Determinants of Increased Central Excess Pressure in Dialysis: Role of Dialysis Modality and Arteriovenous Fistula

Abstract BACKGROUND Arterial reservoir-wave analysis (RWA)—a new model of arterial hemodynamics—separates arterial wave into reservoir pressure (RP) and excess pressure (XSP). The XSP integral (XSPI) has been associated with increased risk of clinical outcomes. The objectives of the present study were to examine the determinants of XSPI in a mixed cohort of hemodialysis (HD) and peritoneal dialysis (PD) patients, to examine whether dialysis modality and the presence of an arteriovenous fistula (AVF) are associated with increased XSPI. METHOD In a cross-sectional study, 290 subjects (232 HD and 130 with AVF) underwent carotid artery tonometry (calibrated with brachial diastolic and mean blood pressure). The XSPI was calculated through RWA using pressure-only algorithms. Logistic regression was used for determinants of XSPI above median. Through forward conditional linear regression, we examined whether treatment by HD or the presence of AVF is associated with higher XSPI. RESULTS Patients with XSPI above median were older, had a higher prevalence of diabetes and cardiovascular disease, had a higher body mass index, and were more likely to be on HD. After adjustment for confounders, HD was associated with a higher risk of higher XSPI (odds ratio = 2.39, 95% confidence interval: 1.16–4.98). In a forward conditional linear regression analysis, HD was associated with higher XSPI (standardized coefficient: 0.126, P = 0.012), but on incorporation of AVF into the model, AVF was associated with higher XSPI (standardized coefficient: 0.130, P = 0.008) and HD was excluded as a predictor. CONCLUSION This study suggests that higher XSPI in HD patients is related to the presence of AVF.

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Health and nutrition literacy in adults: Links with lifestyle factors and obesity

Mediterranean Journal of Nutrition and Metabolism ◽

10.3233/mnm-200471 ◽

2020 ◽

Vol 13 (4) ◽

pp. 361-370

Author(s):

Maria Michou ◽

Demosthenes B. Panagiotakos ◽

Christos Lionis ◽

Vassiliki Costarelli

Keyword(s):

Physical Activity ◽

Alcohol Consumption ◽

Linear Regression ◽

Smoking Status ◽

Linear Regression Analysis ◽

Cross Sectional Study ◽

Lifestyle Factors ◽

Linear Regression Models ◽

Chi Square ◽

Cross Sectional

BACKGROUND: Low Health Literacy (HL) and Nutrition Literacy (NL) are associated with serious negative health outcomes. OBJECTIVES: The aim of this study was to investigate certain lifestyle factors and obesity, in relation to HL and NL. METHODS: This cross-sectional study was conducted in the urban area of the Attica region, in Greece. The sample consisted of 1281 individuals, aged ≥18 years. HL, NL sociodemographic characteristics and lifestyle factors (physical activity, smoking status, alcohol consumption,) were assessed. Mann-Whitney U, the Kruskall Wallis, Pearson chi-square tests and multiple linear regression models were used. RESULTS: Linear regression analysis has shown that smoking, alcohol consumption and physical activity, were associated with HL levels (–1.573 points for ex-smokers in comparison to smokers, p = 0.035, –1.349 points for alcohol consumers in comparison to non-consumers, p = 0.006 and 1.544 points for physically active individuals to non-active, p = 0.001). With respect to NL levels, it was also not associated with any of these factors. Obesity was not associated with HL and NL levels. CONCLUSIONS: Certain lifestyle factors, including physical activity, are predicting factors of HL levels, in Greek adults. The results contribute to the understanding of the relationship between lifestyle factors and HL and should be taken into account when HL policies are designed.

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Association between Cyclothymic Affective Temperament and Age of Onset of Hypertension

International Journal of Hypertension ◽

10.1155/2019/9248247 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Beáta Körösi ◽

Milán Vecsey-Nagy ◽

Márton Kolossváry ◽

Zsófia Nemcsik-Bencze ◽

Bálint Szilveszter ◽

...

Keyword(s):

Emotional Reactivity ◽

Age Of Onset ◽

Linear Regression Analysis ◽

Age At Onset ◽

Positive Family History ◽

Cross Sectional Study ◽

Cross Sectional ◽

Affective Temperaments ◽

Affective Temperament

Affective temperaments represent a biologically stable core of emotional reactivity and have previously been associated with hypertension and arterial stiffening. The age, when hypertension is initiated, is influenced by different factors, but the role of personality traits in this regard is not clarified yet. Our aim was to study the association between affective temperaments and the age at onset of hypertension. In this cross-sectional study, 353 patients were included. After the evaluation of history, patients completed the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire. We used linear regression analysis to identify predictors of the age of onset of hypertension in the whole cohort and in male and female subpopulations. The independent predictors of the age at onset of hypertension were male sex (B = −4.57 (95% CI = −1.40 to −7.74)), smoking (B = −4.31 (−7.41 to −1.22)), and positive family history (B = −6.84 (−10.22 to −3.45)). In women, cyclothymic temperament score was an independent predictor of the initiation of hypertension (B = −0.83 (−1.54 to −0.12)), while this association was absent in men. Besides traditional factors, cyclothymic affective temperament might contribute to the earlier initiation of hypertension in women.

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Longer shared parental leave is associated with longer duration of breastfeeding: a cross-sectional study among Swedish mothers and their partners

BMC Pediatrics ◽

10.1186/s12887-020-02065-1 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Maria Grandahl ◽

Jenny Stern ◽

Eva-Lotta Funkquist

Keyword(s):

Linear Regression ◽

Parental Leave ◽

Linear Regression Analysis ◽

Cross Sectional Study ◽

Vaginal Birth ◽

Breastfeeding Duration ◽

Multivariate Linear Regression Analysis ◽

Sectional Study ◽

Cross Sectional ◽

Duration Of Breastfeeding

Abstract Background Breastfeeding is associated with health benefits for both the mother and infant and is therefore important to support; moreover, parental leave is a beneficial factor for breastfeeding. The Swedish parental leave is generous, allowing each parent to take 90 days; additionally, a further 300 days can be taken by either parent. Generally, mothers take 70% of the parental leave days, mainly during the first year. However, breastfeeding duration has declined in the last decade, and it is not known how shared parental leave is associated with the duration of breastfeeding. Aim To investigate how parental leave is associated with the duration of exclusive and partial breastfeeding of the infant during the first 12 months after birth. An additional aim was to describe infants’ and parents’ characteristics and mode of birth in association with the duration of exclusive and partial breastfeeding. Methods This cross-sectional study was part of the Swedish Pregnancy Planning Study, conducted in Sweden in 2012–2015. The parents were recruited at 153 antenatal clinics in nine counties. In total, 813 couples completed a follow-up questionnaire 1 year after birth. Linear regression models were used to analyse the association between parental leave and the duration of breastfeeding. Results Infants were exclusively breastfed for, on average, 2.5 months (range 0–12 months) and partially breastfed, on average, 7 months (range 0–12 months). Most of the parental leave was taken by the mother (mean = 10.9 months) during the infant’s first 12 months, while the partner took 3 months, on average. The parental leave (used and planned) during the infant’s first 24 months were, on average, 21 months. In the multivariate linear regression analysis, mothers’ and partners’ high level of education (p < 0.001, p = 0.044, respectively), mothers’ higher age (p = 0.049), non-instrumental vaginal birth (p = 0.004) and longer parental leave for the first 24 months (p < 0.001) were associated with longer duration of partial breastfeeding. Conclusion The duration of partial breastfeeding was associated with higher parental educational level, higher age, non-instrumental vaginal birth and longer parental leave.

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Structural and Biomechanical Corneal Differences between Type 2 Diabetic and Nondiabetic Patients

Journal of Ophthalmology ◽

10.1155/2019/3764878 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 5

Author(s):

João N. Beato ◽

João Esteves-Leandro ◽

David Reis ◽

Manuel Falcão ◽

Vítor Rosas ◽

...

Keyword(s):

Linear Regression ◽

Linear Regression Analysis ◽

Corneal Thickness ◽

Biomechanical Properties ◽

Cross Sectional Study ◽

Applanation Tonometry ◽

Multivariate Linear Regression ◽

Multivariate Linear Regression Analysis ◽

Cross Sectional

Purpose. To analyze and compare corneal structural and biomechanical properties, characterized by corneal hysteresis (CH) and resistance factor (CRF), between patients with and without type 2 diabetes mellitus (DM), and determine the main ocular variables that influence them. Methods. Sixty diabetic and 48 age- and sex-matched non-DM patients were enrolled in this cross-sectional study. The DM group was analyzed according to DM duration (<or ≥ 10 years), HbA1c levels (<or ≥ 7%), and presence of retinopathy. CH and CRF were evaluated using the Ocular Response Analyzer® (ORA). Central corneal thickness (CCT) was determined by Scheimpflug tomography (Pentacam® HR). Intraocular pressure was obtained with ORA (IOPcc) and Goldmann applanation tonometry (IOP-GAT). Univariate and multivariate linear regression analyses were performed to evaluate the relationship between demographical, clinical, and ocular variables with the biomechanical properties. Results. There were no statistically significant differences in the CH and the CRF between DM and non-DM groups (p=0.637 and p=0.439, respectively). Also, there was no statistical difference between groups for the CCT, IOPcc, or IOP-GAT. Multivariate linear regression analysis showed that CH was positively associated with CCT (p<0.001) and negatively associated with IOPcc (p<0.001), while CRF was positively associated with CCT (p<0.001) and IOPcc (p=0.014). Conclusion. The CCT and IOPcc were found to be the main parameters that affect corneal biomechanical properties both in diabetics and controls. In this study, there was no significant effect of DM type 2 on corneal biomechanics.

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Do aggregates of multiple questions better capture overall fish consumption than summary questions?

Public Health Nutrition ◽

10.1017/s1368980007000468 ◽

2008 ◽

Vol 11 (2) ◽

pp. 196-202 ◽

Cited By ~ 5

Author(s):

Kym Mina ◽

Lin Fritschi ◽

Matthew Knuiman

Keyword(s):

Linear Regression ◽

Fish Consumption ◽

Linear Regression Analysis ◽

Multiple Linear Regression Analysis ◽

Population Based ◽

Cross Sectional Study ◽

Validity And Reliability ◽

Cross Sectional ◽

Fresh Fish ◽

Fresh Frozen

AbstractObjectiveTo compare intake estimates, validity and reliability of two summary questions to measure fish consumption with information from a detailed semi-quantitative food-frequency questionnaire (FFQ) on fish consumption.DesignPopulation-based, cross-sectional study. Participants completed an FFQ and provided blood samples for erythrocyte membrane eicosapentaenoic acid (EPA) analysis. Aggregate measures of consumption of fresh/frozen/canned fish (fresh fish) and smoked/salted/dried fish (preserved fish) were generated from the FFQ and were compared with responses to the summary questions regarding intakes of similar items. Both methods were tested for validity, using correlation and linear regression techniques with EPA, and retest reliability.SettingPerth metropolitan area, Western Australia.SubjectsOne hundred and nine healthy volunteers of both sexes, aged 21–75 years.ResultsThe summary fresh fish measure underestimated frequency and grams per week given by the aggregate question by about 50%, while estimates from the summary preserved fish measure were approximately three times that of the aggregate measure. Multiple linear regression analysis suggested that the aggregates accounted for more of the variation in EPA levels, but the difference was minimal. Intra-class correlations confirmed that both methods were reliable.ConclusionsOur study indicates that extensive questioning results in different absolute intakes of fish compared with brief questioning, but does not add any information if ranking individuals according to overall consumption of fish.

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Nutritional status and quality of life in diabetic patients on hemodialysis: a cross-sectional study from Palestine

Journal of Health Population and Nutrition ◽

10.1186/s41043-021-00255-w ◽

2021 ◽

Vol 40 (1) ◽

Author(s):

Eba’a Hafi ◽

Ro’ya Soradi ◽

Sarah Diab ◽

Ahmad M. Samara ◽

Marah Shakhshir ◽

...

Keyword(s):

Quality Of Life ◽

Regression Analysis ◽

Linear Regression ◽

Nutritional Status ◽

Linear Regression Analysis ◽

Cross Sectional Study ◽

Diabetic Patients ◽

Sectional Study ◽

Cross Sectional

Abstract Background End-stage renal disease (ESRD) is a leading cause of death and morbidity worldwide. Malnutrition is a common problem among hemodialysis (HD) patients that negatively impacts their prognosis and is linked to an increase in morbidity and mortality in these patients, as well as a decrease in their quality of life (QOL). In this study, we aimed to evaluate the QOL and to investigate factors that can influence it, including nutritional status, as well as socio-demographic factors, among Palestinian diabetic patients on HD therapy. Methods This was a cross-sectional study that occurred at a large hemodialysis center in Palestine. Malnutrition was assessed by the malnutrition-inflammation scale (MIS), and the quality of life was evaluated by using the EuroQoL five-dimensional instrument (EQ-5D). Multivariable linear regression analysis was carried out to look at the effect of multiple variables on QOL. Results A total of 118 diabetic patients on HD were included. Of these, 66.9% were male, and 60.2% were aged 60 years or higher. Having multiple comorbid diseases (p=0.004) and having been on HD for >4 years (p=0.003) were significantly associated with a higher MIS score, whereas living alone (p=0.037) and having been on HD for >4 years (p=0.002) was significantly associated with lower EQ-5D score. We also observed a significant association between the MIS score and the EQ-5D score(r=−0.616, p<0.001). Multiple linear regression analysis demonstrated that diabetic hemodialysis patients who lived within a family household were positively correlated with the QOL score (standardized coefficient, 0.178; 95% confidence interval (CI), 0.042 to 0.372; p = 0.015), and MIS score was significantly and negatively correlated with QOL scores (standardized coefficient, −0.587; 95% CI, −0.047 to −0.028; p < 0.001). Conclusions We found that malnutrition was associated with a lower QOL score among diabetic patients on HD. We recommend general practitioners, dietitians, nephrologists, and nurses to make plans that pay more attention to this group of patients who show evidence of malnutrition. Patients on dialysis for ≥ 4 years, patients who live alone, and those suffering from multiple co-morbid diseases should receive special care due to their higher risk of being impacted by this problem.

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Impact of the COVID-19 pandemic on migraine in Japan: a multicentre cross-sectional study

The Journal of Headache and Pain ◽

10.1186/s10194-021-01263-1 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Keisuke Suzuki ◽

Takao Takeshima ◽

Hisaka Igarashi ◽

Noboru Imai ◽

Daisuke Danno ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Linear Regression ◽

Linear Regression Analysis ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Stepwise Linear Regression Analysis ◽

Stepwise Linear Regression ◽

New Onset

Abstract Objectives To assess the impacts of social situation changes due to the coronavirus disease 2019 (COVID-19) pandemic on headache-related disability and other symptoms in patients with migraine in Japan. Methods We conducted a multicentre, cross-sectional study including 659 outpatients with migraine diagnosed by headache specialists. The participants were asked about the impacts of the first wave of the COVID-19 pandemic on headache-related disability, headache days, headache intensity, stress, physical activity, hospital access and their work and home lives. For headache-related disability, the total Migraine Disability Assessment (MIDAS) score and part A and B scores were analysed. Multivariate stepwise linear regression analysis was performed to identify the clinical predictors of changes in the total MIDAS score before and during the COVID-19 pandemic. Logistic regression analysis was performed to determine the factors related to new-onset headache during the COVID-19 pandemic. Results Finally, 606 migraine patients (73 M/533 F; age, 45.2 ± 12.0 years) were included in the study, excluding those with incomplete data. Increased stress, substantial concern about COVID-19 and negative impacts of the first wave of the COVID-19 pandemic on daily life were reported in 56.8 %, 55.1 and 45.0 % of the participants, respectively. The total MIDAS and A and B scores did not significantly change after the first wave of the COVID-19 pandemic. New-onset headache, which was observed in 95 patients (15.7 %), was associated with younger age and worsened mood and sleep in the logistic regression analysis. The multivariate stepwise linear regression analysis of changes in the total MIDAS score before and during the first wave of COVID-19 pandemic identified worsened sleep, increased acute medication use, increased stress, medication shortages, comorbidities, the absence of an aura and new-onset headache were determinants of an increased total MIDAS score during the first wave of the COVID-19 pandemic. Conclusions In this multicentre study, clinical factors relevant to headache-related disability, such as new-onset headache, stress and sleep disturbances, were identified, highlighting the importance of symptom management in migraine patients during the first wave of the COVID-19 pandemic.

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Hospital Nurses’ Perception of Death and Self-Reported Performance of End-of-Life Care: Mediating Role of Attitude towards End-of-Life Care

Healthcare ◽

10.3390/healthcare8020142 ◽

2020 ◽

Vol 8 (2) ◽

pp. 142

Author(s):

Hyo-Jin Park ◽

Yun-Mi Lee ◽

Mi Hwa Won ◽

Sung-Jun Lim ◽

Youn-Jung Son

Keyword(s):

Linear Regression ◽

End Of Life ◽

Mediation Analysis ◽

End Of Life Care ◽

Cross Sectional Study ◽

Hospital Nurses ◽

Life Care ◽

Cross Sectional ◽

Mediating Role

Few studies have explored how nurses in acute care hospitals perceive and perform end-of-life care in Korea. Therefore, this study aimed to evaluate the influence of nurses’ perceptions of death on end-of-life care performance and analyze the mediating role of attitude towards end-of-life care among hospital nurses. This cross-sectional study included a total of 250 nurses who have had experience with end-of-life care from four general hospitals in Korea. We used the Korean validated tools with the View of Life and Death Scale, the Frommelt Attitudes Toward Care of the Dying (FATCOD) scale, and the performance of end-of-life care. Hierarchical linear regression and mediation analysis, applying the bootstrapping method. The results of hierarchical linear regression showed that nurses’ positive perceptions of death and attitude towards end-of-life care were significantly associated with their performance of end-of-life care. A mediation analysis further revealed that nurses’ attitude towards end-of-life care mediates the relationship between the perceptions of death and performance of end-of-life care. Our findings suggest that supportive and practical death educational programs should be designed, based on nurses’ professional experience and work environment, which will enable them to provide better end-of-life care.

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Association of coronary dominance with the severity of coronary artery disease: a cross-sectional study in Shaanxi Province, China

BMJ Open ◽

10.1136/bmjopen-2017-021292 ◽

2018 ◽

Vol 8 (11) ◽

pp. e021292 ◽

Cited By ~ 1

Author(s):

Bin Yan ◽

Jian Yang ◽

Yajuan Fan ◽

Binbin Zhao ◽

Qingyan Ma ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Linear Regression ◽

Linear Regression Analysis ◽

Cross Sectional Study ◽

Shaanxi Province ◽

Sectional Study ◽

Cross Sectional ◽

Artery Disease ◽

Coronary Dominance

ObjectiveTo investigate whether coronary artery dominance is associated with the severity of coronary artery disease (CAD).DesignCross-sectional study.SettingSingle-centre.ParticipantsBetween July 2015 and February 2017, 1654 patients who underwent coronary angiography (CAG) were recruited into this cross-sectional study.Measurement and methodsAccording to coronary dominance, patients were classified into left dominance (LD), right dominance (RD) and codominance (CD) based on the CAG results. Multiple linear regression analysis was performed to test the association between severity of CAD and coronary dominance.ResultsThe total Gensini score was significantly higher in the RD group than in the left-CD group (42.3±33.6 vs 36.3±29.8; p=0.033). After adjusting for potential confounding factors, the results of multivariate linear regression showed that RD was associated with the severity of CAD (β=6.699, 95% CI 1.193 to 12.205, p=0.017).ConclusionsThe results suggest that right coronary dominance was associated with the severity of CAD.

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Waist circumference as a determinant of hypertension and diabetes in Brazilian women: a population-based study

Public Health Nutrition ◽

10.1079/phn2003582 ◽

2004 ◽

Vol 7 (5) ◽

pp. 629-635 ◽

Cited By ~ 38

Author(s):

MTA Olinto ◽

LC Nacul ◽

DP Gigante ◽

JSD Costa ◽

AMB Menezes ◽

...

Keyword(s):

Waist Circumference ◽

Odds Ratio ◽

Age Groups ◽

Population Based ◽

Cross Sectional Study ◽

Central Adiposity ◽

Cross Sectional ◽

Younger Women ◽

Increased Risk

AbstractObjective:To evaluate the role of central adiposity, as evaluated by the measurement of waist circumference (WC), as an independent risk factor for hypertension and type 2 diabetes mellitus in the setting of a developing country.Design:Population-based, cross-sectional study.Setting:A medium-sized town in southern Brazil.Participants:One thousand and ninety-five non-pregnant women, 20 to 69 years old, recruited by cluster random sampling between 1999 and 2000. Their mean WC was 85.3 cm (standard deviation 13.9 cm) and 23.3% (n = 255) were obese (body mass index >30 kg m−2). The prevalence of hypertension and diabetes was 25.6% (n = 280) and 6.2% (n = 68), respectively.Results:The risks of hypertension and diabetes were directly related to WC measurement. Women with WC > 80 cm had increased risk of hypertension (odds ratio (OR) = 6.2, P < 0.001). The association remained significant (OR = 1.04 per cm increase in WC, P = 0.02) after adjusting for confounders. The effect of WC on diabetes was modified by age. The effect was stronger in women younger than 40 years old (OR = 12.7, P = 0.016) than in those over 40 years old (OR = 2.8, P = 0.013). In the multivariate analysis, the odds ratio was 5.7 (P = 0.12) in those under 40 years old and 2.8 (P = 0.008) in older women.Conclusions:Waist circumference is an independent determinant for hypertension and diabetes in women in this population. The stronger association between WC and diabetes in younger women suggests that the validity of this indicator to assess abdominal adiposity is age-specific. Further studies should validate the usefulness of WC measurement in different age groups.

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