 (95% CI [-4.73, -0.53]). Conclusions: This study underscores the potential of a wooden toy intervention in nursing homes that combines cognitive challenges with traditional cultural elements to improve cognitive functions in elderly individuals with mild cognitive impairment. Our findings suggest a novel method of promoting the cognitive and psychological health of nursing home residents through emotional comfort and social interaction. [ABSTRACT FROM AUTHOR]

The removal of vestibular schwannomas carries a risk of facial palsy. This study aims to evaluate the usefulness and technical aspects of intraoperative monitoring (IOM) for the facial nerve. A total of 96 patients who underwent surgery for vestibular schwannoma were retrospectively investigated. The cohort was divided into two groups: those with intraoperative facial nerve monitoring (IOM group) and those without IOM (non-IOM group). Preoperative and postoperative facial nerve functions were assessed using the House-Brackmann (HB) scale immediately after surgery, at discharge, and at the 1-year follow-up. HB grade I and II were classified as satisfactory outcomes, HB grade III and IV as intermediate, and HB grade V and VI as poor. Facial nerve functions were compared between the groups. Additionally, the ratio of satisfactory results was investigated in the IOM group, focusing on whether the root exit zone (REZ) was identified at an early or late stage of surgery. Among the 65 (67%) patients in the IOM group and 31 (32%) patients in the non-IOM group, there were no differences in demographic and tumor characteristics. The extent of resection varied from subtotal to gross total removal, with no statistical differences between the groups. Although facial nerve function was more favorably preserved in the non-IOM group immediately after surgery, this trend reversed at discharge and the 1-year follow-up, showing significant statistical differences. In the IOM group, more patients achieved satisfactory outcomes when the REZ was identified early compared to late during tumor resection. Intraoperative facial nerve monitoring provides more satisfactory outcomes in preserving nerve function in vestibular schwannoma surgery. Early recognition of the REZ may contribute to improved surgical outcomes. [ABSTRACT FROM AUTHOR]

This study was aimed to compare the clinical and radiographic outcomes of patients with intercondylar fractures of the humerus treated with orthogonal and parallel plating methods via precontoured plates. This was a retrospective comparative study conducted on 50 adult patients with intercondylar humerus fractures that were surgically treated over an eleven-year period. The patients were divided into two groups: Group A underwent internal fixation via parallel plating, whereas Group B received orthogonal plating. Clinical outcomes were evaluated via the Mayo Elbow Performance Score (MEPS), and the radiographic assessments included time to consolidation, pseudoarthrosis, malunion and hardware removal. Both groups presented similar demographic and preoperative characteristics. The functional outcomes assessed by the MEPS were not significantly different between the groups. Radiographically, comparable healing times and rates of complications, including pseudoarthrosis, malunion and hardware removal, were observed. The study findings suggest that both orthogonal and parallel plating methods yield comparable clinical and radiographic outcomes in the treatment of intercondylar humerus fractures. These results underscore the effectiveness of both techniques and emphasize the importance of further research to elucidate the optimal plating method for specific fracture patterns. [ABSTRACT FROM AUTHOR]

PurposeMethodsResultsConclusionsThe purpose of this study was to extend on previous research finding by investigating adverse childhood experiences (ACEs) and brain injury in children younger than 12 years old.A total of 58,601 US children under 12 years old were included in the 2020–2021 National Survey of Children’s Health, a self-reported national survey administered to caregivers.ACEs were significantly associated with increased risk for unconfirmed (χ2 (55891, 55904) = 141.84, p < 0.001, R2 = .03) and confirmed brain injury, χ2 (56481, 56494) = 508.28, p < 0.001, R2 = .05 when accounting for demographic characteristics. The association between ACEs and brain injury was not contingent on sports involvement; females not involved in sports had the strongest association between ACEs and brain injury (χ2 (10938, 10951) = 99.40, p < 0.001, R2 = .03) compared to sports-involved females and males. For children under 12 years old with brain injury, the relations between experiencing at least one ACE and health and educational outcomes were significant for all health and educational outcomes (p < 0.001).Caregiver education on and screening for brain injury in families experiencing ACEs would likely support more timely identification and management of co-occurring brain injury in this population. Further research is needed to identify prevention, assessment, and management strategies that would be specifically beneficial to children at risk for co-occurring brain injury and ACEs to improve health and educational outcomes. [ABSTRACT FROM AUTHOR]

Objective Methods Results Interpretation Pathological studies suggest that multiple sclerosis (MS) lesions endure multiple waves of damage and repair; however, the dynamics and characteristics of these processes are poorly understood in patients living with MS.We studied 128 MS patients (75 relapsing–remitting, 53 progressive) and 72 healthy controls who underwent advanced magnetic resonance imaging and clinical examination at baseline and 2 years later. Magnetization transfer saturation and multi‐shell diffusion imaging were used to quantify longitudinal changes in myelin and axon volumes within MS lesions. Lesions were grouped into 4 classes (repair, damage, mixed repair damage, and stable). The frequency of each class was correlated to clinical measures, demographic characteristics, and levels of serum neurofilament light chain (sNfL).Stable lesions were the most frequent (n = 2,276; 44%), followed by lesions with patterns of “repair” (n = 1,352; 26.2%) and damage (n = 1,214; 23.5%). The frequency of “repair” lesion was negatively associated with disability (β = −0.04; p < 0.001) and sNfL (β = −0.16; p < 0.001) at follow‐up. The frequency of the “damage” class was higher in progressive than relapsing–remitting patients (p < 0.05) and was related to disability (baseline: β = −0.078; follow‐up: β = −0.076; p < 0.001) and age (baseline: β = −0.078; p < 0.001). Stable lesions were more frequent in relapsing–remitting than in progressive patients (p < 0.05), and in younger patients versus older (β = −0.07; p < 0.001) at baseline. Further, “mixed” lesions were most frequent in older patients (β = 0.004; p < 0.001) at baseline.These findings show that repair and damage processes within MS lesions occur across the entire disease spectrum and that their frequency correlates with patients disability, age, disease duration, and extent of neuroaxonal damage. ANN NEUROL 2024 [ABSTRACT FROM AUTHOR]

To identify the differences between COVID-19-associated and non-COVID-19-associated olfactory dysfunction (OD), we analyzed demographic and clinical characteristics based on the causative virus (COVID versus non-COVID groups) in patients with post-infectious olfactory dysfunction (PIOD) who underwent the olfactory questionnaire and olfactory function test. Out of 169 patients with PIOD, 99 were diagnosed with COVID-19 (COVID group), while 70 were not (non-COVID group). The COVID group was younger and had a higher percentage of male patients as well as patients with parosmia than the non-COVID group. In the initial olfactory function tests, the TDI, discrimination and identification scores were significantly higher in the COVID group than in the non-COVID group. TDI scores were significantly increased in patients with PIOD after treatment, regardless of the group. The threshold score was significantly increased by 1.38 in the COVID group while the identification score was significantly increased by 2.67 in the non-COVID group. Patients with COVID-19-associated OD were younger in age, tended to be male, had a higher incidence of parosmia, and had better initial olfactory function test results compared to those with non-COVID-19-associated OD. Following treatment, odor detection threshold improved in the COVID group, whereas odor identification improved in the non-COVID group. [ABSTRACT FROM AUTHOR]

Background: This study aimed to measure patient-reported health-related quality of life amongst post-partum women in Queensland, Australia. Methods: Patient-reported health-related quality of life data was prospectively collected from 134 post-partum women using the EQ-5D-5L at weekly intervals during the first six weeks following birth. Data across the five health domains of the EQ-5D-5L was converted to a single health utility value to represent overall health status. Linear mixed modelling and regression analysis were used to examine changes in utility over the first six weeks post-birth and determine associations between utility and clinical and demographic characteristics of post-partum women. Findings: Gestation at birth and weeks post-partum were significantly associated with utility values when considered in a multivariate linear mixed model. Mean utility values increased by 0.01 for every week increase in gestation at birth, and utility values were 0.70 at one week post-partum and increased to 0.85 at six weeks post-partum, with the largest increase occurring between one- and two-weeks post-birth. When controlling for variables that were found to predict utility values across the first six weeks post-partum, no single state of health predicted utility values at one-week post-partum. Conclusions: Maternity services can use our data and methods to establish norms for their own service, and researchers and maternity services can partner to conduct cost-effectiveness analysis using our more relevant utility values than what is currently available. Time since birth and gestational age of the woman's baby should be considered when selecting post-partum health state utility values for maternity services cost-effectiveness analyses. [ABSTRACT FROM AUTHOR]

This article reports original survey data collected in both parts of the divided Donbas region of Ukraine on the eve of Russia’s full-scale invasion in February 2022. The research employs a methodological innovation by having the same telephone survey implemented by three different survey agencies: one based in Ukraine, one based in Russia, and one based in the UK. Comparing similarities and differences in results identify key effects induced by the origin of phone calls. The question of preference for final status in Ukraine or Russia was asked in all four samples. Regression model results are very similar for the two samples in the territories of Donbas under Kyiv’s control but there are significant differences between the Ukrainian and Russian survey companies’ results in the non-government controlled areas. The results reflect a situational response due partly to the origin of the phone calls as well as to important demographic differences in the composition of the sub-samples in a very tense environment that had experienced conflict since 2014. [ABSTRACT FROM AUTHOR]

Background: Hepatic manifestations of hemophagocytic lymphohistiocytosis (HLH), an underrecognized primary presentation in pediatric age group, mandate high levels of suspicion for early diagnosis. Aim: This is to study the frequencies of clinical and laboratory hepatic involvement in patients with familial/primary or secondary/acquired HLH in relation to disease reactivation and outcome. Methods: A 6-month retrospective cohort study recruited 35 patients with HLH. Detailed clinical, laboratory, and genetic characteristics of HLH were collected. Hepatic transaminases and synthetic liver functions were collected at presentation, weeks 2 and 8 after starting treatment, and at time of reactivation. Biochemical liver involvement was considered when alanine aminotransferase (ALT) lived three-times more than the upper normal level. Overall (OS) and reactivation free survival were analyzed according to liver involvement. Results: Twenty patients (57%) had genetically confirmed HLH, 12 (34.3%) had MUNC13D mutations, 3 (8.5%) had STXBP2 mutations, and 5 (14.3%) had RAB27A mutations, while 9 (25.7%) had no genetic mutations with 4 of them had secondary HLH. Six patients (17.2%) patients had unknown genetics status. Median (IQR) age of the whole group was 18 months (6–36) with an age range of 2–108 months. Liver enlargement was detected at diagnosis in 29 (82.9%) and at reactivation in 18 (51.4%) patients. Eight (22.86%) patients had biochemical hepatic involvement at presentation with no significant difference in their demographic, initial clinical presentation, survival, or the type of mutant gene according to liver involvement. Conclusion: Variable hepatic biochemical involvement might be the presenting manifestation of HLH at diagnosis and upon reactivation, yet it did not impact disease outcome. [ABSTRACT FROM AUTHOR]

Background: High body-mass index (BMI) is an established risk factor for late-life cognitive impairment and dementia, but most evidence comes from high-income contexts. Existing evidence from cross-sectional data in low- and middle-income settings is inconsistent, and many studies do not adequately address potential sources of bias. Methods: We used data from Wave 1 of the Longitudinal Aging Study in India (LASI) (analytic N = 56,753) to estimate the association between BMI categories and cognitive functioning among older adults aged 45 + years using survey-weighted linear regression models stratified by gender and controlling for potential confounders including demographic factors, socio-economic status (SES) characteristics, and health-related behaviors. To probe potential sources of bias, including residual confounding and reverse causation, we used weighting and trimming methods, sample restriction, and explored effect modification. Results: In fully adjusted models, relative to normal BMI underweight BMI was associated with lower cognitive scores (Men: -0.16 SD difference, 95% CI -0.18, -0.13; Women: -0.12 SD, -0.15, -0.10). Overweight and obesity were associated with higher cognitive scores in both men (overweight: 0.09; 0.07, 0.12, obese: 0.10; 0.05, 0.15) and women (overweight: 0.09; 0.07–0.12, obese: 0.12; 0.08–0.15). Estimates were similar after weighting and trimming but were attenuated after excluding those with low cognition (≥1 SD below the mean relative to those with similar demographic characteristics). Positive associations between overweight and obese BMI and cognition were attenuated or null in those living in urban settings and those with higher levels of educational attainment. Conclusions: Underweight BMI is a risk factor for poor cognitive outcomes in adults 45 years and older and may be indicative of poor nutritional status and life-course disadvantage in India. In tandem with existing literature, supplemental analyses and effect modification results indicate that unmeasured confounding and reverse causation may explain the observed positive associations between overweight and obese BMI and cognitive functioning from cross-sectional studies in low- and middle-income settings. Future data with longitudinal follow-up will be helpful to further disentangle biases. [ABSTRACT FROM AUTHOR]

Background: Kawasaki disease is a rare systemic inflammatory syndrome that mainly affects children under five years of age and is the first cause of pediatric acquired cardiovascular disease. The pathogenesis is complex and a viral trigger is suspected, as well as genetic susceptibility. Multiple studies around the world have shown a decrease in the incidence of Kawasaki disease and have hypothesized that the different sanitary measures enforced in each country during the pandemic period could be responsible to a certain extent. The aim of this study is to evaluate the effects of the COVID-19 pandemic on the disease's incidence, defining characteristics, coronary artery outcomes and management in a tertiary center in Switzerland. Methods: This study is a retrospective analysis of children who have been diagnosed with Kawasaki disease that compares clinical, laboratory, SARS-CoV-2 exposure, and echocardiographic data as well as treatments before (January 1st 2017 to February 24th 2020) and during (February 25th 2020 to December 31st 2022) the COVID-19 pandemic in Switzerland. Statistical significance of differences in the compared parameters was assessed. Results: Of the 90 patients included, 31 belonged to the first group and 59 belonged to the second group. There was a statistically significant (p < 0.05) increase in incidence during the pandemic period (5.91/100,000 children) of 88% compared to the pre-pandemic period (3.14/100,000 children). A lesser seasonal variation was observed during the pandemic. 30% of the patients in the pandemic group had an exposure to SARS-CoV-2. There was no other notable difference in demographic factors, clinical presentation, coronary outcome or administered treatment. Conclusions: To the best of our knowledge, this is the first prolonged European study comparing Kawasaki disease before and during the COVID-19 pandemic. There was a significant increase in incidence in Kawasaki disease during the COVID-19 pandemic. In contrast, studies done in Japan, South Korea and the USA have shown a decrease in incidence. Differences in methodologies, genetics, ethnicities, environments, microbiome-altering behaviors, sanitary measures and SARS-CoV-2 spread are factors that should be considered. Further studies analyzing the differences between countries with increased incidence of Kawasaki disease could help better understand the relevance of such factors and provide more insight into the etiologies of this particular disease. [ABSTRACT FROM AUTHOR]

The aim of this work is to explore the relationship between the skills acquired by students of Engineering in the Nigerian university education system and the demographic characteristics of the students, such as gender and age, which could influence the attainment of these skills. A total of 112 students were surveyed to determine which of 24 stated skills they possess. Afterwards, dummy variable multiple regression technique was used for analysis. Results showed a significant relationship between gender especially, and age of students to a lesser degree, and the total number of skills acquired by the students. Specifically, the study was able to show that being a male student is more likely to lead to a student acquiring an average of about 1.79 more skills than his female counterparts. This is so if the values of all other variables such as student age and source of the skills acquisition are held at constant levels. The result presented in this work was also able to show that students who engage external sources and activities for skills acquisition fare better than students who do not. [ABSTRACT FROM AUTHOR]

Background: It is controversial whether double-J (DJ) stent insertion is necessary in tubeless percutaneous nephrolithotomy (PCNL) for patients with staghorn stones. We compared the outcomes of using ureteral catheters and double-J stents in tubeless complete supine PCNL (csPCNL) of staghorn stones. Methods: In this analytical cross-sectional study, from May 2008 to August 2022, 123 patients who underwent tubeless csPCNL were assessed. Patients were divided into two groups by either tubeless csPCNL with DJ stent (Group I; n = 23) or totally tubeless just with perioperative ureteral stent (Group II; n = 100). Demographic characteristics, stone-related factors, perioperative and postoperative parameters were compared in groups. Results: Baseline characteristics were comparable in groups. The operative time in group I was significantly longer than group II (68.26 vs. 55.25 min, P = 0.05). However, the duration of hospitalization in Group I was shorter than the other group (1.81 vs. 2.37 days, P = 0.03). Stone free rate was notably higher in Group I (90.5% vs. 79.8.0%) with no statistically significant difference. No significant differences were found in major complications. Patients in Group II had a significantly shorter time to return to normal life (6.48 vs. 7.91 day; P = 0.043). Multivariable linear regression showed the preoperative creatinine level and stone size can affect the operative time (P = 0.02). In addition, stone number and underlying disease can affect the length of hospital stay (P = 0.007 & 0.030, respectively). Conclusion: Although not inserting a double J stent after csPCNL has acceptable results, because of higher residual rate in staghorn stone which cause more incidence of renal colic, longer time of hospital stay and return to normal life, inserting DJ stent is recommended. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to investigate medical students' perceptions of telehealth in Pakistan and assess the relationship between students' proficiency in computers and technology, gender, and age. Methods: A cross-sectional study was conducted on 330 medical students from various universities in Karachi, Pakistan. Data on demographic characteristics, computer proficiency, and perceptions of telehealth were collected using a self-administered questionnaire. Descriptive statistics, chi-square tests, and Spearman's rank correlation coefficient were utilized for data analysis. Results: The study included 330 participants, predominantly from public universities (83.3%), with a mean age of 21.40 ± 4.24 years. Most participants were pursuing MBBS (67%). In terms of computer proficiency, 41.8% fell into the middle category. Gender correlated significantly with proficiency (p < 0.05), with females more often in the middle category and males in the not-that-amateur category. Age demonstrated a small positive correlation with proficiency (p < 0.05). A majority (77.6%) expressed a general interest in technology. Regarding healthcare apps, 51.8% had 1–3 apps, and 33.6% had none. Most participants believed telehealth would enhance healthcare (72.1%) and make it cheaper (63.3%). Additionally, 56.7% agreed that Pakistan should invest in telehealth, while only 2.7% disagreed. Conclusion: The study revealed that medical students in Pakistan exhibit an interest in technology and perceive telehealth as beneficial. These findings suggest that telehealth holds the potential to enhance healthcare opportunities in Pakistan. Therefore, investing in and expanding telehealth services may represent a viable solution for improving access to healthcare in the country. [ABSTRACT FROM AUTHOR]

Aims: The once-daily extended-release tacrolimus formulation (ER-Tac) has demonstrated similar efficacy and safety to the twice-daily immediate-release formulation (IR-Tac), but few population-based pharmacokinetic models have been developed in de novo kidney transplant patients to optimize doses. Therefore, this study aimed i) at developing a population pharmacokinetic model for ER-Tac in de novo adult kidney transplant patients ii) and identifying genetic factors and time-varying covariates predictive of pharmacokinetic variability to guide tacrolimus dosage during the early posttransplant period. Methods: A total of 1,067 blood tacrolimus concentrations from 138 kidney transplant patients were analyzed. A total of 29 out of 138 patients were intensively sampled for 24 h on the day 5 post-transplantation; meanwhile, for the remaining patients, concentrations were collected on days 5, 10, and 15 after transplantation. Tacrolimus daily doses and genetic and demographic characteristics were retrieved from the medical files. Biochemistry timevarying covariates were obtained on different days over the pharmacokinetic (PK) study. A simultaneous PK analysis of all concentrations was carried out using the non-linear mixed-effects approach with NONMEM 7.5. Results: A two-compartment model with linear elimination and delayed absorption best described the tacrolimus pharmacokinetics. Between-patient variability was associated with oral blood clearance (CL/F) and the central compartment distribution volume (Vc/F). Tacrolimus concentrations standardized to a hematocrit value of 45% significantly improved the model (p < 0.001). This method outperformed the standard covariate modeling of the hematocrit-blood clearance relationship. The effect of the CYP3A5 genotype was statistically (p < 0.001) and clinically significant on CL/F. The CL/F of patients who were CYP3A5*1 carriers was 51% higher than that of CYP3A5*1 non-carriers. Age also influenced CL/F variability (p < 0.001). Specifically, CL/F declined by 0.0562 units per each increased year from the value estimated in patients who were 60 years and younger. Conclusion: The 36% between-patient variability in CL/F was explained by CYP3A5 genotype, age, and hematocrit. Hematocrit standardization to 45% explained the variability of tacrolimus whole-blood concentrations, and this was of utmost importance in order to better interpret whole-blood tacrolimus concentrations during therapeutic drug monitoring. The dose requirements of CYP3A5*/1 carriers in patients aged 60 years or younger would be highest, while CYP3A5*/1 non-carriers older than 60 years would require the lowest doses. [ABSTRACT FROM AUTHOR]