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Objective: Micronutrient status, specifically vitamin D and iron, represent modifiable factors for optimizing military readiness. The primary purpose of this investigation was to determine associations between micronutrient deficiency (i.e., iron status and 25-hydroxy-vitamin D [25(OH)D]) and operationally relevant outcomes (i.e., skeletal health, musculoskeletal injury) at baseline and post-10 weeks of arduous military training. Methods: A total of 227 (177 men, 50 women) Marine Officer Candidates School (OCS) candidates who completed OCS training with complete data sets were included in this analysis. Vitamin D and iron status indicators were collected at two timepoints, pre (baseline) and post OCS. Musculoskeletal outcomes at the mid- and proximal tibial diaphysis were assessed via peripheral quantitative computed tomography. Results: Micronutrient status declined following OCS training in men and women and was associated with musculoskeletal outcomes including greater bone strength (strength strain index) at the mid-diaphysis site in those with optimal status (M = 38.26 mm3, SE = 15.59) versus those without (M = −8.03 mm3, SE = 17.27). In women (p =.037), endosteal circumference was greater in the deficient group (M = 53.26 mm, SE = 1.19) compared with the optimal group (M = 49.47 mm, SE = 1.31) at the proximal diaphysis. In men, greater baseline hepcidin concentrations were associated with an increased likelihood of suffering musculoskeletal injury during training. Conclusions: Vitamin D and iron status declined over the course of training, suggesting impaired micronutrient status. Differences in musculoskeletal outcomes by micronutrient group suggests optimal vitamin D and ferritin concentrations may exert beneficial effects on bone fatigability and fracture reduction during military training. [ABSTRACT FROM AUTHOR]

Purpose: To investigate temporomandibular disorder (TMD) prevalence as well as potential TMD risk factors among postgraduate students. Materials and Methods: In this cross-sectional and correlation study, 1,255 postgraduate students from different universities were recruited to answer Fonseca's Anamnestic Index (FAI) in addition to collected demographic data and relevant dental history. FAI was used to classify TMD severity. Of the 1,255 participants included, 593 had previous clinical/radiographic TMD reports. Chi-square and Fisher exact tests investigated the relation between each predictor and TMD at P = .05. A logistic binary regression analysis examined the model fit using -2Log likelihood and Pseudo R2 tests at P = .05. Results: Based on previous clinical/radiographic reports and FAI, 73.4% of the participants had TMDs, of whom 57% had mild dysfunction, followed by moderate (31.7%) and severe (11.3%). There was a statistically significant association between sex, depression, lip/object biting, and clenching with TMDs (P < .001), where women were 2.302 times more likely to develop TMDs than men. The combination of lip biting and clenching in women dramatically increased the risk of TMDs (-2Log Likelihood = 385.7, P < .001 and a Cox and Snell value = 0.315 and a Nagelkerke value = 0.395). Conclusions: TMDs seem to be highly prevalent among postgraduate students in Egypt, and female postgraduate students who bite their lips or grind their teeth are particularly highly prone to the condition. Object biting and depression could also be considered risk factors. [ABSTRACT FROM AUTHOR]

The primary aim of this study was to evaluate the efficacy of alveolar ridge preservation (ARP) therapy compared with unassisted socket healing (USH) in attenuating interproximal soft tissue atrophy. Adult patients who underwent maxillary single-tooth extraction with or without ARP therapy were included. Surface scans were obtained and CBCT was performed to digitally assess interproximal soft tissue height changes and measure facial bone thickness (FBT), respectively. Logistic regression models were conducted to investigate the individual effect of demographic and clinical variables. Ninety -six subjects (USH = 49; ARP = 47) constituted the study population. Linear soft tissue assessments revealed a significant reduction of the interproximal soft tissue over time within and between groups (P < .0001). ARP therapy significantly attenuated interproximal soft tissue height reduction compared to USH: -2.0 ± 0.9 mm mesially for USH vs -1.0 ± 0.5 mm mesially for ARP; -1.9 ± 0.7 mm distally for USH vs -1.1 ± 0.5 mm distally for ARP (P < .0001). Thin (< 1 mm) facial bone thickness (FBT) upon extraction was associated with greater interproximal soft tissue atrophy compared to thick FBT (> 1 mm), independent of the treatment received (P < .0001). Nevertheless, ARP therapy resulted in better preservation of interproximal soft tissue height, especially in thin bone phenotype, by a factor of 2 for the mesial site (+1.3 mm) and by a factor of 1.6 for the distal site (+0.9 mm). This study demonstrated that ARP therapy largely attenuates interproximal soft tissue dimensional reduction after maxillary single-tooth extraction compared to USH. [ABSTRACT FROM AUTHOR]

Introduction: Unlike the most common training approaches for bodybuilding, powerlifting programs are generally based on maximum and submaximal loads, putting enormous stresses on the lumbar spine. The flexion relaxation phenomenon evaluation is a clinical tool used for low back pain (LBP) assessment. This study aimed to evaluate the role of the flexion relaxation phenomenon in the analysis of LBP in the powerlifters. Methods: Healthy professional powerlifters participated in the study. In fact, we divided the participants into a LBP-low-risk group and a LBP-high-risk group, based on a prior history of LBP. Outcome measures included flexion relaxation ratio (FRR) and trough surface electromyography collected during trunk maximum voluntary flexion; furthermore, during a bench press lifting, we measured the height of the arched back (ARCH), using a camera and the Kinovea video editing software, to consider a potential correlation with the risk of LBP. Results: We included a group of 18 male (aged 24–39 y) powerlifters of 93 kg category. We measured a nonsignificant mean difference of ARCH between low-risk LBP group and high-risk LBP subjects. Curiously, maximum voluntary flexions were both above the threshold of 3.2 μV; therefore, with an absence of appropriate myoelectric silence, on the contrary, the FRR ratios were higher than 9.5, considering the presence of the phenomenon, exclusively for the low-risk group. The lumbar arched back measurement data did not report any association with the LBP risk, regarding the maximum voluntary flexion value, and even more than the FRR there is a relationship with the presence or the absence of LBP risk. Conclusions: FRR could be considered as a useful parameter for studying the risk of LBP in powerlifting. The FRR index not only refers to the possible myoelectric silence of the lumbar muscles in trunk maximum forward flexion but also takes into account the energy value delivered by the lumbar muscles during the flexion. Furthermore, we can indicate that the size of the powerlifter ARCH may not be a determining factor in the occurrence of LBP. [ABSTRACT FROM AUTHOR]

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]

Purpose: This study aimed to investigate the peak performance characteristics of the world top-8 swimmers and the key factors involved in the journey toward achieving better peak performance. Methods: The results of the world top-8 swimmers from 2001 to 2022 were collected from the World Aquatics performance database. Progression to peak performance was tracked with individual quadratic trajectories (1191 cases). Utilizing k-means clustering to group competitive feature variables, this study investigated key developmental factors through a binary logistic regression model, using the odds ratio (OR) to represent whether a factor was favorable (OR > 1) or unfavorable (OR < 1). Results: Significant differences (P <.001) in the peak age between men (23.54/3.80) and women (22.31/4.60) were noticed, while no significant differences (P >.05) in the peak-performance window for both sexes appeared. Peak performance occurred at later ages for the sprint for both sexes, and women had a longer duration in peak-performance window for sprint (P <.05). Peak-performance occurred at later ages for the breaststroke and butterfly for both sexes (P <.05). Binary logistic regression revealed that high first-participation performance (OR = 1.502), high major-competition performance (OR = 4.165), early first-major-competition age (OR = 1.441), participation frequency above 4 times/year in both phase 2 (4.3–8.0 times/y, OR = 3.940; 8.1–20.0 times/y, OR = 5.122) and phase 3 (4.1–7.5 times/y: OR = 5.548; 7.7–15.0 times/y: OR = 7.526), and a career length of 10 years or more (10–15 y, OR = 2.102; 16–31 y, OR = 3.480) were favorable factors for achieving better peak performance. Conclusions: Peak performance characteristics varied across sex, swimming stroke, and race distance in the world top-8 swimmers. Meanwhile, the research indicated that certain specific developmental factors were key conditions for the world top-8 swimmers to achieve better peak performance in the future. [ABSTRACT FROM AUTHOR]

Objective: The goal was to identify the lifestyle risk factors associated with benign and potentially malignant oral disorders. Method and materials: The study enrolled first-time patients from the Oral Pathology Section, volunteers from Oviedo, and first-time patients from the University of Oviedo dental clinic. Patients underwent a survey that included sociodemographic information, lifestyle habits, and medical history. A comprehensive examination of the oral mucosa was conducted. Univariate and multivariate logistic regression were conducted using R software. Results: Among the 183 participants, the most prevalent lesions were varicose veins (43.20%), cheek/lip biting (34.97%), and coated tongue (33.33%). Among the oral potentially malignant disorders (16.39%) were oral lichen planus (12.64%) and leukoplakia (3.33%). Tobacco was associated with melanotic pigmentation (OR 3.87, P = .001) and coated tongue (OR 5.90, P = .001). Longer intervals since the last check-up were associated with traumatic keratosis (OR 2.95, P = .031). Age and heavy smoking were found to have higher risk of developing an oral potentially malignant disorder (OR 1.04, P = .035, and OR 7.35, P = .028, respectively). Conclusions: These data should be considered when organizing public health programs focused on the detection and screening of heavy smokers. It is also important to strengthen the oral pathology units in universities as reference centers for students to acquire the necessary knowledge for their diagnosis and treatment, while simultaneously promoting awareness of this risk factor for oral precancer among the general population. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the clinical effectiveness of regenerative treatment of intrabony defects in combination with consecutive orthodontic therapy with clear aligners in stage IV (type 2) periodontitis. Method and materials: Ten patients with a total of 103 intrabony defects were analyzed after regenerative surgery using collagen-deproteinized bovine bone mineral with or without collagen membrane or enamel matrix derivative followed by orthodontic therapy with clear aligners. Changes in radiographic bone level and probing pocket depths were evaluated after 1 year (T1) and at final splinting (T2) after orthodontic tooth movement. Results: Mean radiographic bone level gain was significant, with 2.13 ± 1.64 mm at T1 and 3.02 ± 2.00 mm at T2. Mean probing pocket depth was significantly reduced from 5.40 ± 1.80 mm at baseline to 3.78 ± 1.73 mm at T1, and remained stable with 3.73 ± 1.70 mm at T2. Pocket closure (≤ 4 mm probing pocket depth) was accomplished in 76% of all defects. Tooth loss amounted to 2.9%. Conclusion: Within the limitations of the retrospective study design, the findings suggest that the interdisciplinary treatment of periodontitis stage IV by regenerative periodontal surgery and consecutive orthodontic therapy with clear aligners can lead to favorable results. [ABSTRACT FROM AUTHOR]

Women are more likely than men to be targets of incivility in the workplace. Scholars have referred to this pattern as selective incivility and suggest that incivility directed toward women—that is, selective incivility—is a form of modern sexism in the workplace. However, it remains unclear whether women themselves make sense of incivility from men as a form of gender bias, and when such perceptions shape whether women engage in unique responses to incivility perceived as selective. Drawing on social identity theory, we develop a conceptual model to better understand these relationships. Across two studies with working women, we show that women perceive male‐instigated incivility as selective. Further, our findings show that women are more likely to engage in problem‐focused‐responses (i.e., direct confrontation and formal reporting), rather than emotion‐focused responses (i.e., avoidance) in response to incivility perceived as selective and that these coping responses are, at times, moderated by the frequency of incivility. Overall, our research advances the literature on incivility, selective incivility, and gender bias at work, offers practical implications for managers seeking to foster workplace inclusion, and suggests novel directions for future research. [ABSTRACT FROM AUTHOR]

Background: Monitoring survey methods, as well as movement recommendations, evolves over time. These changes can make trend observations over time difficult. The aim of this study was to examine the differences between 2 computer-assisted survey administration methods and the effect of the omission of the 10-minute minimum bout requirement in physical activity (PA) questions on PA outcomes. Methods: We used data from the second Austrian PA Surveillance System for 2998 adults (18–64 y), applying computer-assisted personal interviewing and computer-assisted web interviewing. Within the computer-assisted web interviewing sample only, we added PA questions without the 10-minute requirement. Quantile and logistic regressions were applied. Results: Between computer-assisted web interviewing and computer-assisted personal interviewing, within the computer-assisted personal interviewing sample, we found lower PA estimates in the leisure domain and work and household domain, but not in the travel domain, and no significant difference in the proportion of people meeting the PA recommendations. In all 3 PA domains, the median minutes did not differ when assessed with or without the 10-minute requirement. However, the percentage participation in the travel domain and work and household domain performing >0 minutes per week PA was higher when there was no 10-minute requirement. The proportion of people meeting the Austrian aerobic recommendation for adults when computed with or without the 10-minute requirement did not differ. Conclusion: Our findings suggest that the omission of the 10-minute requirement does not seem to result in marked differences in PA estimates or the proportion of adults meeting the recommendations. [ABSTRACT FROM AUTHOR]

Background: The current physical activity guidelines recommend engagement in strength activities at least 2 days per week. Currently, there is a lack of literature examining strength activities among people with disabilities. The purpose of this study is to estimate and compare the prevalence of engagement in strength activities and adherence to strength activity guidelines among adults with and without disabilities in the United States. Methods: A total of 1,005,644 adults (18–80 y old) with and without disabilities from the 2013 to 2017 Behavioral Risk Factor Surveillance System were included in this secondary data analysis. Descriptive analyses were performed to describe the prevalence of strength activity behaviors of adults with and without disabilities. Logistic and Poisson regression models were performed to evaluate the relative contribution of disability status on strength activity behaviors. Results: A higher proportion of participants without disabilities (46.42%, 95% CI, 46.18–46.65) reported engaging in strength activities compared with participants with disabilities (30.68%, 95% CI, 30.29–31.08; P <.01). Participants with disabilities were less likely to engage in strength activities (odds ratio = 0.51, 95% CI, 0.50–0.52; adjusted odds ratio = 0.75, 95% CI, 0.73–0.77) and meet strength activity guidelines (odds ratio = 0.56, 95% CI, 0.54–0.57; adjusted odds ratio = 0.75, 95% CI, 0.73–0.77) than participants without disabilities. Conclusion: Experiencing a disability is associated with lower engagement in strength activities; thus, it is important to identify effective and efficient approaches to promoting strength activities among people with disabilities. [ABSTRACT FROM AUTHOR]

Both navigation abilities and gait can be affected by the atrophy in the medial temporal cortex. This study aimed to determine whether navigation abilities could differentiate seniors with and without medial temporal lobe atrophy who complained about their cognitive status. The participants, classified to either the medial temporal atrophy group (n = 23) or the control group (n = 22) underwent neuropsychological assessment and performed a spatial navigation task while their gait parameters were recorded. The study showed no significant differences between the two groups in memory, fluency, and semantic knowledge or typical measures of navigating abilities. However, gait parameters, particularly the propulsion index during certain phases of the navigation task, distinguished between seniors with and without medial temporal lobe lesions. These findings suggest that the gait parameters in the navigation task may be a valuable tool for identifying seniors with cognitive complaints and subtle medial temporal atrophy. [ABSTRACT FROM AUTHOR]

The purpose of this study was to further explore the relationship between travel time and frequency of visits to collegiate recreation facilities. After surveying all students using collegiate recreation facilities at a large public southeastern US university, the local address of the 559 respondents was converted into travel time to their preferred facility using their preferred transportation method. This travel time was compared with swipe data on visits to the facility over a semester. A multinomial logistic regression was conducted to analyze the relationship between collegiate recreation facility usage level and travel time. Results support past research and ecological models of health behaviors demonstrating that proximity of recreation facilities is positively associated with higher usage by college students. [ABSTRACT FROM AUTHOR]

Background: There is a scarcity of studies on the association between physical multimorbidity and lower levels of physical activity among older adults from low- and middle-income countries, while the potential mediating variables in this association are largely unknown. Methods: Cross-sectional, community-based, nationally representative data from the World Health Organization Study on global AGEing and adult health were analyzed. Data on 11 chronic physical conditions were collected. Scoring <150 minutes of moderate- to high-intensity physical activity per week was considered low physical activity. Multivariable logistic regression and mediation analysis were done to assess associations and quality of life measures which might influence these associations. Results: Data on 14,585 people aged ≥65 years were analyzed (mean [SD] age 72.6 (11.5) y, maximum age 114 y; 55.0% women). After adjustment for potential confounders, compared with no chronic conditions, ≥3 conditions were associated with a significant 1.59 to 2.42 times higher odds for low physical activity. Finally, mobility mediated the largest proportion of the association between ≥3 chronic physical conditions and low physical activity (mediated percentage 50.7%), followed by activities of daily living disability (30.7%), cognition (24.0%), affect (23.6%), and pain/discomfort (22.0%). Conclusions: Physical multimorbidity was associated with higher odds for low physical activity among older adults residing in low- and middle-income countries. Mobility, disability, cognition, affect, and pain/discomfort explained the largest proportion of this association. Given the universal benefits of regular and sustained participation in physical activity, it would be prudent to implement interventions among older people with physical multimorbidity to increase levels of physical activity. Future studies should assess the impact of addressing the identified potential mediators among people with multimorbidity on physical activity levels. [ABSTRACT FROM AUTHOR]

Background: Little evidence is available from culturally and linguistically diverse (CALD) communities on the association between motherhood and physical activity (PA). This study aimed to examine independent and joint associations of cultural background and motherhood with meeting PA guidelines, participation in organized sports, and high sitting time (>8 h/d). Methods: We used self-reported cross-sectional data from survey 8 of the 1973–1978 cohort of the Australian Longitudinal Study on Women's Health. PA was measured using the Active Australia Survey while organized sport and sitting time were measured using single items. CALD was defined as being born in a non-English speaking country or primarily speaking a non-English language at home. Multivariable-adjusted logistic regression analyses were used to examine independent and joint associations. Results: Data from 5967 women (mean age 42.4 [SD 1.5] y, 6.9% CALD, 81.2% mothers) were analyzed. Women of CALD background had lower odds of meeting PA guidelines (odds ratio; 95% confidence interval: 0.80; 0.64–0.98) and participation in organized sports (0.68; 0.54–0.86), but no statistically significant association with sitting time (0.90; 0.72–1.14). Mothers had lower odds of meeting PA guidelines (0.75; 0.64–0.87) and high sitting time (0.42; 0.36–0.49). Compared with non-CALD women without children, mothers (irrespective of cultural background) were less likely to meet PA guidelines and have high sitting time. The association of "cultural background and motherhood" with organized sports participation was only significant for CALD mothers. Conclusions: Increased efforts and investments are needed to ensure that sports and other PA promotion interventions are culturally sensitive and engaging for CALD women and those with children. [ABSTRACT FROM AUTHOR]

Objective: To rate athletes' functional ability and return to sport (RTS) success at the end of their individual, formal, medically prescribed rehabilitation after anterior anterior cruciate ligament (ACL) reconstruction. Methods: In our prospective multicenter cohort study, 88 (42 females) adults aged 18-35 years after acute unilateral ACL rupture and subsequent hamstring grafting were included. All patients were prospectively monitored during their rehabilitation and RTS process until the end of their formal rehabilitation and RTS release. As outcome measures, functional hop and jump tests (front hop, balance hops, and drop jump screening test) and self-report outcomes (Knee Injury and Osteoarthritis Outcome Score, ACL-RTS after injury) were assessed. Literature-based cut-off values were selected to rate each performance as fulfilled or not. Results: At 7.5 months (SD 2.3 months) after surgery, the percentage of participants meeting the functional thresholds ranged from 4% (Knee Injury and Osteoarthritis Outcome Score SPORT) and over 44% (ACL-RTS after injury sum score) to 59% (Knee Injury and Osteoarthritis Outcome Score activities of all daily living) in the self-report and from 29% (Balance side hop) to 69% (normalized knee separation distance) in performance testing. Only 4% fulfilled all the cut-offs, while 45% returned to the same type and level of sport. Participants who successfully returned to their previous sport (type and level) were more likely to be "over-cut-off-performers." Conclusions: The low share of the athletes who fulfilled the functional RTS criteria highlights the importance of continuing the rehabilitation measures after the formal completion to assess the need for and success of, inter alia, secondary-preventive therapies. [ABSTRACT FROM AUTHOR]

Background: Studying effective interventions already operating at scale is critical to improving physical activity intervention research translation. The free, weekly, timed 5-km run or walk parkrun represents a unique opportunity to examine successful organic dissemination. We conducted an ecological analysis to identify patterns of growth in Australian parkrun participation and their correlates from 2011 to 2020. Method: Outcome variables were (1) weekly counts of walkers/runners and (2) monthly number of new parkrun registrants. We used latent class analysis to characterize growth trajectories followed by logistic regression on class membership. Covariates included parkrun course characteristics (eg, surface type and route), site-level aggregate participant profile (eg, proportion women and mean age), and surrounding area characteristics (eg, population density and physical activity norm). Results: Three hundred and sixty-three parkruns were included (n = 8,388,695 participation instances). Sixty-nine percent followed a low-growth and 31% a high-growth participation pattern. High growth was associated with greater participation by women, concrete/bitumen surface type, lower area socioeconomic status, and greater volunteer heterogeneity. Odds of being in the slow-growth class were higher if the course contained >1 km of repetition, higher average age of participants, better average parkrun performance, and higher running group membership. Two patterns of new registration were identified: high start followed by steep decline; and low start, slow decline with similar correlates to participation. Conclusions: Parkruns with a less competitive social milieu may have more rapid dissemination. As a free and regular event, parkruns in low socioeconomic areas have the potential to improve the activity levels of those with fewer resources. [ABSTRACT FROM AUTHOR]

Purpose: School recess provides a valuable opportunity for children's daily moderate- to vigorous-intensity physical activity (MVPA). This study aimed to quantify MVPA during school recess in a representative sample of Scottish children and examine whether recess MVPA varied by gender, socioeconomic status, season, urban/rural residency, and recess length. Method: Five-day accelerometry MVPA data were analyzed from 773 children (53.9% girls, 46.1% boys, 10- to 11-y-olds) from 471 schools. Binary logistic regression explored associations between meeting/not meeting the recommendation to spend 40% of recess time in MVPA and the aforementioned risk factors. Descriptive recess data were also analyzed. Results: Participants spent an average of 3.2 minutes (SD 2.1) in MVPA during recess. Girls engaged in 2.5 minutes (SD 1.7) of MVPA compared with 4.0 minutes (SD 2.2) for boys. Only 6% of children met the recess MVPA recommendation. The odds of girls (odds ratio 0.09; 95% confidence interval, 0.04–0.25) meeting the recommendation was lower (P <.001) compared with boys. No statistically significant differences were observed in meeting the recommendation for the other risk factors. Conclusion: Levels of MVPA during school recess are very low in Scottish children, and interventions aimed at increasing MVPA during recess are needed. [ABSTRACT FROM AUTHOR]

This study explores the relationship between the governance of architecturally embedded applications and their longevity in organizational use. Using a contingency-fit logic, it posits that alignment between application governance (distribution of decision rights) and architectural contingencies contributes to sustained durations of organizational use. Architectural contingencies include internal application modularity, application inter-connectedness, and governance of surrounding application clusters. Evidence for the governance-architecture fit hypothesis is derived from analyzing temporally ordered data about applications (n = 225, n = 498, n = 193) from organizations in the media, banking, and utilities sectors over five years. Using a two-step approach with ordinal regression, along with Cox proportional hazards and logistic regression models, our findings indicate that a fit between observed governance and the governance induced by architectural contingencies reduces the likelihood of application decommissioning. The study advances the fields of information systems (IS) governance and architecture by offering a micro-level perspective on the longevity of organizational IS use while also shedding light on the importance of governance choices aligned with unique architectural application properties. [ABSTRACT FROM AUTHOR]

Purpose: To determine the caries status in children’s deciduous teeth and examine the influence of family oral health behaviours on the caries status. Materials and Methods: This cross-sectional study included 329 children aged 3–6 years in rural Heishanzui Township, Hebei Province, China, and used a completely random sampling method. These children underwent physical and oral health examinations. The questionnaires were given to the parents and caregivers of the examined children. Results: The prevalence of caries in the deciduous dentition among children aged 3–6 years was 80.55%, with a dmft index of 4.93. Children in the caries group ate sweets, chocolates, and carbonated drinks more frequently than did children in the caries-free group (p < 0.05). Children in the caries-free group brushed their teeth more frequently, with parents helping their children brush, more often than did those in the caries-affected group (p < 0.05). The level of parental education and annual household income also had statistically significant effects on the prevalence of caries in the two groups (p < 0.05). Logistic regression analysis revealed that the frequency of eating sweets was a risk factor for caries in deciduous teeth (odds ratio = 2.20; p < 0.05). Conclusion: The prevalence of caries in deciduous teeth among children aged 3–6 years in rural Heishanzui Township was high. Compared to children in the caries-affected group, the families and children in the caries-free group had better oral hygiene behaviours. Moreover, the frequency of eating sweets was shown to be a risk factor for caries in deciduous teeth in children aged 3–6 years. [ABSTRACT FROM AUTHOR]

This study aimed to examine the relationship between Walk Score index with walking to commuting, moderate-to-vigorous physical activity, and screen time in older adults. Georeferenced addresses were entered into the Walk Score platform. Walking to commute and moderate-to-vigorous physical activity were assessed using the International Physical Activity Questionnaire and categorized according to the World Health Organization recommendations. Screen time was analyzed through self-reported time watching television/being on the computer. We used binary logistic regression to estimate the association between variables. Older adults who lived in places with higher Walk Score had a higher prevalence of walking to commuting (odds ratio = 1.73; 95% confidence interval [1.18, 2.55]) and engaging in moderate-to-vigorous physical activity (odds ratio = 1.76; 95% confidence interval [1.05, 2.98]). A relationship also was observed between higher Walk Score and more time in screen time (odds ratio = 1.67; 95% confidence interval [1.19, 2.34]). The results showed that residing in a more walkable neighborhood increased the chances of the older adults spending 3 hr or more in front of a screen. [ABSTRACT FROM AUTHOR]

Background: Several studies have found that individuals with a partner were less physically active than those without. To better understand the reasons for this association, we examine whether the existence of a relationship or the current presence of a partner influences physical activity (PA). Methods: We use data from the most recent German Time Use Survey 2012/13 to examine leisure-time PA. All leisure-time activities reported in the time diaries are classified according to their metabolic equivalent of task (MET) to calculate the mean MET scores. First, we use ordinary least square regressions and logistic regressions to examine the effects of living together with a partner or not on mean daily MET scores and on exercise. Second, we apply person-day fixed effects models to estimate the impact of current partner presence on current PA levels. Results: Having a partner is negatively associated with exercising but is not correlated with mean leisure-time MET scores for both women and men. For those with a partner, current MET levels are substantially lower when the partner is present than when the partner is absent. When partners spend leisure-time activities apart, their MET levels are higher than those of individuals without a partner. Conclusions: The results suggest that it is not the mere existence of a romantic relationship but the current copresence with a partner that affects PA behavior. Therefore, interventions to increase PA may be promising if they can encourage couples to be active together. [ABSTRACT FROM AUTHOR]

Purpose: To compare the 3D accuracy of three scanning strategies and conventional impressions using an edentulous model with six implants. Materials and Methods: An edentulous maxillary master model was fabricated with six equigingival internal connection implants at 0 degrees of angulation. Ten conventional open-tray splinted implant-level impressions were made and poured in stone. A master model and conventional casts were digitized with a reference scanner. Digital impressions were made by calibrated clinicians with a TRIOS 3 intraoral scanner ([IOS] 3Shape) according to three scanning strategies: DIG1 (occlusal-palatal-lingual), DIG2 (S-type motion from buccal to palatal), and DIG3 (scanning two half arches and connecting them at the midline). Each technique was repeated 10 times on the master model. Deviations from the STL datasets (N = 40) were compared to those of the reference master model using the Hexagon Metrology software system PC-DMIS CAD++. Linear distortions (dX, dY, dZ), global linear distortion (dR), and angular distortions (Absdθx, Absdθy) were calculated. Kruskal-Wallis test and mixed linear and logistic regression models were used to compare the original and binary distortion measures between the techniques. Results: The mean dR ranged from 91 μm (conventional method) to 183 μm (DIG1). The mean angular distortion ranged from 0.20 degrees (Absdθx for DIG2) to 0.69 degrees (Absdθy for DIG3). No scan pattern resulted in a more accurate reproduction in any of the measured parameters than the conventional impression method. There were significant differences between the methods for all distortion measures. Conclusions: No group reproduced the 3D position of the six-implant master model below the thresholds for both global linear and angular distortions. All the digital strategies tested were less accurate than the conventional open-tray splinted implant-level impression technique. [ABSTRACT FROM AUTHOR]

A major problem in employee selection coalesces around convincing decision‐makers (e.g., hiring managers) to use analytically derived models. Existing recommendations in the literature largely focus on convincing executives to adopt analytical models and then exert their top‐down influence on lower‐level hiring decisions. In contrast to these solutions, we explore end user modifiability (i.e., allowing decision‐makers to modify a statistical model before use) as a bottom‐up approach for increasing hiring managers' implementation of analytical recommendations. From a utility standpoint, we consider how incorporating end user modifiability into hiring decisions will result in a less statistically valid, but potentially more valuable, organizational selection process. We explore these ideas in two studies. In Study 1, we experimentally test whether model modification increases decision‐maker reliance on a statistical model, as well as how much decision‐makers need to modify a model in order to use it. In Study 2, we examine the extent that modifiability introduces implicit biases that might adversely affect marginalized groups. Results suggest that modifiability can increase decision‐makers' perceived usefulness of a model and, importantly, that only a small amount of modifiability is needed to elicit this effect. Further, end user modifications were statistically insignificant predictors of hiring rates across race‐based subgroups, though supplementary analyses suggest important cautionary nuance. Given that analytical models are rarely perfectly or wholly implemented, end user modifiability may offer a viable solution for organizations seeking to increase the implementation of algorithmic guidance in selection decisions, even if it deviates modestly from a statistical optimality. [ABSTRACT FROM AUTHOR]

Both men and women who violate gender stereotypes incur backlashes, or penalties, for these transgressions. However, men who engage in warm, communal behaviors occasionally receive a boost (or benefit) for this female‐stereotyped behavior. To understand how and why warmth and gender interact to predict backlashes or boosts, we integrate uncertainty reduction theory with the stereotype content model and examine warmth by gender interactions. In our first study (a field examination of job seekers), we find that men receive a boost in hireability (i.e., an increased likelihood of obtaining a job offer) for exhibiting gender incongruent (i.e., high) levels of warmth, but women do not receive a backlash in hireability for exhibiting gender incongruent (i.e., low) levels of warmth. In our second study (a laboratory experiment), we replicate and extend these findings by elucidating why they occur: warmth reduces relational uncertainty for male, but not female, applicants. In our third study (another laboratory experiment), we again replicate and extend our findings by identifying when these effects are stronger: in male‐dominated roles. Our investigation suggests that the valence of the gender stereotype violation matters when it comes to hiring decisions. Indeed, we find that displaying warmth appears to promote, rather than impede, career outcomes for men. [ABSTRACT FROM AUTHOR]

This study explored the association between socioecological factors and outdoor physical activity (PA) and play in children with disabilities during the COVID-19 pandemic. Parents (N = 133) completed a survey to report changes in their child's outdoor PA and play during the pandemic (from prepandemic levels), and child, household, and neighborhood environment factors. Children with a PA-supporting parent and from multichild and White households had lower odds of reporting decreased outdoor PA. Children from multichild, higher income, married couple households and a PA-supporting parent had lower odds of decreased outdoor play. Living in neighborhoods with higher urbanization (i.e., high dwelling density, street intersections, and land-use mix) was associated with greater odds of decreased outdoor PA and play. Future research that uses larger and more representative samples of children with disabilities is needed to test for the multivariate effects of socioecological variables on outdoor PA and play. [ABSTRACT FROM AUTHOR]

This study aimed to examine physical activity (PA) levels and mental health status (i.e., anxiety and depression) among parents of children with autism spectrum disorder (ASD). Secondary data analysis was conducted using the 2018 National Health Interview Survey. We identified 139 parents of children with ASD and 4,470 parents of children with no disability. Their PA levels, anxiety, and depression were analyzed. Compared with parents of children with no disability, parents of children with ASD were significantly less likely to meet the PA guideline for Americans and had lower odds of vigorous PA (aOR = 0.702), strengthening PA (aOR = 0.885), and light to moderate PA (aOR = 0.994). Parents of children with ASD reported significantly higher odds of anxiety (aOR = 1.559) and depression (aOR = 1.885). This study revealed lower PA levels and higher risks of anxiety and depression in parents of children with ASD. [ABSTRACT FROM AUTHOR]

Our study aimed to demonstrate the association between physical activity (PA) and frailty incidence among Japanese community-dwelling older adults with a narrow age range of 70–74 years. This study included 485 participants from the Japan Gerontological Evaluation Study. Frailty was assessed at baseline and 3 years later by using the Kaigo-Yobo Checklist. PA was assessed using the short-term International PA Questionnaire at baseline. Logistic regression was performed to calculate the odds ratio with 95% confidence intervals after adjusting for potential confounders. The associations of frailty scores with both PA volume and daily walking time presented a U-shaped curve, albeit only the latter was statistically significant. After adjusting for potential confounders, walking for 0.5–1 hr/day displayed a greater association with decreased frailty risk than higher levels of daily walking time. Further study is needed to cumulate the evidence that moderate PA levels may delay frailty incidence and improve the aging process. [ABSTRACT FROM AUTHOR]

To investigate the association between physical activity (PA) domains and chronic low back pain (LBP) in older adults. A cross-sectional study where sociodemographic, behavioral, and health variables; PA; and presence of chronic LBP were collected. Higher scores of PA defined the "more active" participants. Binary logistic regression was used to test the association between PA domains and chronic LBP. A total of 516 participants were included. The mean age was 71.8 (95% confidence interval, CI, [71.1, 72.5]) years, and 29%, 27%, 25%, and 31% were identified as "more active" in the household, sports, leisure-time, and total PA domains, respectively. "More active" participants in sports (odds ratio = 0.62, 95% CI [0.40, 0.97]), leisure-time (odds ratio = 0.54, 95% CI [0.35, 0.85]) and total (odds ratio = 0.60, 95% CI [0.39, 0.92]) PA domains were less likely to report chronic LBP. High levels of sports, leisure-time, and total PA were inversely associated with chronic LBP. [ABSTRACT FROM AUTHOR]

Purpose: To examine whether patient-level disease diagnoses, drug treatments, and dental clinical factors are correlates of early implant failure. Materials and Methods: This historical, nested case-control study used electronic medical records to retrieve patient-level data on individuals with implant failure occurring up to 6 months after implantation, including demographics, clinical information (number, location, and complicated status of implants), underlying diseases (osteoporosis, diabetes, hypertension, inflammatory bowel disease [IBD], myocardial infarction [MI]), and drug purchases (chemotherapy, bisphosphonates, selective serotonin inhibitors, antihypertensive medications, proton pump inhibitors [PPIs], disease-modifying antirheumatic drugs, corticosteroids, and nonsteroidal anti-inflammatory drugs) among adult members of a large, state-mandated health provider in Israel between 2015 and 2020. Individuals with implant extraction occurring up to 6 months after implantation were matched 1:1 to controls. Univariate and adjusted multivariate conditional logistic regression models were used to examine the odds ratios (ORs) of all dental implant risk factors among the patients. Results: A total of 585 individuals with implant failure (mean age, 53 years [42,62], 51.3% females and 49.7% males) were identified among 29,378 eligible patients. Compared to controls, patients who experienced implant failure (ie, cases) were more likely to have smoked in their lifetime (18% vs 11.5%, P = .009), experienced IBD (1.5% vs 0.02%, P = .059), and consumed PPIs within 6 months of the implant surgery (40.0% vs 32.5%, P = .028). Clinical factors, including the number of implants per person (individuals with two implants, OR = 1.53; individuals with at least four implants, OR = 3.33; P < .01), location of implant (maxilla; OR = 1.59; 95% CI: 1.2-2.04), and smoking (OR = 1.57; 95% CI: 1.09-2.26) were significant correlates of early implant failure among the included cases. Crohn's disease, MI, and osteoporosis were found to be borderline significant correlates of early dental implant failure. Conclusions: Among the factors examined, the number of implants, the location of implants, and smoking history were significant correlates of early implant failure, while Crohn's disease, MI, and osteoporosis were found to not be significant. Larger patient-level studies are needed to examine the individual and combined effects of diseases, medications, and clinical factors on early implant failure. [ABSTRACT FROM AUTHOR]

Objectives: Work in animal models has implicated excessive occlusal forces and occlusal trauma as co-destructive factors for periodontitis. The main aim of the present study was to make a radiographic assessment of the effects of excessive occlusal forces, ie occlusal/incisal tooth wear, widening of the periodontal space, and the presence of a mandibular torus, on interproximal marginal bone loss in a large series of patients. A secondary aim was to evaluate the statistical correlation between the parameters in two specific teeth and those of 12 teeth for marginal bone loss and six teeth for occlusal/incisal tooth wear within the same individual. Method and materials: A total of 1,950 full-mouth radiographic surveys were analyzed retrospectively. Interproximal marginal bone loss was quantified relative to the root length (Schei ruler technique). In addition, occlusal/incisal tooth wear and periodontal ligament space widening of the periodontal space were assessed, as well as the presence of a mandibular torus. Odds ratio and logistic regression analysis were used to determine the association between occlusal trauma and marginal bone loss. Results: The correlation of the measured parameters between the values for specific teeth and the whole dentition was evaluated from data from the first 400 radiographs. Teeth 41 and 33 showed the best correlation to the whole dentition: 0.85 for interproximal marginal bone loss, 0.83 for widening of the periodontal space, and 0.97 forocclusal/incisal tooth wear. The results of a logistic regression analysis with age as an independent variable, revealed a significant association between bone loss and both tooth wear (odds ratio = 2.767) and bone loss and widening of the periodontal space (odds ratio = 2.585). Conclusion: Tooth wear was positively correlated to both widening of the periodontal space and marginal bone loss. No correlation was found between the presence of a mandibular torus and marginal bone loss. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer death worldwide, and classifying the developmental stages of HCC can help with early prognosis and treatment. This study aimed to investigate diagnostic and prognostic molecular signatures underlying the progression of HCC, including tumor initiation and growth, and to classify its developmental stages based on gene expression levels. We integrated data from two cancer systems, including 78 patients with Edmondson-Steiner (ES) grade and 417 patients with TNM stage cancer. Functional profiling was performed using identified signatures. Using a multinomial logistic regression model (MLR), we classified controls, early-stage HCC, and advanced-stage HCC. The model was validated in three independent cohorts comprising 45 patients (neoplastic stage), 394 patients (ES grade), and 466 patients (TNM stage). Multivariate Cox regression was employed for HCC prognosis prediction. We identified 35 genes with gradual upregulation or downregulation in both ES grade and TNM stage patients during HCC progression. These genes are involved in cell division, chromosome segregation, and mitotic cytokinesis, promoting tumor cell proliferation through the mitotic cell cycle. The MLR model accurately differentiated controls, early-stage HCC, and advanced-stage HCC across multiple cancer systems, which was further validated in various independent cohorts. Survival analysis revealed a subset of five genes from TNM stage (HR: 3.27, p < 0.0001) and three genes from ES grade (HR: 7.56, p < 0.0001) that showed significant association with HCC prognosis. The identified molecular signature not only initiates tumorigenesis but also promotes HCC development. It has the potential to improve clinical diagnosis, prognosis, and therapeutic interventions for HCC. This study enhances our understanding of HCC progression and provides valuable insights for precision medicine approaches. • 35 genes gradually regulate in HCC progression in both cancer stage and grade. • These molecular signatures enhance cell proliferation via impact on the mitotic cycle. • Using MLR model, 10 genes accurately classify HCC stages across cancer systems. • Statistically significant subsets of genes emerge as prognostic markers for HCC. [ABSTRACT FROM AUTHOR]

Background: Despite the rise in gender‐affirming care, our understanding of prostate cancer (PCa) in transgender women (TGW) remains in its infancy. Health disparities and lack of PCa awareness and screening are possible barriers to providing quality care for this population. In addition, the implication of hormonal manipulation for the aggressiveness of PCa in TGW is yet to be determined. Here, this study sought to compare oncological characteristics and survival outcomes between transgender and cisgender (CG) patients with PCa via two national data sets. Methods: The Veterans Affairs Informatics and Computing Infrastructure database (1999–2020) and the Surveillance, Epidemiology, and End Results–Medicare database (2010–2017) were reviewed. Demographic and clinical details were analyzed. Logistic regression analysis was performed on propensity score–matched groups to identify predictors of high‐risk disease and metastasis in patients with PCa. Groups were matched 5:1 (CG:TGW) on the basis of age, race, year of diagnosis, and Charlson Comorbidity Index score. Primary outcomes included metastatic presentation, high‐risk localized disease, overall survival (OS), and prostate cancer–specific mortality (PCSM). Results: A total of 1194 patients were included (199 TGW; 995 CG). Associations between transgender identity and metastatic presentation (odds ratio [OR], 0.38; p =.2), high‐risk localized disease (OR, 1.19; p =.50), or PCSM (hazard ratio [HR], 0.65; p =.3) were not detected. Transgender identity was associated with improved OS (HR, 0.67; p =.014). Conclusions: PCa‐specific outcomes seem comparable between TGW and CG men, although the study was underpowered to detect modest differences. Further investigation into the incidence and outcomes of PCa in TGW is warranted. Despite the increasing availability of gender‐affirming care, our understanding of prostate cancer (PCa) in transgender women (TGW) is limited. This study comparing oncological characteristics and survival outcomes between transgender and cisgender patients with PCa suggests comparable outcomes, which indicates the need for further investigation into PCa incidence and outcomes in TGW. [ABSTRACT FROM AUTHOR]

Summary: Background and Aims: Diminished quality of life has been well characterized in patients with autoimmune hepatitis (AIH); however, the full spectrum of unmet needs is unclear. We hypothesized that there is a high burden of health‐related unmet needs in patients with AIH, and this burden differs by socioeconomic status (SES). Methods: Members of the Autoimmune Hepatitis Association were invited online and by email to complete a modified version of the Systemic Lupus Erythematosus Patient Needs Questionnaire. Demographic and clinical data were also captured. Low SES was defined as annual household income <30 k, education level below high school, or moderate–high concern for transportation, food or housing. Multivariable logistic regression assessed the association between unmet health‐related needs and SES. Results: There were 433 participants; 89.8% identified as women, 16.2% lived outside the US, and 25.6% were classified as low SES. Over 70% of respondents reported at least one moderate–high need in the health‐related unmet need domains. In multivariable logistic regression, patients in the low‐SES group reported significantly higher odds of unmet needs compared to the moderate–high‐SES group: for adequate information about side effects (OR 1.64, 95% CI 1.06–2.53, p = 0.026), opportunity to speak with others with AIH (OR 2.34, 95% CI 1.50–3.66, p < 0.001), healthcare professionals acknowledging patient emotions (OR 2.41, 95% CI 1.56–3.74, p < 0.001) and being taken seriously by medical providers (OR 2.09, 95% CI 1.34–3.28, p = 0.001). Conclusion: There is a high burden of health‐related unmet needs in all patients with AIH that is exacerbated by low SES. [ABSTRACT FROM AUTHOR]

To examine associations between depression, anxiety, and stress, as measured by the Depression, Anxiety and Stress Scale (DASS-21) scale, with current e-cigarette use. Data from the Truth Longitudinal Cohort – a nationally representative sample of youth and young adults – was collected between October 2022 to February 2023. The analytic sample was comprised of participants who provided information on e-cigarette use and the DASS-21 scale (N = 4198). Chi-square statistics were used to determine differences by current e-cigarette use across covariates and DASS-21 items. Logistic regression analyses were applied to the cross-sectional data to determine which scales predicted current e-cigarette use, adjusted for the effects of age, gender identity, race and ethnicity, parental educational attainment, perceived financial situation, and current use of alcohol, marijuana, and other tobacco use. Those who had severe/extremely severe levels of depression, anxiety, and stress had greater odds of current e-cigarette use, relative to those who had normal levels of depression, anxiety, and stress, even after adjusting for covariates. Results also demonstrated associations between age, race/ethnicity, parental education, and current use of alcohol, marijuana, and other tobacco products with current e-cigarette use. Cross-sectional analyses of self-reported data limit the ability to determine directionality of effects between depression, anxiety, stress, and current e-cigarette use. More severe levels of depression, anxiety, and stress were associated with a greater likelihood of current e-cigarette use. Future research is needed to evaluate changes in e-cigarette use, in response to depression, anxiety, and stress symptomatology. • Results demonstrate associations between depression, anxiety, and stress with current electronic nicotine delivery systems (ENDS) use. • More severe levels of depression, anxiety, and stress were associated with greater odds of current ENDS use. • Older age and current use of alcohol, marijuana, or other tobacco products were also associated with greater odds of current ENDS use. • Identifying as Non-Hispanic Black, Hispanic, and non-Hispanic Asian and having parents with higher education were associated with lower odds of current ENDS use. [ABSTRACT FROM AUTHOR]

Research on the associations of type-specific bullying victimization and poly-bullying victimization with suicidal ideation is limited and contradictory. This study aimed to examine these associations among school-aged adolescents. A total of 13,258 students from 3 middle schools and 4 high schools in a southern city in China completed a cross-sectional questionnaire in 2019. Multinomial logistic regressions were used to examine associations between type-specific bullying victimization and poly-victimization with suicidal ideation. The latent class analysis identified three subgroups of suicidal ideation: low (70.0 %), moderate (24.0 %), and high (6.0 %). Compared with non-bullying victimization in the past year, the corresponding adjusted odds ratios [aOR] (95 % CI) of moderate and high suicidal ideation for only physical victimization were 1.74 (1.15, 2.63) and 2.51 (1.18, 5.38), respectively, for only relational victimization were 1.26 (0.97, 1.62) and 2.48 (1.65, 3.71), respectively, for only verbal victimization were 1.45 (1.17, 1.78) and 1.42 (0.90, 2.22), respectively, for only property victimization were 1.30 (1.03, 1.65) and 1.31 (0.80, 2.16), respectively, and for sexual victimization were 1.38 (1.03, 1.83) and 2.45 (1.50, 3.99), respectively. Poly-bullying victimization was associated with moderate (aOR two = 1.45 (1.24, 1.70); aOR three = 1.70 (1.41, 2.05), aOR four = 2.03 (1.61, 2.58), aOR five = 2.48 (1.74, 3.53)) and high suicidal ideation (aOR two = 2.01 (1.49, 2.70), aOR three = 3.87 (2.86, 5.25), aOR four = 4.55 (3.20,6.46), aOR five = 7.90 (5.06, 12.33)). The research design is cross-sectional, and relevant data was based on self-reports. Different types of bullying victimization were associated with suicidal ideation and poly-bullying victimization and suicidal ideation association shows a dose-response-relationship. • Type-specific school bullying victimization and poly-victimization were associated with suicidal ideation. • Poly-victimization and suicidal ideation association showed a dose-response-relationship, and poly-victimization had stronger relative effects. • Among five type-specific bullying victimizations, experiencing only physical bullying had the strongest independent effect followed by only relational and only sexual bullying victimization. • Consideration of types of bullying victimization might be effective intervention and prevention of suicidal ideation. [ABSTRACT FROM AUTHOR]

In recent years, several studies have suggested that obesity may play an important role in cognitive impairment. Individuals with cognitive impairment often also exhibit depressive symptoms. This study aimed to explore the association between obesity and cognitive impairment and to elucidate the mediating role of depressive symptoms in this association. Older participants in the U.S. were examined in this cross-sectional study (n = 2391). The WWI was computed as follows: WWI = waist circumference/square root of body weight. The Consortium for Alzheimer's Disease Word Learning (CERAD-WL), the Animal Fluency Test (AFT), and the Digit Symbol Substitution Test (DSST) were used to evaluate cognitive function. Depression symptoms were evaluated with the Patient Health Questionnaire 9 (PHQ-9). Subgroup analysis and multiple logistic regression analysis were utilized to investigate the relationships between the WWI and depressive symptoms and cognitive decline. Threshold effects were computed using a two-segment linear regression model. To ascertain whether depression mediates the relationship between the WWI and cognitive impairment, mediation analysis was also employed. A total of 2391 participants were included, 33.29 % of whom had cognitive impairment. There was a significant correlation between the WWI and depressive symptoms and cognitive function (P < 0.05). With increasing WWI quartiles, the prevalence of cognitive impairment increased (Q1: 27.09 %, Q2: 33.00 %, Q3: 31.44 %, Q4: 41.64 %). It was highly likely that the WWI and cognitive impairment were positively correlated (OR = 1.34, 95 % CI = 1.13, 1.59), and this link was steady across all subgroups (P for trend >0.05). A nonlinear curve with an inflection point of 10.71 connected the WWI and cognitive deterioration. A significant correlation was found between the WWI and cognitive impairment on the left side of the inflection point (OR = 3.58, 95 % CI = 1.57, 8.15). With a 5.4 % mediation rate, mediation analysis revealed that depressive symptoms mediated the relationship between cognitive impairment and the WWI. There was a positive association between the WWI and the incidence of cognitive impairment in older Americans. Among other factors, depressive symptoms slightly mediated the association between the WWI and cognitive impairment. However, large-scale prospective studies are still needed to analyse the interactions between the three factors in depth. • This study explores the Waist-to-Weight Index (WWI) and its link to cognitive impairment, highlighting depression's mediating role. • Higher WWI linked to increased cognitive impairment risk, suggesting abdominal obesity's role in cognitive decline. • Study links abdominal obesity and depression with cognitive impairment, offering insights into prevention strategies. [ABSTRACT FROM AUTHOR]

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Context.--: Galactose-deficient immunoglobulin A1 (Gd-IgA1) deposition in the renal mesangium plays a role in the pathogenesis of IgA nephropathy. Objective.--: To assess the serum Gd-IgA1 level in biopsy-proven IgA nephropathy cases at diagnosis and 3 months post treatment and its relation with histologic Oxford classification. Design.--: In this hospital-based prospective cohort study, 40 cases and 20 controls were enrolled. Serum samples of biopsy-proven IgA nephropathy cases collected on the day of biopsy and 3 months post treatment were evaluated. Solid-phase ELISA (enzyme-linked immunosorbent assay) was performed for assessment of Gd-IgA1 level. All renal biopsies were scored by using the Oxford classification (C-MEST score). The association of serum Gd-IgA1 levels with other established prognostic parameters was assessed. To estimate the prognostic value of markers, logistic regression analysis and Kruskal-Wallis ANOVA (analysis of variance) were used. Results.--: A significant difference was observed in the serum Gd-IgA1 level values in the IgA nephropathy cases and healthy controls (P = .001) at baseline. However, no significant correlation between serum Gd-IgA1 levels at baseline and 3 months of follow-up (P = .31) or between baseline levels and age, proteinuria, hematuria, or estimated glomerular filtration rate was noted. There was no significant correlation between C-MEST score and serum Gd-IgA1 levels at baseline (P > .05); however, the distribution of Gd-IgA1 at 3 months was found to differ significantly between different grades of S score (P = .008). Conclusions.--: Serum Gd-IgA1 levels may be of utility in predicting disease progression in IgA nephropathy cases. Measurement of serum Gd-IgA1 levels for the diagnosis and prognosis of IgA nephropathy may preclude the need for invasive renal biopsies. [ABSTRACT FROM AUTHOR]

Background: Medical devices commonly used for the treatment and care of critically ill patients can cause pressure injuries in intensive care units (ICUs). The endotracheal tube (ETT) is one of the most common medical devices to cause pressure injuries. Aim: This study investigated the incidence of, characteristics of and risk factors for ETT‐related pressure injuries for ICU patients. Study Design: This study adopted a prospective descriptive research design. The sample consisted of 146 endotracheally intubated patients. Data were collected using a patient information form, an Endotracheal Tube‐Related Pressure Injuries Assessment Form, the Braden Risk Assessment Tool and the Nutritional Assessment Test. Results: The study revealed that 80.14% of the patients developed ETT‐related pressure injuries. Over half of the ETT‐related pressure injuries appeared on Day 3 or 4 (56.41%). High body mass index was found to be associated with the development of ETT‐related pressure injuries (OR: 1.15, 95% CI: 1.05–1.26, p =.003). None of the other variables were statistically significant in the development of pressure injuries. Conclusions: The incidence of ETT‐related pressure injuries was quite high in the internal, surgical and anaesthesia ICUs. High body mass index was associated with the development of ETT‐related pressure injuries. Intensive care nurses should implement interventions to prevent ETT‐related pressure injuries in critically ill patients receiving mechanical ventilation support. Relevance to Clinical Practice: ETT‐related pressure injuries are common in ICU patients. High body mass index was associated with the development of ETT‐related pressure injuries in critically ill patients. The skin and mucosa should be assessed for the development of ETT‐related pressure injuries during the daily assessment of the patients receiving mechanical ventilation support. The ETT should be repositioned regularly, and the most suitable ETT fixation method should be used. [ABSTRACT FROM AUTHOR]

Background: Clinical practice guidelines for the prevention of catheter associated urinary tract infection (CAUTI) recommend urinary catheter securement in critical patients although there is scant research on its effectiveness. Aim: To analyse whether securement of an indwelling urinary catheter (IUC) reduces the risk of CAUTI and meatal pressure injury among intensive care unit (ICU) patients and assess medical adhesive‐related skin injury (MARSI) associated with the securement device. Study Design: Open randomized controlled trial involving patients admitted to two ICUs in Spain. In the intervention group (n = 169 patients), the IUC was secured to the thigh using an in‐house device piloted as part of this trial. Controls (n = 181) received standard care, including non‐securement of the IUC. Barrier film spray was applied to the securement site with the aim of preventing MARSI. The definitions of the main outcomes were: CAUTI was diagnosed according to the criteria of the European Centre for Disease Prevention and Control, meatal pressure injury was categorized into four grades and MARSI was classified as either erythema or skin tears. Bivariate analysis and multivariate logistic regression were performed. Log‐rank and Cox regressions were used to compare risk over time to CAUTI and meatal pressure injury in the two groups. Results: Data from 350 patients were analysed, 169 (48.29%) from IG and 181 (51.71%) from CG. In the multiple logistic regression analysis, IUC securement was an independent protective factor against both CAUTI (RR = 0.2, 95% CI [0.05, 0.67]) and meatal pressure injury (RR = 0.31, 95% CI [0.15, 0.58]). The incidence of MARSI was 7.1%. Conclusion: Effective IUC securement significantly reduces the risk of CAUTI and meatal pressure injury among ICU patients. The in‐house device piloted in the present trial is simple for nurses to use, and the incidence of MARSI was low. These results underline the benefits of IUC securement. Relevance to Clinical Practice: Indwelling urinary catheter (IUC) securement reduces the risk of urinary tract infection. IUC securement helps prevent meatal pressure injury. IUC securement with in‐house devices is safe and effective. [ABSTRACT FROM AUTHOR]

Background: Delirium, which is prevalent in critical care settings, remains underexplored in acute coronary syndrome (ACS) patients in the cardiac intensive care unit (CICU). Aim: To investigate the prevalence and clinical significance of delirium in patients with ACS admitted to the CICU. Study Design: A prospective study (n = 106, mean age 74.2 ± 5.7 years) assessed delirium using the confusion assessment method‐intensive care unit (CAM‐ICU) tool in 21.7% of ACS patients during their CICU stay. Baseline characteristics, geriatric conditions and clinical procedures were compared between delirious and nondelirious patients. The outcomes included in‐hospital mortality, 30‐day and 6‐month mortality, acute adverse events and length of CICU stay and hospital stay (LOS). Results: Delirious patients who were older and had a higher incidence of coronary artery disease underwent more complex procedures (e.g., pacemaker placement). Multivariate analysis identified central venous catheter insertion, urinary catheterization and benzodiazepine use as independent predictors of delirium. Delirium was correlated with prolonged LOS (p <.001) and increased in‐hospital, 30‐day and 6‐month mortality (p <.001). Conclusions: Delirium in ACS patients in the CICU extends hospitalization and increases in‐hospital, 30‐day and 6‐month mortality. Early recognition and targeted interventions are crucial for mitigating adverse outcomes in this high‐risk population. Relevance to Clinical Practice: This study highlights the critical impact of delirium on outcomes in hospitalized patients with ACS in the CICU. Delirium, often overlooked in ACS management, significantly extends hospitalization and increases mortality rates. Nurses and physicians must be vigilant in identifying delirium early, particularly in older ACS patients or those with comorbidities. Recognizing independent predictors such as catheterization and benzodiazepine use allows for targeted interventions to reduce delirium incidence. Integrating routine delirium assessments and preventive strategies into ACS management protocols can improve outcomes, optimize resource utilization and enhance overall patient care in the CICU setting. [ABSTRACT FROM AUTHOR]

Background: There is scarcity of data on the incidence and factors associated with the occurrence of ocular lesions in critically ill children. Aim: Test the applicability and utility of an ocular assessment scale and to identify risk factors of ocular lesions. Study Design: Prospective observational study. A tertiary care medical‐surgical Paediatric Intensive Care Unit. 194 children without previous ocular disease who stayed in the Paediatric Intensive Care Unit for more than 48 h. An ocular lesions risk scale was designed including risk factors lagophthalmos, eye dryness, conjunctival hyperemia, slow blinking, intubation, sedation, relaxation, face mask and hemodynamic instability. Patients were classified as high‐, medium‐, and low‐risk patients. Corneal lesions were examined by fluorescein staining according to their risk and were confirmed by an ophthalmologist. Results: 76 patients were examined with fluorescein staining. Thirty‐two ocular lesions were detected by nursing staff, 26 confirmed by the ophthalmologist. 53.6% of the high‐risk patients developed a corneal lesion. Univariate analysis revealed an association between ocular damage and all factors included in the scale, except for face mask. In the multivariate analysis, ocular lesions were associated with lagophthalmos, hyperemia, invasive mechanical ventilation and inotropic support. Conclusions: The scale was useful to detect corneal lesions in critically ill children. The identification of risk factors will enable the development of measures to reduce the incidence of ocular lesions. Relevance for Clinical Practice: A new, non‐validated scale allowed staff to detect eye injuries, study this problem and improve future prevention. [ABSTRACT FROM AUTHOR]

BACKGROUND: The COVID‐19 pandemic triggered a worldwide socio‐sanitary crisis, continuing to impact societies worldwide. With many school systems shifted to online education, the current study presents a unique opportunity to investigate relevant phenomena related to serious health issues during the schooling and later in life, cyberbullying and bullying. This study began just before the COVID‐19 lockdown was declared and resumed 5 months later allowing to explore 2 main objectives: first, to explore whether cyberbullying increased during the lockdown, and second, to analyze transitions from to time of bullying and cyberbullying. METHODS: The participants included 792 students from sixth and seventh years of Primary Education (Meanage = 10.81, SD = 0.85) in Ecuador. This is a quantitative longitudinal study. Cyberbullying and bullying scales were used for data collection before the lockdown in January and February 2020 (T1), and after 5 months of lockdown, at the end of the same academic year in July 2020 (T2). Descriptive, comparative and predictive analyses, a latent transition analysis was used to identify latent status of cyberbullying and bullying behavior at T1 and T2. RESULTS: The results revealed a significant increase of cyberbullying after 5 months of the lockdown. Interestingly, only a small percentage of students who were uninvolved in cyberbullying and bullying in T1 remained uninvolved in T2. CONCLUSIONS: The discussion explores the dynamics of cyberbullying involvement and examines changes in the roles and groups of bullying and cyberbullying after 5 months of lockdown. The political‐ and school‐related implications of these findings are thoroughly discussed. [ABSTRACT FROM AUTHOR]

BACKGROUND: We aimed to better understand the impact of statewide legislation removing personal belief exemptions (PBEs) for the measles, mumps, and rubella (MMR) school immunization requirement and factors associated with resulting health‐seeking behaviors. METHODS: We used chi‐squared tests and logistic regression models to determine individual‐ and school‐level characteristics associated with holding a MMR PBE and with post‐law MMR immunization status among students linked to the Washington State Immunization Information System. RESULTS: Of students with a MMR PBE pre‐law change, 43.0% completed the MMR vaccine series and 40.4% sought another exemption type. Religious exemptions made up most new MMR exemptions signed (71.8%), followed by medical exemptions (18.5%), and religious membership exemptions (9.7%). Students were more likely to complete the vaccine series post‐law change if they attended a school with a low school‐level MMR exemption rate, a public school, or held a lower number of school‐required immunization exemptions. CONCLUSIONS: This study confirms previous concerns that parents might replace their PBE with another exemption type; however, nearly half the students in the cohort completed the MMR vaccine series. Our findings suggest that targeted immunization policies can increase MMR coverage 1‐year post‐law change but must account for a replacement effect when exemption categories are eliminated. [ABSTRACT FROM AUTHOR]

BACKGROUND: Disparities in school attendance exist for children with medical complexity (CMC) due to COVID‐19. Longitudinal changes in family‐reported school safety perceptions and predictors of full‐time, in‐person school attendance are unknown. METHODS: This was a prospective, longitudinal cohort study with 3 survey waves (June 2021‐June 2022) among English‐ and Spanish‐speaking families of CMC aged 5 to 17 years and pre‐pandemic school attendance. Changes in Health Belief Model perceptions and full‐time in‐person school attendance were estimated using multivariate generalized linear modeling with repeated measures. RESULTS: Among 1601 respondents (52.9% of 3073 invited), 86.8% participated in all 3 surveys. School safety perceptions improved with time; however, perceived susceptibility to COVID‐19 increased. Full‐time in‐person school attendance rose from 48.4% to 90.0% from wave 1 to 3 (p <.0001), and was associated with motivation, benefits, and cues. For example, families with low compared to high motivation for in‐person attendance had 76% versus 98% predicted probability for child's school attendance, respectively at wave 3 (p <.0001). IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: Probability of full‐time in‐person school attendance was associated with several health belief model perceptions. School health policy and programs may benefit from promoting family motivation, benefits, and cues during future respiratory illness epidemics including COVID‐19. CONCLUSIONS: In‐person school attendance improved for CMC over time. Opportunities exist to continue optimizing in‐person attendance and family‐perceived safety for CMC at school. [ABSTRACT FROM AUTHOR]

Women who have premature menopause are increasing in number and there is a wide regional diversity across the World, including India. However, in India, the relationship between age at menopause and cardiovascular diseases is still unclear. To fill this research gap, we undertook the present study using data from the Longitudinal Aging Study of India (Wave1, 2017–18). Bivariate logistic regression with three different models controlling for socio-economic and demographic characteristics, reproductive history, nutritional status, and co-morbidities of CVDs was used to show the relationship between CVDs and premature menopause. In all three models, the adjusted odds of having CVDs were higher for premature menopausal women than for those who had menopause between the ages of 45–50. There is a need to understand menopausal problems and their risk factors. The government should initiate a reproductive and sexual health awareness program at the macro level and provide treatment for the same. [ABSTRACT FROM AUTHOR]

Background: Clinical remission has recently been proposed as a possible treatment goal even in severe asthma. In this real-world study, we aimed to assess the achievement rate and predictive factors of clinical remission using omalizumab in patients with severe asthma. Methods: This retrospective observational study included patients with severe asthma initiated with omalizumab therapy and recruited from the asthma clinic of the Akdeniz University Hospital, Turkey. Clinical remission was defined as patients who received no oral corticosteroid (OCS) therapy; showed no exacerbations; showed an asthma control questionnaire score of ≤ 1, asthma control test (ACT) of ≥ 20, or both and, FEV1 of ≥ 80% predicted. Results: A total of 58 patients were included in the study, with an average age of 56.4 ± 13.6 years. The mean duration of asthma was 23.5 ± 11.8 years and the mean duration of omalizumab treatment was 80.05 ± 35.04 months. Clinical remission rates were 25.9% in the first and second year, 34.0% in the third year, 34.1% in the fourth year and 47.4% in the fifth year. Pre-omalizumab ACT, FEV1 (%) and OCS use were significantly higher in patients with clinical remission at 1 year. Logistic regression analyses showed that none of the factors predicted clinical remission. Conclusion: Omalizumab has the potential to induce disease remission in a significant proportion of people with severe asthma, and this is maintained and improved over time. [ABSTRACT FROM AUTHOR]

Objective: To investigate the role of 14-3-3β in acute asthma exacerbations in children and analyze the risk factors for asthma exacerbations. Methods: This study recruited 101 children with acute asthma exacerbations, 101 children with stable asthma, and 65 healthy children. Serum 14-3-3β was compared among the three groups. Factors such as asthma family history, skin prick test, serum-specific IgE test, coinfections, and clinical indicators (FeNO, FEV1, white blood cells, eosinophils, and serum IgE level) were compared between the asthma groups. Risk factors associated with acute asthma exacerbations were identified using multivariate logistic regression models. ROC curve was drawn to determine the diagnostic sensitivity and specificity of 14-3-3β. Results: Serum 14-3-3β was significantly greater in the acute asthma group than in the stable asthma and control groups. Serum 14-3-3β was higher in severe acute asthma group than in mild-moderate asthma group. There were no significant differences in serum 14-3-3β levels between stable asthma and control groups (p >.05). Multivariate logistic regression analysis revealed that serum 14-3-3β level, FeNO, coinfection, and FEV1 z-score significantly increased the odds of acute asthma exacerbations in children. The optimal 14-3-3β cutoff value (39.79 ng/mL), had a sensitivity of 69.3% and specificity of 94.1% for predicting acute asthma exacerbations. Conclusions: 14-3-3β is elevated in children with acute exacerbations of asthma, and increases with exacerbation severity. 14-3-3β, FeNO, FEV1, and coinfection could be independent risk factors for predicting asthma exacerbations. The optimal 14-3-3β cutoff value for predicting asthma exacerbations was 39.79 ng/mL. [ABSTRACT FROM AUTHOR]