Twinning Rates According to Maternal Birthweight

AbstractDizygotic twinning rates have changed over time, which has been seen as a sign of a decline in fecundity. Since a woman's birthweight has been shown to be a marker of her fecundity, maternal birthweight may correlate with subsequent twinning rates. In the Danish National Birth Cohort (1996–2002), we examined if maternal birthweight, and whether she was born at term or preterm, correlated with her probability of multiple birth. For 20,719 live born infants, we had self-reported information about maternal birthweight, collected during the first wave of the 7-year follow-up, and information on multiple births from record linkage. The association between maternal birthweight and multiple births was investigated by use of logistic regression and presented as odds ratios (ORs) with 95% confidence intervals (CIs). Compared to women born at term with a birthweight of 3001–4000 g, women with a birthweight > 4500 g appeared to have higher chance of multiple birth while women with a birthweight of 4001–4500 had a lower chance, especially if the analysis was restricted to women with a BMI < 25 (Adjusted ORs 2.3 [1.0–5.4] and 0.4 [0.2–0.9] respectively). Odds ratios for dizygotic twinning were of the same magnitude. In women with a BMI ≥ 25, no obvious pattern was present. Our findings do not indicate that twinning is a fecundity indicator. Women with a birthweight that may indicate a pregnancy complicated with gestational diabetes had the highest rate of multiple birth. These findings are new and should be put to a critical test in other data sources.

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Global Sensory Impairment Independently Predicts Decreased Social Function Over Time

Innovation in Aging ◽

10.1093/geroni/igaa057.1335 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 414-414

Author(s):

Anna Huang ◽

Kristen Wroblewski ◽

Ashwin Kotwal ◽

Linda Waite ◽

Martha McClintock ◽

...

Keyword(s):

Mental Health ◽

Logistic Regression ◽

Cognitive Function ◽

Social Engagement ◽

Social Function ◽

Ordinal Logistic Regression ◽

Sensory Function ◽

Sensory Impairment ◽

Over Time

Abstract The classical senses (vision, hearing, touch, taste, and smell) play a key role in social function by allowing interaction and communication. We assessed whether sensory impairment across all 5 modalities (global sensory impairment [GSI]) was associated with social function in older adults. Sensory function was measured in 3,005 home-dwelling older U.S. adults at baseline in the National Social Life, Health, and Aging Project and GSI, a validated measure, was calculated. Social network size and kin composition, number of close friends, and social engagement were assessed at baseline and 5- and 10-year follow-up. Ordinal logistic regression and mixed effects ordinal logistic regression analyzed cross-sectional and longitudinal relationships respectively, controlling for demographics, physical/mental health, disability, and cognitive function (at baseline). Adults with worse GSI had smaller networks (β=-0.159, p=0.021), fewer close friends (β=-0.262, p=0.003) and lower engagement (β=-0.252, p=0.006) at baseline, relationships that persisted at 5 and 10 year follow-up. Men, older people, African-Americans, and those with less education, fewer assets, poor mental health, worse cognitive function, and more disability had worse GSI. Men and those with fewer assets, worse cognitive function, and less education had smaller networks and lower engagement. African-American and Hispanic individuals had smaller networks and fewer close friends, but more engagement. Older respondents also had more engagement. In summary, GSI independently predicts smaller social networks, fewer close friends, and lower social engagement over time, suggesting that sensory decline results in decreased social function. Thus, rehabilitating multisensory impairment may be a strategy to enhance social function as people age.

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Female Authorship in Radiology: Trends in the Past Decade in CARJ

Canadian Association of Radiologists Journal ◽

10.1177/0846537120946641 ◽

2020 ◽

pp. 084653712094664

Author(s):

Nicole Li ◽

Mostafa Alabousi ◽

Michael N. Patlas

Keyword(s):

Logistic Regression ◽

Statistical Analysis ◽

P Value ◽

Inclusion Criteria ◽

Odds Ratios ◽

The Past ◽

Single Author ◽

Canadian Association ◽

Female Authorship ◽

Over Time

Purpose: To identify trends in female authorship in the Canadian Association of Radiologists Journal (CARJ) from 2010 to 2019. Methods: We retrieved papers published in the CARJ over a 10-year period, and retrospectively reviewed 602 articles. All articles except editorials and advertisements were included. We categorized the names of the first and last position authors as female or male and excluded articles that had at least one author of which gender was not known. We compared the trends in the first and last position authors of the articles from 2010 to 2019. For statistical analysis, logistic regression was performed with reported odds ratios (ORs), and a P value of <.05 was defined as statistically significant. Results: Five hundred thirteen articles met inclusion criteria. Among them, 23 articles with a single author were classified as having only a first author. 39.8% (204/513) of first authors were female and 26.9% (132/490) of last authors were female. There has been an overall temporal increase in the odds of both the first and last author being female in CARJ publications (OR: 1.11, P = .034). Similarly, the odds a CARJ publication’s first author being female increased over time (OR: 1.07, P = .033). Female last author did not predict female first author (OR: 1.48, P = .056). There was no association identified between female last author and year of publication (OR: 1.04, P = .225). Conclusion: There has been an overall increase in engagement of female authorship in CARJ.

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Pineal cysts and other pineal region malignancies: determining factors predictive of hydrocephalus and malignancy

Journal of Neurosurgery ◽

10.3171/2016.8.jns16220 ◽

2017 ◽

Vol 127 (2) ◽

pp. 249-254 ◽

Cited By ~ 10

Author(s):

Robert M. Starke ◽

Justin M. Cappuzzo ◽

Nicholas J. Erickson ◽

Jonathan H. Sherman

Keyword(s):

Logistic Regression ◽

Multivariate Analysis ◽

Regression Analysis ◽

Pineal Gland ◽

Contrast Enhancement ◽

Logistic Regression Analysis ◽

Pineal Region ◽

Benign Lesions ◽

Over Time

OBJECTIVECystic lesions of the pineal gland are most often uncomplicated benign lesions with typical MRI characteristics. The authors aimed to study pineal lesion characteristics on MRI to better distinguish benign pineal cysts from other pineal region malignancies as well as to determine which characteristics were predictive of the latter malignancies. They also aimed to study risk factors predictive of hydrocephalus or malignancy in patients harboring these lesions.METHODSThe authors performed a retrospective review of a prospectively compiled database documenting the outcomes of patients with suspected pineal cysts on MRI who had presented in the period from 1998 to 2004. Inherent patient and lesion characteristics were assessed in a univariate logistic regression analysis to predict the following dependent variables: development of hydrocephalus, biopsy-confirmed malignancy, and intervention. Possible inherent patient and lesion characteristics included age, sex, T1 and T2 MRI signal pattern, contrast enhancement pattern, presence of cyst, presence of blood, complexity of lesion, presence of calcification, and duration of follow-up. Inherent patient and lesion characteristics that were predictive in the univariate analysis (p < 0.15) were included in the multivariable logistic regression analysis.RESULTSOf the 79 patients with benign-appearing pineal cysts, 26 (33%) were male and 53 (67%) were female, with a median age of 38 years (range 9–86 years). The median cyst radius was 5 mm (range 1–20 mm). Two patients (2.5%) had evidence of calcifications, 7 (9%) had multicystic lesions, and 25 (32%) had some evidence of contrast enhancement.The median follow-up interval was 3 years (range 0.5–13 years). Seven patients (9%) had an increase in the size of their lesion over time. Eight patients (10%) had a hemorrhage, and 11 patients (14%) developed hydrocephalus. Nine (11%) received ventriculoperitoneal shunts for the development of hydrocephalus, and 12 patients (16%) were found to have malignancies following biopsy or resection. In the multivariate analysis, contrast enhancement on MRI (OR 1.6, 95% CI 2.86–74.74, p = 0.013) and hemorrhage (OR 26.9, 95% CI 3.4–212.7, p = 0.022) were predictive of hydrocephalus. Increasing lesion size and hydrocephalus were near perfect predictors of malignancy and thus were removed from multivariate analysis. In addition, contrast enhancement on MRI (OR 8.8, 95% CI 2.0–38.6, p = 0.004) and hemorrhage (OR 6.8, 95% CI 1.1–40.5, p = 0.036) were predictive of malignancy.CONCLUSIONSAlthough cystic abnormalities of the pineal gland are often benign lesions, they are frequently monitored over time, as other pineal region pathologies may appear similarly on MRI. Patients with growing lesions, contrast enhancement, and hemorrhage on MRI are more likely to develop hydrocephalus and have malignant pathology on histological examination and should therefore be followed up with serial MRI with a lower threshold for neurosurgical intervention.

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A129 THE VALUE OF REPEAT MANOMETRIC TESTING

Journal of the Canadian Association of Gastroenterology ◽

10.1093/jcag/gwz047.128 ◽

2020 ◽

Vol 3 (Supplement_1) ◽

pp. 149-150

Author(s):

A Pandey ◽

A Liu ◽

M C Buresi ◽

M Gupta ◽

Y Nasser ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Logistic Regression Analysis ◽

Binary Logistic Regression ◽

Motility Disorder ◽

Initial Diagnosis ◽

Binary Logistic Regression Analysis ◽

Interval Therapy ◽

Over Time

Abstract Background While motility disorders may evolve over time, there is scant guidance around the role of repeat high-resolution esophageal manometry (HRM). Given the invasive nature of HRM and the implications on financial cost and patient discomfort, it is obvious that the emphasis should be on minimizing unnecessary repeat examinations. However, there are no recommendations around indications or timing of repeat HRM. Aims We aimed to determine the outcomes in patients who underwent repeat manometry and look for predictors of progression to achalasia or major motility disorder. Methods Consecutive reports from HRM studies performed between Aug 2013 – May 2017 were retrospectively analyzed. All patients with ≥ 2 HRM studies were included. Studies without a Chicago classification diagnosis were excluded. Chi-squared analysis was performed to determine if initial HRM diagnosis was associated with change in diagnosis on follow-up HRM. Initial and follow-up manometric parameters were compared with paired T-tests. Binary logistic regression analysis was performed to look for predictors of progression to achalasia or major motility disorder. Results 134 patients underwent ≥ 2 HRM studies. Initial diagnoses were IEM (45 patients [33.6%], EGJOO (34 [25.4%], absent peristalsis (18 [13.4%], achalasia (11 [8.2%], DES (4 [3.0%]), and JH (3 [2.2%]; 29 (14.2%) of patients had a normal HRM. 109 (81.3%) patients underwent 2 HRM, 18 (13.4%) 3 HRM, 4 (3%) 4 HRM, and 3 (2.2%) 5 HRM. The final follow-up HRM occurred after a median 496 [80 – 1823] days. 72 (53.7%) of patients had no change from their initial diagnosis. Patients with an initial diagnosis of DES were significantly more likely to have a change in diagnosis on the final follow-up (3 normal:1 IEM) (p = .043). No other classes reached significance. Patients with IEM had a significantly higher mean DCI (395.1 [0 - 3248] vs 790.8 [0 – 10715.0], p = .006) and IRP (4.5 [-10.4 – 14.2] vs [6.6 [-6.2 – 21.0], p = .017) on their follow-up HRM. 4 patients without achalasia (3 EGJOO:1 IEM) on their index HRM had a diagnosis of achalasia on their final HRM. The median IRP in non-achalasia patients with a diagnosis of achalasia on final HRM (22.3 [8.4 – 30.7] was significantly higher than those without a diagnosis of achalasia on final HRM (6.6 [-10.4 – 39.8]) (p = .013); however no manometric criteria or initial HRM diagnoses predicted progression to achalasia or major motility disorder on binary logistic regression analysis. Conclusions In most patients, repeat manometry did not change the manometric diagnosis. Patients with DES were significantly likely to have their diagnosis change with repeat HRM, and most of these patients had normalization of their HRM. Manometric parameters in IEM appear to improve over time. This finding could reflect interval therapy, or shed some light on the natural history of this disease. Funding Agencies None

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Post-bariatric surgery lab tests: are they excessive and redundant?

Surgical Endoscopy ◽

10.1007/s00464-019-07216-9 ◽

2019 ◽

Vol 34 (10) ◽

pp. 4626-4631

Author(s):

Terri Menser ◽

Jose Muniz Castro ◽

Adriana Lopez ◽

Stephen L. Jones ◽

Bita A. Kash ◽

...

Keyword(s):

Bariatric Surgery ◽

Logistic Regression ◽

Nutritional Deficiency ◽

Nutritional Deficiencies ◽

Multiple Time ◽

Time Points ◽

Bariatric Patients ◽

Lab Test ◽

Over Time

Abstract Introduction Following bariatric surgery, ongoing postoperative testing is required to measure nutritional deficiencies; the purpose of this study was to quantify the prevalence of these nutritional deficiencies based on two-year follow-up tests at recommended time points. Methods and procedures A retrospective data analysis was conducted of all laboratory tests for bariatric patients who underwent surgery between May 2016 and January 2018 with available lab data (n = 397). Results for nine different nutritional labs were categorized into six recommended postoperative time periods based on time elapsed since the procedure date. Binary variables were created for each laboratory result to calculate descriptive statistics of abnormalities for each lab test over time and used in the individual GEE logistic regression models. Grouped logistic regression examined the total nutritional deficiencies of the nine combined nutrients considering total available labs. Results Multiple lab tests indicated a very low frequency of abnormalities (e.g., Vitamin A, Vitamin B12, Copper, and Folate). Many of the nine included nutritional labs had an average deficiency of less than 10% across all time points. The grouped logistic model found preoperative nutritional deficiency to be predictive of postoperative nutritional deficiency (OR 3.70, p < 0.001). Conclusions We found the vast majority of routine lab test results to be normal at multiple time points. Current practice can add up to significant lab expenses over time. The frequency of postoperative testing in this population may be redundant and of very little value. Unnecessary follow-up laboratory testing costs the patients and the health care system in both time and resources. Patients with preoperative deficiencies appear to be at higher risk for nutritional deficiencies when compared to bariatric surgery patients that did not have preoperative nutritional deficiencies. Future research should focus on defining cost effective postoperative lab testing guidelines for at risk bariatric patients.

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998. Understanding Retention in PrEP Care in the South: Insights from an Academic HIV Prevention Clinic

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1184 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S528-S528

Author(s):

Charles Burns ◽

Monica Borges ◽

Justin Frye ◽

Kathryn V Keicher ◽

Scotty Elliott ◽

...

Keyword(s):

Hiv Prevention ◽

Retention In Care ◽

Odds Ratios ◽

The South ◽

Short Term ◽

Term Retention ◽

Long Term Retention ◽

Over Time

Abstract Background Daily emtricitabine-tenofovir disoproxil fumarate has emerged as one of the most effective tools to prevent HIV transmission. However, it remains poorly utilized in the South. We report on PrEP retention in care and sexually transmitted infections (STIs) in a large academic PrEP clinic in Durham, North Carolina. Methods We conducted a retrospective chart review of patients in the Duke University PrEP Clinic from Jan. 1, 2015 through Oct. 15, 2019. Short-term retention in care was completion of a 3 month (mo) follow up as per CDC guidelines. Long-term retention was defined as completion of a 3 mo visit and an additional visit between 8 and 12 mo. Baseline STI was defined as a diagnosis at or within 1 year prior to initial PrEP visit. STI diagnosis while on PrEP was any subsequent diagnosis while retained in care. Odds ratios (OR) were generated using multivariable logistic regression. Kaplan-Meier curves were generated for retention in care and compared using the log rank test. Results A total of 255 patients attended at least one PrEP clinic encounter; 89% were men, 37% were Black, and 73% identified as men who have sex with men (MSM); 153 (60%) returned for at least one follow-up visit. Short and long term retention in care were met by 130/237 (55%) and 80/217 (37%) patients respectively. OR for retention are reported in Table 1. MSM are more likely to be retained in the short-term (OR 5.22 [95% confidence interval (CI) 1.57-17.32]). Self-referred patients were more likely to be retained in the long-term (OR 2.18 [95% CI 1.12-4.23]). Patients without insurance were less likely to attain long-term retention in care outcomes (OR 0.32 [95% CI 0.11-0.91]). STI diagnoses include 30 (12%) patients for a total of 42 unique infections at baseline and 44 (17%) for a total of 69 unique infections at follow up. Two new HIV diagnoses were made at first PrEP clinic encounter with no new diagnoses made at follow-up. Baseline STI was not associated with retention in care over time with disengagement defined as 6 mo post last visit (Figure 1). Table 1) Odds Ratios of Retention in Care at 3 and 12 Months Figure 1) Retention in Care for Patients with Baseline STI Diagnosis. Conclusion Our PrEP clinic shows a decline in patient retention over time. STIs were also prevalent, reinforcing that frequent STI testing and counseling should be part of each PrEP encounter. Further investigations into how to increase and improve PrEP utilization for HIV prevention are needed. Disclosures All Authors: No reported disclosures

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Evaluating the implementation potential of a transcultural tool for Tamil migrants with gestational diabetes mellitus living in Switzerland

Medical & Clinical Research ◽

10.33140/mcr.02.02.06 ◽

2017 ◽

Vol 2 (2) ◽

Keyword(s):

Diabetes Mellitus ◽

Logistic Regression ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Online Survey ◽

Healthcare Professionals ◽

Binary Logistic Regression ◽

Private Practices ◽

Populations At Risk ◽

Management Procedures

Background: Gestational diabetes mellitus is a condition that affects many pregnancies and ethnicity appears to be a risk factor. Data indicate that approximately 18% of Tamil women are diagnosed with gestational diabetes mellitus. Today, approximately 50,000 of Tamils live in Switzerland. To date, there is no official tool available in Switzerland that considers the eating and physical activity habits of this migrant Tamil population living in Switzerland, while offering a quick overview of gestational diabetes mellitus and standard dietetics management procedures. The NutriGeD project led by Bern University of Applied Sciences in Switzerland aimed at closing this gap. The aim of this present study was to evaluate the implementation potential of the tools developed in the project NutriGeD for dietetic counseling before their wide scale launch in Swiss hospitals, clinics and private practices. Method: An online survey was developed and distributed to 50 recruited healthcare professionals working in the German speaking region of Switzerland from October – December 2016 (31% response rate). The transcultural tools were sent to participants together with the link to the online survey. The evaluation outcome was analysed using binary logistic regression and cross tabulation analysis with IBM SPSS version 24.0, 2016. Results: 94% (N=47) respondents believed that the transcultural tools had good potential for implementation in hospitals and private practices in Switzerland. A binary logistic regression analysis revealed that the age of participants had a good correlation (42.1%) on recommending the implementation potential of the transcultural tool. The participants with age group 34- 54 years old where the highest group to recommend the implementation potential of the transcultural tool and this was found to be statistically significant (p=0.05). 74% (34 out of 50) of the respondents clearly acknowledged the need for transcultural competence knowledge in healthcare practices. 80% (N =40) of the respondents agreed that the information presented in the counseling display folder was important and helpful while 60% (N= 30) agreed to the contents being clinically applicable. 90% (N=45) participants recommended the availability of the evaluated transcultural tools in healthcare settings in Switzerland. Conclusion: The availability in healthcare practice of the evaluated transcultural tools was greatly encouraged by the Swiss healthcare practitioners participating in the survey. While they confirmed the need for these transcultural tools, feed-backs for minor adjustments were given to finalize the tools before their official launch in practice. The developed materials will be made available for clinical visits, in both hospitals and private practices in Switzerland. The Migmapp© transcultural tool can serve as a good approach in assisting healthcare professionals in all fields, especially professionals who practice in areas associated with diet - related diseases or disorders associated with populations at risk.

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Intimate Partner Violence and its Association With Contraceptive Use Among Women in Pakistan

Pakistan Journal of Psychological Research ◽

10.33824/pjpr.2019.34.1.9 ◽

2019 ◽

Vol 34 (Spring 2019) ◽

pp. 157-173

Author(s):

Kashif Siddique ◽

Rubeena Zakar ◽

Ra’ana Malik ◽

Naveeda Farhat ◽

Farah Deeba

Keyword(s):

Intimate Partner Violence ◽

Logistic Regression ◽

Partner Violence ◽

Contraceptive Use ◽

Binary Logistic Regression ◽

Intimate Partner ◽

Married Women ◽

Reproductive Age ◽

Outcome Variable ◽

Odds Ratios

The aim of this study is to find the association between Intimate Partner Violence (IPV) and contraceptive use among married women in Pakistan. The analysis was conducted by using cross sectional secondary data from every married women of reproductive age 15-49 years who responded to domestic violence module (N = 3687) of the 2012-13 Pakistan Demographic and Health Survey. The association between contraceptive use (outcome variable) and IPV was measured by calculating unadjusted odds ratios and adjusted odds ratios with 95% confidence intervals using simple binary logistic regression and multivariable binary logistic regression. The result showed that out of 3687 women, majority of women 2126 (57.7%) were using contraceptive in their marital relationship. Among total, 1154 (31.3%) women experienced emotional IPV, 1045 (28.3%) women experienced physical IPV and 1402 (38%) women experienced both physical and emotional IPV together respectively. All types of IPV was significantly associated with contraceptive use and women who reported emotional IPV (AOR 1.44; 95% CI 1.23, 1.67), physical IPV (AOR 1.41; 95% CI 1.20, 1.65) and both emotional and physical IPV together (AOR 1.49; 95% CI 1.24, 1.72) were more likely to use contraceptives respectively. The study revealed that women who were living in violent relationship were more likely to use contraceptive in Pakistan. Still there is a need for women reproductive health services and government should take initiatives to promote family planning services, awareness and access to contraceptive method options for women to reduce unintended or mistimed pregnancies that occurred in violent relationships.

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