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Purpose: To assess whether a health education video increased prosthodontic treatment demand for replacing missing teeth compared to a traditional health education (IEC) leaflet among patients visiting a university dental care center in Saudi Arabia. Materials and Methods: A nonrandomized educational intervention was conducted among patients with missing teeth. A total of 350 participants were divided equally into two health-education intervention groups: leaflet group and video group. Two major variants were ascertained: demand for prosthodontic dental care and awareness (knowledge) about the importance of replacing missing teeth. These two variants were studied for the difference in the scores between base line and at the end of the program (after 3 months). Bivariate analysis was done with chi-square test, McNemar chi-square test, and Wilcoxon matched-pairs tests, and finally binary logistic regression analysis was done. Results: The final analysis included 324 participants. There was improvement in both knowledge and demand for prosthodontic care in both the groups after health education, but a statistically significant improvement in demand for dental care was observed in the video group compared to the leaflet group (42.9% vs 63.2%). Logistic regression analysis identified that missing teeth in the anterior region and being in the video group were two significant factors associated with increased demand for care. Conclusions: The health education video method was found to be a more effective method compared to leaflets in improving knowledge and demand for replacing missing teeth. [ABSTRACT FROM AUTHOR]

Background: Despite progress in national reproductive health, pastoralist regions, including the Fentale District in Eastern Ethiopia, face challenges with limited contraceptive coverage due to gaps in understanding and adoption among couples. Methods: This cross-sectional study of 1496 couples in Fentale District, Eastern Ethiopia, from October 1 to December 25, 2021, utilized multistage sampling. Data entered into EPI Data underwent analysis with SPSS (v23.0) and STATA (v14.0), employing descriptive statistics, bivariate analysis, and binary logistic regression to identify predictors of contraceptive knowledge. Results: Of the 1496 couples, 93.8% (1404) participated in the survey. Significant educational disparities were observed, with 53.8% having no formal education, particularly among women (65.2%). Despite this, 80.2% of couples were aware of at least one family planning (FP) method, and 78.6% knew modern methods. The median knowledge of contraception methods was 3 for both genders. Men showed higher awareness of male (43.2%) and female condoms (17.4%) compared to women (31.8% and 6.0%). Overall, 27.4% of couples used contraception, with a significant gender difference: 41.2% of women and 13.5% of men. Modern contraceptives were used by 18.2% of couples, predominantly by women (34.8%). Binary logistic regression analysis indicated positive associations between contraceptive knowledge and education, bank account ownership, occupation, proximity to healthcare, and media exposure, while a nomadic-pastoralist lifestyle and specific treatment preferences showed negative associations. Conclusion: The limited knowledge and utilization of family planning in the Fentale District stem from gaps in comprehension and disparities among couples. Factors influencing this situation include socio-demographic considerations, such as variations based on education, occupation, media exposure, bank account ownership, treatment preferences, and distance from healthcare facilities. This ensures that the interventions are having the desired effect and allows for adjustments as needed to promote family planning uptake. [ABSTRACT FROM AUTHOR]

Introduction: Retroplacental hematoma is a paroxysmal accident that threatens maternal and fetal prognosis. It is a major emergency in obstetric pathology. The objective of this study was to identify the factors associated with retroplacental hematomas at the Maradi Mother and Child Health Center in 2022. Methods: This was a case‒control cross-sectional analytical study that used patient records for the year 2022 from September 20 to October 20, 2023. The presence of a retropl placental hematoma was the outcome variable and was measured by a case (yes) or control (no) response. The exposure variables included sociodemographic characteristics, obstetric characteristics, care, progression of patients and neonatal characteristics. Pearson's chi-square tests at the 5% significance level were used to analyze differences between categorical variables. All variables that had a bilateral p value < 0.05 in the bivariate analysis were introduced into the binary logistic regression model to identify factors associated with retroplacental hematoma. Results: A total of 246 cases of retroplacental hematoma were recorded out of 4731 deliveries recorded during the study period, for an estimated frequency of 5.20%. The mean age of the patients was 29.41 ± 6.94 years. Factors associated with retroplacental hematoma included multiple parity [adjusted odds ratio (ORA): 0.38, 95% confidence interval (CI) (0.24–0.61)], fewer than 4 antenatal visits [AOR: 10.70, 95% CI (1.14–99.74)], blood transfusion [AOR: 2.01, 95% CI (1.11–3.60)], a newborn birth weight less than 2500 g [AOR: 1.92, 95% CI (1.53–2.42)] and fetal mortality in utero [AOR: 13.20, 95% CI (1.86–93.70)]. Conclusion: This study identified the factors associated with retroplacental hematoma. Prevention requires regular, high-quality prenatal care. Early diagnosis and cesarean section improve maternal–fetal prognosis. Clinical trial number: Not applicable. [ABSTRACT FROM AUTHOR]

Increasingly, studies compare risk and protective factors for involvement in violent and nonviolent terrorist behaviors. This exploratory study investigates whether this distinction is sufficient, or whether it should be disaggregated further into more granular terrorist roles and behaviors. Using data on 404 referrals to a UK countering violent extremism Prevent hub specializing in mental health and associated needs, we compare violent and nonviolent referrals, and then more specific behaviors (vulnerability, proactive extremism, foreign fighting, and violence planning). Bivariate and multivariate analyses show there is value in disaggregating beyond the binary violence versus nonviolence distinction, as more (and more detailed) relationships emerged when using the disaggregated set of behaviors. While gender did not differentiate violent and nonviolent referrals, women were more likely to be referred for radicalization vulnerability or potential foreign fighting. Extreme right‐wing and extreme Islamist referrals were no more or less violent overall, but Islamist referrals were disproportionately referred for both the most and least violent behaviors. Personality and developmental disorders were associated with violence, and disaggregated behaviors provided detailed insight into the drivers of these associations. These exploratory findings, while interesting, likely do not generalize beyond our specific sample. Instead, this study's value lies in demonstrating the utility for both research and, eventually, practice of disaggregating beyond violence and nonviolence. The results demonstrate clear operational implications for threat assessment in the need to include a more refined set of risk factors to aid in assessing risk of more relevant outcomes than terrorist involvement overall. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer, albeit preventable, is the second-most deadly gynecological cancer in developing nations. Little is known about cervical cancer among Bangladeshi women. This study aims to estimate the prevalence of cervical cancer screening and demographic correlates to identify potential variabilities in screening rates among different demographic groups and regions. Methods: This study used secondary data from the WHO STEPS 2018 Survey. We used Bayesian regression to perform the bivariate analyses between the outcome and each explanatory factor, as it generates more acceptable results and improves parameter estimates. The top-ranked socio-demographic factors were identified using a two-step cluster analysis. This method determines the relevance of predictor variables and automatically establishes the number of clusters. Results: The prevalence of Bangladeshi women who had ever been screened for cervical cancer was 6.2%. In the adjusted model, women with the following socio-demographic factors had a higher likelihood of developing cervical cancer: being 18–29 years old (AOR = 3.3, 95% CI: 0.24, 15.27) or 45–59 years old (AOR = 2.8, 95% CI: 1.22, 6.0), currently married (AOR = 2.3, 95% CI: 1.36, 3.70), and employed (AOR = 2.4, 95% CI: 1.40, 4.06). Women in the Barisal division were found to have higher odds of being screened for cervical cancer (AOR = 21, 95% CI: 0.66, 121.97). Cluster analysis found residence status predisposes women to cervical cancer screening. Conclusion: There is a significant potential for substantial reductions in the burden of cervical cancer in Bangladesh by strengthening the application of cervical cancer screening. Future studies should examine how socioeconomic status, culture, and healthcare access affect cervical cancer screening trends for different divisions in Bangladesh. An independent national cancer registry is urgently needed to evaluate screening trends and outcomes. [ABSTRACT FROM AUTHOR]

This paper aims to understand the potential factors influencing the accessibility of early childhood education (ECE) in Bangladesh. Utilising data from the Multiple Indicator Cluster Survey (MICS) 2019, this study explored the influence of individual, household, socio-economic as well as geographical variables on ECE enrollment. It employed a comprehensive approach, which involved using descriptive statistics for univariate analysis, chi-square and t-statistics for bivariate analysis, and the logit model for multivariate analysis. The findings revealed that a child's likelihood of attending an ECE program increases with their age, while those with functional difficulties and larger household sizes exhibit lower odds of attendance. Children with mothers possessing higher education levels demonstrated increased odds of ECE enrollment. Wealthy households and urban or Mymensingh division residency were associated with higher odds of ECE enrollment, while Barishal, Rajshahi, and Sylhet divisions indicated lower odds. To enhance ECE accessibility, the study recommends implementing a roadmap for ensuring universal early childcare and early education with an emphasis on socioeconomically underprivileged children, particularly in rural areas. Proposed strategies may include providing financial assistance to poor households and fostering public–private partnerships for ECE provision in remote regions like Barishal, Rangpur, Rajshahi, and Sylhet divisions. Moreover, it is crucial to make parents and communities aware about the significance of ECE in order to make sure that children ages 3–5 years are involved in ECE programs. [ABSTRACT FROM AUTHOR]

Objective: The incidence of splanchnic vein thrombosis (SVT) is reported to be <25 times lower than that of deep vein thrombosis and pulmonary emboli, which occur in 70 to 270/100,000 cases in the general population. Current guidelines recommend initial treatment with therapeutic low-molecular-weight heparin followed by a transition to a vitamin K antagonist (VKA) or a direct oral anticoagulant (DOAC) in patients with cirrhosis who develop SVT without severe liver dysfunction. This, however, is based on observational data. This study aimed to evaluate the efficacy and safety of anticoagulant therapy in patients with cirrhosis who present with SVT and receive either a DOAC or a VKA. Methods: This multicenter retrospective cohort study was conducted from December 2021 to November 2022. Patients between the ages of 18 and 75 years with cirrhosis and acute SVT who received either a VKA or a DOAC between July 2019 and July 2021 were eligible for inclusion. The primary outcome was the efficacy of treatment, defined as a new thrombotic event. The secondary outcome was the safety of treatment, defined as the development of major bleeding. Readmission data were followed up at 6 and 10 months. Bivariate analysis was conducted to assess the relationship between the medication groups and each outcome and summarized as odds ratios (ORs) with 95% confidence intervals (Cis). Statistical significance was set at 5% for all of the comparisons. Results: A total of 80 patients from 50 hospitals were included in this study. Sixty-one patients (59.02% male) received DOACs and 19 (57.89% male) received a VKA. Of the patients who received DOACs, 41 (67.21%) received apixaban, one (1.64%) received dabigatran, and 19 (31.15%) received rivaroxaban. The results from the bivariate analysis revealed no significant differences between DOACs and warfarin for both the efficacy (OR 1.46,95% CI 0.44-4.84, P = 0.53) and safety outcomes (OR 1.03, 95% CI 0.04-26.43, P = 1) at 10 months. Conclusions: The use of DOACs in patients with cirrhosis who present with SVT may be efficacious and safe compared with warfarin. The findings from our study may inform power analyses for well-conducted randomized trials to confirm these findings. [ABSTRACT FROM AUTHOR]

To examine post-operative urinary and sexual functional outcomes for men with high-risk prostate cancer (HRPCa) who underwent radical prostatectomy (RP) within the Michigan Urological Surgery Improvement Collaborative (MUSIC). We identified patients who underwent RP for HRPCa in MUSIC between 2014 and 2023. HRPCa was defined according to American Urological Association criteria. Patients completed Expanded Prostate Cancer Index Composite (EPIC-26) pre-RP and 3-, 6-, 12-, and 24-months postoperatively. Primary outcomes included social continence, defined as 0-1 pads used daily; and recovery of sexual function, defined as the ability to achieve erections firm enough for intercourse. Multivariable and bivariate analyses were performed to identify factors associated with recovery of social continence and sexual function. Around 1323 patients were included in the post-RP urinary continence analysis and 422 men in the sexual function analysis. Fifty-eight percent and 86% of patients achieved social continence at 3- and 12-months post-RP, respectively. Continence recovery was associated with higher baseline EPIC-26 urinary continence scores (OR 1.10, per 5 points, 95% CI 1.06-1.15, P <.001), and negatively associated with increasing age (OR 0.78 per 5-year increase, 95% CI 0.71-0.85 P <.001). Fifteen percent of patients had recovery of sexual function at 12-month post-RP. On bivariate analysis, recovery of sexual function was associated with nerve-sparing at time of RP, lower pre-operative PSA, and not receiving post-RP ADT/RT. RP for HRPCa has acceptable rates of postoperative social continence. However, post-RP recovery of sexual function remains a challenge. This information has important implications for pre-operative counseling and post-operative follow-up for patients with HRPCa. [ABSTRACT FROM AUTHOR]

Introduction: Postnatal perineal pain is prevalent following childbirth and can impact women both physically and emotionally. The aim of the study was to study the effect of collegial midwifery assistance on perineal pain and pain medication 1 month after birth and to investigate the associations between the type of tear and perineal pain, satisfaction with healing, and resumption of intercourse. Material and Methods: A follow‐up questionnaire was sent 1 month postpartum to women with a first spontaneous vaginal birth participating in a randomized controlled trial (Oneplus trial). Data were collected from December 2019 to May 2020. Differences in perineal pain between women attended by one or two midwives were analyzed according to intention‐to‐treat using bivariate analyses. Associations between the type of tear and perineal pain, satisfaction with healing, and resumption of sexual intercourse were investigated using univariable and multivariable logistic regression. The category no tear/first‐degree tear was compared separately to each of the other tear categories. Trial registration number: ClinicalTrials.gov, NCT03770962. Results: Out of 2233 women, 1762 responded within 30–60 days postpartum. Of women in the no tear/first‐degree tear category, 27.7% reported perineal pain during the past week, in contrast to women with OASI, where 64.2% reported perineal pain. Women with OASI experienced the highest odds of perineal pain (aOR 4.51, 95% CI 2.72–7.47) compared to those with no tear/first‐degree tear, followed by women with major second‐degree tears (aOR 1.87, 95% CI 1.45–2.41), women with an episiotomy (aOR 1.78, 95% CI 1.11–2.87), and those with minor second‐degree tears (aOR 1.43, 95% CI 1.06–1.94). Women with episiotomy reported the highest odds ratios for dissatisfaction with tear healing (aOR 3.48, 95% CI 1.92–6.31). No significant differences in perineal pain and pain medication were observed between women allocated to collegial midwifery assistance and those allocated to standard care. Conclusions: Women with OASI reported the highest odds of perineal pain 30–60 days after birth compared to women with no tear or first‐degree tear, followed by women with major second‐degree tears. Women subjected to an episiotomy reported highest odds ratios of dissatisfaction with tear healing. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the impact of surgical approach and post-operative prophylaxis on heterotopic ossification (HO) development after total hip arthroplasty (THA). Methods: A retrospective analysis of 312 patients who underwent THA between January 2009 and April 2016. Patients were categorized by surgical approach (direct lateral or posterolateral), prosthesis type, and post-operative prophylaxis (Etoricoxib 60 mg daily for two weeks). Two orthopaedic surgeons independently assessed radiographs at serial intervals, and HO was graded as per Brooker classification. Bivariate analysis and regression modelling were performed to assess the associations and confounding effects of different variables, Results: Bivariate analysis identified factors correlated with higher HO incidence: absence of prophylaxis, older age, longer symptom evolution, and lower pre-surgery physical activity. Regression modelling showed a correlation between the direct-lateral approach, post-operative prophylaxis, symptom evolution, and higher HO incidence. Conclusion: Patients with longer symptom evolution before surgery and without post-operative prophylaxis are at higher risk of developing HO. While the direct lateral approach showed higher HO rates, the difference was insignificant. A two-week prophylactic regimen of Etoricoxib 60 mg daily after THA effectively reduced HO formation. Pharmacological prophylaxis should be evaluated case-by-case, considering patient characteristics and risk factors. [ABSTRACT FROM AUTHOR]

This study aimed to assess the ten-year trend in semen quality among couples referred to the Infertility Center in Kerman between 2008 and 2017. The study included 2952 semen samples from men 18 to 60 years old referred to the infertility center as infertile couples living in Kerman province, Iran, whether they had normal or abnormal semen analysis. A total of 2952 sperm samples were included. Statistically significant changes were observed in semen parameters. Particularly, significant changes were observed for volume (−0.08 mL/year), sperm concentration (−2.34 (mio/mL)/year), total sperm count (−13.17 (mio/ejaculate)/year), progressive motility (−2.62%/year), non-progressive motility (−0.59%/year), immotile sperm (2.49%/year), and normal morphology (−0.134%/year). In bivariate analysis, the prevalence of oligozoospermia in this study showed a statistically significant association with age (OR = 1.019; 95% CI = 1.007−1.032; p = 0.003). Likewise, there was a statistically significant association with the year (OR = 1.087; 95% CI = 1.050−1.125; p = 0.000). Semen quality parameters showed a downtrend during the last 10 years in this study, emphasizing the importance of male reproductive health monitoring and warning public health coordinators to pay more attention to this important issue. [ABSTRACT FROM AUTHOR]

Background: The abdominal seat belt sign (SBS) is associated with an increased risk of hollow viscus injury (HVI). Older age is associated with worse outcomes in trauma patients. Thus, older trauma patients ≥65 years of age (OTPs) may be at an increased risk of HVI with abdominal SBS. Therefore, we hypothesized an increased incidence of HVI and mortality for OTPs vs younger trauma patients (YTPs) with abdominal SBS. Study design: This post hoc analysis of a multi-institutional, prospective, observational study (8/2020-10/2021) included patients >18 years old with an abdominal SBS who underwent abdominal computed tomography (CT) imaging. Older trauma patients were compared to YTPs (18-64 years old) with bivariate analyses. Results: Of the 754 patients included in this study from nine level-1 trauma centers, there were 110 (14.6%) OTPs and 644 (85.4%) YTPs. Older trauma patients were older (mean 75.3 vs 35.8 years old, P < .01) and had a higher mean Injury Severity Score (10.8 vs 9.0, P = .02). However, YTPs had an increased abdominal abbreviated-injury scale score (2.01 vs 1.63, P = .02). On CT imaging, OTPs less commonly had intraabdominal free fluid (21.7% vs 11.9%, P = .02) despite a similar rate of abdominal soft tissue contusion (P > .05). Older trauma patients also had a statistically similar rate of HVI vs YTPs (5.5% vs 9.8%, P = .15). Despite this, OTPs had increased mortality (5.5% vs 1.1%, P < .01) and length of stay (LOS) (5.9 vs 4.9 days P < .01). Conclusion: Despite a similar rate of HVI, OTPs with an abdominal SBS had an increased rate of mortality and LOS. This suggests the need for heightened vigilance when caring for OTPs with abdominal SBS. [ABSTRACT FROM AUTHOR]

Background: The vertical banded gastroplasty (VBG) is a historic restrictive bariatric operation often requiring further surgery. In this investigation utilizing the 2021 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) national dataset, we aim to better define the outcomes of VBG conversions.Methods: We queried the 2021 MBSAQIP dataset for patients who underwent a conversion from a VBG to Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG). Demographics, comorbidities, laboratory values, and additional patient factors were examined. Rates of key consequential outcome measures 30-day readmission, reoperation, reintervention, mortality, and a composite endpoint (at least 1 of the 4) were further calculated.Results: We identified 231 patients who underwent conversion from VBG to SG (n = 23), RYGB (n = 208), or other anatomy (n = 6), of which 93% of patients were female, and 22% of non-white race. The median age was 56 years and body-mass index (BMI) was 43 kg/m2. The most common surgical indications included weight considerations (48%), reflux (25%), anatomic causes (eg, stricture, fistula, and ulcer; 10%), and dysphagia (6.5%). Thirty-day morbidity rates included reoperation (7.8%), readmission (9.1%), reintervention (4.3%), mortality (.4%), and the composite endpoint (15%). Upon bivariate analysis, we did not identify any specific risk factor for the 30-day composite endpoint.Discussion: One-stage VBG conversions to traditional bariatric anatomy are beset with higher 30-day morbidity relative to primary procedures. Additional MBSAQIP data will be required for aggregation, to better characterize the risk factors inherent in these operations. [ABSTRACT FROM AUTHOR]

Introduction: The American College of Surgeons (ACS) recommends that special considerations be made during triage of trauma patients aged ≥55 due to an observed increase in morbidity and mortality in this population. The geriatric population aged ≥65 represents 30% of all trauma patients. Our objective was to assess which pre-existing conditions (PECs) are associated with worse outcomes in trauma patients aged ≥55. Methods: Study population was selected from the local trauma registry (2020-22). Bi-variate analysis compared PEC status with outcomes controlling for each Injury Severity Score (ISS) category. Injury Severity Score was defined as mild (1-8), moderate (9-15), severe (16-24), and critical (≥25). Results: A total of 5,168 patients were identified (54.9% female, 56.7% age ≥75, 49.1% mild injury). Patients who had chronic renal failure (CRF) were at increased odds of mortality after adjusting for mild (adjusted odds ratio [aOR]: 2.63), moderate (aOR: 2.97), severe (aOR: 2.84), and critical (aOR: 2.62) injuries. Patients who had cirrhosis or congestive heart failure (CHF) were at increased odds of mortality after adjusting for mild (aOR: 3.03, 1.61), moderate (aOR: 3.63, 2.14), and severe (aOR: 3.46, 1.93) injuries, respectively. In addition, there was a relationship between having chronic obstructive pulmonary disease (COPD), dementia, anticoagulant therapy, or diabetes with unplanned intensive care unit (ICU) admission and development of acute kidney injury (AKI). Discussion: There is an association between certain pre-exiting conditions and worse outcomes. Early identification of these factors could provide a foundation for better interdisciplinary management, prevention of complications and associated mortality. [ABSTRACT FROM AUTHOR]

Data about the impact of Belimumab on corticosteroid sparing in real life are scarce. To assess the corticosteroid-sparing effect among patients with systemic lupus erythematosus (SLE) treated with Belimumab in real-life settings. Multicentric observational retrospective study including patients with SLE and having received Belimumab for at least 6 months between 2011 and 2020, in eight French hospitals. "Low dose" referred to patients receiving up to 7.5 mg of prednisone a day and "Very low dose" to those receiving strictly ≤ 5 mg prednisone a day The primary endpoint was the reduction of daily prednisone dose after six months of Belimumab. The secondary endpoint was a change in the proportion of patients with low or very low dose of prednisone as well as those without prednisone during the Belimumab course. Censoring occurred for patients who stopped Belimumab. Bivariate analyses were performed using the Wilcoxon signed-rank test. The threshold for statistical significance was set at p < 0.05. Thirty patients were included. All were female with a median age of 38 years. A significant reduction in prednisone dose was observed at month 6 (10 [7–20] vs 6.75 [2–9] mg, p < 0.0001), continued until month 12 (10 [7–20] mg vs 5 [0–7.12] mg, p < 0.001) and was sustained until month 24. The proportion of patients with very low dose of prednisone and those without prednisone progressively increased during the Belimumab course. Introducing Belimumab in patients with SLE, in real-life conditions, is associated with early and sustained corticosteroid-sparing effect. [ABSTRACT FROM AUTHOR]

This study aimed to investigate students' digital (ICT) skills, perceived relevance (usefulness), and actual use of digital (ICTs) skills for learning. Data were obtained via Google Forms from 325 students who were conveniently sampled from two public universities in Ghana. The results from the multivariate analysis of variance showed that age and marital status had significant multivariate effects on ICT (digital) skills. Further univariate analyses showed that younger students reported significantly lower skills related to multimedia, collaborative platforms, and graphics, whereas married students reported higher skills related to engagement in collaborative platforms. Bivariate correlation analyses showed that multimedia skills, software application skills, virtual reality environment skills, collaborative platform skills, and perceived usefulness of ICT were positively correlated with the actual use of ICT. However, further analysis using multiple linear regression showed that only multimedia skills significantly predicted actual ICT use. The implications of the findings for policy are discussed. [ABSTRACT FROM AUTHOR]

Objective: Traumatic brain injury (TBI) proves to be an obstacle for Bangladeshi patients due to the lack of facilities and specialist doctors in regional sections of the country. This study aimed to record different attributes of Bangladeshi TBI patients over a year i.e., their injury characteristics, treatments received and understand their impacts on the severity of TBI. Method: This cross-sectional study was carried out among 280 TBI patients treated in a tertiary care hospital in Dhaka. The physicians determined TBI's severity and prognosis as per the Glasgow Coma Scale (GCS) and Glasgow Outcome Score (GOS) respectively. Results: Most TBI patients were male (76.1%) and aged between 18 and 50 years (52.2%), as in previous studies in South Asian countries. However, the prevalence of TBI due to road traffic accidents (RTAs) was much higher (67.9%) than in the earlier studies in South Asia. Additionally, more patients suffered from severe TBI (29.3%) and moderate TBI (35.7%), and a higher percentage of patients went through surgery (56.8%) compared to previous studies. A significant association of demographic (residence) and clinical characteristics (consciousness after injury, CT scan findings and treatment type) with the severity of TBI was found in bivariate analysis. It also revealed the significant dependence of clinical characteristics (TBI etiology, post-injury consciousness, treatment type and TBI severity) on TBI prognosis. Multivariate analysis showed that patients who were unconscious after TBI and with evident brain injury observed in CT scans have a substantially higher risk of having moderate or severe TBI than mild TBI. Moreover, patients with TBI due to RTAs or falls, evident brain injury in CT scans, post-surgical seizure, and moderate or severe TBI have a significantly higher risk of getting a more unfavorable TBI prognosis than moderate disability. Conclusions: In this study, RTAs were found to be the major cause of TBI. Additionally, some variables were identified as possible determinants of TBI severity and prognosis among Bangladeshi patients. The correlation of these variables with TBI should be further studied with the hopes that steps will be taken to reduce TBI incidents and improve its management to reduce the overall burden. [ABSTRACT FROM AUTHOR]

Evidence on how journalistic role performance changes in time and in relation to which factors is largely missing. This study investigates the presence of civic, infotainment, and service roles in the news, and examines whether their presence varies in time given the worsening economic conditions on the press market and changes in ownership type. A longitudinal content analysis of a representative sample of news (N = 1871) published in four Czech quality dailies during three year-long periods (i.e., 2006–2007, 2011–2012, 2016–2017) was conducted. Bivariate analyses showed that the presence of the roles varied in time for all of the newspapers but to a relatively small extent. Ridge logistic regressions revealed that the presence of all three audience-related roles was associated with specific dailies and ownership types, but not with worsening economic conditions. As compared to privately-owned newspapers, likelihood for the presence of the service role was bigger in corporate-owned newspapers, and for the civic role it was bigger in oligarchic-owned newspapers. The findings suggest that corporate-owned dailies responded to worsening economic conditions by preferring a service role rather than an infotainment role, and that the effects of oligarchic ownership on journalism practice are complex and far from being straightforward. [ABSTRACT FROM AUTHOR]

Aims: To investigate the risk factors for neurogenic lower urinary tract dysfunction (NLUTD) in patients with acute ischemic stroke (AIS), and develop an internally validated predictive nomogram. The study aims to offer insights for preventing AIS‐NLUTD. Methods: We conducted a retrospective study on AIS patients in a Shenzhen Hospital from June 2021 to February 2023, categorizing them into non‐NLUTD and NLUTD groups. The bivariate analysis identified factors for AIS‐NLUTD (p < 0.05), integrated into a least absolute shrinkage and selection operator (LASSO) regression model. Significant variables from LASSO were used in a multivariate logistic regression for the predictive model, resulting in a nomogram. Nomogram performance and clinical utility were evaluated through receiver operating characteristic curves, calibration curves, decision curve analysis (DCA), and clinical impact curve (CIC). Internal validation used 1000 bootstrap resamplings. Results: A total of 373 participants were included in this study, with an NLUTD incidence rate of 17.7% (66/373). NIHSS score (OR = 1.254), pneumonia (OR = 6.631), GLU (OR = 1.240), HGB (OR = 0.970), and hCRP (OR = 1.021) were used to construct a predictive model for NLUTD in AIS patients. The model exhibited good performance (AUC = 0.899, calibration curve p = 0.953). Internal validation of the model demonstrated strong discrimination and calibration abilities (AUC = 0.898). Results from DCA and CIC curves indicated that the prediction model had high clinical utility. Conclusions: We developed a predictive model for AIS‐NLUTD and created a nomogram with strong predictive capabilities, assisting healthcare professionals in evaluating NLUTD risk among AIS patients and facilitating early intervention. [ABSTRACT FROM AUTHOR]

Although relatively rare, sexual homicide has stimulated research efforts to better understand and intervene in the prevention of such crime. However, specific high-risk victims such as sex-trade workers have been understudied. To contribute to the limited scientific literature on this topic, the current study examines the characteristics of the sexual victimization of sex-trade workers using a sample of 402 lethal and non-lethal cases. Bivariate and multivariate analyses indicated that the lethal outcome associated with the sexual victimization of sex-trade workers may not be associated with sadism and paraphilic behaviors, but rather by excessive violence and victim's vulnerabilities. Conjunctive analysis further indicated that the combination of excessive violence, victim's intoxication, situational factors, and crime characteristics was associated with lethal sexual victimization of sex-trade workers. Findings suggest strategies in the development of situational prevention and intervention strategies. [ABSTRACT FROM AUTHOR]

Background: Antimicrobial resistance (AMR) is a serious public health issue which is exacerbated by increased inappropriate use of antibiotics for common eye infections. This cross sectional survey was to assess the appropriate use of antibiotics for eye infections in an ambulatory clinic in Ghana and possible determinants. Method: The medical records of all patients who sought eye care between January 2022 to December 2022 and were prescribed antibiotics were extracted from the hospital's electronic database. Descriptive, bivariate and multivariate analyses were then conducted. Results: A total of 1925 patient medical records were extracted, whose median age was 40 years (IQR 26–69), and were mostly females (58.91%, n = 1134/1925). The eye condition commonly treated with antibiotics was bacteria conjunctivitis (33.51%, n = 645/1925). The most prescribed antibiotic was gentamycin (22.96%, n = 442/1925) followed by ciprofloxacin (16.78%, n = 321/1925). These were mostly topical dosage forms (82.13%, n = 1581/1925). Systemic antibiotics prescribed were mostly from the WHO 'Access' class (83.33%, n = 280/338). The appropriate choice of antibiotic prescribed was 42.44% (n = 817/1925) and this was positivity associated with age (p<0.001), number of antibiotics prescribed (p <0.001), the prescription of topical dosage forms (p <0.001), and WHO 'Access' antibiotic class (p <0.034). Conclusion: The level of appropriateness of antibiotic prescriptions for eye infections was sub-optimal. Antimicrobial stewardship programs, including prescriber education on guidelines and prescription audit to address associated factors, must now be instigated in this hospital to improve future antibiotic use and prevent the rise of AMR. [ABSTRACT FROM AUTHOR]

Background: Hospital readmission after discharge for stroke is associated with high morbidity and mortality. There is a paucity of data on the burden of stroke readmission in most sub-Saharan African countries. We aimed to determine the rate, reasons and predictors of hospital readmission and the mortality rate within 12 months of discharge among stroke survivors in Cameroon. Methods: This prospective cohort included patients who survived hospitalization for an acute stroke and who were discharged from two referral hospitals in the capital city of Cameroon between January 2013 and December 2013.We performed logistic regression analysis to identify demographic and clinical factors associated with readmission within 1 year of discharge and causes of readmission. Results: Of the 254 consecutive patients admitted for acute stroke, 198 were discharged alive. There were 107 (54%) males, and their mean age (SD) was 61.7 (13.9) years (range: 10 to 95 years). A total of 30 (15.2%) patients were readmitted following discharge from the index admission over a mean follow-up time of 286.9 (127.6) days. Of these, 14 (46.7%) were discharged and 16 (53.3%) died after readmission. Thirty percent (30%) of readmissions occurred within the first month. The most frequent causes of readmissions were infections (30%) and recurrent stroke (26.7%). Factors associated with readmission in bivariate analysis were initial admission temperature > 37.5°C (risk ratio [RR]: 1.3, p = 0.021) and initial admission Glasgow Coma Score < 14 (RR: p = 1.23, p = 0.019). After stratified adjustment for age and sex, temperature > 37.5°C (adjusted RR: 1.3, 95% CI: 1–1.7, p = 0.036) and GCS <14 (adjusted RR: 1.23, 95% CI: 1–1.6, p = 0.041) were associated with readmission. Conclusion: Readmission after discharge for stroke was common with nearly one third occurring within the first month and more than half dying following readmission. The most common causes of readmission were infections and recurrent stroke. [ABSTRACT FROM AUTHOR]

Background: Uncontrolled blood pressure is a significant public health problem associated with a high rate of mortality and morbidity worldwide. In Ethiopia, 48% of hypertensive patients have Uncontrolled blood pressure. Therefore, this study aimed to identify the determinants of uncontrolled blood pressure among adult hypertensive patients on follow-up at the Negele and Adola General Hospitals in the Guji Zone, Oromia, Ethiopia. Methods: A facility-based, unmatched case–control study was conducted in Negelle and Adola General Hospitals, Guji Zone, from January-01–30, 2023, on 384 samples. Study participants were selected consecutively as they came for treatment until the required sample size was obtained. The data were collected using an interview-administered structured questionnaire and medical chart review. The data were entered into Epi-data version 3.1 and exported to SPSS version 25 for analysis. Binary logistic regression analysis was used to model the association between the dependent and independent variables. The candidate variables with p < 0.25 in the bivariate analysis were entered into the multivariable logistic regression. An Adjusted Odds ratio (AOR) and 95% CI were used to measure the strength of the association. Finally, at p < 0.05, statistical significance was declared. Results: A sample of 384 respondents (128 cases and 256 controls) were included, for a response rate of 100%. No adherence to medication (AOR = 2.01, 95% CI = 1.16–3.44), no adherence to smoking abstinence (AOR = 1.84, 95% CI = 1.05–3.22), no adherence to weight management (AOR = 2.02, 95% CI = 1.04–3.92), poor hypertension knowledge (AOR = 2.18, 95% CI = 1.26–3.76), use of traditional medicine (AOR = 9.13, 95% CI = 5.31–15.69), and overweight (AOR = 3.35, 95% CI = 1.79–6.26) were significantly associated with uncontrolled blood pressure. Conclusion: This study revealed that no adherence to medication, smoking, weight management, poor hypertension knowledge, traditional medicine use, and being overweight were determinants of uncontrolled blood pressure. Since these are modifiable and preventable factors, there is a need to implement interventions that will enhance self-care practices in this population to improve treatment outcomes. [ABSTRACT FROM AUTHOR]

ABSTRACT The aim of the present study was to infer phenotypic responses and genetic parameters of the F1 calf diseases diarrhoea (DIAR) and pneumonia (PNEU) in dependency of the prenatal maternal health status (PMHS) of the dam and of the herd‐calving year. The PMHS considered diagnoses for the cow disease mastitis (MAST) and claw disorders (CD) during gestation of F0 dams. Furthermore, 305‐d milk production traits of F1 offspring from either healthy or diseased dam groups were compared. The study comprised 20,045 female calves (F1 = generation 1) and their corresponding dams (F0 = parental generation 0), kept in 41 large‐scale herds. All F1 calves were from their dams' 2nd parity, implying that all dam (maternal) diseases were recorded during the first lactation and dry period of the dams. The F1 calves were phenotyped for DIAR up to 30 days post‐partum, and for PNEU up to 180 days of age. At least one entry for the respective disease implied a score = 1 = sick, otherwise, a score = 0 = healthy, was assigned. Production records of the 10,129 F1 cows comprised 305‐d records in first lactation for milk yield (MY), protein yield (PY) and fat yield (FY). Linear and generalised linear mixed models were applied to infer phenotypic responses of F1 traits in dependency of the PMHS for CD and MAST. A diagnosis for MAST or CD in F0 cows during gestation was significantly (p ≤ 0.05) associated with an increased prevalence for DIAR and PNEU, with pairwise differences of least‐squares‐means between calves from healthy and diseased cow groups up to 3.61%. The effects of PMHS on 305‐d production traits in offspring were non‐significant (p > 0.05). In bivariate genetic analyses, DIAR and PNEU were defined as different traits according to the PMHS, i.e., DIAR‐MASThealthy and DIAR‐MASTdiseased, DIAR‐CDhealthy and DIAR‐CDdiseased, PNEU‐MASThealthy and PNEU‐MASTdiseased, and PNEU‐CDhealthy and PNEU‐CDdiseased. The direct heritabilities for DIAR and PNEU were quite similar in the healthy and respective diseased dam group. Slightly larger direct heritabilities in the diseased dam groups were due to increased genetic variances. Maternal heritabilities were quite stable and smaller than the direct heritabilities. In random regression models, genetic parameters for DIAR and PNEU were estimated along the continuous herd‐calving‐year prevalence scale, considering a prevalence for MAST and CD (based on the 20,045 dam records plus 16,193 herd contemporary records) in the range from 0% to 30%. Direct heritabilities for PNEU were quite stable along the herd‐calving‐year gradient for MAST and CD. For DIAR, we observed stronger estimate fluctuations, especially increasing direct heritabilities in dependency of the herd‐calving‐year prevalence for MAST from 0.13 (at a MAST prevalence of 0%) to 0.30 (at a MAST prevalence of 30%). Consequently, obvious genotype x herd‐calving‐year PMHS interactions were observed for DIAR on the prenatal MAST scale, with a minimal correlation of 0.48 between direct genetic effects at 0% MAST prevalence and at 30% MAST prevalence. The correlations between direct genetic and maternal genetic effects were antagonistic at all herd‐calving‐year prevalence levels, displaying strongest fluctuations for “DIAR‐MAST.” The genotype x herd‐calving‐year PMHS interactions for DIAR suggest consideration of specific sires according to the herd health status for CD and for MAST. [ABSTRACT FROM AUTHOR]

Background: Violence against women is considered a fundamental violation of their human rights. According to the world health organization (WHO), one-third of women worldwide experience some form of intimate partner violence (IPV). This study aimed to investigate the relationship between dowry demand, perception of wife-beating, decision-making on work and household purchases and physical, sexual, and emotional violence against married adolescent girls in India by using a large dataset. Methods: Data from the Understanding the lives of adolescents and young adults (UDAYA) project survey were used in this study. The final sample size included 4893 married adolescent girls. Descriptive statistics and bivariate analyses were performed to examine preliminary results. Multivariate logistic regression analysis was used to analyze the associations between dowry demand, perception of wife-beating, decision-making and types of IPV. Results: The prevalence of emotional, physical, and sexual violence among married adolescent girls were 28.6%, 22.9%, and 26.1%, respectively. Approximately 44% of married adolescent girls have experienced some form of violence (emotional, physical, or sexual). The likelihood of experiencing violence was 3.64 times more likely among adolescent girls who reported that dowry was demanded by their in-laws than their counterparts [aOR: 3.64; CI: 3.05–4.35]. Moreover, married girls who justified wife-beating were more likely to face any violence than their counterparts [aOR: 1.56; CI: 1.28–1.90]. Similarly, adolescent girls whose work decisions were made by others had higher odds of experiencing any violence than those who decided their work themselves/jointly with others [aOR: 1.34; CI: 1.07–1.68]. The odds of any violence were higher among adolescent girls whose decisions on household purchases were made by others compared to those who decided to make purchases themselves or jointly with others [aOR: 1.37; CI: 1.09–1.71]. Conclusions: The findings revealed significant associations between dowry-demand, justification of wife-beating, decision making power and IPV among married adolescent girls, and suggest policies that help reduce violence related to the predominantly practiced dowry system in the country, and programs aimed at educating adolescent married girls about their rights against violence and empowering them to retain equal decision-making power within their families and reduce their vulnerability to domestic violence. [ABSTRACT FROM AUTHOR]

In Bangladesh, many disabled children are not attending school. Despite the country's special policies, laws, and services, most disabled children face a barrier to enrollment in school. To increase the school attendance of children, particularly disabled children, research on barriers to school attendance is essential. It will help to ensure that all children, including those with disabilities, receive an education. This paper will investigate the factors associated with children with disabilities missing school. This study will utilize data from a large sample based on Nationally representative multiple indicator cluster survey 2019 in Bangladesh. The study group included 5024 disabled children ranging in age from 6 to 17 years. To determine the significant covariates for the multivariate analysis, a bivariate analysis was performed. The findings indicate that age of the child, gender, household head sex, education of the household head, area (urban/rural), husband age, whether the husband has more wives, and disability types are all associated with disabled children being absent from school. Using these findings, the government of Bangladesh and other stakeholders should advocate for policies and programs that reduce barriers to education and ensure that all disabled children attend school. [ABSTRACT FROM AUTHOR]

PurposeMethodsResultsConclusionsTo evaluate a worker’s self-perceived difficulty in job performance as a whole and by subscales of job demands in a sample of working patients with uveitis and to analyze the relationship with sociodemographic, occupational, and clinical variables.A cross-sectional, cross-association study was conducted. Participants completed the Work Role Functioning Questionnaire (WRFQ) to assess self-perceived difficulty in job performance. Clinical data were collected from the patients’ medical records or instruments used to evaluate clinical parameters in practice. Two clinical groups were established for this study. Bivariate and multivariate analyses were performed to assess associations between variables.Sixty participants were included in the study. In the multivariate linear regression analysis, active uveitis was significantly associated with a worse WRFQ total score (coefficient, −25.1; 95% CI, −36.6 to −13.6; p < 0.001). Acute course uveitis was significantly associated with a better total score than recurrent and chronic uveitis (coefficient, 17.7; 95% CI, 3.7 to 31.7; p = 0.014). In bivariate analysis, patients with active uveitis also scored worse on all subscales and on the total score.Patients with active uveitis presented with greater self-perceived difficulty in the performance of their work as a whole and in all subscales of work demands. Patients with acute uveitis presented with less difficulty than those with recurrent and chronic uveitis. Early and correct treatment of uveitis in specialized units may reduce its impact on patients’ work impairment. [ABSTRACT FROM AUTHOR]

Mental health issues, especially depression among adolescents is a global concern. This study focuses on understanding the prevalence and factors influencing depression among adolescents in Uttar Pradesh (UP), India. The study was utilized data from the Understanding the Lives of Adolescents and Young Adults (UDAYA) survey (Wave-1) conducted in 2015–16 among adolescents (aged 10–19 years). Bi-variate analysis, t-test, ANOVA, and ordered probit regression were employed for statistical analysis (N = 8,363). The ordered probit model demonstrated significant associations with higher depression among older adolescents (coef. = 0.16; 95% CI: 0.09, 0.24), females (coef. = 0.19; 95% CI: 0.13, 0.26), those with higher schooling (coef. = 0.19; 95% CI: 0.05, 0.33), and non-Hindu individuals (coef. = 0.08; 95% CI: 0.01, 0.15). Additionally, depression was notably higher in the richest households (coef. = 0.14; 95% CI: 0.05, 0.23), with high parental interaction (coef. = 0.11; 95% CI: 0.02, 0.21), and high peer interaction (coef. = 0.23; 95% CI: 0.16, 0.31). Conversely, lower depression was linked to good academic performance (coef. = -0.10; 95% CI: −0.18, −0.02), belonging to OBC (coef. = -0.11; 95% CI: −0.18, −0.05), and general (coef. = -0.09; 95% CI: −0.17, −0.01) categories. The study concludes that addressing adolescent depression in UP requires a nuanced approach considering demographic, socio-economic, and interpersonal factors. Interventions should target vulnerable groups while addressing academic stress, promoting positive social interactions, and providing mental health support. Further research is needed to explore underlying mechanisms and develop effective strategies for improving adolescent mental well-being in the region. [ABSTRACT FROM AUTHOR]

Background: One of the challenges in surgery of tumors in motor eloquent areas is the individual risk assessment for postoperative motor disorder. Previously a regression model was developed that permits estimation of the risk prior to surgery based on topographical and neurophysiological data derived from investigation with nTMS (navigated Transcranial Magnetic Stimulation). This study aims to analyze the impact of including additional neurophysiological TMS parameters into the established risk stratification model for motor outcome after brain tumor surgery. Methods: Biometric and clinical data of 170 patients with glioma in motor eloquent areas were collected prospectively. In addition, the following nTMS parameters were collected bihemispherically prior to surgery: resting motor threshold (RMT), recruitment curve (RC), cortical silent period (CSP) and a nTMS based fibertracking to measure the tumor tract distance (TTD). Motor function was quantified by Medical Research Council Scale (MRCS) preoperatively, seven days and three months postoperatively. Association between nTMS parameters and postoperative motor outcome was investigated in bivariate and multivariable analyses. Results: The bivariate analysis confirmed the association of RMT ratio with the postoperative motor outcome after seven days with higher rates of worsening in patients with RMT ratio > 1.1 compared to patients with RMT ratio ≤ 1.1 (31.6% vs. 15.1%, p = 0.009). Similarly, an association between a pathological CSP ratio and a higher risk of new postoperative motor deficits after seven days was observed (35.3% vs. 16.7% worsening, p = 0.025). A pathological RC Ratio was associated postoperative deterioration of motor function after three months (42.9% vs. 16.2% worsening, p = 0.004). In multiple regression analysis, none of these associations were statistically robust. Conclusions: The current results suggest that the RC ratio, CSP ratio and RMT ratio individually are sensitive markers associated with the motor outcome 7 days and 3 months after tumor resection in a presumed motor eloquent location. They can therefore supply valuable information during preoperative risk–benefit-balancing. However, underlying neurophysiological mechanisms might be too similar to make the parameters meaningful in a combined model. [ABSTRACT FROM AUTHOR]

There has been an increasing focus on the interplay between physical frailty and cognitive impairment, as both conditions pose significant risks for life-threatening health complications and are receiving considerable attention in global geriatric health initiatives. A recent consensus introduces "cognitive frailty," denoting the co-existence of physical frailty and cognitive impairment without dementia. This study aims to ascertain the prevalence of cognitive frailty and investigate the factors contributing to gender differentials of cognitive frailty among older adults in India. This study has used the data from the nationally representative survey Longitudinal Ageing Study in India 2017–18. This study included a sample of 13,946 males and 14,989 females aged 60 and above. Descriptive and bivariate analyses were conducted. A proportion test was employed to assess gender disparities and determine the statistical significance of risk factors. Furthermore, multivariate decomposition analysis was performed to identify the extent to which various covariates contribute to explaining the gender differences observed in cognitive frailty. The overall prevalence of cognitive frailty was 4.4%. There was a significant gender difference in cognitive frailty among older adults in India (Difference: 4.3%; p-value < 0.001] with 2.1% (95% CI: 1.8–2.3) older males and 6.4% (95% CI: 6.0-6.8) older females suffering from cognitive frailty. The considerable gender gap in cognitive frailty would be reduced if women had similar levels of education (37% reduction) than men. Results highlight that increasing age, being a woman (AOR: 1.61; 95% CI: 1.33–1.95), out-of-wedlock, less education and non-working status (AOR:2.19; 95% CI: 1.71–2.80) were significantly associated with cognitive frailty. Poor nutritional status, and depression are also prone among the cognitively frail participants. Gender sensitive interventions improving education access for women are crucial. Developing countries like India urgently require a multidimensional approach to ensure appropriate and comprehensive healthcare for the elderly population. [ABSTRACT FROM AUTHOR]

Background and aim Methods Findings Conclusion In 2018, the country of Georgia legalized cannabis for recreational use and decriminalized limited possession. This study aimed to assess whether cannabis use increased among young adults (ages 18–29 years) in Georgia after national policy changes and to evaluate whether perceived access became easier after legalization and current risk factors of young adult cannabis use.We used data from the Georgian nationally representative survey administered in 2015 (n = 1308) and 2022 (n = 758), before and after decriminalization. We performed appropriate bivariate analyses and multivariable linear and logistic regressions to assess the following: legalization's impact on cannabis use; perceived difficulty to obtain cannabis; age of first use; differences in use between females and males; and factors associated with current use.Among young adults lifetime prevalence of cannabis use was similar in 2015 (17.3%) and 2022 (18.1%) [Odds Ratio (95% confidence interval) = 1.1 [0.7, 1.6], P = 0.726). Annual prevalence (7% in 2015 vs 7.7% in 2022) was also similar (1.1 [0.7, 2.0], P = 0.650). In 2022 it was less difficult to obtain cannabis than in 2015 (0.5 [0.4, 0.8], P = 0.021). The age of first use increased statistically significantly (18.1 years in 2015 vs 19.1 in 2022, P = 0.003).In 2022, annual prevalence of use was lower among females (1.9% vs 13.1%; OR = 0.1 [0.0, 0.3], P < 0.0001) and higher among those who gambled (11.7% vs 4.4%; OR = 3.2 [1.5, 6.8], P < 0.003). Males initiated cannabis use at an earlier age (19.1 years vs 20.6 for females, P = 0.03), and could obtain cannabis easier than females (P < 0.0001).There was a minimal shift of cannabis use in young adults following implementation of recreational cannabis use legalization in Georgia. Males and people who gambled were at higher risk of cannabis use. [ABSTRACT FROM AUTHOR]

Background: This study analyzed weaning characteristics and assessed the association of clinical and ultrasonographic indices—maximum inspiratory pressure (MIP), rapid shallow breathing index (RSBI), peak flow expiratory (PFE), diaphragm-thickening fraction (DTF), diaphragm thickness (DT), diaphragm excursion (DE), diaphragm-RSBI (D-RSBI), and lung ultrasound (LUS) patterns—with weaning failure. Methods: This retrospective cohort study included critically ill COVID-19 patients aged 18 and older who had been on invasive mechanical ventilation for at least 48 h and undergoing weaning. Exclusion criteria included absence of ultrasound assessments, neuromuscular diseases, and chronic cardio-respiratory dysfunction. Results: Among 61 patients, 44.3% experienced weaning failure, 27.9% failed the spontaneous breathing trial (SBT), 16.4% were re-intubated within 48 h, and 28% required tracheostomy. Weaning failure was associated with prolonged ventilation (29 vs. 7 days, p < 0.001), extended oxygen therapy, longer ICU stays, and higher ICU mortality. These patients had higher pressure support, lower oxygenation levels, a higher RSBI, and a lower MIP. While PEF, DTF, DE, and D-RSBI showed no significant differences, both right and left diaphragm thicknesses and the inspiratory thickness of the left diaphragm were reduced in failure cases. LUS scores were significantly higher before and after SBT in the failure group. Bivariate analysis identified RSBI [OR = 1.04 (95% CI = 1.01–1.07), p = 0.010], MIP [OR = 0.92 (95% CI = 0.86–0.99), p = 0.018], and LUS [OR = 1.15 (95% CI = 0.98–1.35), p = 0.025] as predictors of weaning failure; however, these associations were not confirmed in multivariate analysis. Conclusions: Ultrasound provides supplementary information during weaning, but no definitive association between ultrasound indices and weaning failure was confirmed in this study. [ABSTRACT FROM AUTHOR]

Objective: Retention to complete follow-up surveys in extensive longitudinal epidemiological cohort studies is vital yet challenging. All of Us developed pilot interventions to improve response rates for follow-up surveys. Study design and setting: The pilot interventions occurred from April 27, 2020, to August 3, 2020. The three arms were: (1) telephone appointment [staff members calling participants offering appointments to complete surveys over phone] (2) postal [mail reminder to complete surveys through U.S. Postal Service], and (3) combination of telephone appointment and postal. Controls received digital-only reminders [program-level digital recontact via email or through the participant portal]. Study sites chose their study arm and participants were not randomized. Results: A total of 50 sites piloted interventions with 17,593 participants, while 47,832 participants comprised controls during the same period. Of all participants, 6,828 (10.4%) completed any follow-up surveys (1448: telephone; 522: postal; 486: combination; 4372: controls). Follow-up survey completions were 24% higher in the telephone appointment arm than in controls in bivariate analyses. When controlling for confounders, telephone appointment and combination arms increased rates of completion similarly compared to controls, while the postal arm had no significant effect (odds ratio [95% Confidence Interval], telephone appointment:2.01[1.81–2.23]; combination:1.91[1.66–2.20]; postal:0.92[0.79–1.07]). Although the effects of the telephone appointment and combination arms were similar, differential effects were observed across sub-populations. Conclusion: Telephone appointments appeared to be the most successful intervention in our study. Lessons learned about retention interventions, and improvement in follow-up survey completion rates provide generalizable knowledge for similar cohort studies and demonstrate the potential value of precision reminders and engagement with sub-populations of a cohort. [ABSTRACT FROM AUTHOR]

Background: Candidemia is an invasive mycosis with an increasing global incidence and high mortality rates in cancer patients. The production of biofilms by some strains of Candida constitutes a mechanism that limits the action of antifungal agents; however, there is limited and conflicting evidence about its role in the risk of death. This study aimed to determine whether biofilm formation is associated with mortality in cancer patients with candidemia. Methods: This retrospective cohort study included patients treated at Peru's oncologic reference center between June 2015 and October 2017. Data were collected by monitoring patients for 30 days from the diagnosis of candidemia until the date of death or hospital discharge. Statistical analyses evaluated the association between biofilm production determined by XTT reduction and mortality, adjusting for demographic, clinical, and microbiological factors assessed by the hospital routinary activities. Survival analysis and bivariate and multivariate Cox regression were used, estimating the hazard ratio (HR) as a measure of association with a significance level of p < 0.05. Results: A total of 140 patients with candidemia were included in the study. The high mortality observed on the first day of post-diagnosis follow-up (81.0%) among 21 patients who were not treated with either antifungal or antimicrobial drugs led to stratification of the analyses according to whether they received treatment. In untreated patients, there was a mortality gradient in patients infected with non-biofilm-forming strains vs. low/medium and high-level biofilm-forming strains (25.0%, 66.7% and 82.3%, respectively, p = 0.049). In treated patients, a high level of biofilm formation was associated with increased mortality (HR, 3.92; 95% p = 0.022), and this association persisted after adjusting for age, comorbidities, and hospital emergency admission (HR, 6.59; CI: 1.87–23.24, p = 0.003). Conclusions: The association between candidemia with in vitro biofilm formation and an increased risk of death consistently observed both in patients with and without treatment, provides another level of evidence for a possible causal association. The presence of comorbidities and the origin of the hospital emergency, which reflect the fragile clinical condition of the patients, and increasing age above 15 years were associated with a higher risk of death. [ABSTRACT FROM AUTHOR]

This study examined the associations among cardiovascular comorbidities, symptoms of depression and anxiety, and physical activity in persons with multiple sclerosis. Participants with multiple sclerosis (N = 217) completed demographic, cardiovascular comorbidity, depression, and anxiety self-report measures, and wore an accelerometer for 7 days. We examined the bivariate, non-parametric correlations among the variables and conducted parametric, independent samples t-tests when examining the differences in variables based on cardiovascular comorbidity status. Bivariate correlation analysis indicated that there were statistically significant associations between anxiety scores, but not depression scores, and cardiovascular comorbidities. Physical activity, especially moderate-to-vigorous physical activity (MVPA), was correlated with cardiovascular comorbidities. There were small significant differences based on hyperlipidemia status in anxiety scores (p = 0.015, d = -0.42), MVPA (p < 0.001, d = 0.44), and steps/day (p < 0.001, d = 0.50), and based on hypertension status in anxiety scores (p = 0.010, d = -0.35), depression scores (p = 0.046, d = -0.26), MVPA (p = 0.003, d = 0.41), and steps/day (p < 0.001, d = 0.53). The findings indicate that there are significant associations among cardiovascular comorbidities, symptoms of depression and anxiety, and physical activity in persons with multiple sclerosis. Physical activity, specifically MVPA, may be a target for managing those outcomes in persons with multiple sclerosis. [ABSTRACT FROM AUTHOR]

Mass media exposure (MME) plays an important role in changing health-related behavior or decision-making. This study aimed to examine the association of MME with enrollment in health insurance and its moderating effect on the associations of education and wealth with enrollment in health insurance among older adults in India. The data of 29,935 older adults aged 60 years and older from the first wave (baseline) of the Longitudinal Ageing Study in India (LASI-2017/18) were utilized. Descriptive statistics, bivariate analysis, multivariable logistic regression models, and Fairlie decomposition were used. The findings revealed that 18.3% of older adults had MME and enrollment in health insurance in India. Older adults with MME were 1.42 times more likely to be enrolled in health insurance than those with no MME, and years of schooling increased the probability of enrolling in health insurance compared to those who did not have formal schooling. With increasing monthly per capita expenditure (MPCE), the probability of enrolling in health insurance is lower than the poorest. Further, MME moderates the effects of education and MPCE on enrollment in health insurance and increases the likelihood of enrollment in health insurance. The study’s findings imply strategic communication plans to encourage health insurance enrollment in India should take into account the usage of these communication channels. [ABSTRACT FROM AUTHOR]

Background: Malaria affects children under the age of five and pregnant women, leading to high morbidity and mortality rates. In sub-Saharan Africa, Patent and Proprietary Medicine Vendors (PPMVs) have been identified as key players in the provision of malaria treatment due to their accessibility and availability in communities, but PPMVs are not usually tested before fever cases are treated as malaria or refer clients. The aim of this study was to explore the factors influencing caregivers' acceptance of the test, treatment and referral practices for malaria management provided by CPs and PPMVs in Kaduna and Lagos states, Nigeria. Methods: A cross-sectional quantitative telephone survey was conducted among 150 caregivers of children under five years old who received malaria services from trained CPs and PPMVs between May and July 2022. Descriptive and bivariate analyses were performed to identify factors significantly associated with the acceptability of malaria management services. All statistically significant factors from the bivariate analysis were explored using logistic regression models, and odds ratios (ORs) with confidence intervals (CIs) were calculated to predict acceptability. The 95% level was used to define statistically significant associations (p ≤ 0.05). Results: All caregivers were asked questions that aided in obtaining a diagnosis of malaria. More than two-thirds of the caregivers (68%) reported that the child was tested by a CP/PPMV. Among those treated (148), 89% reported that the child was administered artemisinin combination therapy (ACT) irrespective of whether the child tested positive or negative for malaria. At the bivariate level, acceptability was greater among caregivers of children aged 13 months and older than among caregivers of children aged 0–12 months (93% vs. 76%, p = 0.004). Caregivers of children who prescribed ACT had greater acceptance than did those not prescribing ACT (92% vs. 69%, p = 0.010). Multivariate analysis revealed that these relationships held. Conclusions: The adoption of the test, treat, and refer practice as a standard approach by CPs and PPMVs could replace the widespread practice of prescribing medications without conducting tests. This shift has the potential to improve the quality of malaria management services and enhance patient outcomes. [ABSTRACT FROM AUTHOR]

Objective Data Sources and Study Setting Study Design Principal Findings Conclusions To examine whether Medicaid managed care plan (MCP) utilization management policies for buprenorphine–naloxone and injectable naltrexone are related to key state Medicaid program policy decisions.We abstracted data on state Medicaid regulatory and policy information from publicly available sources and publicly available insurance benefit documentation from all 241 Medicaid MCPs operating in 2021.In this cross‐sectional study, we used bivariate and multivariate analyses to examine whether Medicaid MCP prior authorization and quantity limits on receipt of buprenorphine and injectable naltrexone were associated with key state Medicaid choices to leverage federal funds to expand coverage and eligibility (Medicaid expansion, 1115 waivers) and to regulate Medicaid MCPs (uniform preferred drug lists, medical loss ratio remittance). Models were adjusted for MCP characteristics, including profit status, behavioral health contracting arrangement, National Committee for Quality Assurance accreditation, size, market share, and state opioid overdose death rates. Average marginal effects (AME) were reported.Utilization management was common among MCPs, and restrictions were more commonly applied to buprenorphine than injectable naltrexone, despite its higher cost. States that required MCPs to comply with utilization management policies stipulated in a uniform preferred drug list were more likely to require prior authorization for buprenorphine (AME: 0.29, 95% CI: 0.15–0.42) and injectable naltrexone (AME: 0.25, 95% CI: 0.12–0.38). MCPs in states that required plans to pay back earnings above a certain threshold were less likely to require prior authorization for buprenorphine (AME: −0.30, 95% CI: −0.43 to −0.18).Restrictions on medications for opioid use disorder are widespread among MCPs and vary by medication. State Medicaid regulatory and policy characteristics were strongly linked to MCPs' utilization management approaches. State Medicaid policy and contracting approaches may be levers to eliminate utilization management restrictions on medications for opioid use disorder. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusion Sexual assault is pervasive in today's society, with the numbers of those reporting it increasing. In Ireland, 50% of women will experience some form of sexual violence in their lifetime. We sought to describe the incident details of females presenting to the Sexual Assault Treatment Unit (SATU) network in the Republic of Ireland and to determine associations between incident characteristics and: (1) victim age, (2) presence of injury, (3) victim‐perpetrator relationship, and (4) number of assailants.This was a retrospective cross‐sectional study of all females who attended between 2017 and 2023. Descriptive bivariate analysis was performed.There were 5942 female attendances, with an average age of 26 years. The largest age group was women between 18 and 25 years (38.1%, n = 2263). Forensic examinations were performed in 76.6% (n = 4549). Assailants were male in 92% (n = 5469) of incidents, with multiple assailants disclosed in 7.3% (n = 435). Strangers or recent acquaintances were the assailant in 38.5% (n = 2290) of incidents, and close associates in 22.9% (n = 1359). Incidents occurred at the survivor's home in 22% (n = 1306) of incidents, and in the assailant's home in 22.6% (n = 1342). Drug use within 24 h was reported in 15.1% (n = 897) of cases, and alcohol use in 72% (n = 4276). Drug‐facilitated assault was suspected by 16.1% (n = 955). Injuries (genital and extra‐genital) occurred in 30.3% (n = 1800) of attendances and were more likely to be seen in those who disclosed ingesting alcohol (Relative risk [RR] 1.325, P < 0.001) or drugs (RR 1.111, P = 0.04) in the 24 h preceding the incident, in those who presented within 24 h (RR 1.646, P < 0.001), those aged 18 years or older (RR 1.07, P = 0.003), and those where the incident occurred outdoors (RR 1.24, P < 0.001).This study, one of the largest on female attendances to a national SATU network, offers detailed insights into demographics, incident details, and circumstances. Most were young women, mainly 18 years and older, many of whom were full‐time students. Forensic examinations were the primary reason for attendance, underscoring the network's key role in evidence collection. The study also identified factors linked to a higher risk of injury detection, such as immediate post‐incident attendance, being over 18, outdoor incidents, perpetration by a stranger, and prior alcohol or drug use. [ABSTRACT FROM AUTHOR]

Pornography has become increasingly prevalent and normalized within society, raising questions about how today’s adolescents might differ in their responses to and attitudes toward pornography compared to earlier generations. This study begins to fill this gap by comparing cross-sectional data from two cohorts of high school students in Sweden in 2004 (n  = 4,266, mean age = 18.15, SD  = 0.74, 53.9% girls) and 2020–21 (n  = 3,256, mean age = 18.20, SD  = 0.61, 55.4% girls). Gender-stratified bivariate analyses and logistic regression models were performed to examine the impact of survey year on outcomes. Results reveal an increase in frequent pornography use among both genders and a narrowing of the gender gap in responses and attitudes by 2020–21. Boys reported decreased arousal responses, fewer positive emotional responses, and were less inclined to imitate the behaviors seen in pornography. Girls were less averse to and upset by the pornography they encountered. Both genders became more tolerant of pornography, yet more critical of its purported benefits. Notable gender differences remain, especially with girls being more likely to recognize pornography as degrading and exploitative. These findings underscore the need for educational strategies that foster critical understandings of pornography and its societal impact. [ABSTRACT FROM AUTHOR]

BACKGROUND: Human milk oligosaccharide (HMO) is a unique component of breastmilk. To date, no study has investigated the correlation between HMO and infant nutritional status particularly through the lens of gut microbiota. Therefore, our study aims to investigate the relationships between 2'-Fucosyllactose (2'-FL) in HMO and Firmicutes/Bacteroidetes (F/B) ratio among stunted infants. METHODS: A case-control study was conducted among 103 mother-infant pairs in Malang City, Indonesia. The quantification of 2'-FL HMO was assessed using High-Performance Liquid Chromatography (HPLC). The F/B ratio was analyzed with real-time poly-chain reaction (RT-PCR). For bivariate analysis, we employed the Spearman correlation and Mann--Whitney tests, while for multivariate analysis, we utilized multiple linear regression. RESULTS: The findings showed that the stunted nutritional status was detected in 49 out of 103 infants. In this group, 40.81% of mothers of infants with a stunted nutritional status had a secretor-positive status, while all mothers of infants with appropriate nutritional status tested positive for the secretor status (100%). However, the association between maternal secretor status and infant nutritional status was not statistically significant (p>0.05). The average levels of 2'-FL HMO in breast milk were lower in the group with stunted infants compared to non-stunted infants (1.21 mg/L vs 1.40 mg/L). The regression analysis revealed a significant association of 2'-FL HMO levels with the presence of Bacteroidetes and value of the F/B ratio (p>0.05). CONCLUSIONS: The breast milk component 2'-FL HMO significantly influences the gut microbiota of stunted infants. Future research aimed at elucidating the mechanisms by which 2'-FL HMO modulates infant gut microbiota should consider not only concentration and specific bacterial taxa but also intake levels [ABSTRACT FROM AUTHOR]

In this study, we consider the objective Bayesian analysis for the ratio of means in the bivariate lognormal distribution, in which properly assigning priors for the ratio of means is challenging due to the presence of nuisance parameters. As a result, we create probability matching priors and reference priors for the ratio of means. Jeffreys' prior and the two group reference prior do not satisfy a first-order matching criterion. We also investigate the posterior distribution property for the general prior class, which includes Jeffreys' prior, the reference prior, and the matching prior. Through a simulation study, we check the frequentist coverage probabilities and compare them with the generalized confidence interval method. It demonstrated that the proposed probability matching priors match very well with the target coverage probabilities even when the sample sizes are small in a frequentist sense. Two real examples are also provided. [ABSTRACT FROM AUTHOR]

Subjects with initially extreme observations upon remeasurement are found closer to the population mean. This tendency of observations toward the mean is called regression to the mean (RTM) and can make natural variation in repeated data look like real change. Studies, where subjects are selected on a baseline criterion, should be guarded against the RTM effect to avoid erroneous conclusions. In an intervention study, the difference between pre-post variables is the combined effect of intervention/treatment and RTM. Thus, accounting for RTM is essential to accurately estimate the intervention effect. Many real-life examples are better modeled by a bivariate binomial model with varying probability of success. In this article, a bivariate beta-binomial distribution is used that allows the probability of success to vary from subject to subject. Expressions for the total, RTM, and treatment effect are derived, and their behavior is demonstrated graphically. Maximum likelihood estimators of RTM are derived, and their statistical properties are studied via Monte Carlo simulation. The proposed techniques are employed to estimate the RTM effect by utilizing data related to the Countway WM-class circulation. [ABSTRACT FROM AUTHOR]

Background: Lower respiratory tract infections (LRTIs) are a significant cause of primary care consultations. Differentiating between viral and bacterial infections is critical for effective treatment and to minimize unnecessary antibiotic use. This study investigates the impact of combining lung ultrasound (LUS) with capillary blood C-reactive protein (CRP) rapid testing on clinical decision-making for patients with LRTIs. Objectives: The primary objective is to assess how the integration of CRP testing and LUS influences antibiotic prescription decisions. The study aims to quantify the percentage change in antibiotic prescriptions before and after performing LUS, following history taking, clinical examination, and CRP testing. Methods: This analytical observational study will be conducted in six primary care centers within the Health Region of Lleida, Catalonia, serving a mixed urban and rural population of approximately 105,000 residents. The study will recruit 196 patients aged 18 and over, presenting with LRTI symptoms and not treated with antibiotics in the preceding 14 days. Participants will undergo CRP testing followed by LUS during their consultation. Statistical analyses, including linear regression, bivariate analysis, Pearson or Spearman correlation, and logistic regression, will be used to evaluate the impact of LUS on clinical decisions and its predictive value in diagnosing bacterial infections. Results and Conclusions: This study will provide insights into the role of LUS combined with CRP testing in improving diagnostic accuracy and guiding antibiotic prescription decisions in primary care. The findings aim to enhance treatment protocols for LRTIs, reducing unnecessary antibiotic use and improving patient outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Various classifications for osteoporotic vertebral fractures (OVFs) have been introduced to enhance patient care and facilitate clinical communication. However, there is limited evidence of their effectiveness in predicting vertebral collapse, and very few studies have compared this association across different classification systems. This study aims to investigate the association between OVF categories, according to the most widely used classification systems, and vertebral collapse. Patients and Methods: A retrospective single-center study was conducted involving patients diagnosed with acute OVFs at the emergency department of a tertiary-level academic hospital with a minimum follow-up of 6 months. Vertebral fractures were independently classified by two radiologists according to several classification systems, including those proposed by Genant, Sugita, the German Society for Orthopedics and Trauma (DGOU), and the AO Spine. Associations between vertebral collapse and OVF classification systems were analyzed using bivariate and logistic regression analyses. Results: This study included 208 patients (82.7% females; mean age of 72.6 ± 9.2 years). The median follow-up time was 15 months, with L1 being the most common fracture site (47.6%). The most frequent OVF types observed, according to Genant's morphological, Genant's quantitative, Sugita 's, DGOU's, and AO Spine's classifications, were biconcave (50%), grade 0.5 (47.6%), bow-shaped (61.5%), OF2 (74%), and A1 (61.5%), respectively. All classifications, except for Genant's quantitative system, were significantly associated with vertebral collapse in bivariate analyses. Logistic regression analyses showed a significant association (p = 0.002) between the AO Spine classification and vertebral collapse, with 85.7% of A4 fractures developing collapse on follow-up. Conclusions: The AO Spine classification showed the highest predictive capacity for vertebral collapse. Specifically, A4 fracture types showed a very high risk of vertebral collapse, confirming the need for non-conservative management of these fractures. Further multicentric and prospective studies are warranted to confirm these findings. [ABSTRACT FROM AUTHOR]

Chronic insufficient and poor-quality sleep are linked to hypertension, diabetes, depression, heart attack, and stroke. While studies on substance use and sleep typically focus on people in or entering treatment, there is a lack of research on sleep health among community-recruited people who inject drugs (PWID). To address this literature gap, we examined factors associated with insufficient and poor-quality sleep among community-recruited PWID. We recruited and interviewed 472 active opioid-using PWID (injected within the last 30 days) in Los Angeles, CA and Denver, CO between 2021 and 2022. Participants completed computer-assisted interviews covering demographics, subsistence measures, drug use patterns, injection-related behaviors, health risks, and sleep duration and quality in the last 3 months. Descriptive statistics were used to analyze all variables for subjects with complete responses to sleep items (n = 464). Bivariate analyses determined factors associated with sleep measures using chi-square and t-tests. Collinear variables were removed, and binomial linear multivariable regression calculated risk ratios (RR) for insufficient and poor-quality sleep in the last 3 months. Participants exhibited low sleep duration (mean = 4.99, standard deviation (SD) = 2.70), with 76% reporting insufficient sleep and 62% poor-quality sleep. Bivariate analyses associated both sleep measures with drug use, high subsistence scores, violent victimization, and poor health outcomes. Multivariable analyses showed a high subsistence score predicting insufficient (RR = 1.31) and poor-quality sleep (RR = 1.69) compared to low subsistence. Poor sleep health is common among structurally vulnerable community-recruited PWID, as measured by subsistence index associated with adverse sleep outcomes. Further research on structural interventions to address sleep and subsequent health outcomes among PWID is imperative. [ABSTRACT FROM AUTHOR]

Background: Respiratory viruses have clinical and epidemiological importance. With the COVID-19 pandemic, interest has focused on SARS-CoV-2, but as a result, the number of samples available for the differential diagnosis of other respiratory viruses has increased. Study design: Cross-sectional study. Objective: To describe the epidemiological behavior of respiratory viruses based on a laboratory-based epidemiological surveillance system using data from 2017 to 2023. Methods: Univariate, bivariate and multivariate analyses of data from a laboratory database of respiratory viruses detected by multiplex RT‒qPCR were performed. Results: A total of 4,632 samples with positive results for at least 1 respiratory virus, not including influenza or SARS-CoV-2, were analyzed. The most common virus detected was respiratory syncytial virus in 1,467 (26.3%) samples, followed by rhinovirus in 1,384 (24.8%) samples. Most of the samples were from children under 5 years of age. The age-adjusted odds ratio (OR) of death for patients infected with parainfluenza virus 4 was 4.1 (95% confidence interval [95% CI] 2.0–8.2). Conclusion: Respiratory syncytial virus and rhinovirus had the highest frequency and proportion of coinfections, whereas parainfluenza virus 4 was associated with an increased risk of death. [ABSTRACT FROM AUTHOR]

To date, despite the many recognised benefits of participation in sport, many older people do not participate in it. This study explored the opinions about barriers to participating in sport among non-active older people from the perspective of 463 senior athletes (M = 61.4, SD = 5.5 years) engaged in competitive sports. Participants completed a questionnaire including an incomplete sentence regarding the reason why many older people do not play sports. We analysed their answers using content analysis and performed bivariate analyses to determine possible associations with the sociodemographic and participatory characteristics of the sample. The results highlighted a range of perceived barriers which mostly related to past and present opportunities, and contained significant variations according to age, country of residence, and years participating in sports. These findings contribute to a better understanding of the way in which senior athletes perceive the barriers for the initiation of non-active older people in sports participation which could inform potential measures to promote greater participation in sport as a meaningful leisure activity among this age group. [ABSTRACT FROM AUTHOR]

To determine if perioperative administration of dexmedetomidine affects postoperative fluid intake in tonsillectomy patients. A retrospective chart review was performed at University Medical Center, Texas Tech Health Science Center, Lubbock, Texas. The study identified 534 patients within the last five years who met the criteria. Common indications for the surgeries included recurrent tonsillitis, obstructive sleep apnea, and sleep disordered breathing. Patients with concurrent peritonsillar abscess drainage, microlaryngoscopy, bronchoscopy, supraglottoplasty, and other procedures that may impact fluid intake were excluded. The relationship between dexmedetomidine and fluid intake was evaluated using bivariate analysis as well as multivariable regression to account for possible confounders such as age, concurrent medication, surgery type, and method of surgery using STATA statistical software, version 17.0 (StataCorp LLC, College Station, TX). Administration of dexmedetomidine did not significantly impact the amount of fluid intake, fluid intake per kilogram per hour, or average postoperative pain levels in patients who underwent tonsillectomy or adenotonsillectomy in the bivariate analysis (p = 0.217, 0.489, 0.512 respectively) and multiple regression model (p = 0.156, 0.802, 0.795) Dexmedetomidine does not negatively influence postoperative fluid intake levels in patients and should continue to be utilized in appropriately selected patients experiencing anxiety or agitation prior to surgery. [ABSTRACT FROM AUTHOR]

Parents of children with cancer provide paediatric palliative care (PPC). However, the activities they perform remain underexplored, especially in low- and middle-income countries (LMICs) where the care heavily relies on family involvement. The aim of this study is to identify parental PPC tasks and intentions to perform PPC tasks and to determine their associated factors. A quantitative cross-sectional descriptive design was used to recruit parents of children with cancer from three major paediatric oncology centres in Lebanon. Data were collected through structured interviews using an adapted questionnaire. The statistical analyses included descriptive, bivariate and regression analyses of PPC tasks and intentions. One hundred and five participants completed the study. On average, parents performed 22 PPC activities. The findings suggested statistically significant associations of the number of PPC tasks with the participants' marital status, number of people living with the child, the intentions to perform the tasks and the number of the child's symptoms in the previous week. Examining parents' tasks in PPC in LMICs, such as Lebanon, enhances knowledge of PPC practice in these regions and informs improvement strategies. These results promote PPC understanding, highlight factors influencing PPC delivery and provide a useful measure of PPC tasks performed by parents of children with cancer. [ABSTRACT FROM AUTHOR]