scholarly journals Associations between Early-Life Food Deprivation and Risk of Frailty of Middle-Age and Elderly People: Evidence from the China Health and Retirement Longitudinal Study

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3066
Author(s):  
Chen Ye ◽  
Sumiya Aihemaitijiang ◽  
Ruoyu Wang ◽  
Mairepaiti Halimulati ◽  
Zhaofeng Zhang
Keyword(s):  
Longitudinal Study ◽  
Old Age ◽  
Food Deprivation ◽  
Regression Models ◽  
Middle Age ◽  
Later Life ◽  
Logistic Regression Models ◽  
Ordered Logistic Regression ◽  
Loss Of Weight ◽  
Increased Risk

Background: The association between childhood food deprivation (FD) and health in later life has been extensively studied; however, studies on the association between childhood food deprivation and frailty are scarce. This study assessed the associations between childhood FD and the risk of frailty at middle-age and old age. Methods: Three waves of the China Health and Retirement Longitudinal Study (CHARLS), including 11,615 individuals aged over 45 years, were used for this research. Frailty was operationalized according to the FRAIL scale as a sum of fatigue, resistance, ambulation, illness, and the loss of weight. Childhood FD experiences and levels were measured by self-reported FD and historical content. Logistic mixed-effects models and proportional odds ordered logistic regression models were used to analyse the association between childhood FD and frailty. Findings: Childhood FD increased the odds of frailty at old age (1.30, 95% CI: 1.26–1.36). Compared with subjects with mild FD, those with extreme FD experiences had increased risks of frailty (1.34, 95% CI: 1.26–1.43). Subjects exposed to hunger at different ages all had an increased risk of frailty, and subjects who had FD during ages 6–12 (1.15, 95% CI: 1.09–1.22) were more likely to have an increased risk of frailty than those who had experienced FD in younger ages. The interaction of experience of FD at ages 0–6 and the experience of FD at ages 6–12 is not statistically significant after adjusting all covariates. Conclusions: Our findings suggest that childhood FD exerts long-lasting effects on frailty among older adults in China. The prevention of childhood FD may delay or even avert the emergence of frailty in people of middle-age and old age.

scholarly journals COVID-19 Vaccination Willingness among Chinese Adults under the Free Vaccination Policy

Vaccines ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 292
Author(s):  
Rugang Liu ◽  
Yuxun Zhang ◽  
Stephen Nicholas ◽  
Anli Leng ◽  
Elizabeth Maitland ◽  
...  
Keyword(s):  
Regression Models ◽  
Medical Insurance ◽  
Vaccine Safety ◽  
Decision Makers ◽  
Vaccination Policy ◽  
Chinese Adults ◽  
Logistic Regression Models ◽  
Ordered Logistic Regression ◽  
Professional Workers ◽  
Target Intervention

(1) Background: China will provide free coronavirus disease 2019 (COVID-19) vaccinations for the entire population. This study analyzed the COVID-19 vaccination willingness rate (VWR) and its determinants under China’s free vaccination policy compared to a paid vaccine. (2) Methods: Data on 2377 respondents were collected through a nationwide questionnaire survey. Multivariate ordered logistic regression models were specified to explore the correlation between the VWR and its determinants. (3) Results: China’s free vaccination policy for COVID-19 increased the VWR from 73.62% to 82.25% of the respondents. Concerns about the safety and side-effects were the primary reason for participants’ unwillingness to be vaccinated against COVID-19. Age, medical insurance and vaccine safety were significant determinants of the COVID-19 VWR for both the paid and free vaccine. Income, occupation and vaccine effectiveness were significant determinants of the COVID-19 VWR for the free vaccine. (4) Conclusions: Free vaccinations increased the COVID-19 VWR significantly. People over the age of 58 and without medical insurance should be treated as the target intervention population for improving the COVID-19 VWR. Contrary to previous research, high-income groups and professional workers should be intervention targets to improve the COVID-19 VWR. Strengthening nationwide publicity and education on COVID-19 vaccine safety and effectiveness are recommended policies for decision-makers.

scholarly journals Low HbA1c levels and all-cause or cardiovascular mortality among people without diabetes: the US National Health and Nutrition Examination Survey 1999–2015

2020 ◽  
Author(s):  
Kosuke Inoue ◽  
Roch Nianogo ◽  
Donatello Telesca ◽  
Atsushi Goto ◽  
Vahe Khachadourian ◽  
...  
Keyword(s):  
Cardiovascular Mortality ◽  
Regression Models ◽  
Machine Learning Algorithms ◽  
Logistic Regression Models ◽  
Health And Nutrition ◽  
Increased Risk ◽  
The Us ◽  
All Cause Mortality ◽  
Hba1c Levels

Abstract Objective It is unclear whether relatively low glycated haemoglobin (HbA1c) levels are beneficial or harmful for the long-term health outcomes among people without diabetes. We aimed to investigate the association between low HbA1c levels and mortality among the US general population. Methods This study includes a nationally representative sample of 39 453 US adults from the National Health and Nutrition Examination Surveys 1999–2014, linked to mortality data through 2015. We employed the parametric g-formula with pooled logistic regression models and the ensemble machine learning algorithms to estimate the time-varying risk of all-cause and cardiovascular mortality by HbA1c categories (low, 4.0 to <5.0%; mid-level, 5.0 to <5.7%; prediabetes, 5.7 to <6.5%; and diabetes, ≥6.5% or taking antidiabetic medication), adjusting for 72 potential confounders including demographic characteristics, lifestyle, biomarkers, comorbidities and medications. Results Over a median follow-up of 7.5 years, 5118 (13%) all-cause deaths, and 1116 (3%) cardiovascular deaths were observed. Logistic regression models and machine learning algorithms showed nearly identical predictive performance of death and risk estimates. Compared with mid-level HbA1c, low HbA1c was associated with a 30% (95% CI, 16 to 48) and a 12% (95% CI, 3 to 22) increased risk of all-cause mortality at 5 years and 10 years of follow-up, respectively. We found no evidence that low HbA1c levels were associated with cardiovascular mortality risk. The diabetes group, but not the prediabetes group, also showed an increased risk of all-cause mortality. Conclusions Using the US national database and adjusting for an extensive set of potential confounders with flexible modelling, we found that adults with low HbA1c were at increased risk of all-cause mortality. Further evaluation and careful monitoring of low HbA1c levels need to be considered.

scholarly journals Catastrophic Household Expenditure Associated with Out-of-Pocket Healthcare Payments in Spain

2021 ◽  
Vol 18 (3) ◽  
pp. 932
Author(s):  
Samuel López-López ◽  
Raúl del Pozo-Rubio ◽  
Marta Ortega-Ortega ◽  
Francisco Escribano-Sotos
Keyword(s):  
Health Care ◽  
Logistic Regression ◽  
Regression Models ◽  
Financial Risk ◽  
Household Expenditure ◽  
Financial Protection ◽  
Logistic Regression Models ◽  
Ordered Logistic Regression ◽  
Out Of Pocket Payments ◽  
The Subject

Background. The financial effect of households’ out-of-pocket payments (OOP) on access and use of health systems has been extensively studied in the literature, especially in emerging or developing countries. However, it has been the subject of little research in European countries, and is almost nonexistent after the financial crisis of 2008. The aim of the work is to analyze the incidence and intensity of financial catastrophism derived from Spanish households’ out-of-pocket payments associated with health care during the period 2008–2015. Methods. The Household Budget Survey was used and catastrophic measures were estimated, classifying the households into those above the threshold of catastrophe versus below. Three ordered logistic regression models and margins effects were estimated. Results. The results reveal that, in 2008, 4.42% of Spanish households dedicated more than 40% of their income to financing out-of-pocket payments in health, with an average annual gap of EUR 259.84 (DE: EUR 2431.55), which in overall terms amounts to EUR 3939.44 million (0.36% of GDP). Conclusion. The findings of this study reveal the existence of catastrophic households resulting from OOP payments associated with health care in Spain and the need to design financial protection policies against the financial risk derived from facing these types of costs.

scholarly journals Association of ADH1B polymorphism and alcohol consumption with increased risk of intracerebral hemorrhagic stroke

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Chun-Hsiang Lin ◽  
Oswald Ndi Nfor ◽  
Chien-Chang Ho ◽  
Shu-Yi Hsu ◽  
Disline Manli Tantoh ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Alcohol Consumption ◽  
Genetic Variants ◽  
Regression Models ◽  
Hemorrhagic Stroke ◽  
Alcohol Exposure ◽  
Modifiable Risk Factors ◽  
Aldehyde Dehydrogenase 2 ◽  
Logistic Regression Models ◽  
Increased Risk

Abstract Background Alcohol consumption is one of the modifiable risk factors for intracerebral hemorrhage, which accounts for approximately 10–20% of all strokes worldwide. We evaluated the association of stroke with genetic polymorphisms in the alcohol metabolizing genes, alcohol dehydrogenase 1B (ADH1B, rs1229984) and aldehyde dehydrogenase 2 (ALDH2, rs671) genes based on alcohol consumption. Methods Data were available for 19,500 Taiwan Biobank (TWB) participants. We used logistic regression models to test for associations between genetic variants and stroke. Overall, there were 890 individuals with ischemic stroke, 70 with hemorrhagic stroke, and 16,837 control individuals. Participants with ischemic but not hemorrhagic stroke were older than their control individuals (mean  ±  SE, 58.47 ± 8.17 vs. 48.33 ± 10.90 years, p  <  0.0001). ALDH2 rs671 was not associated with either hemorrhagic or ischemic stroke among alcohol drinkers. However, the risk of developing hemorrhagic stroke was significantly higher among ADH1B rs1229984 TC  +  CC individuals who drank alcohol (odds ratio (OR), 4.85; 95% confidence interval (CI) 1.92–12.21). We found that the test for interaction was significant for alcohol exposure and rs1229984 genotypes (p for interaction  =  0.016). Stratification by alcohol exposure and ADH1B rs1229984 genotypes showed that the risk of developing hemorrhagic stroke remained significantly higher among alcohol drinkers with TC  +  CC genotype relative to those with the TT genotype (OR, 4.43, 95% CI 1.19–16.52). Conclusions Our study suggests that the ADH1B rs1229984 TC  +  CC genotype and alcohol exposure of at least 150 ml/week may increase the risk of developing hemorrhagic stroke among Taiwanese adults.

Prognostic significance of international normalised ratio and prothrombin time in Chinese acute ischaemic stroke patients

2022 ◽  
pp. postgradmedj-2021-141204
Author(s):  
Shoujiang You ◽  
Qiao Han ◽  
Xiaofeng Dong ◽  
Chongke Zhong ◽  
Huaping Du ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Ischaemic Stroke ◽  
Prothrombin Time ◽  
Hospital Discharge ◽  
Acute Ischaemic Stroke ◽  
Regression Models ◽  
Logistic Regression Models ◽  
Risk Of Death ◽  
Increased Risk ◽  
International Normalised Ratio

BackgroundWe investigated the association between international normalised ratio (INR) and prothrombin time (PT) levels on hospital admission and in-hospital outcomes in acute ischaemic stroke (AIS) patients.MethodsA total of 3175 AIS patients enrolled from December 2013 to May 2014 across 22 hospitals in Suzhou city were included. We divided patients into four groups according to their level of admission INR: (<0.92), Q2 (0.92–0.98), Q3 (0.98–1.04) and Q4 (≥1.04) and PT. Logistic regression models were used to estimate the effect of INR and PT on death or major disability (modified Rankin Scale score (mRS)>3), death and major disability (mRS scores 4–5) separately on discharge in AIS patients.ResultsHaving an INR level in the highest quartile (Q4) was associated with an increased risk of death or major disability (OR 1.69; 95% CI 1.23 to 2.31; P-trend=0.001), death (OR, 2.64; 95% CI 1.12 to 6.19; P-trend=0.002) and major disability on discharge (OR, 1.56; 95% CI 1.13 to 2.15; P-trend=0.008) in comparison to Q1 after adjusting for potential covariates. Moreover, in multivariable logistic regression models, having a PT level in the highest quartile also significantly increased the risk of death (OR, 2.38; 95% CI 1.06 to 5.32; P-trend=0.006) but not death or major disability (P-trend=0.240), major disability (P-trend=0.606) on discharge.ConclusionsHigh INR at admission was independently associated with death or major disability, death and major disability at hospital discharge in AIS patients and increased PT was also associated with death at hospital discharge.

scholarly journals Risk factors for macular pucker after rhegmatogenous retinal detachment surgery

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Toshiaki Hirakata ◽  
Yoshimune Hiratsuka ◽  
Shutaro Yamamoto ◽  
Koki Kanbayashi ◽  
Hiroaki Kobayashi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retinal Detachment ◽  
Surgical Technique ◽  
Regression Models ◽  
Rhegmatogenous Retinal Detachment ◽  
Surgical Repair ◽  
Macular Pucker ◽  
Logistic Regression Models ◽  
Retinal Breaks ◽  
Increased Risk

AbstractMacular pucker, also known as an epiretinal membrane, sometimes forms after surgical repair of a rhegmatogenous retinal detachment (RRD) and can decrease visual acuity and cause aniseikonia. However, few reports are evaluating the risk factors of macular pucker using multivariate analysis. To evaluate the risk factors for macular pucker after RRD surgery, 226 patients who underwent RRD surgery and were monitored for greater than 12 months (23.2 ± 6.4 months) after surgery were analyzed retrospectively. Of these cases, macular pucker developed in 26 cases. Multiple logistic regression models of 22 clinical characteristics were performed. An increased risk of macular pucker after RRD surgery was significantly associated with preoperative vitreous haemorrhage (Odds ratio (OR), 4.71; 95% CI 1.19–18.62), multiple retinal breaks (OR, 8.07; 95% CI 2.35–27.71), re-detachment (OR, 19.66; 95% CI 4.87–79.38), and retinal detachment area (OR, 12.91; 95% CI 2.34–71.19). Macular pucker was not associated with the surgical technique. Regardless of the surgical technique used, careful observation for postoperative macular pucker is needed after RRD surgery in high-risk cases. These findings can be used to improve the surgical management of patients with RRD. (183 words).

scholarly journals Pedestrian Compliance at Signalized Intersections along Major Arterials

2021 ◽  
Vol 15 (1) ◽  
pp. 210-216
Author(s):  
Khaled Shaaban
Keyword(s):  
Regression Models ◽  
Middle Age ◽  
Compliance Rate ◽  
Signalized Intersections ◽  
Video Data ◽  
Logistic Regression Models ◽  
Several Variables ◽  
Pedestrian Crashes ◽  
Pedestrian Crossing ◽  
Multiple Intersections

Background: Pedestrian non-compliance at signalized crossings is unsafe and considered one of the causes of pedestrian crashes. The speed limit on most major urban roads is 60 km/hr or less. However, the speed on some urban roads is higher in some countries. In this case, the situation is more unsafe and increases the possibility of fatal injuries or fatalities in the case of a crash. Therefore, it is expected that the pedestrians will be more cautious on these roads. Aim: This study aims to explore pedestrian compliance at signalized intersections on major arterials with 80 km/hr speeds in Qatar. Methods: Video data were collected for pedestrian movements at multiple intersections. Results: The study reported a 68.1 percent compliance rate at the study locations. The results also revealed that 14.6 percent of the pedestrians crossed during the Flashing Don’t Walk interval and 17.3 percent crossed during the Steady Don’t Walk interval. These rates are considered high compared to other countries. Several variables that may influence pedestrians’ behavior were investigated. Binary and ordinal logistic regression models were developed to describe the pedestrian crossing behavior as a function of these variables. Conclusion: Male and middle-age pedestrians were more likely to cross during these two intervals. The analysis showed that female pedestrians, elder pedestrians, pedestrians crossing in groups, pedestrians waiting before crossing, and pedestrians crossing against a flow of other pedestrians are more likely to comply and cross during the Walk interval compared to other groups. Several solutions were proposed in the study to increase compliance rates.

scholarly journals The association between childhood neighborhood relationship and mental health in middle and later life: Evidence from the China Health and Retirement Longitudinal Study

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Jian Sun ◽  
Hongye Luo ◽  
Chaofan Li ◽  
Qianqiang Wang
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Longitudinal Study ◽  
Regression Models ◽  
Later Life ◽  
Ordinary Least Squares ◽  
Middle Aged ◽  
Logit Regression ◽  
Neighborhood Relationship ◽  
Research Gap

Abstract Background It is unclear that whether childhood neighborhood relationship is associated with mental health among middle-aged and older adults. To overcome this research gap, this study aimed to investigate the association between childhood neighborhood relationship and mental health among the middle-aged and older adults in China. Methods The data of this study was sourced from the 2014 and 2015 waves of China Health and Retirement Longitudinal Study. We used ordinary least squares and logit regression models to explore the association between childhood neighborhood relationship and mental health among the middle-aged and older adults in China. Results The regression results indicate that the middle-aged and older adults who lived in place where neighbors had close-knit relationships at childhood was significantly associated with decreased odds of suffering from depressive symptoms (OR = 0.4259, p < 0.001). Furthermore, compared to the middle-aged and older adults who lived in place where neighbors were not close-knit at childhood, those who lived in place where neighbors were close-knit at childhood had a reduced CES–D score (coefficient = − 2.7822, p < 0.001). Conclusion This study demonstrates the importance of living in place where neighbors had close-knit relationships at childhood. The integrated interventions, including maintaining close-knit neighborhood relationships and strengthening the construction of community, may be useful to improve mental health.

Abstract WP482: Early Life Exposure to the Stroke Belt and Later Life Incident Cognitive Impairment: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Virginia J Howard ◽  
George Howard ◽  
Jennifer J Manly ◽  
M M Glymour ◽  
Laura B Zahodne ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Racial Differences ◽  
Early Adulthood ◽  
Later Life ◽  
Logistic Regression Models ◽  
Early Life Exposure ◽  
Increased Risk ◽  
Regards Study ◽  
Adjusted Logistic Regression ◽  
Stroke Belt

Introduction: Incidence of cognitive impairment is higher for residents of the Stroke Belt (SB) compared to those living outside it, but the importance of timing of SB residence is unclear. Methods: Participants were aged 45+ yrs, and enrolled in 2003-2007 in REGARDS. Cognition was assessed annually, by telephone, using the Six-Item Screener (SIS) in 11,488 black or white stroke-free participants currently living in the SB, and 8,949 currently living outside of the SB. Incident cognitive impairment was defined as SIS score of < 4 at last assessment among participants with initial SIS >4. Exposures were defined as SB residence all years, some years, or no years of childhood (ages 0-18) and early adulthood (ages 19-30). Demographic adjusted logistic regression models were stratified by SB residence at enrollment, and were used to estimate the demographic-adjusted odds of incident cognitive impairment. Results: Among those currently residing in the SB, childhood residence outside the SB for some (OR = 0.82; 95% CI: 0.68 - 0.99) or all (OR = 0.76; 95% CI: 0.65 - 0.90) of the time predicted lower odds of incident cognitive impairment. Similarly, early adulthood residence outside the SB for some (OR = 0.86; 95% CI: 0.74 - 0.98) or all (OR = 0.70; 95% CI: 0.58 - 0.84) of the time predicted lower incident cognitive impairment. Conversely, for those currently living outside the SB, the risk of incident cognitive impairment was higher for those who had spent their entire early adulthood in the SB (OR = 1.51; 95% CI: 1.01 - 2.57), with non-significant increased risk for childhood exposure or some early adulthood exposure to the SB (table). Conclusions: These findings suggest that early residence in the SB during childhood or early adulthood increases the risk of cognitive impairment regardless of place of residence in later adulthood. Further research is needed to determine the characteristics of early SB life that are linked to later adult cognitive impairment.

scholarly journals Association of Combined Sero-Positivity to Helicobacter pylori and Streptococcus gallolyticus with Risk of Colorectal Cancer

2020 ◽  
Vol 8 (11) ◽  
pp. 1698
Author(s):  
Meira Epplein ◽  
Loïc Le Marchand ◽  
Timothy L. Cover ◽  
Mingyang Song ◽  
William J. Blot ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Helicobacter Pylori ◽  
Regression Models ◽  
Conditional Logistic Regression ◽  
Serum Antibody ◽  
Antibody Responses ◽  
Vacuolating Cytotoxin ◽  
Logistic Regression Models ◽  
Streptococcus Gallolyticus ◽  
Increased Risk

Previously, we found that risk of colorectal cancer (CRC) is increased in individuals with serum antibody response to both Helicobacter pylori (HP) Vacuolating Cytotoxin (VacA) toxin or Streptococcus gallolyticus (SGG) pilus protein Gallo2178. In the present analysis, we tested the hypothesis that combined seropositivity to both antigens is a better indicator of CRC risk than seropositivity to single antigens. We used multiplex serologic assays to analyze pre-diagnostic serum for antibody responses from 4063 incident CRC cases and 4063 matched controls from 10 US cohorts. To examine whether combined SGG Gallo2178 and HP VacA sero-status was associated with CRC risk, we used conditional logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Compared to dual sero-negative individuals, there was no increased risk for individuals sero-positive to SGG Gallo2178 only (OR: 0.93; 95% CI: 0.66–1.31) or to HP VacA only (OR: 1.08; 95% CI: 0.98–1.19). However, dual sero-positive individuals had a >50% increased odds of developing CRC (OR: 1.54; 95% CI: 1.16–2.04), suggesting an interaction between antibody responses to these two pathogens and CRC risk (pinteraction = 0.06). In conclusion, this study suggests that dual sero-positivity to HP VacA and SGG Gallo2178 is an indicator of increased risk of CRC.

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