Associations between levels of physical literacy and adherence to the 24-h movement guidelines among university students: A cross-sectional study

Objectives

Emerging evidence indicates that the composition of movement behaviours within a 24-h period is associated with multiple health benefits across the lifespan. A concept that emphasises an individual's active lifestyle is physical literacy (PL), yet empirical research exploring the potential associations between PL and 24-h movement guidelines remains scarce. This study aimed to evaluate the associations between levels of PL and adherence to the guidelines among Chinese university students.

Study design

A cross-sectional study.

Methods

Seven hundred and ninety-eight university students (390 male, 19.2 ± 1.2 years) completed all the measurements. Levels of PL and participants' adherence to guidelines including physical activity, sedentary behaviour and sleep were self-reported through Perceived Physical Literacy Instrument, International Physical Activity Questionnaire and Pittsburgh Sleep Quality Index, respectively. Two-way ANOVA was conducted to determine the associations between the number of guidelines met (0, 1, 2, or 3) and levels of PL.

Results

The results demonstrate that 36.5% (n = 291) of the participants met all the three guidelines, while 4.1% (n = 33) met none. Further analysis indicated that meeting physical activity or sedentary behaviour guidelines was associated with significantly higher total PL scores, and scores in the sub-domains of Confidence and Physical Competence and Motivation.

Conclusions

The findings provide evidence that young adults who obtained higher PL scores may meet more guidelines during a 24-h period. Future studies should incorporate accelerometer-based physical activity measurements and investigate the causal relationship between PL and adherence to the movement guidelines.

Fe(II)-catalyzed phase transformation of Cd(II)-bearing ferrihydrite-kaolinite associations under anoxic conditions: New insights to role of kaolinite and fate of Cd(II)

Cadmium-bearing ferrihydrite-kaolinite associations (Cd-associations) are commonly found in cadmium-contaminated paddy soils in tropical and subtropical regions. In the presence of anaerobic conditions caused by flooding, the creation of Fe(II) can facilitate the transformation of ferrihydrite into secondary Fe (hydr)oxides, resulting in the redistribution of Cd. However, the role of kaolinite in iron oxides transformation and changes in Cd chemical species have largely not been determined. In this study, Cd-associations were prepared for reaction with Fe(II) under anoxic conditions. The results obtained from powder XRD and EXAFS indicated that the presence of kaolinite association noticeably hastened the transformation of ferrihydrite into crystalline goethite. Specific surface area and electrochemical analyses revealed that smaller particle sizes and higher reactivity of ferrihydrite within Cd-associations collaboratively contribute to the acceleration. Chemical analyses demonstrated a significant negative correlation between ferrihydrite-Fe and aqueous-Cd, and a significant positive correlation between crystalline-Fe and residual-Cd. HRTEM analyses indicated that a portion of the Cd was incorporated into the crystal lattices of lepidocrocite and goethite, with the majority of Cd being sequestered within goethite lattice. These findings provide new insights into the roles of clay minerals in the geochemical cycling of Fe and Cd in paddy soils under anoxic conditions.

The prevalence and demographic associations of headache in the adult population of Peru: a national cross-sectional population-based study

BACKGROUND

The Global Campaign against Headache is conducting a series of population-based studies to fill the large geographical gaps in knowledge of headache prevalence and attributable burden. One major region not until now included is South America. Here we present a study from Peru, a country of 32.4 million inhabitants located at the west coast of South America, notable for its high Andes mountains.

METHODS

The study was conducted in accordance with the standardized methodology used by the Global Campaign. It was a cross-sectional survey using cluster randomised sampling in five regions to derive a nationally representative sample, visiting households unannounced, and interviewing one randomly selected adult member (aged 18-65 years) of each using the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire translated into South American Spanish. The neutral screening question ("Have you had headache in the last year?") was followed by diagnostic questions based on ICHD-3 and demographic enquiry.

RESULTS

The study included 2,149 participants from 2,385 eligible households (participating proportion 90.1%): 1,065 males and 1,084 females, mean age 42.0 ± 13.7 years. The observed 1-year prevalence of all headache was 64.6% [95% CI: 62.5-66.6], with age-, gender- and habitation-adjusted prevalences of 22.8% [21.0-24.6] for migraine (definite + probable), 38.9% [36.8-41.0] for tension-type headache (TTH: also definite + probable), 1.2% [0.8-1.8] for probable medication-overuse headache (pMOH) and 2.7% [2.1-3.5] for other headache on ≥ 15 days/month (H15+). One-day prevalence of headache (reported headache yesterday) was 12.1%. Migraine was almost twice as prevalent among females (28.2%) as males (16.4%; aOR = 2.1; p < 0.001), and strongly associated with living at very high altitude (aOR = 2.5 for > 3,500 versus < 350 m).

CONCLUSION

The Global Campaign's first population-based study in South America found headache disorders to be common in Peru, with prevalence estimates for both migraine and TTH substantially exceeding global estimates. H15 + was also common, but with fewer than one third of cases diagnosed as pMOH. The association between migraine and altitude was confirmed, and found to be strengthened at very high altitude. This association demands further study.

Secondary analysis of cross-sectional data

Understanding unfinished nursing care and its relationship with modifiable care environment factors is crucial for the service delivery to long-term frail patients. This secondary analysis aimed to explore the associations between characteristics of the care environment and unfinished nursing care, as reported by nursing care workers in Norwegian nursing homes. Of 931 respondents (37% response rate) from 66 nursing homes, six care environment characteristics correlated with at least two types of unfinished nursing care. Resources and Multidisciplinary collaboration showed a positive association with all four unfinished care categories. Input and acknowledgement, Professional, or Interpersonal leadership were not associated to unfinished care. In summary, our findings suggest that nursing care workers reporting positive care environment descriptions also reported lower frequencies of unfinished nursing care. This study offers insights crucial for human resource management which ultimately can be used to improve patient outcomes in nursing homes.

Comparison of Self-Reported and Capacity-Based Measures of Mobility in Community-Dwelling Older Adults in Nigeria: The Mediating Role of Age, Cognitive Status, and Chronic Conditions

Background and Objectives

Although the association between self-reported and capacity-based mobility outcomes is prominently researched, the pathways through which self-reported measures affect capacity-based measures remains poorly understood. Therefore, our study examines the association between self-reported and capacity-based mobility measures and explores which mobility determinants mediate the association in Nigerian community-dwelling older adults.

Research Design and Methods

This cross-sectional study included 169 older adults [mean age (SD) = 67.7 (7.0)]. Capacity-based mobility outcomes included the Short Physical Performance Battery (SPPB), the 6-Minute Walk Test (6MWT), and the 10-Meter Walk Test (10mWT), whereas the self-reported mobility outcomes included the Lower Extremity Functional scale (LEFS), the Life Space Questionnaire (LSQ), and the Mänty Preclinical Mobility scale (inability to walk 2 km, 0.5 km, or climb a flight of stairs). Spearman's correlations were conducted to examine the relationship between self-reported and capacity-based mobility measures, whereas structural equation modeling was used to determine the mediators.

Results

The correlation between SPPB and LEFS (rho = 0.284) and 0.5 km (rho = -0.251) were fair, whereas the correlation between SPPB and inability to walk 2 km (rho = -0.244) and inability to climb a flight of stairs (rho = -0.190) were poor. Similarly, correlations between 6MWT and the LEFS (rho = 0.286), inability to walk 2 km (rho = -0.269), and 0.5 km (rho = -0.303) were fair. The 6WMT was poorly correlated with inability to climb one flight of stairs (rho = -0.233). The LSQ was not correlated with SPPB or 10mWT. Age was the only significant mediator, whereas the number of chronic conditions and cognitive status were not.

Discussion and Implications

The correlation between self-reported and capacity-based mobility outcomes in older adults in Nigeria is lower than those in developed countries. Our analysis provides a foundation to explore mobility determinants that could be predictive mediators for mobility outcomes, making meaningful contributions to explaining mobility complexities.

What Do Higher Alanine Aminotransferase Levels Mean in Premature Ovarian Insufficiency?

The objective of this study was to investigate the relationship between alanine aminotransferase and related biochemical parameters and potential risk factors in women with premature ovarian insufficiency (POI). This is a retrospective cohort study with 126 POI patients (including subclinical POI, n= 27) and 130 healthy controls who visited our clinic between April 2021 to November 2022. Associations were investigated by multiple linear regression, Person correlation analysis, the Kruskal-Wallis test, Mann-Whitney U test, and the independent t-test. When compared to controls, analysis of POI patients showed that body mass index (BMI), uric acid (UA) and urea, alanine aminotransferase (ALT), aspartate aminotransferase (AST), monocyte/lymphocyte ratio, monocyte count (MONO), neutrophil count (NEUT), follicle-stimulating hormone (FSH), luteinizing hormone, and neutrophil/lymphocyte ratio (NLR) were significantly higher, while estradiol (E2), the lymphocyte count and the AST/ALT ratio were lower (P < 0.05). According to linear correlation, it was clear that BMI, FSH, white blood cell count (WBC), NEUT, MONO, UA, AST, and NLR were positively associated with ALT (r = 0.215, 0.388, 0.195, 0.187, 0.184, 0.605, 0.819, and 0.189, respectively, all P < 0.05) while E2 was negatively associated with ALT (r = -0.278, P < 0.05). In addition, multiple linear regression revealed a significant, independent, and positive correlation between AST, FSH, and ALT (B =1.403 and 0.069, respectively, P < 0.05). Analysis revealed that the levels of ALT were significantly higher in POI patients. In addition, BMI, FSH, UA, AST, MONO, NLR, NEUT, and WBC were positively associated with ALT in POI patients. E2 was negatively associated with ALT. Multiple linear regression revealed an independent and positive correlation between AST, FSH, and ALT. In addition, there was also a risk of liver function damage in women with POI and subclinical POI. If patients were diagnosed with POI, early examination and corresponding intervention will be required to effectively prevent the further development of liver disease.

The deployment of advanced practice nurses in the French health system: From clinics to professional networks

AIM

The aim of this study is to contribute to an understanding of the role deployment of advanced practice nurses (APNs) in French healthcare settings.

INTRODUCTION

The introduction of APNs was formalised in France by the decrees issued on 18 July 2018, which described the areas, activities and training of APNs.

BACKGROUND

A qualitative study on the role implementation of APNs was conducted between July 2021 and May 2022 following a call for projects launched by the Île-de-France Regional Health Agency to evaluate the deployment of APNs in the area.

METHODS

Data were collected through field observations and semi-structured interviews in order to explore both the APNs deployment processes in nine healthcare structures and the roles played by APN networks and associations with regard to the deployment of APN activities in their working environments.

RESULTS

The projects proved to be evolutionary, and their development was marked by various forms of APN isolation and multiple obstacles that were specific to their professional practice settings. Some APNs relied on a variety of forms of mutual assistance and advocacy deployed throughout APN networks and associations.

DISCUSSION

The deployment of APNs' role was impacted by diverse configurations of professional power relations and the nature of the obstacles that were structural for APNs in primary care. Their experience of isolation derived from the novelty of their role, the challenge they posed to the cohesion of the nursing profession and a lack of supportive policies for their deployment. Their participation in APN networks and associations enabled them to access advocacy and manage the uncertainties and unknowns related to the deployment of their activities.

CONCLUSION

The results suggest that the formalisation of schemes for mutual assistance among APNs and advocacy should be integrated into the guidelines for the implementation of their role.

IMPLICATIONS FOR NURSING POLICY

APN policy should strengthen a bottom-up approach, relying in particular on the development of different forms of collaboration and communication between APN networks and associations on the one hand and the public authorities on the other.

Predictors of mortality among under-five children in rural Ethiopia: a cross sectional study

BACKGROUND

Under-five child mortality (UFCM) is one of the major significant and sensitive indicators of the health status of the public. Although the world has seen a remarkable and substantial decrease in UFCM since 1990, its progression rate still remains alarmingly high in Sub-Saharan African (SSA) countries, particularly in Ethiopia. Therefore, this study aimed to assess associations between mortality and under-five children in rural Ethiopia.

METHODS

This study used a secondary data analysis of the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS) report. A total of 4,425 under-five children were included in the final analysis. The Kaplan-Meier (K-M) and Cox proportional hazard (PH) model analyses were utilized to estimate survival time and investigate the major predictors of mortality in under-five children, respectively. An adjusted hazard ratio (AHR) along with a 95% confidence interval (CI) was employed to measure the association size and direction of the association (STATA 12).

RESULTS

The study showed that 6.2% (95% CI: 5.43, 6.86) of children died beforehand celebrating their fifth birthday in rural Ethiopia. The multivariable Cox PH regression model analysis revealed associations of large spacing preceding birth interval (16-26 months) (AHR = 0.61; 95% CI: (0.402-0.920)), 27-38 months (AHR = 0.72; 95% CI: (0.496-1.03)), and ≥ 39 months, multiple births (AHR = 3.9; 95% CI: (2.77-5.62)), being breastfeeding (AHR = 0.13; 95% CI: (0.099-0.162)), and unvaccinated child (AHR = 11.6; 95% CI: (1.62-83.1)) were significant associations of under-five children mortality.

CONCLUSIONS

In this study, the UFCM rate was present, with 6.2% in the rural areas of Ethiopia. The birth type, preceding birth interval, vaccination of the child, and breastfeeding are identified as significant associations with under-five child mortality in rural Ethiopia. Therefore, public health interventions should be given attention to multiple births, unvaccinated, and non-breastfeeding children, as well as mothers' better encouragement to have a large spacing preceding the birth interval. Moreover, investigators should conduct continuous research on UFCM, which is imperative to provide current information and inform interventions in a timely manner.

The prevalence of sarcopenia in Parkinson's disease and related disorders- a systematic review

BACKGROUND

The prevalence of sarcopenia (reduced skeletal muscle strength and mass), Parkinson's disease (PD) and Parkinson's related disorders (PRD) all increase with age. They also share risk factors and pathogenetic features. An increased prevalence of sarcopenia in PD and PRD than the general population was thus postulated.

METHODS

Four databases were searched using predefined literature search strategies. Studies conducted in participants with PD or PRD reporting the prevalence of sarcopenia and those providing data to compute the prevalence were included. Pre-sarcopenia, probable/possible sarcopenia and confirmed sarcopenia were defined according to the main sarcopenia working groups. Risk of bias was assessed using the AXIS tool.

RESULTS

1978 studies were identified; 97 assessed in full; 14 met inclusion criteria. The median study quality score was 15/20. The range of probable sarcopenia was 23.9 to 66.7%, and it did not change after excluding PRD participants. The prevalence of confirmed sarcopenia in participants with any parkinsonian disorder ranged from 2 to 31.4%. Including just PD participants, the range was 10.9 to 31.4%. In studies with controls, sarcopenia was more prevalent in PD and PRD. There was a positive non-significant trend between severity of motor symptoms and prevalence of sarcopenia or components of sarcopenia. High heterogeneity precluded meta-analysis, therefore there was insufficient evidence to conclude whether sarcopenia is more prevalent in PD or PRD.

CONCLUSIONS

Probable and confirmed sarcopenia are common in PD and PRD and they may be associated with disease severity. This co-occurrence supports the value of screening for sarcopenia in parkinsonian populations.

Clinical consequences of a genetic predisposition toward higher benign prostate-specific antigen levels

BACKGROUND

Prostate-specific antigen (PSA) levels are influenced by genetic variation unrelated to prostate cancer risk. Whether a genetic predisposition to a higher PSA level predisposes to a diagnostic work-up for prostate cancer is not known.

METHODS

Participants were 3110 men of African and European ancestries ages 45-70, without prostate cancer and with a baseline PSA < 4 ng/mL, undergoing routine clinical PSA screening. The exposure was a polygenic score (PGS) comprising 111 single nucleotide polymorphisms associated with PSA level, but not prostate cancer. We tested whether the PGS was associated with a: 1) PSA value > 4 ng/mL, 2) International Classification of Diseases (ICD) code for an elevated PSA, 3) encounter with a urologist, or 4) prostate biopsy. Multivariable Cox proportional hazards models were adjusted for age and genetic principal components. Analyses were stratified by age (45-59 years, and 60-70 years old). Association estimates are per standard deviation change in the PGS.

FINDINGS

The median age was 56.6 years, and 2118 (68%) participants were 45-59 years. The median (IQR) baseline PSA level was 1.0 (0.6-1.7) ng/mL. Among men ages 45-59, the PGS was associated with a PSA > 4 (hazard ratio [HR] = 1.35 [95% CI, 1.17-1.57], p = 4.5 × 10-5), an ICD code for elevated PSA (HR = 1.30 [1.12-1.52], p = 8.0 × 10-4), a urological evaluation (HR = 1.34 [1.14-1.57], p = 4.8 × 10-4), and undergoing a prostate biopsy (HR = 1.35 [1.11-1.64], p = 0.002). Among men ages 60-70, association effect sizes were smaller and not significant.

INTERPRETATION

A predisposition toward higher PSA levels was associated with clinical evaluations of an elevated PSA among men ages 45-59 years.

FUNDING

National Institutes of Health (NIH).

Associations between body composition and cardiovascular disease risk in pre- and postmenopausal women

BACKGROUND

Menopause transition is a critical phase of women's life since body composition and cardiovascular risk factors begin to change during this period. This study investigated the associations between body composition and cardiovascular disease risk (CVDR) in pre (PrMW) and postmenopausal women (PMW).

METHODS

A community-based cross-sectional study involving 184 PrMW and 166 PMW, selected randomly from Bope-Poddala area in Galle, Sri Lanka was carried out. Total-body fat mass (TBFM, kg), total body skeletal muscle mass (TBSMM, kg), total body bone mineral density (TBBMD, g/cm2) and total body bone mineral content (TBBMC, g) were measured with total body DXA scanner and they were taken as indices of body composition. CVDR was evaluated using Framingham risk score (FRS%) and individual CVDR factors, such as systolic blood pressure (SBP, mmHg), diastolic blood pressure (DBP, mmHg), fasting blood sugar (FBS, mg/dl), total cholesterol, (TC, mg/dl), tryglycerides (TG, mg/dl), high-density lipoprotein (HDL, mg/dl) and low-density lipoprotein (LDL, mg/dl). Correlations between indices of body composition and CVDR factors were assessed with adjusted partial correlation (adjusted for socio-demographic and gynecologic status, age, daily calorie consumption and physical activity level).

RESULTS

Mean(SD) age of PrMW and PMW were 42.4(6.0) and 55.8(3.8) years respectively. TBFM correlated with SBP and DBP (r range; 0.15 to 0.21) and TBSMM correlated with SBP, DBP and HDL (r range; - 0.24 to 0.17) only in PrMW (p < 0.05). TBBMD correlated only with FBS in PMW (r; - 0.21, p = 0.01). TBBMC did not show correlations with CVDR factors (p > 0.05). Body composition indices did not show correlations with total CVDR estimated by FRS and in both groups of women (p > 0.05).

CONCLUSIONS

Both SBP and DBP are associated with FM and SMM in different ways among PrMW. This association, however, was not seen among PMW. FBS is associated with BMD only in PMW.

Association of post-stroke fatigue with physical activity and physical fitness: A systematic review and meta-analysis

BACKGROUND

It has been hypothesized that post-stroke fatigue (PSF) is associated with reduced physical activity (PA) and impaired physical fitness (fitness). Understanding associations between PSF and PA, and/or fitness could help guide the development of targeted exercise interventions to treat PSF.

AIMS

Our systematic review and meta-analysis aimed to investigate PSF's associations with PA and fitness.

SUMMARY OF REVIEW

Following a registered protocol, we included studies with cross-sectional or prospective observational designs, published in English or a Scandinavian language, which reported an association of PSF with PA and/or fitness in adult stroke survivors. We searched MEDLINE, Embase, AMED, CINAHL, PsycINFO, ClinicalTrials.gov, and World Health Organization's International Clinical Trials Registry Platform from inception to November 30, 2022. Risk of bias was assessed using Quality in Prognosis Studies. Thirty-two unique studies (total n = 4721 participants, 55% male), and three study protocols were included. We used random-effects meta-analysis to pool data for PA and fitness outcomes, and vote-counting of direction of association to synthesize data that could not be meta-analyzed. We found moderate-certainty evidence of a weak association between higher PSF and impaired fitness (meta r = -0.24; 95% confidence interval (CI) = -0.33, -0.15; n = 905, 7 studies), and very low-certainty evidence of no association between PSF and PA (meta r = -0.09; 95% CI = -0.34, 0.161; n = 430, 3 studies). Vote-counting showed a higher proportion of studies with associations between higher PSF and impaired fitness (pˆ = 0.83; 95% CI = 0.44, 0.97; p = 0.22, n = 298, 6 studies), and with associations between higher PSF and lower PA (pˆ = 0.75; 95% CI = 0.51, 0.90; p = 0.08, n = 2566, 16 studies). Very low- to moderate-certainty evidence reflects small study sample sizes, high risk of bias, and inconsistent results.

CONCLUSIONS

The meta-analysis showed moderate-certainty evidence of an association between higher PSF and impaired fitness. These results indicate that fitness might protect against PSF. Larger prospective studies and randomized controlled trials evaluating the effect of exercise on PSF are needed to confirm these findings.

Association Strategies of Speech Behavior of Communicators in Coding Discourse: An Interdisciplinary Approach Towards Understanding the Role of Cognitive and Linguistic Processes in Communication

In modern media, the names of fairy-tale and mythological images are used to convey certain emotions and connotations. The aim of the study is to analyze the characteristic associative strategies presented with the mythological images of a dragon, a paper tiger and a chimera in news texts of European and Chinese mass media. In this article, the method of text analysis was used to identify patterns and the most possible interpretations of lexical units. 100 articles from Chinese and European publications were selected for the analysis (About People's Daily Online, China News Service, Guardian and France 24). The required lexemes were most widely used in articles on political topics. The most used was the image of a paper tiger (4001 and 3587 units). This is due to its well-known metaphorical meaning in both cultures, while dragon differs in Chinese and European ones. Further research may focus on the search and analysis of other fairy tale and mythological images in mass media. The present study results may also be applied for further research in the field of linguistics and journalism.

Exposure to negative foreign COVID-19 news predicts lower support for immigration policy in China

We present a framework for studying the spillover effect of negative foreign COVID-19 news on attitudes towards immigration. Our framework proposes that exposure to negative COVID-19 news from foreign countries can activate negative associations with foreigners, reduce positive attitudes towards them, and increase perceived threat, ultimately leading to decreased support for immigration. We conducted three studies to test this framework. Study 1 found that exposure to negative COVID-19 news about a foreign country increased negative valence associations with that country. Study 2 showed that exposure to more negative COVID-19 news about foreign countries was associated with lower acceptance of immigration policies in real life. Study 3 replicated the spillover effect of negative news exposure using a scenario manipulation. The effects of negative news exposure on immigration policy acceptance in both Studies 2 and 3 were mediated by changes in foreigner attitudes and intergroup threat. Our results demonstrate the important spillover effect of negative foreign COVID-19 news exposure on immigration attitudes and highlight the association perspective as a foundation for understanding attitude changes during the COVID-19 pandemic.

Different associations of anthropometric indices with diabetic retinopathy and diabetic kidney disease in chinese patients with type 2 diabetes mellitus

AIMS

To investigate the associations of anthropometric indices, including body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), waist circumference (WC) and hip circumference (HC), with diabetic retinopathy (DR) and diabetic kidney disease (DKD) in Chinese patients with type 2 diabetes mellitus (T2DM).

MATERIALS AND METHODS

This cross-sectional study evaluated 5226 Chinese participants with T2DM at three hospitals between 2005 and 2016. Logistic regression models and restricted cubic spline analysis were used to assess the associations of anthropometric indices with DR and DKD.

RESULTS

A BMI of around 25 kg/m2 was related to a low risk of DR (OR based on the third fifth: 0.752, 95%CI: 0.615-0.920). Besides, HC had an inverse association with DR in men independently of BMI (OR based on the highest fifth: 0.495, 95%CI: 0.350-0.697). In the restricted cubic spline models, BMI, WHtR, WC, and HC showed J-shaped associations with DKD, while WHR showed an S-shaped association with DKD. Compared to the lowest fifth, the odds ratios (OR) based on the highest fifth of BMI, WHR, WHtR, WC and HC for DKD were 1.927 (1.572-2.366), 1.566 (1.277-1.923), 1.910 (1.554-2.351), 1.624 (1.312-2.012) and 1.585 (1.300-1.937) respectively in multivariable models.

CONCLUSIONS

A median BMI and a large hip might be related to a low risk of DR, while lower levels of all the anthropometric indices were associated with a lower risk of DKD. Our findings suggested maintain a median BMI, a low WHR, a low WHtR and a large hip for prevention of DR and DKD.

Dietary diversity and nutritional status of children attending early childhood development centres in Vhembe District, Limpopo province, South Africa

The present study assessed dietary diversity and anthropometric status of children attending early development centres in South Africa. In the Vhembe District of Limpopo province, South Africa, 273 children were conveniently chosen from 8 randomly selected early childhood development centres for a cross-sectional study. Data were gathered via a questionnaire administered by the interviewer in June 2021. Height, body weight and mid-upper arm circumference were measured to assess anthropometric status. A 24-h dietary recall was obtained to provide information on dietary diversity. The prevalence of underweight, wasting and stunting was 9, 4 and 26 %, respectively. More than half of the children had a low dietary diversity score, according to the Food and Agriculture Organization scoring system for children. Grains, roots, tubers, dairy products, other fruits and vegetables, and flesh-based foods were the highest consumed food groups. The lowest consumption was for eggs, vitamin A-rich fruits and vegetables, legumes and nuts. Height for age and weight for age were significantly associated with dietary diversity score, but not weight for height. Children who did not meet the reference value of greater than 4 for dietary diversity had a significant risk of being underweight (AOR 0⋅25, 95 % CI 0⋅08, 0⋅75) and stunted (AOR 0⋅32, 95 % CI 0⋅14, 0⋅74). The nutritional status of the children was impacted by a lack of adequate dietary diversity. Young children in rural areas need to receive a wide range of food to promote greater diversification of diets in order to diminish the risk of undernutrition.

Prevalence and associated factors for non-alcoholic fatty liver disease among adults in the South Asian Region: a meta-analysis

Background

Non-alcoholic fatty liver disease (NAFLD) is the commonest chronic liver disease worldwide. We estimated the prevalence and predefined associated factors for NAFLD among South-Asian adults.

Methods

We searched PubMed and included descriptive, epidemiological studies with satisfactory methodology, reporting the prevalence of NAFLD with ultrasound. Two authors screened and extracted data independently. Gender, urban/rural settings, general population and individuals with metabolic diseases (MetD) stratified the analysis. In addition, a random-effects meta-analysis of the prevalence and effect sizes of associations of NAFLD was performed.

Findings

Twenty-two publications were included after the quality assurance process. The difference in the NAFLD prevalence between the general population and people with MetD was found to be statistically significant (Q = 15.8, DF = 1, P < 0.001). The pooled overall prevalence of NAFLD in the general population was 26.9% (95% CI: 18.9-35.8%) with high heterogeneity. The prevalence was similar among men and women (Q = 0.06, DF = 1, P = 0.806). The NAFLD prevalence in the rural communities was 22.6% (95% CI: 13.6-33.1%), and the prevalence in urban communities was 32.9% (95% CI: 22.8-43.8%) and the difference was not statistically significant (Q = 1.92, DF = 1, P = 0.166). The pooled overall prevalence of NAFLD in patients with MetD was 54.1% (95% CI: 44.1-63.9%) with high heterogeneity. The pooled overall prevalence of NAFLD in the non-obese population was 11.7% (95% CI: 7.0-17.3%). The pooled prevalence of non-obese NAFLD in the NAFLD population was 43.4% (95% CI: 28.1-59.4%). Meta-analysis of binary variables showed that NAFLD in the South Asian population was associated with diabetes mellitus, hypertension, dyslipidaemia, general obesity, central obesity and metabolic syndrome. Gender was not associated with NAFLD.

Interpretation

The overall prevalence of NAFLD among adults in South Asia is high, especially in those with MetD, and a considerable proportion is non-obese. In the South Asian population, NAFLD was associated with diabetes mellitus, hypertension, dyslipidaemia, general obesity, central obesity, and metabolic syndrome.

Funding

None.

The time elapsed between assessments of blood metabolome and live weight affects associations between the abundance of metabolites and growth rate in beef cattle

INTRODUCTION

This study aimed to assess the associations between the relative abundance (RA) of blood metabolites and growth rate (i.e., live weight change, LWC) calculated using different intervals of time between live weight (LW) measurements from the metabolome assessment.

METHODS

Grazing beef cattle were raised for 56 days and blood samples from each animal were taken on day 57. Live weight was continuously measured using an automatic in-paddock weighing scale. The RA of plasma metabolites were determined using proton nuclear magnetic resonance (NMR). Live weight data were filtered for outliers and one LW record was selected every 1, 7, 14, 21, 28, 35, 42, 49 and 56 days before the metabolome assessment (LWC1 to LWC56, respectively). Live weight change was then re-calculated for each interval between LW data selected.

RESULTS

Associations between LWC calculations and the RA of metabolites were greatly affected by the interval of time between LW data selected. Thus, the number of significant associations decreased from 9 for LWC1 to 5 for LWC35 whereas no significant associations were found for LWC56 (P > 0.05). There were 7 metabolites negatively associated with LWC1 including leucine, 2-hydroxybutyrate, valine, creatinine, creatine, phenylalanine and methylhistidine; however, correlations were positive for 2 lipids. The strength of the correlation coefficients decreased as the length of the interval between LW measures increased although this reduction was greater for some metabolites such as leucine compared to others such as lipids. Our findings suggest that the time frame in which a particular response variable, such as LWC, is measured and metabolomic samples are taken could largely impact associations and thus conclusions drawn.

CONCLUSIONS

Depending on the variable to be explored, rapid changes in cattle metabolome may not be reflected in correlations if they are not assessed close in time. Our findings suggest that LWC should be measured for a period shorter than 28 days before the metabolome assessment as the number of significant associations decreases when LWC is measured for longer periods.

Neurosurgery societies around the world: A study and discussion about its importance

Background

Harvey Cushing and collaborators created the first society of neurosurgeons in 1920, in the United States of America, the Society of Neurological Surgeons. In 1955, the World Federation of Neurosurgical Societies (WFNS) was created in Switzerland to improve neurosurgical care globally through the scientific cooperation of members. The performance of neurosurgical associations today is fundamental to discuss diagnostic methods and therapeutic approaches, transforming modern medicine. Although most neurosurgical associations are recognized worldwide, there are some societies that are not recognized internationally due to a lack of regulatory bodies and lack of official digital channels, among other reasons. The main objective of the article is to list the neurosurgical societies and to provide a more integrated view of the interactions between neurosurgical societies in different countries.

Methods

We developed a table summarizing the countries recognized by the United Nations, the continents, capitals, name of the present societies, and social networks. We utilized "Country AND (Neurosurgery OR Neurological Surgery) AND (Society OR Association)," in English, and in the native language of the country. Our search included: PubMed, Scopus, Google, Google Scholar, and the WFNS website, without filters.

Results

We found 189 neurosurgery associations, from 131 countries and territories; 77 countries did not have their own neurosurgical societies.

Conclusion

There is a difference between the number of internationally recognized societies, and the number of societies found in this study. In the future, we should better organize neurosurgical societies in countries that have neurosurgical activity with those without such resources.

The relationship between diet and lifestyle behaviours in a sample of higher education students; a cross-sectional study

BACKGROUND & AIMS

Transitioning into higher education (HE) impacts health behaviours. Poor dietary and lifestyle behaviours may correlate and increase risk of co-morbidities. The introduction of the Okanagan Charter detailed the important role of health promotion within a HE setting. The aim of this study was to assess the relationship between dietary quality and lifestyle behaviours of students attending HE.

METHODS

Full-time students, aged 18+, were eligible to participate in this online cross-sectional study. Self-reported questions were asked in relation to demographics, body mass index (BMI), smoking, and COVID-19. A food frequency questionnaire measured dietary quality along with tools assessing alcohol use, sleep quality, perceived stress, and physical activity. Statistical analyses were performed using chi-square, one-way ANOVA, independent sample t-tests, Pearson's correlation, and multivariate linear regression.

RESULTS

Evidence of a correlation between poor diet quality and having a higher BMI (p = 0.040), higher alcohol consumption (p = <0.001), poorer sleep quality (p = 0.003), higher stress levels (p = 0.006) and smoking (p = 0.001) was found. Low fruit and vegetable consumption were associated with higher BMI (p = 0.013), higher alcohol consumption (p = <0.001), lower physical activity levels (p = 0.006), higher stress levels (p = <0.001), smoking (p = <0.001) and being male (p = 0.002).

CONCLUSIONS

This study provides data on the association between dietary quality and lifestyle behaviours among HE students and will inform healthy campus initiatives.

Urban food systems: Factors associated with food insecurity in the urban settings evidence from Dessie and Combolcha cities, north-central Ethiopia

In Ethiopia, food security and vulnerability assessments have traditionally focused on rural areas. Recently, the issue of urban food security has been attracting attention in global policy debates. However, limited studies are found in the study areas that link food insecurity with major food market chains in the urban food system settings. This study is therefore, aimed at measuring the status of food insecurity in the urban food systems. A mixed study design has been used with randomly selected 506 resident households in Dessie and Combolcha cities, of north-central Ethiopia. We used a pre-tested, semi-structured survey questionnaire to collect quantitative data. The qualitative data has been collected with key informant interview, and focus group discussion among food system actors and facilitators in the selected commodities. We applied Household Food Insecurity Access Scale (HFIAS) to measure the food security status and narration and summarization techniques to analyze the qualitative data. The study confirmed that 33.1% of the respondents were food insecure. Moreover, nine and six individuals per 100 people were forced to 'sleep hungry' and 'not eat in the whole day and night' respectively. Households' food insecurity was significantly associated with the gender of the household head, participation in casual labor, and living house ownership. The degree of food insecurity was deemed to be higher due to weak food system governance, an inconsistent food supply chain, and socio-economic and gender inequalities. However, both formal and informal food systems have their own unique qualities and maximum food security benefit can be achieved if they are well integrated. This implies food security intervention in urban areas needs to refocus their strategies towards systematic and integrated approaches that can promote social security programs like: urban housing, job security, urban agriculture and inclusive food safety net programs. Moreover, multidimensional studies are still important to obtain a wider picture of sustainable urban food security in urban areas and to better integrate the formal and informal food systems.

Diseases and comorbidities associated with early-onset scoliosis: a retrospective multicenter analysis

PURPOSE

To determine the frequencies of various diseases associated with all types of early-onset scoliosis, both idiopathic and nonidiopathic.

METHODS

Retrospective collection of patients within a 21-year interval. Children under 10 years old presenting with scoliosis were included. Medical records were used to collect: identifier, date of birth, sex, diagnosis, follow-up, curve pattern, comorbidities, initial and final cobb angle. Different patient variables were tabulated with associated comorbidities for comparison.

RESULTS

The cohort contained 469 patients, with 227(48.4%) males and 242(51.6%) females. Total comorbidities equaled 1051, where 190 were unique. Only 124(26.4%) patients had an isolated diagnosis of early-onset scoliosis, 79(16.8%) had a single comorbidity, and 266(56.7%) had multiple comorbidities. "Global developmental delay" was most commonly observed, 198(42.2%) times. The central nervous system was involved more often than other organ systems, seen in 394(54.4%) instances. Males had more comorbidities than females. Idiopathic patients had the least number of comorbidities, while neuromuscular patients had the most. Idiopathic types had more musculoskeletal conditions, while congenital types had more cardiovascular diseases. Curve sides did not affect distributions. Cases which progressed had more comorbidities, especially in the respiratory, digestive, and cardiovascular systems. Diseases that could affect either extremity or side, were more likely to be bilateral.

CONCLUSIONS

Early-onset scoliosis patients may present with complex comorbidities in multiple organ systems. The most commonly observed disease entities were: global developmental delay, developmental dysplasia of the hip, and epilepsy. Clinicians should be aware of the common associations, in order to screen for and begin appropriate investigations, referrals, and treatments in affected cases.

LEVEL OF EVIDENCE

Level III.

Factors associated with an increased risk of developing postoperative symptomatic lumbar spondylolisthesis after decompression surgery: an explorative two-centre international cohort study

PURPOSE

Symptomatic lumbar spinal stenosis can be treated with decompression surgery. A recent review reported that, after decompression surgery, 1.6-32.0% of patients develop postoperative symptomatic spondylolisthesis and may therefore be indicated for lumbar fusion surgery. The latter can be more challenging due to the altered anatomy and scar tissue. It remains unclear why some patients get recurrent neurological complaints due to postoperative symptomatic spondylolisthesis, though some associations have been suggested. This study explores the association between key demographic, biological and radiological factors and postoperative symptomatic spondylolisthesis after lumbar decompression.

METHODS

This retrospective cohort study included patients who had undergone lumbar spinal decompression surgery between January 2014 and December 2016 at one of two Spine Centres in the Netherlands or Switzerland and had a follow-up of two years. Patient characteristics, details of the surgical procedure and recurrent neurological complaints were retrieved from patient files. Preoperative MRI scans and conventional radiograms (CRs) of the lumbar spine were evaluated for multiple morphological characteristics. Postoperative spondylolisthesis was evaluated on postoperative MRI scans. For variables assessed on a whole patient basis, patients with and without postoperative symptomatic spondylolisthesis were compared. For variables assessed on the basis of the operated segment(s), surgical levels that did or did not develop postoperative spondylolisthesis were compared. Univariable and multivariable logistic regression analyses were used to identify associations with postoperative symptomatic spondylolisthesis.

RESULTS

Seven hundred and sixteen patients with 1094 surgical levels were included in the analyses. (In total, 300 patients had undergone multilevel surgery.) ICCs for intraobserver and interobserver reliability of CR and MRI variables ranged between 0.81 and 0.99 and 0.67 and 0.97, respectively. In total, 66 of 716 included patients suffered from postoperative symptomatic spondylolisthesis (9.2%). Multivariable regression analyses of patient-basis variables showed that being female [odds ratio (OR) 1.2, 95%CI 1.07-3.09] was associated with postoperative symptomatic spondylolisthesis. Higher BMI (OR 0.93, 95%CI 0.88-0.99) was associated with a lower probability of having postoperative symptomatic spondylolisthesis. Multivariable regression analyses of surgical level-basis variables showed that levels with preoperative spondylolisthesis (OR 17.30, 95%CI 10.27-29.07) and the level of surgery, most importantly level L4L5 compared with levels L1L3 (OR 2.80, 95%CI 0.78-10.08), were associated with postoperative symptomatic spondylolisthesis; greater facet joint angles (i.e. less sagittal-oriented facets) were associated with a lower probability of postoperative symptomatic spondylolisthesis (OR 0.97, 95%CI 0.95-0.99).

CONCLUSION

Being female was associated with a higher probability of having postoperative symptomatic spondylolisthesis, while having a higher BMI was associated with a lower probability. When looking at factors related to postoperative symptomatic spondylolisthesis at the surgical level, preoperative spondylolisthesis, more sagittal orientated facet angles and surgical level (most significantly level L4L5 compared to levels L1L3) showed significant associations. These associations could be used as a basis for devising patient selection criteria, stratifying patients or performing subgroup analyses in future studies regarding decompression surgery with or without fusion.

The Associations Between Alanine Aminotransferase and Other Biochemical Parameters in Lean PCOS

To explore the associations of alanine aminotransferase in lean women of polycystic ovary syndrome (PCOS) with other biochemical parameters and the potential risk factors. This is a retrospective cohort study with lean PCOS (n = 91) and healthy controls (n = 45); we reviewed the electrical records and databases of the PCOS patients in our infertility clinic between January 2019 and September 2021; independent t-test, linear correlation analysis, and multiple linear regression were used to explore the associations. Higher levels of luteinizing hormone, total testosterone, thyroid stimulating hormone, platelet count, lymphocyte count, homocysteine, alanine aminotransferase (ALT), and uric acid were identified in lean PCOS patients, while follicle-stimulating hormone level was lower in in lean PCOS as expected (P < 0.05). Of note, the linear correlation showed that BMI, total testosterone, white blood cell count, lymphocyte count, aspartate aminotransferase, and uric acid were positively associated with alanine aminotransferase (r = 0.232, 0.318, 0.218, 0.388, 0.602, 0.353 respectively, P < 0.05). After multiple linear regression was performed, total testosterone and aspartate aminotransferase were independently and positively correlated with alanine aminotransferase in lean PCOS (B = 0.251, 0.605 respectively, P < 0.05). Higher level of ALT was identified in the lean PCOS. BMI, white blood cell count, lymphocyte count, aspartate aminotransferase, uric acid, and total testosterone were positively correlated with ALT in lean PCOS. Total testosterone and aspartate aminotransferase were independently and positively associated with ALT in lean PCOS after multiple linear regression. There might exist a potential risk of afflicting liver impairment for the lean PCOS women in the earlier period. Early examination and intervention might be necessary to prevent or delay the progression of the liver disease as soon as the diagnosis of PCOS.

Rates of and factors associated with exclusive and any breastfeeding at six months in Canada: an analysis of population-based cross-sectional data

BACKGROUND

Breastfeeding has many health, economic and environmental benefits for both the infant and pregnant individual. Due to these benefits, the World Health Organization and Health Canada recommend exclusive breastfeeding for the first six months of life. The purpose of this study is to examine the prevalence of exclusive and any breastfeeding in Canada for at least six months, and factors associated with breastfeeding cessation prior to six months.

METHODS

We performed a secondary analysis of breastfeeding-related questions asked on the cross-sectional 2017-2018 Canadian Community Health Survey. Our sample comprised 5,392 females aged 15-55 who had given birth in the five years preceding the survey. Descriptive statistics were carried out to assess the proportion of females exclusively breastfeeding and doing any breastfeeding for at least six months by demographic and behavioural factors. We also assessed, by baby's age, trends in the introduction of solids and liquids, breastfeeding cessation and the reasons females stopped breastfeeding. Multivariate log binominal regression was used to examine the association between breastfeeding at six months and selected maternal characteristics hypothesized a priori to be associated with breastfeeding behaviour.

RESULTS

Overall, for at least six months, 35.6% (95% confidence interval (CI): 33.3%-37.8%) of females breastfed exclusively and 62.2% (95% CI: 60.0%-64.4%) did any breastfeeding. The largest decline in exclusive breastfeeding occurred in the first month. Factors most strongly associated with breastfeeding for at least six months were having a bachelor's or higher degree, having a normal body mass index, being married and daily co-sleeping. Insufficient milk supply was given as the most common reason for breastfeeding cessation irrespective of when females stopped breastfeeding.

CONCLUSION

Six-month exclusive breastfeeding rates in Canada remain below targets set by the World Health Assembly. Continued efforts, including investment in monitoring of breastfeeding rates, are needed to promote and support exclusive breastfeeding, especially among females vulnerable to early cessation.

Contrasting domain-general and domain-specific accounts in cognitive neuropsychology: An outline of a new approach with developmental prosopagnosia as a case

The backbone of cognitive neuropsychology is the observation of (double) dissociations in performance between patients, suggesting some degree of independence between cognitive processes (domain specificity). In comparison, observations of associations between disorders/deficits have been deemed less evidential in neuropsychological theorizing about cognitive architecture. The reason is that associations can reflect damage to independent cognitive processes that happen to be mediated by structures commonly affected by the same brain disorder rather than damage to a shared (domain-general) mechanism. Here we demonstrate that it is in principle possible to discriminate between these alternatives by means of a procedure involving large unbiased samples. We exemplify the procedure in the context of developmental prosopagnosia (DP), but the procedure is in principle applicable to all neuropsychological deficits/disorders. A simulation of the procedure on a dataset yields estimates of dissociations/associations that are well in line with existing DP-studies, and also suggests that seemingly selective disorders can reflect damage to both domain-general and domain-specific cognitive processes. However, the simulation also highlights some limitations that should be considered if the procedure is to be applied prospectively. The main advantage of the procedure is that allows for examination of both associations and dissociations in the same sample. Hence, it may help even the balance in the use of associations and dissociations as grounds for neuropsychological theorizing.

Lower buprenorphine elimination rate constant is associated with lower opioid use

BACKGROUND

Opioid craving is suggested to correlate with the rate of reduction in buprenorphine (BUP) plasma levels. No studies explored Buprenorphine elimination rate constant (BUP EL.R) as a predictor of opioid use or retention in BUP treatment.

METHODS

Analysis was performed using data from a randomized controlled trial of 141 adults with opioid use disorder (OUD) randomized to Incentivized Adherence and Abstinence monitoring (I-AAM; experimental (n = 70) and treatment-as-usual; control (n = 71). In the I-AAM, structured access to unsupervised BUP doses was provided up to 28 days contingent of adherence measured by Therapeutic Drug Monitoring and abstinence by Urinary Drug Screens (UDS). In contrast, the treatment-as-usual (control) provided unstructured access to unsupervised doses was provided for up to 14 days considering UDS results. The primary outcome was percentage negative UDS. The secondary outcome, retention in treatment, was continuous enrollment in the study and analysis was via intention-to-treat. Significant bivariate correlations with the outcomes were adjusted for group allocation.

RESULTS

A significant negative correlation between BUP EL.R and percentage negative opioid screens (Pearson correlation coefficient - 0.57, p < 0.01) was found. After adjusting for trial group, BUP EL.R was shown to be an independent predictor of percentage negative opioid screens (Standardized Beta Coefficient - 0.57, 95% CI - 221.57 to - 97.44, R² 0.322).

CONCLUSION

BUP EL.R predicted 32.2% of the variation in percentage negative opioid UDS and may serve as a potential promising tool in precision medicine of BUP treatment. Higher buprenorphine elimination is associated with higher positive opioid urine screens during treatment.

TRIAL REGISTRATION

ISRCTN41645723 retrospectively registered on 15/11/2015.

Prevalence and associations of asteroid hyalosis: the Beijing Eye Study

Background

To determine the prevalence and associations of asteroid hyalosis (AH) in a Chinese population-based cohort.

Methods

The retrospective, cross-sectional, population-based Beijing Eye Study 2011 included 3468 individuals with a mean age of 64.6 ± 9.8 years (range: 50–93 years). Participants underwent detailed ophthalmic examinations including fundus photographs for diagnosis of AH. Data on systemic and ocular factors were collected for all participants according to the standardized protocol. Multiple linear regression and multivariate Logistic regression analysis were performed.

Results

Fundus photographs were gradable in 3419 subjects. AH was detected in 63 (0.9%, 95% CI: 0.7%, 1.1%) eyes of 53 (1.6%, 95% CI: 1.1%, 2.0%) subjects. AH was bilateral in 18.9%. Mean age of all subjects with AH was 69.2 ± 9.5 years (median, 71.0 years; range, 51–91 years), mean spherical equivalent was 0.63 ± 1.53D (median, 0.75 D; range, -4.12 to 4.00D). In multivariate analysis, prevalence of AH was associated with elder age (P = 0.014, OR 1.057), thicker lens (P = 0.032, OR 3.887), higher spherical equivalent (P = 0.017, OR 1.396).

Conclusions

In adult Chinese in Beijing, the prevalence of AH was 0.9% for eyes or 1.6% for subjects. AH was associated with elder age, thicker lens, and higher spherical equivalent. It was not associated with diabetes or other systemic indicators.

The incidence and prevalence of early-onset scoliosis: a regional multicenter epidemiological study

BACKGROUND CONTEXT

Despite the many advances in understanding and treating early-onset scoliosis, the incidence and prevalence of this disease in the population remains unknown. Such knowledge is important for guiding clinical practice, directing research and raising awareness.

PURPOSE

To identify the incidence and prevalence of early-onset scoliosis, including all categories, within the population.

STUDY DESIGN

A regional multicenter retrospective cohort study PATIENT SAMPLE: All patients diagnosed with early-onset scoliosis in the region, who were followed-up between January 2000 and December 2020.

OUTCOME MEASURES

Frequency distributions for early-onset scoliosis subtypes, demographics, curve patterns and progression statuses.

METHODS

Relevant population data, for children under 10 years old, was extracted from the official government census for the years 2000 to 2020. Identification of cases was carried out by pediatricians at mandatory government funded regular child wellness check-up visits. Outpatient records were reviewed for all included patients, with extraction of the following: Medical identifier, date of birth, date of initial visit, sex, primary diagnosis, length of follow-up, curve pattern, initial cobb angle, and final cobb angle. Incidence and prevalence values were calculated using population figures and case numbers. Kaplan-Meier survival analysis and Log-rank testing was performed on curve progression data.

RESULTS

The regional population of children, under the age of 10 years, included a total of 2,295,929 children, 1,170,149 (51.0%) males and 1,125,780 (49.0%) females, between the years 2000 and 2020. Early-onset scoliosis cases followed within the same timeframe, totaled 469 patients, 227 (48.4%) males and 242 (51.6%) females. The annual incidence of early-onset scoliosis was found to be 0.019% (95% CI: 0.015%-0.023%), and the prevalence was 0.077% (95% CI: 0.059%-0.096%). The most common age at first presentation was 6 years old. More females (51.6%) than males (48.4%) were observed, and more left-sided curves (54.2%) than right-sided curves (45.8%) were encountered, with the majority being single thoracic curves (38.2%). Scoliosis curves did not progress in 44.3% of cases, while they progressed in 38% of them. Follow-up was inadequate to determine progression status in 17.7% of cases. Neuromuscular etiologies were the most common, at 40.1%, of which 83.5% had cerebral palsy.

CONCLUSIONS

Based on the regional population included in this study, the annual incidence of early-onset scoliosis in children under 10 years old was calculated to be 0.019%, while the prevalence of early-onset scoliosis in children under 10 years old was found to be 0.077%.

How associative thinking influences scene perception

Perception of our external environment is not isolated from the influence of our internal thoughts, and past evidence points to a possible common associative mechanism underlying both the perception of scenes and our internal thought. Here, we investigated the nature of the interaction between an associative mindset and scene perception, hypothesizing a functional advantage to an associative thought pattern in the perception of scenes. Experiments 1 and 2 showed that associative thinking facilitates scene perception, which evolved over the course of the experiments. In contrast to scene perception, Experiment 3 showed that associative thinking hinders the perception of mundane objects, in which associative information is minimized. Nevertheless, object perception was facilitated when associative thinking was reduced. This double dissociation suggests that an associative mind is more receptive of externally perceived associative information, and that a match between the orientation of internal and external processing may be key for perception.

Effect of age and sex on the associations between potential modifiable risk factors and both type 2 diabetes and impaired fasting glycaemia among West African adults

Background

Type 2 diabetes mellitus (T2DM) is becoming one of the leading causes of morbidity and mortality worldwide, including among Africans. Knowledge of the association between traditional risk factors and both diabetes and pre-diabetes, and whether these differ by age and sex, is important for designing targeted interventions. However, little is known about these associations for African populations.

Methods

The study used data from WHO STEPS surveys, comprising 15,520 participants (6,774 men and 8,746 women) aged 25–64 years, from 5 different West African countries, namely Burkina Faso (4,711), Benin (3,816), Mali (1,772), Liberia (2,594), and Ghana (2,662). T-test and chi-square tests were used to compare differences in the prevalence of traditional risk factors for both sexes. Multinomial logistic regression was conducted to ascertain the relative risks (RR) and 95% confidence intervals (CI) for both T2DM and impaired fasting glucose (IFG) relating to each risk factor, including obesity [defined by BMI, waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR)], high blood pressure (HBP), fruit and vegetable consumption, physical inactivity, alcohol consumption, and smoking. Models for each of these traditional risk factors and interactions with age and sex were fitted.

Results

Factors associated with T2DM and IFG were age, obesity [defined by BMI, WC, WHtR, and WHR], HBP, smoking, physical inactivity, and fruit and vegetable consumption (p < 0.05). Analysis of interaction effects showed few significant differences in associations between risk factors and T2DM according to age or sex. Significant interaction with age was observed for HBP*age and T2DM [RR; 1.20, 95% CI: (1.01, 1.42)) (p = 0.04)], WHtR*age and T2DM [RR; 1.23, 95% CI: (1.06, 1.44) (p = 0.007)] and WHR*age and IFG [RR: 0.79, 95% CI: (0.67, 0.94) (p = 0.006)]. Some interactions with age and sex were observed for the association of alcohol consumption and both IFG and T2DM, but no clear patterns were observed.

Conclusion

The study found that with very few exceptions, associations between traditional risk factors examined and both IFG and T2DM did not vary by age or sex among the West African population. Policies and public health intervention strategies for the prevention of T2DM and IFG should target adults of any age or sex in West Africa.

Intimate partner violence among pregnant women in Kenya: forms, perpetrators and associations

BACKGROUND

Intimate Partner violence (IPV) among pregnant women is a significant problem of public health importance. Nevertheless, there are relatively few studies which have examined the phenomenon in sub-Saharan settings. The aim of this study was to provide an overview of the prevalence, perpetrators, and associated factors of IPV during pregnancy in Kenya.

METHODS

We were making use of the 2014 Kenyan Demographic and Health Survey (KDHS) data and included women and girls of reproductive age (15-49 years) who have ever been pregnant ([Formula: see text]). A weighted sample of respondents who have experienced violence during pregnancy ([Formula: see text]) were selected for further bivariate and multivariable logistic regression analyses in order to examine the association between IPV and socio-demographic factors.

RESULTS

The prevalence of violence among pregnant women in Kenya was 9.2%, perpetrated mostly by the current husband or partner (47.6%), followed by the former husband or partner (31.5%). Physical violence was the most common (78.6%), followed by emotional (67.8%) and sexual (34.8%). Having one or two children ([Formula: see text]; [Formula: see text]), having secondary or higher education ([Formula: see text]; [Formula: see text]) and being 18 years and above at first cohabitation ([Formula: see text]; [Formula: see text]) and at sexual debut ([Formula: see text]; [Formula: see text]) were significantly associated with fewer reports of violence during pregnancy. Pregnant women who were divorced, separated or widowed ([Formula: see text]; [Formula: see text]), who were employed ([Formula: see text]; [Formula: see text]), who had witnessed their fathers beat their mothers ([Formula: see text]; [Formula: see text]) and who had primary education ([Formula: see text]; [Formula: see text]) were significantly more likely to experience violence.

CONCLUSIONS

To prevent violence among pregnant women in Kenya, training health care providers should go hand in hand with interventions sensitising and mobilising community members, both addressing the socio-demographic drivers of IPV during pregnancy and directing a particular attention to the most vulnerable ones.

Emotion schema effects on associative memory differ across emotion categories at the behavioural, physiological and neural level: Emotion schema effects on associative memory differs for disgust and fear

Previous behavioural and neuroimaging studies have consistently reported that memory is enhanced for associations congruent or incongruent with the structure of prior knowledge, termed as schemas. However, it remains unclear if similar effects arise with emotion-related associations, and whether they depend on the type of emotions. Here, we addressed this question using a novel face-word pair association paradigm combined with fMRI and eye-tracking techniques. In two independent studies, we demonstrated and replicated that both congruency with emotion schemas and emotion category interact to affect associative memory. Overall, memory retrieval was higher for faces from pairs congruent vs. incongruent with emotion schemas, paralleled by a greater recruitment of left inferior frontal gyrus (IFG) during successful encoding. However, emotion schema effects differed across two negative emotion categories. Disgust was remembered better than fear, and only disgust activated left IFG stronger during encoding of congruent vs. incongruent pairs, suggestive of deeper semantic processing for the associations. On the contrary, encoding of congruent fear vs. disgust-related pairs was accompanied with greater activity in right fusiform gyrus (FG), suggesting a stronger sensory processing of faces. In addition, successful memory formation for congruent disgust pairs was associated with a higher pupil dilation index related to sympathetic activation, longer gaze time on words compared to faces, and more gaze switches between paired words and faces. This was reversed for fear-related congruent pairs where the faces attracted longer gaze time (compared to words). Overall, our results provide converging evidence from behavioural, physiological, and neural measures to suggest that congruency with available emotion schemas influence memory associations in a similar manner to semantic schemas. However, these effects vary across distinct emotion categories, pointing to a differential role of semantic processing and visual attention processes in the modulation of memory by disgust and fear, respectively.

Long-term patterns of an interconnected core marine microbiota

BACKGROUND

Ocean microbes constitute ~ 70% of the marine biomass, are responsible for ~ 50% of the Earth's primary production and are crucial for global biogeochemical cycles. Marine microbiotas include core taxa that are usually key for ecosystem function. Despite their importance, core marine microbes are relatively unknown, which reflects the lack of consensus on how to identify them. So far, most core microbiotas have been defined based on species occurrence and abundance. Yet, species interactions are also important to identify core microbes, as communities include interacting species. Here, we investigate interconnected bacteria and small protists of the core pelagic microbiota populating a long-term marine-coastal observatory in the Mediterranean Sea over a decade.

RESULTS

Core microbes were defined as those present in > 30% of the monthly samples over 10 years, with the strongest associations. The core microbiota included 259 Operational Taxonomic Units (OTUs) including 182 bacteria, 77 protists, and 1411 strong and mostly positive (~ 95%) associations. Core bacteria tended to be associated with other bacteria, while core protists tended to be associated with bacteria. The richness and abundance of core OTUs varied annually, decreasing in stratified warmers waters and increasing in colder mixed waters. Most core OTUs had a preference for one season, mostly winter, which featured subnetworks with the highest connectivity. Groups of highly associated taxa tended to include protists and bacteria with predominance in the same season, particularly winter. A group of 13 highly-connected hub-OTUs, with potentially important ecological roles dominated in winter and spring. Similarly, 18 connector OTUs with a low degree but high centrality were mostly associated with summer or autumn and may represent transitions between seasonal communities.

CONCLUSIONS

We found a relatively small and dynamic interconnected core microbiota in a model temperate marine-coastal site, with potential interactions being more deterministic in winter than in other seasons. These core microbes would be essential for the functioning of this ecosystem over the year. Other non-core taxa may also carry out important functions but would be redundant and non-essential. Our work contributes to the understanding of the dynamics and potential interactions of core microbes possibly sustaining ocean ecosystem function.

Alveolar soft part sarcoma in a young woman: A case report from Hong Kong

Alveolar soft part sarcoma (ASPS) is a rare, highly vascular, deep soft tissue mesenchymal malignancy that is classically seen in the lower extremities of young adults. We reported a case of a 32-year-old young Chinese woman in Hong Kong with a biopsy-proven alveolar soft part sarcoma. The condition can be suggested by classical features using contrast-enhanced CT scans and MRIs or confirmed by image-guided biopsies. Early recognition of the condition is important due to its poor prognosis and lack of awareness. The mainstay of treatment for ASPS is complete surgical resection of the primary tumor and radiotherapy for microscopic residual disease at the primary site, or chemotherapy in special cases.

Prenatal breastfeeding knowledge, attitude and intention, and their associations with feeding practices during the first six months of life: a cohort study in Lebanon and Qatar

Background

Prenatal knowledge, attitude, and intention related to breastfeeding are postulated as important modulators of feeding practices. Using data from the Mother and Infant Nutritional Assessment (MINA) study, a three year cohort conducted in Lebanon and Qatar, this study aimed to characterize breastfeeding practices during the first six months postnatally and examine their associations with prenatal breastfeeding knowledge, attitude, exposure, and intention.

Methods

Pregnant women during their first trimester were recruited from primary healthcare centers in Beirut and Doha. Data collection was conducted in 2015 − 2018. Participants were followed-up until the child was twoyears old. Exposure, knowledge, attitude, and intentions regarding breastfeeding were assessed during the third trimester of pregnancy (n = 230), using validated questionnaires and scales. Breastfeeding practices were evaluated at four months (n = 185) and six months (n = 151) postpartum. Early initiation of breastfeeding was defined as putting the infant to the breast within one hour of birth, and exclusive breastfeeding (EBF) as feeding exclusively with breast milk.

Results

Breastfeeding practices were as follows: ever breastfeeding: 95.8%; early initiation of breastfeeding: 72.8%; breastfeeding at four and six months: 70.3% and 62.3%; EBF at four and six months: 35.7% and 18.5%. Over 95% of participants had high breastfeeding exposure, and 68.8% had strong / very strong intentions to breastfeed. Only 25% had very good knowledge, and 9.2% reported positive/strong positive attitude towards breastfeeding. After adjustment, high exposure was associated with greater odds of breastfeeding initiation (OR 10.1: 95% CI 1.25, 80.65). Both positive attitude towards breastfeeding and strong intention to breastfeed were associated with EBF at four months (OR 2.51; 95% CI 1.02, 6.16 and OR 4.0; 95% CI 1.67, 9.6), breastfeeding at four months (OR 2.92: 95% CI 1.29, 6.62 and OR 5.00: 95% CI 2.25, 11.1), and breastfeeding at six months (OR 3.74: 95% CI 1.24, 11.32 and OR 8.29: 95% CI 2.9, 23.68).

Conclusions

Findings of this study documented suboptimal knowledge and attitude towards breastfeeding and showed that prior exposure, a positive attitude, and a strong intention to breastfeed prenatally were significant predictors of breastfeeding practices postnatally. This highlights the need to develop specific interventions and policies aimed at improving breastfeeding attitudes and creating an enabling environment that supports women throughout their breastfeeding journey.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13006-022-00456-x.

Facing Muscular Dystrophy During Covid-19 Pandemic: The Role of Support Associations and Spirituality

Several researches in scientific literature analyze the theme of Muscular Dystrophy (MD), As well as many others focus on the theme of the Covid-19 pandemic; however, there is a rather limited number of studies that analyse how the pandemic has affected the life of people suffering from MD, especially during the time of the first lockdown in the spring of 2020. The present study has applied a qualitative research design with the aim to investigate how patients with MD have lived the social restrictions imposed for the contagion containment and whether the assistance of associations for their support has contributed to make the participants feel closer or more distant from the spiritual dimension. The analysis involved 12 participants, and they were presented with a semi-structured interview. The data obtained from the interviews have been analysed through a thematic analysis from which 4 thematic areas have emerged: (1) the impact of the pandemic on an emotional level; (2) the illness management and the role of family; (3) the role of the associations; (4) aspects related to spirituality. The crucial role that the closeness of family and the activities promoted remotely by the associations for patients' support has emerged, since they have allowed the participants to feel united by something beyond, to discover new aspects of themselves, to give more value to Life and to move closer to their spiritual dimension.

Breastfeeding associated hypernatraemia: clinical presentations, complications and outcome in a subset of Sudanese neonates

A descriptive cross-sectional hospital-based study was conducted with the objectives to study clinical presentations, complications and outcomes of breastfeeding-associated hypernatraemia (BFAHN) in full-term neonates admitted to Ibrahim Malik Teaching Hospital, Khartoum, Sudan, during the period September 2017-2019. Eighty-four neonates with BFAHN were enrolled in the study. Collected demographic data of the neonates and their mothers included age at presentation, gender, birth weight, current weight, mode and place of delivery, maternal age, parity, education level, time of starting breastfeeding, presenting symptoms and signs, complications and outcome. The prevalence of the BFAHN was 15.5%. The mean age at presentation was 9.38 ± 5.95 days, range of 2-27 days and 59.5% were males. Most of them delivered vaginally (85.7%) and in hospital (63.1%). The mothers were multigravida in 58% and with a mean age of 28.14 ± 6.68 years and 3/4th of them started breastfeeding within the first hour. The most common symptoms and signs were fever, poor feeding, decreased urine output, jaundice, dehydration and loss of weight more than 10% of birth weight. The mortality rate was 21.4%. Complications included acute kidney injury in 82.1%, two patients needed peritoneal dialysis, one-third developed convulsions and two patients had intracranial bleeding. Factors associated with the development of the BFAHN were excessive loss of weight, multigravida, low maternal education level and vaginal delivery. Associated factors for death included thrombocytopenia, convulsions and severe hypernatraemia. Breast-milk sodium levels in mothers of 10 of the patients were high compared to 10 controls.

Food neophobia and the evaluation of novel foods in adults; the sensory, emotional, association (SEA) model of the decision to taste a novel food

Reluctance to eat new foods, known as food neophobia, is well researched in children but not adults. Two studies were carried out to understand the emotional, sensory, and cognitive factors associated with food neophobia in an adult sample, and to propose a preliminary explanation of the decision to taste a novel food named the SEA model (Sensory, Emotional, cognitive Association model). Participants were recruited through opportunity sampling of a university population in the Leicester region of the UK. Study one (n = 534) was a cross sectional study examining associations between self-report measures of food neophobia, emotional variables and sensory variables. In study two (n = 160), participants completed an online cognitive evaluation of 7 images of novel fruits and vegetables, rating perceived familiarity, categorisation as fruit or vegetable, cognitive associations based on appearance (what does the food look like), liking of any associated foods, and expected liking of the novel food. In study 1 it was found that tactile sensitivity and disgust sensitivity were the main sensory and emotional variables associated with food neophobia. In study 2, it was found that food neophobia and lower expected liking of novel foods were associated with disgust sensitivity, associating the novel foods with disliked foods, and lower perceived familiarity. The SEA model further proposes that underlying tendencies and automatic reactions to foods, combine with cognitive associations based on negative memories and negative beliefs about tasting new foods, to create expected disliking of a food and a decreased likelihood that it will be tried. Further work is needed to fully test the SEA model of the decision to taste a novel food, in particular to further examine how associations are formed.

Serum concentrations of neonicotinoids, and their associations with lipid molecules of the general residents in Wuxi City, Eastern China

Exposure to neonicotinoid insecticides (NNIs) was proven to be harmful to organisms, however, there is a dearth of information regarding their occurrence and adverse effects on the general residents. Here, n = 120 human serum samples were collected from the same area of Wuxi city, Eastern China, and these serum samples were further analyzed for nine NNIs and nine target lipid molecules by use of ultrahigh performance liquid chromatography-quadrupole orbitrap high-resolution mass spectrometer. We observed that four out of nine NNIs exhibited relatively high detection frequencies (DF), and these NNIs were imidacloprid (IMI; DF = 28.3%), clothianidin (CLO; 16.7%), thiacloprid (THI; 14.2%), and acetamiprid (ACE; 12.5%), respectively, with 95th concentrations ranging from 32.0 to 427 pg/mL. Median concentrations of imidacloprid-equivalent total neonicotinoids (IMI_eq) and ∑₇NNI were 46.6 pg/mL and 26 pg/mL, respectively. Five out of nine lipid molecules exhibited higher levels, that were docosahexaenoic acid [FA(22:6)], 18:0 phosphocholine [LysoPC(18:0)], 18:0 phosphoethanolamine [LysoPE(18:0)], D18:1-18:0 sphingomyelin [SM(d18:1/18:0)], and 18:1-18:1 diglycerol [DG(18:1/18:1)], respectively. More interestingly, we observed statistically significant correlations (student's t-test, one-way ANOVA, or Mann-Whitney test; p < 0.05) between NNI levels and population characteristics (i.e. age, smoking, and health status). Beyond that, we also observed statistically significant correlations between levels of selected NNIs (CLO, ACE, or THI) and lipid molecules [LysoPE(18:0), SM(d18:1/18:0), and DG(18:1/18:1)]. Collectively, for the first time, we provided the information on contamination levels of NNIs in serum samples of general residents in China and demonstrated the associations between concentrations of NNIs and levels of lipid molecular species.

Children's experienced and imaginary stories about lunch packs and lunch breaks: Associations and perceptions of school lunch among primary school students in Norway

This article examined Norwegian students' associations with lunch packs and lunch breaks in primary schools, highlighting the Norwegian school meal system. Empathy-based stories were used; that is, participants were asked to write on a story about a good or a bad school lunch, either based on actual experiences or imagination. The data included stories from 181 fifth graders (105 girls and 76 boys) aged 10-11 years. Additionally, this study employed a social-constructivist approach. The analysis of the stories on the lunch packs resulted in four sub-themes: food and sensory properties of food; food norms and the violation of the norms; physical and psychological consequences of (not) eating lunch; and expressions of peer-relations and family bonds. The analysis of the stories on lunch breaks resulted in two sub-themes: social interaction and simultaneous activity, and contextual factors. In the stories the lunch pack was found to evoke both enthusiasm and discontent. Students' associations and perceptions of the food were often related to how it looked, smelled, and tasted. Furthermore, a clear feature of the stories concerning lunch break in the classroom was that the students were concerned with the social aspects of the eating situation, such as interacting with classmates by chatting, watching television, or listening to music together. This study can contribute to a deeper understanding of children's experiences with a school meal system used in countries within and outside the Nordic region.

Key factors associated with oral health-related quality of life in Sri Lankan adolescents: a cross sectional study

Background

Oral Health Related Quality of Life (OHRQoL) measures have emerged as an important oral health outcome that is able to reveal the subjective burden of illness due to oral diseases. The association between sociodemographic and socioeconomic factors, clinical dental conditions and OHRQoL indicators has been investigated in adolescent populations across the world. The purpose of this study was to investigate key factors associated with oral health-related quality of life of Sri Lankan adolescents.

Methods

A cross sectional study was conducted in a sample of 15–19 year-old secondary school students in the Gampaha district of Sri Lanka. The data was collected using two self-administered questionnaires. A modified Sinhalese version of the Oral Impact on Daily Performance (OIDP) questionnaire that has been validated for Sri Lankan adolescents was administered. A second questionnaire collected information on socioeconomic characteristics, oral health care seeking and oral health behaviours. A clinical oral examination was performed on each participant. Oral health related quality of life was measured using OIDP domains and total OIDP scores. Poisson regression was used to investigate the key factors associated with the OIDP additive score.

Results

A total of 1332 adolescents participated in the study. Negative quality of life impacts were more prevalent in the social and psychological domains of OIDP as compared with the functional domain. Total OIDP scores ranged from 0 to 36 with a mean of 3.16 (SD = 4.71). The multivariable analysis revealed that increasing age, low income, brushing teeth only once per day, and increased number of decayed teeth were found to be associated with poor overall OHRQoL, while male gender, frequent oral healthcare seeking patterns and absent dento-facial anomalies were associated with good OHRQoL.

Conclusion

This study identified modifiable behavioural and oral health related factors which are associated with OHRQoL in Sri Lankan adolescents. Oral health interventions should target these modifiable factors to improve the OHRQoL in these populations.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12903-021-01569-1.

Bacterial community structure alterations within the colorectal cancer gut microbiome

BACKGROUND

Colorectal cancer is a leading cause of cancer-related deaths worldwide. The human gut microbiome has become an active area of research for understanding the initiation, progression, and treatment of colorectal cancer. Despite multiple studies having found significant alterations in the carriage of specific bacteria within the gut microbiome of colorectal cancer patients, no single bacterium has been unequivocally connected to all cases. Whether alterations in species carriages are the cause or outcome of cancer formation is still unclear, but what is clear is that focus should be placed on understanding changes to the bacterial community structure within the cancer-associated gut microbiome.

RESULTS

By applying a novel set of analyses on 252 previously published whole-genome shotgun sequenced fecal samples from healthy and late-stage colorectal cancer subjects, we identify taxonomic, functional, and structural changes within the cancer-associated human gut microbiome. Bacterial association networks constructed from these data exhibited widespread differences in the underlying bacterial community structure between healthy and colorectal cancer associated gut microbiomes. Within the cancer-associated ecosystem, bacterial species were found to form associations with other species that are taxonomically and functionally dissimilar to themselves, as well as form modules functionally geared towards potential changes in the tumor-associated ecosystem. Bacterial community profiling of these samples revealed a significant increase in species diversity within the cancer-associated gut microbiome, and an elevated relative abundance of species classified as originating from the oral microbiome including, but not limited to, Fusobacterium nucleatum, Peptostreptococcus stomatis, Gemella morbillorum, and Parvimonas micra. Differential abundance analyses of community functional capabilities revealed an elevation in functions linked to virulence factors and peptide degradation, and a reduction in functions involved in amino-acid biosynthesis within the colorectal cancer gut microbiome.

CONCLUSIONS

We utilize whole-genome shotgun sequenced fecal samples provided from a large cohort of late-stage colorectal cancer and healthy subjects to identify a number of potentially important taxonomic, functional, and structural alterations occurring within the colorectal cancer associated gut microbiome. Our analyses indicate that the cancer-associated ecosystem influences bacterial partner selection in the native microbiota, and we highlight specific oral bacteria and their associations as potentially relevant towards aiding tumor progression.

Frequency, pattern, and associations of generalized osteoarthritis among Nigerians with knee osteoarthritis

BACKGROUND

Osteoarthritis (OA) is a common degenerative condition leading to significant pain, functional limitation, and economic loss. Generalized OA (GOA) is associated with greater morbidity and accounts for 5-25% of total OA cases depending on definition used. This paper aims to determine the frequency and pattern of GOA, compare clinical and laboratory parameters of GOA and non-GOA subjects, then identify independent associations of GOA among Nigerians with knee OA.

METHODS

A cross-sectional study of 180 knee OA patients with knee and generalized OA defined using ACR criteria. Questionnaire administration was followed by physical examination and appropriate radiographs. Data was summarized using tables and figures. Multivariate regression was done to identify independent GOA associations with statistical significance p<0.05. Ethical approval was obtained for the study.

RESULTS

There were 180 participants with mean age 59.7±9.1 years. Twenty-eight patients (15.6%) had GOA of which 26 were female. The hip/knee/spine pattern was the commonest while hand OA was rare. Comparisons showed that GOA patients were significantly older with longer pain duration, higher pain score, more Heberden's nodes, and greater fatigue. There were no significant differences between both groups in levels of inflammatory markers and other laboratory parameters. Further analysis identified joint stiffness as the only independent association of GOA (OR 3.34, p=0.01).

CONCLUSION

A 15.6% frequency of GOA was identified among knee OA sufferers with the hip/knee/spine pattern most frequent. Nigerians with GOA are predominantly females with a large joint phenotype. Joint stiffness was the only independent association of GOA observed. Key Points • Generalized osteoarthritis occurs in 15.6% of Nigerian patients with knee osteoarthritis. • Females are predominantly affected with a large joint phenotype involving the hip/knee/spine. • Joint stiffness is an independent association of generalized osteoarthritis.

Relationship between body mass index, cardiovascular biomarkers and incident heart failure

AIMS

There are limited data examining whether body mass index (BMI) influences the association between cardiovascular biomarkers and incident heart failure (HF).

METHODS AND RESULTS

Thirteen biomarkers representing key HF domains were measured: N-terminal pro-B-type natriuretic peptide (NT-proBNP), mid-regional pro-A-type natriuretic peptide (MR-proANP), cardiac troponin T (cTnT), C-reactive protein, procalcitonin, galectin-3, C-terminal pro-endothelin-1 (CT-proET-1), mid-regional pro-adrenomedullin, plasminogen activator inhibitor-1, copeptin, renin, aldosterone, and cystatin-C. Associations of biomarkers with BMI were examined using linear regression models, and with incident HF using Cox regression models. We selected biomarkers significantly associated with incident HF, and evaluated whether BMI modified these associations. Among 8202 individuals, 41% were overweight (BMI 25-30 kg/m² ), and 16% were obese (BMI ≥30 kg/m² ). Mean age of the cohort was 49 years (range 28-75), and 50% were women. All biomarkers except renin were associated with BMI: inverse associations were observed with NT-proBNP, MR-proANP, CT-proET-1 and aldosterone whereas positive associations were observed with the remaining biomarkers (all P ≤ 0.001). During 11.3 ± 3.1 years of follow-up, 357 HF events were recorded. Only NT-proBNP, MR-proANP and cTnT remained associated with incident HF (P < 0.001), and a significant biomarker*BMI interaction was not observed (interaction P > 0.1). Combined NT-proBNP and cTnT measurements modestly improved performance metrics of the clinical HF model in overweight (ΔC-statistic = 0.024; likelihood ratio χ²  = 38; P < 0.001) and obese (ΔC-statistic = 0.020; likelihood ratio χ²  = 32; P < 0.001) individuals.

CONCLUSIONS

Plasma concentrations of several cardiovascular biomarkers are influenced by obesity. Only NT-proBNP, MR-proANP and cTnT were associated with incident HF, and BMI did not modify these associations. A combination of NT-proBNP and cTnT improves HF risk prediction in overweight and obese individuals.

Unusual Radiological Features of a Breast Cancer Patient Presenting with Nipple Discharge in Hong Kong

A 62-year-old woman was presented with blood stained nipple discharge for many years. Mammograms and ultrasound study revealed a prominent left nipple, increase in nipple vascularity and nipple calcifications. Ductogram revealed an obstruction at the proximal part of the discharging duct. Surgical excision of the nipple demonstrated encapsulated papillary carcinoma. The excision margins appeared to be clear, but tumor tissue was found within 1 mm from the deep margin. Ultra-filtered sulfur colloid sentinel node examination was negative. Thus, simple left mastectomy was performed. The specimen was confirmed as ductal carcinoma in situ of the left breast.

Relationships between types of balance performance in healthy individuals: Role of age

BACKGROUND

Balance is considered to be task-specific as indicated by studies reporting only small-sized and non-significant correlations between types of balance (e.g., static, dynamic). However, it remains unclear whether these associations differ by age and the comparability of studies is limited due to methodological inconsistencies.

RESEARCH QUESTION

Are associations between types of balance performance affected by age in children, adolescents, and young adults?

METHODS

Static, dynamic, and proactive balance performance was assessed in 30 children (7.6 ± 0.6 years), 43 adolescents (14.7 ± 0.5 years), and 54 young adults (22.8 ± 2.8 years) using the same standardized balance tests. Pearson's correlation coefficients (r) were calculated for associations between types of balance and statistically compared to detect differences between age groups.

RESULTS

Except for the association between static (i.e., medio-lateral [M/L] sway) and proactive (Y-balance test) balance performance in young adults (r = .319, p < .05), our analyses revealed small-sized and non-significant associations between measures of static, dynamic, and proactive balance performance in children (-.302 ≤ r ≤ .245, p > .05), adolescents (-.276 ≤ r ≤ .202, p > .05), and young adults (-.120 ≤ r ≤ .161, p > .05). Significant differences between age groups were observed for associations between dynamic and proactive balance, which were lesser in young adults (r = .161) compared to adolescents (r = -.276, p = .017) and children (r = -.302, p = .023) and for associations between static (i.e., M/L sway) and proactive balance, which were larger in young adults (r = .319) compared to adolescents (r = -.131, p = .029).

CONCLUSIONS

Practitioners (e.g., PE teachers) should be aware that associations between types of balance performance are small and hardly affected by age in youth. Therefore, they should be trained and tested individually in children, adolescents, and young adults.

Gestational exposures to outdoor air pollutants in relation to low birth weight: A retrospective observational study

Findings for impacts of outdoor air pollutants on birth outcomes were controversial. We performed a retrospective observational study in 2527 preschoolers of Shanghai, China and investigated associations of duration-averaged concentrations of outdoor sulphur dioxide (SO₂), nitrogen dioxide (NO₂), and particulate matter with an aerodynamic diameter ≤ 10 μm (PM₁₀) in different months and trimesters of gestation, with preterm birth (PB), low birth weight (LBW), term low birth weight (T-LBW), and small for gestational age (SGA). Daily concentrations of outdoor air pollutants were collected in each residence-located district. Parents reported health information. In the multivariate logistic regression analyses, exposures to outdoor NO₂ were consistently associated with the higher odds of LBW and T-LBW. These associations were generally stronger for early months than for later months of the gestation. Adjusted odds ratios generally were larger in multi-pollutant model than in single-pollutant model. Exposure to NO₂ in the first month of the gestation was significantly associated with T-LBW (adjusted OR, 95%CI: 1.91, 1.02-3.58 for increment of interquartile range (18.5 μg/m³); p-value = 0.044) in multi-pollutant model. This association was stronger in girls, renters, and children whose mothers ≥30 years-old, with household dampness-related exposures, and with parental smoking during pregnancy. Our results indicate that exposure to NO₂ during gestation perhaps is a risk factor for LBW and T-LBW, and effects of NO₂ exposures could be greater during early periods than during later periods of gestation.

Prevalence and correlates of adherence to the combined movement guidelines among Czech children and adolescents

Background

There are limited studies on the prevalence of adherence to the combined guidelines for physical activity (PA), sedentary behavior, and sleep in children and adolescents. Moreover, little is known about correlates of adherence to the guidelines. Therefore, the main aim of this study is to examine the prevalence and identify the correlates of adherence to the combined movement guidelines among children and adolescents.

Methods

A total of 355 children aged 8–13 years (44% boys) and 324 adolescents aged 14–18 years (43% boys) from the Czech Republic participated in this study. PA and sleep duration were estimated using multi-day 24-h raw data from wrist-worn accelerometers. Recreational screen time was parent proxy-reported in children and self-reported in adolescents. Seventeen potential correlates were grouped into three homogenous categories for biological and cognitive, behavioral, and family correlates. The multi-level multivariable logistic regression was applied to identify correlates of adherence to combined movement guidelines and to specific combinations of any of two recommendations.

Results

Approximately 6.5% of children and 2.2% of adolescents met all recommendations of the combined movement guidelines. In children, girls (OR = 0.4; 95% CI = 0.1–0.9) and participants with overweight or obese fathers (OR = 0.3; 95% CI = 0.1–0.7) had significantly lower odds of adherence to the combined movement guidelines. Additionally, children had higher odds of meeting specific combinations of two recommendations if they reported regular fruit and vegetable intake, participated in organized PA, or if their fathers had a university degree. Meanwhile, paternal overweight and obesity, and high sleep efficiency were associated with lower odds of meeting specific combinations of recommendations. In adolescents, sex, fruit and vegetable intake, organized PA, and active play were correlates of meeting specific combinations of any two recommendations.

Conclusions

A low proportion of children and adolescents met the combined movement guidelines and several correlates related to family were identified. Family is a key source of influence for healthy movement behaviors during childhood and adolescence.

Prevalence and associated factors for suicidal behaviours (ideation, planning, and attempt) among high school adolescents in Lagos, Nigeria

To plan effective school-based adolescent suicide prevention strategies, there is need for valid epidemiology data. The aim of this study was to estimate the current (1 month) prevalence and associated factors of suicidal behaviours (ideation, planning, and attempt) amongst secondary school adolescents in Lagos, Nigeria. A total of 9441 adolescents (4684 males and 4757 females) with mean age 15.61 years (SD 1.49) recruited from 47 public senior secondary schools self-completed questionnaire consisting of sociodemographic, family, school, physical health, and mental health-related variables. Suicidal behaviours (ideation, planning, and attempt) in the past 1 month were also assessed. The weighted 1-month prevalence for suicidal ideation was 6.1% (95% CI 5.5-6.7), suicidal planning was 4.4% (95% CI 3.8-4.9), and suicidal attempt was 2.8% (95% CI 2.4-3.2). The factors significantly associated with suicidal behaviours included being female, not staying with the mother, maternal drinking, witnessing domestic violence, past and present academic difficulties, having no close friend in school and having problems relating with peers and teachers. Also, presence of chronic physical illnesses, depression, anxiety, behavioural disorders, and psychotic-like experiences were associated with adolescent suicidal behaviour. We have shown that a substantial percentage of adolescent have suicidal behaviours, and that there were demographic, family, school, physical health, and psychological health-related factors. We believe that our findings will be important when planning suicide prevention services that could be incorporated into the school mental health services.