Effect of age-related premium readjustment on health insurance cancellation in Brazil: Regression discontinuity approach.

Age is one of the most relevant observable risk attributes in determining the value of health insurance premiums. Empirical evidence indicates that the cost of health insurance is the leading cause of contract switching, which can compromise access to healthcare services and potentially result in treatment discontinuities. Using data from a Health Maintenance Organization in the Southern region of Brazil, we examined the effect of health plan price readjustment resulting from changes in the beneficiary's age group on disenrollment or switches to a more limited coverage plan. The estimates were obtained using the method of regression discontinuity. The main findings indicate that for age group transitions at 59 years old, the price readjustment effect led to an increase in contract cancellations and switching to cheaper plans. These findings highlight that an important consequence of the difference in premium sensitivity among age groups is that the exit of individuals from the health insurance sector is selective in age. The results of this paper can support policymaking to improve access to health insurance.

Automated Machine Learning Tools to Build Regression Models for Schizosaccharomyces pombe Omics Data.

Machine learning is a powerful tool for analyzing biological data and making useful predictions. The surge of biological data from high-throughput omics technologies has raised the need for modeling approaches capable of tackling such amounts of data, which is pivotal to understanding the nature of complex molecular systems. Here, we show how to construct a simple model using automated machine learning (AutoML) to predict protein abundance in Schizosaccharomyces pombe, using data obtained from codon usage bias and quantitative proteomics.

Aerobic performance in rats subjected to incremental-speed running exercise: A multiple regression analysis study emphasizing thermoregulation-related variables.

Single-variable analyses have limited ability to explain complex phenomena such as the regulation of prolonged physical (aerobic) performance. Our study aimed to identify predictors of performance in rats subjected to incremental-speed running exercise. Notably, most variables assessed were associated with rats' thermoregulation. We extracted data from 355 records obtained in 216 adult Wistar rats. Hierarchical multiple linear regression analyses were conducted to identify the predictive power of eight variables. The distance traveled, a performance index, was the dependent variable. The independent variables included body mass, biological sex, body core temperature (TCORE) measurement site, and the following thermoregulation-related variables: ambient temperature (TAMB), initial TCORE, exercise-induced change in TCORE (ΔTCORE), ΔTCORE from 0 to 10 min (ΔTCORE 0-10; when TCORE increase is fastest), and heat loss index (HLI). This analysis with eight variables revealed an adjusted R2 of 0.495; TAMB, ΔTCORE, body mass, and ΔTCORE 0-10 had the highest predictive powers (ß values: -0.700, 0.463, -0.353, and -0.130, respectively). Additional analyses consisted of separate regressions for each TCORE index measured: abdominal (TABD), brain (TBRAIN), and colonic (TCOL) temperature. These analyses yielded adjusted R2 values of 0.608 (TABD), 0.550 (TBRAIN), and 0.437 (TCOL). Again, the distance traveled was primarily predicted by body mass and thermoregulation-related variables (TAMB, ΔTCORE, and ΔTCORE 0-10). Among these four variables, ΔTCORE was the only one with a positive ß value (directly predicted performance), while the others had negative values. Collectively, these findings advance our understanding of performance regulation in rats, especially regarding the role of thermoregulation-related variables.

The role of development and financial risk in agricultural energy consumption: an empirical analysis based on country panel data and smooth transition regression.

Financial development facilitates farmers' access to credit resources, enabling the adoption of innovative technologies for energy management. On the other hand, long-term planning for agricultural businesses is expected to reduce various types of risks, including financial risk, thus promoting production. Therefore, the aim of this study is to empirically investigate the relationship between development and financial risk with energy consumption in the agricultural sector in Iran and selected developing countries. For this purpose, financial development indicators such as the ratio of deposits and bank facilities to agricultural value-added, as well as economic, financial, and political risk indicators, have been used for two groups of oil-exporting and non-oil-exporting developing countries during the years 2010 to 2020. In order to analyze the data, the Smooth Transition Regression model was used, which allows for examining non-linear relationships between variables. The findings suggest significant differences in the average per capita agricultural energy consumption between the studied oil-exporting and non-oil-exporting countries. Other research results indicate the superiority of non-linear specification relationships between variables and their threshold behavior. Financial development has an inverse effect on per capita energy consumption, and an increase in various types of risk (financial, economic, and political) is associated with an increase in per capita energy consumption in the agricultural sector. The magnitude of the impact of variables in non-oil-exporting countries is generally estimated to be higher than in oil-exporting countries.

Factors associated with the perception of university social responsibility among dental students from two universities in the Peruvian capital: a multivariable regression analysis.

Students play a key role in university social responsibility (USR), as they are the protagonists of change and the fundamental axis in the teaching-learning process. This study aims to assess the factors associated with the perception of university social responsibility among dental students from two universities in the Peruvian capital. This analytical cross-sectional study assessed 754 students from two Peruvian universities between May and July 2023. The study utilized a validated 51-item questionnaire to assess sociodemographic factors and dental students' perception of USR. A Poisson regression model with robust variance and prevalence ratio (PR) was used to assess the influence of variables such as age, sex, marital status, type of university, academic year, and awareness of taking subjects related to USR. The significance was set at p < 0.05. The perception of USR was rated as poor, fair, and good by 16%, 67%, and 17% of the participants, respectively. According to the study, dental students from public universities were 68% more likely to perceive their USR education as poor than those from private universities (APR = 1.68, 95% CI: 1.06-2.66), and those who were aware of taking MSR-related courses were 37% less likely to perceive their USR education as poor (APR = 0.63, 95% CI: 0.40-0.98). Similarly, dental students attending public universities were 2.28 times more likely to perceive poor organizational management in USR compared to their counterparts at private universities (APR = 2.28, 95% CI: 1.51-3.44). Additionally, students in their first and second academic years were 62% and 57% less likely to perceive poor organizational management in USR compared to those in their sixth year (APR = 0.38, 95% CI: 0.19-0.79 and APR = 0.43, 95% CI: 0.20-0.95; respectively). Furthermore, students from public universities were 2.31 times more likely to perceive social participation in USR poorly compared to their counterparts from private universities (APR = 2.31, 95% CI: 1.63-3.26). Lastly, it was observed that students from public universities were 2.51 times more likely to have a poor overall perception of USR compared to students from private universities (APR = 2.51, 95% CI: 1.67-3.78). Acknowledging the diverse contexts and challenges inherent in public and private institutions, it can be concluded that more than half of the dental students had a fair perception of USR. Additionally, attending a public university was found to be a risk factor for having a poor perception of USR. However, taking a course related to USR and being in the early years of the program were identified as protective factors against a poor perception of organizational training and management in USR. It is recommended that students be involved in USR activities, including the Sustainable Development Goals, from the first years of their university education, especially in public universities.

Hemoglobin and hematocrit levels are positively correlated with phase angle in mixed cancer patients: an exploratory cross-sectional study.

The aim of this study is to verify the correlation between hemoglobin (Hb) and hematocrit (Ht) levels with phase angle (PhA) values in patients with cancer of the gastrointestinal tract and accessory digestive organs. A cross-sectional study was conducted with 82 patients (38 females/44 males) diagnosed with cancer of gastrointestinal tract and accessory organs of digestion. Hb (g/dL) and Ht (%) levels were assessed by the cyanomethemoglobin and microhematocrit methods, respectively. Body composition and PhA were evaluated by the bioelectrical impedance analysis (BIA). The cut-off point used to classify patients with low PhA was set < 4°. Fifty-five (67%) of patients had PhA ≥ 4° values. We observed that body weight, BMI, fat mass, % weight loss, Ht, and Hb were higher in the PhA ≥ 4° group than in the PhA < 4° group. In the regression analysis, we found a positive association between PhA, Ht, and Hb without and after adjustment for sex, age, BMI, and type of treatment. In mixed cancer patients, there was a positive correlation between blood-red cell markers and PhA. This may be evidence that we can use of hematological parameters to suggest changes in PhA values during oncological treatment.

A Penalized Regression Method for Genomic Prediction Reduces Mismatch between Training and Testing Sets.

Genomic selection (GS) is changing plant breeding by significantly reducing the resources needed for phenotyping. However, its accuracy can be compromised by mismatches between training and testing sets, which impact efficiency when the predictive model does not adequately reflect the genetic and environmental conditions of the target population. To address this challenge, this study introduces a straightforward method using binary-Lasso regression to estimate ß coefficients. In this approach, the response variable assigns 1 to testing set inputs and 0 to training set inputs. Subsequently, Lasso, Ridge, and Elastic Net regression models use the inverse of these ß coefficients (in absolute values) as weights during training (WLasso, WRidge, and WElastic Net). This weighting method gives less importance to features that discriminate more between training and testing sets. The effectiveness of this method is evaluated across six datasets, demonstrating consistent improvements in terms of the normalized root mean square error. Importantly, the model's implementation is facilitated using the glmnet library, which supports straightforward integration for weighting ß coefficients.

Personalidad Grit y rendimiento anaeróbico en taekwondistas estadounidenses / Personality Grit and anaerobic performance in american taekwondo athletes / Personalidade Grit e Desempenho Anaeróbico em Atletas de Taekwondo Americanos

El propósito de este estudio fue evaluar la relación entre el rendimiento anaeróbico y la personalidad Grit en taekwondistas estadounidenses, su grado de influencia, así como las diferencias que puedan existir entre sexos. Este estudio tuvo una metodología cuantitativa, descriptiva-correlacional, realizada en una población de (n=121) taekwondistas, vinculados a la USAT. La personalidad Grit fue medida mediante la escala Grit, y el rendimiento anaeróbico a través de la prueba del sprint anaeróbico basado en la carrera (Rast). De acuerdo con los resultados se pudo identificar en hombres, una correlación positiva y significativa entre la capacidad y potencia anaeróbica con el Grit (p<0.005 y p<0.007 respectivamente). Asimismo, estas dos variables se relacionaron significativamente con el Grit (p<0.001) en el total de la muestra. En el caso de las mujeres, no hubo relaciones significativas. El índice de fatiga no presentó correlaciones significativas. La personalidad Grit influyó hasta un 14% en la capacidad y potencia anaeróbica en hombres (p<0.001 y p<0.002, respectivamente) y un 12% en estos dos mismos aspectos para la muestra total (p<0.000 en ambos casos). Finalmente, los hallazgos indican una relación entre la potencia, capacidad anaeróbica con la personalidad Grit en hombres y en el total de la muestra, con una influencia significativa del Grit en el rendimiento anaeróbico. No se encontraron tales relaciones en mujeres. Aunque no se hallaron diferencias significativas por sexo en el Grit, capacidad y potencia anaeróbica, sí que se encontró en el índice de fatiga, indicando una disparidad en la resistencia a la fatiga entre sexos.

The purpose of this study was to assess the relationship between anaerobic performance and Grit personality in American taekwondo practitioners, its degree of influence, as well as any differences that may exist between genders. This study employed a quantitative, descriptive-correlational methodology, conducted on a population of (n=121) taekwondo practitioners affiliated with the USAT. Grit personality was measured using the Grit Scale, and anaerobic performance was assessed through the Anaerobic Sprint Test based on running (Rast). According to the results, a positive and significant correlation between anaerobic capacity and power with Grit was identified in men (p<0.005 and p<0.007 respectively). Likewise, these two variables were significantly related to Grit (p<0.001) in the total sample. In the case of women, there were no significant relationships. The fatigue index showed no significant correlations. Grit personality influenced up to 14% in anaerobic capacity and power in men (p<0.001 and p<0.002, respectively) and 12% in these two aspects for the total sample (p<0.000 in both cases). Finally, the findings indicate a relationship between power, anaerobic capacity, and Grit personality in men and the total sample, with a significant influence of Grit on anaerobic performance. Such relationships were not found in women. Although no significant gender differences were found in Grit, anaerobic capacity, and power, differences were found in the fatigue index, indicating a disparity in fatigue resistance between genders.

O objetivo deste estudo foi avaliar a relação entre o desempenho anaeróbico e a personalidade Grit em praticantes de taekwondo americanos, seu grau de influência, bem como as diferenças que possam existir entre os sexos. Este estudo utilizou uma metodologia quantitativa, descritiva-correlacional, realizada em uma população de (n=121) praticantes de taekwondo afiliados à USAT. A personalidade Grit foi medida usando a Escala Grit, e o desempenho anaeróbico foi avaliado através do Teste de Sprint Anaeróbico baseado em corrida (Rast). De acordo com os resultados, foi possível identificar nos homens uma correlação positiva e significativa entre a capacidade e potência anaeróbica com o Grit (p<0.005 e p<0.007, respectivamente). Da mesma forma, essas duas variáveis estavam significativamente relacionadas ao Grit (p<0.001) na amostra total. No caso das mulheres, não foram encontradas relações significativas. O índice de fadiga não apresentou correlações significativas. A personalidade Grit influenciou até 14% na capacidade e potência anaeróbica em homens (p<0.001 e p<0.002, respectivamente) e 12% nesses dois aspectos para a amostra total (p<0.000 em ambos os casos). Finalmente, os achados indicam uma relação entre potência, capacidade anaeróbica e a personalidade Grit em homens e na amostra total, com uma influência significativa do Grit no desempenho anaeróbico. Tais relações não foram encontradas em mulheres. Embora não tenham sido encontradas diferenças significativas por sexo no Grit, capacidade e potência anaeróbica, foi encontrada diferença no índice de fadiga, indicando uma disparidade na resistência à fadiga entre os sexos.

Enhancing hERG Risk Assessment with Interpretable Classificatory and Regression Models.

The human Ether-à-go-go-Related Gene (hERG) is a transmembrane protein that regulates cardiac action potential, and its inhibition can induce a potentially deadly cardiac syndrome. In vitro tests help identify hERG blockers at early stages; however, the high cost motivates searching for alternative, cost-effective methods. The primary goal of this study was to enhance the Pred-hERG tool for predicting hERG blockage. To achieve this, we developed new QSAR models that incorporated additional data, updated existing classificatory and multiclassificatory models, and introduced new regression models. Notably, we integrated SHAP (SHapley Additive exPlanations) values to offer a visual interpretation of these models. Utilizing the latest data from ChEMBL v30, encompassing over 14,364 compounds with hERG data, our binary and multiclassification models outperformed both the previous iteration of Pred-hERG and all publicly available models. Notably, the new version of our tool introduces a regression model for predicting hERG activity (pIC50). The optimal model demonstrated an R2 of 0.61 and an RMSE of 0.48, surpassing the only available regression model in the literature. Pred-hERG 5.0 now offers users a swift, reliable, and user-friendly platform for the early assessment of chemically induced cardiotoxicity through hERG blockage. The tool provides versatile outcomes, including (i) classificatory predictions of hERG blockage with prediction reliability, (ii) multiclassificatory predictions of hERG blockage with reliability, (iii) regression predictions with estimated pIC50 values, and (iv) probability maps illustrating the contribution of chemical fragments for each prediction. Furthermore, we implemented explainable AI analysis (XAI) to visualize SHAP values, providing insights into the contribution of each feature to binary classification predictions. A consensus prediction calculated based on the predictions of the three developed models is also present to assist the user's decision-making process. Pred-hERG 5.0 has been designed to be user-friendly, making it accessible to users without computational or programming expertise. The tool is freely available at http://predherg.labmol.com.br.

Integrating classification and regression learners with bioimpedance methods for estimating weight status in infants and juveniles from the southern Cuba region.

OBJECTIVE: The search for other indicators to assess the weight and nutritional status of individuals is important as it may provide more accurate information and assist in personalized medicine. This work is aimed to develop a machine learning predictions of weigh status derived from bioimpedance measurements and other physical parameters of healthy younger volunteers from Southern Cuba Region. METHODS: A pilot random study at the Pediatrics Hospital was conducted. The volunteers were selected between 2002 and 2008, ranging in age between 2 and 18 years old. In total, 776 female and male volunteers are studied. Along the age and sex in the cohort, volunteers with class I obesity, overweight, underweight and with normal weight are considered. The bioimpedance parameters are obtained by measuring standard tetrapolar whole-body configuration. The bioimpedance analyser is used, collecting fundamental bioelectrical and other parameters of interest. A classification model are performed, followed by a prediction of the body mass index. RESULTS: The results derived from the classification leaner reveal that the size, body density, phase angle, body mass index, fat-free mass, total body water volume according to Kotler, body surface area, extracellular water according to Kotler and sex largely govern the weight status of this population. In particular, the regression model shows that other bioparameters derived from impedance measurements can be associated with weight status estimation with high accuracy. CONCLUSION: The classification and regression predictive models developed in this work are of the great importance to assist the diagnosis of weigh status with high accuracy. These models can be used for prompt weight status evaluation of younger individuals at the Pediatrics Hospital in Santiago de Cuba, Cuba.

Regression models from portable NIR spectra for predicting the carcass traits and meat quality of beef cattle.

The aims of this study were to predict carcass and meat traits, as well as the chemical composition of the 9th to 11th rib sections of beef cattle from portable NIR spectra. The 9th to 11th rib section was obtained from 60 Nellore bulls and cull cows. NIR spectra were acquired at: P1 -center of Longissimus muscle; and P2 -subcutaneous fat cap. The models accurately estimated (P ≥ 0.083) all carcass and meat quality traits, except those for predicting red (a*) and yellow (b*) intensity from P1, and 12th-rib fat from P2. However, precision was highly variable among the models; those for the prediction of carcass pHu, 12th rib fat, toughness from P1, and those for 12th rib fat, a* and b* from P2 presented high precision (R2 ≥ 0.65 or CCC ≥ 0.63), whereas all other models evaluated presented moderate to low precision (R2 ≤ 0.39). Models built from P1 and P2 accurately estimated (P ≥ 0.066) the chemical composition of the meat plus fat, bones and, meat plus fat plus bones, except those for predicting the ether extract (EE) and crude protein (CP) of bones and the EE of Meat plus bones fraction from P2. However, precision was highly variable among the models (-0.08 ≤ R2 ≤ 0.86) of the 9th and 11th rib section. Those models for the prediction of dry matter (DM) and EE of the bones from P1; of EE from P1; and of EE, mineral matter (MM), CP from P2 of meat plus fat plus bones presented high precision (R2 ≥ 0.76 or CCC ≥ 0.62), whereas all other models evaluated presented moderate to low precision (R2 ≤ 0.45). Thus, models built from portable NIR spectra acquired at different points of the 9th to 11th rib section were recommended for predicting carcass and muscle quality traits as well as for predicting the chemical composition of this section of beef cattle. However, it is noteworthy, that the small sample size was one of the limitations of this study.

Can predictive factors determine the time to treatment initiation for oral and oropharyngeal cancer? A classification and regression tree analysis.

This ecological study aimed to identify the factors with the greatest power to discriminate the proportion of oral and oropharyngeal cancer (OOC) records with time to treatment initiation (TTI) within 30 days of diagnosis in Brazilian municipalities. A descriptive analysis was performed on the variables grouped into five dimensions related to patient characteristics, access to health services, support for cancer diagnosis, human resources, and socioeconomic characteristics of 3,218 Brazilian municipalities that registered at least one case of OOC in 2019. The Classification and Regression Trees (CART) technique was adopted to identify the explanatory variables with greater discriminatory power for the TTI response variable. There was a higher median percentage of records in the age group of 60 years or older. The median percentage of records with stage III and IV of the disease was 46.97%, and of records with chemotherapy, radiation, or both as the first treatment was 50%. The median percentage of people with private dental and health insurance was low. Up to 75% had no cancer diagnostic support services, and up to 50% of the municipalities had no specialist dentists. Most municipalities (49.4%) started treatment after more than 30 days. In the CART analysis, treatment with chemotherapy, radiotherapy, or both explained the highest TTI in all municipalities, and it was the most relevant for predicting TTI. The final model also included anatomical sites in the oral cavity and oropharynx and the number of computed tomography services per 100,000. There is a need to expand the availability of oncology services and human resources specialized in diagnosing and treating OOC in Brazilian municipalities for a timely TTI of OOC.

Vancomicina contra metronidazol en infección por Clostridioides difficile leve-moderada de manejo ambulatorio / Vancomycin or metronidazole in the outpatient treatment of mild-moderate Clostridioides difficile infection

INTRODUCCIÓN: En la diarrea asociada a Clostridioides dfficile (DACD) leve-moderada se recomienda tratar con vancomicina por sobre metronidazol, a pesar de su difícil acceso y poca evidencia en el medio ambulatorio. OBJETIVO: Comparar la tasa de cura clínica y recurrencia entre vancomicina y metronidazol en adultos chilenos con primer episodio leve-moderado de DACD de manejo ambulatorio. MÉTODOS: Cohorte retrospectiva entre enero 2015 y diciembre 2020 en centros de una red de salud universitaria de pacientes de ≥ 18 años con DACD tratados ambulatoriamente. RESULTADOS: Se obtuvieron 161 pacientes, 59% mujeres, edad promedio de 53 años (entre 18 y 94 años). De ellos, 109 (67,7%) usaron metronidazol y 52 (32,3%) vancomicina. En el análisis multivariado ajustado por edad y comorbilidades se obtuvo un OR 3,00 (IC 95% 1,12-9,59) para cura clínica y 0,27 (IC 95% 0,06-0,88) para recurrencia a ocho semanas, ambos a favor de vancomicina, sin diferencias en recurrencia a 12 meses, necesidad de hospitalización o mortalidad. CONCLUSIÓN: La terapia con vancomicina comparada contra metronidazol en el tratamiento ambulatorio de la infección leve-moderada por C. dfficile se asocia a mayor cura clínica y menor tasa de recurrencia a corto plazo, sin diferencias en desenlaces a largo plazo.

BACKGROUND: Recommended treatment against mild cases of Clostridioides difficile associated diarrhea is vancomycin despite the difficulties of access compared to metronidazole. AIM: To compare the effectiveness of vancomycin and metronidazole in Chilean adults with first mild-moderate episode of Clostridiodes difficile infection (CDI). METHODS: Retrospective cohort of patients with CDI between January 2015 and December 2020 treated in centers of a university health network. The patients were adults treated for C. difficile infection on an outpatient basis. Recurrent and severe cases were excluded. Outcomes included clinical cure and recurrence rate. RESULTS: Data from 161 patients was recovered. Fifty-nine percent were women and average age was 53 (18-94). One hundred and nine patients were treated with metronidazole (67.7%) and 52 (32.3%) used vancomycin. Multivariate analysis adjusted by age and comorbidities showed an Odds Ratio of 3.00 (IC 95% 1.12-9.59) for clinical cure and 0.27 (IC 95% 0.06-0.88) for 8-week recurrence rate, both in favor of vancomycin, without differences in 12-month recurrence rate, hospitalization rate nor mortality. CONCLUSIONS: Vancomycin is associated with better short-term outcomes in the treatment of outpatient mild-moderate first episode C. difficile infection, without differences in long term recurrence or mortality when compared with metronidazole.

Standing-Long-Jump Test Application in Identifying Female Adolescents at Risk of Sarcopenic Obesity / Aplicación de la Prueba de Salto de Longitud de Pie para Identificar a Adolescentes con Riesgo de Obesidad Sarcopénica

SUMMARY: The identification of children and adolescents who are at risk of sarcopenic obesity development often requires specialized equipment and expensive test procedures. Therefore, the establishment of cheaper and faster methods would be greatly useful, especially if they could be applied in the field. The study's objective was to establish if identification of female adolescents who suffer the risk of developing sarcopenic obesity can be obtained through the standing-long-jump test application. To achieve the research objectives, various anthropometric and body composition measurements were performed and lower limb explosive strength was assessed using the standing long jump fitness test. The research was conducted on a sample of 535 female respondents randomly selected from 9 elementary schools in the Skopje region of the Republic of North Macedonia. The respondents were divided into quintiles according to BMI z-scores, and the arithmetic means and SD about muscle-to-fat ratio were calculated for each quintile. The cutoff was determined based on the mean and standard deviation of the muscle-to-fat ratio for the 3rd quintile of BMI and the percentage of respondents with sarcopenic obesity was examined. The optimal cut-off value of the long jump fitness test results for predicting sarcopenic obesity in an adolescent girl showed that the area under the ROC curve was 0.781 (95 % CI 0.743-0.815). The standing-long-jump test values, on grounds of odds ratio (OR 95 % CI) about the girls at risk of sarcopenic obesity development, which was identified on muscle-to-fat ratio base, were 8.76 (4.39 - 17.54, p 0.001). It can be used to predict sarcopenic obesity presence in female adolescents, which can be vital in case of health intervention.

La identificación de niños y adolescentes que corren riesgo de desarrollar obesidad sarcopénica a menudo requiere equipos especializados y procedimientos de pruebas costosos. Por lo tanto, el establecimiento de métodos más baratos y rápidos sería de gran utilidad, especialmente si pudieran aplicarse en el campo. El objetivo del estudio fue establecer si la identificación de mujeres adolescentes que sufren riesgo de desarrollar obesidad sarcopénica se puede obtener mediante la aplicación de la prueba de salto de longitud de pie. Para lograr los objetivos de la investigación, se realizaron diversas mediciones antropométricas y de composición corporal y se evaluó la fuerza explosiva de los miembros inferiores mediante la prueba de aptitud de salto de longitud de pie. La investigación se realizó con una muestra de 535 mujeres encuestadas seleccionadas al azar de 9 escuelas primarias de la región de Skopje, en la República de Macedonia del Norte. Los encuestados se dividieron en quintiles según las puntuaciones z del IMC, y se calcularon las medias aritméticas y la DE sobre la relación músculo-grasa para cada quintil. El límite se determinó en función de la media y la desviación estándar de la relación músculo-grasa para el tercer quintil del IMC y se examinó el porcentaje de encuestados con obesidad sarcopénica. El valor de corte óptimo de los resultados de la prueba de condición física de salto de longitud para predecir la obesidad sarcopénica en una adolescente mostró que el área bajo la curva ROC fue 0,781 (IC del 95 %: 0,743-0,815). Los valores de la prueba de salto de longitud de pie, sobre la base del odds ratio (OR IC del 95 %) sobre las niñas en riesgo de desarrollar obesidad sarcopénica, que se identificó sobre la base del ratio músculo-grasa, fueron 8,76 (4,39 - 17,54, p. 0,001). Puede utilizarse para predecir la presencia de obesidad sarcopénica en adolescentes, lo que puede ser vital en caso de intervención sanitaria.

Normative Data of Handgrip Strength in Macedonian Children and Adolescents According to Chronological and Biological Age / Datos Normativos de la Fuerza de Prensión Manual en Niños y Adolescentes Macedonios Según la Edad Cronológica y Biológica

SUMMARY: The handgrip strength is used as a means of individual's health prediction during life. It is used as an indicator of the nutrition status, bone fragility, presence of sarcopenia and it correlates with certain diseases and clinical complications. The research goal was to analyze the results of the hand dynamometry test, based on the chronological and biological age, and to offer normative and referent standards about children and adolescents from the Republic of North Macedonia. The study was conducted on a sample of 4031 respondents of both sexes at the age 6-14 years. In order to achieve the research goals, the measured characteristics were of the weight, height, sitting height and handgrip strength. The body mass index and biological maturity values (APHV) were obtained by using formulas. On the basis of the obtained results, it can be concluded that statistically significant differences in handgrip strength are established between the boys and girls of all age categories. Also, statistically significant differences between boys and girls are established in the hand dynamometry test of all APHV levels. In general, the use of the APHV allows a better categorization of the performance of the studied children and adolescents. With boys, the correlation between the chronological age and test was 68 %, and with girls - 77 %. The normative referent standards of the hand dynamometry test are presented in percentiles for both sexes. Thye hand dynamometry test's results during childhood and adolescence should be analyzed and interpret on the basis of biological age, and not on the chronological age. These tools can help specialists who work with children and adolescents in ethnic and epidemiological context.

La fuerza de prensión se utiliza como medio para predecir la salud del individuo durante la vida. Se utiliza como indicador del estado nutricional, fragilidad ósea, presencia de sarcopenia y se correlaciona con determinadas enfermedades y complicaciones clínicas. El objetivo de la investigación fue analizar los resultados de la prueba de dinamometría manual, con base en la edad cronológica y biológica, y ofrecer estándares normativos y referentes sobre niños y adolescentes de la República de Macedonia del Norte. El estudio se realizó en una muestra de 4031 encuestados de ambos sexos con edades comprendidas entre 6 y 14 años. Para lograr los objetivos de la investigación, las características medidas fueron el peso, la altura, la altura al sentarse y la fuerza de prensión. El índice de masa corporal y los valores de madurez biológica (APHV) se obtuvieron mediante fórmulas. Sobre la base de los resultados obtenidos, se puede concluir que se establecen diferencias estadísticamente significativas en la fuerza de prensión manual entre niños y niñas de todas las categorías de edad. Asimismo, se establecen diferencias estadísticamente significativas entre niños y niñas en la prueba de dinamometría manual de todos los niveles APHV. En general, el uso del APHV permite una mejor categorización del desempeño de los niños y adolescentes estudiados. En los niños, la correlación entre la edad cronológica y la prueba fue del 68 %, y en las niñas, del 77 %. Los estándares normativos referentes de la prueba de dinamometría manual se presentan en percentiles para ambos sexos. Los resultados de la prueba de dinamometría manual durante la infancia y la adolescencia deben analizarse e interpretarse en función de la edad biológica y no de la edad cronológica. Estas herramientas pueden ayudar a los especialistas que trabajan con niños y adolescentes en un contexto étnico y epidemiológico.

Spatio-temporal dynamics of visceral leishmaniasis in Brazil: A nonlinear regression analysis.

AIMS: This study describes the spatio-temporal dynamics of new visceral leishmaniasis (VL) cases notified in Brazil between 2001 and 2020. METHODS AND RESULTS: Data on the occurrence of the disease were obtained by means of the Notifiable Diseases Information System of the Brazilian Ministry of Health. Joinpoint, temporal generalized additive models and conditional autoregressive (CAR) models were used to analyse the temporal evolution of the rates in Brazil, states and regions. Spatio-temporal generalized additive and CAR models were used to identify the distribution of annual risks of VL occurrence in the Brazilian territory in relation to variation in the spatial average. There were 63,966 VL cases in the target period (3.198 cases/year), corresponding to a mean incidence rate of 1.68 cases/100,000 inhabitants. Of these, 4451 resulted in deaths, which gives a mean mortality rate of 0.12 deaths/100,000 inhabitants and a case fatality of 6.96%. The highest incidence rate was found in the North region, followed closely by the Northeast region, which presented the second and first highest mortality rates, respectively. For all of Brazil, and in the Northeast region, there were stability in the incidence rates, while the other regions showed an increasing trend in different time segments in the period: Central-West up to 2011, North up to 2008, Southeast up to 2004, and South up to 2010. On the other hand, all regions experienced a reduction in incidence rate during the last years of the series. The Northeast region had the highest number of municipalities with statistically significant elevated relative risks. The spatio-temporal analysis showed the highest risk area predominantly in the Northeast region in the beginning of the time series. From 2002 to 2018, this area expanded to the interior of the country. CONCLUSIONS: The present study has shown that VL has expanded in Brazil. However, the North and Northeast regions continue to have the highest incidence, and the risk of infection has decreased in recent years.

Trends in the mortality of diabetes in Mexico from 1998 to 2022: a joinpoint regression and age-period-cohort effect analysis.

OBJECTIVE: The purpose was to analyze age-standardized trends in diabetes mortality rates (DMR) from 1998 to 2022, stratified by sex and Mexican state, and the effects attributable to age, period, and cohort by sex. STUDY DESIGN: Joinpoint regression and age-period-cohort effect analysis. METHODS: Based on the tenth revision of the International Classification of Diseases, E11, E12, E13, and E14 codes of the death certificate, a daily record of mortality was extracted from the death certificate attributable to diabetes as the main cause. From 1998 to 2022, sexes and ages (≥20 years) were used to calculate the crude mortality rates and standardized at the national and Mexican state levels. Additionally, the age-period-cohort model was used to examine age, period, and cohort effects. RESULTS: From 1998 to 2005, the age-adjusted DMR increased by 3.6% (95% confidence interval [CI]: 2.7, 4.5) for the total population, as shown by the joinpoint regression analysis at a national level; from 2017 to 2020, it increased by 7.4% (95% CI: 0.6, 14.8). The DMR with the highest increase during the study period came mainly from states in the country's southeastern region, 2.3% to 3.7% per year. The net age and period effects showed that mortality increased with advancing age and with going time, respectively; and the net cohort effect revealed that mortality increased in more recent birth cohorts, mainly in men Rate Ratio (RR) = 2.37 (95% CI: 2.29, 2.46) vs RR = 1.13 (95% CI: 1.09, 1.17). CONCLUSION: The DMR increased among older age groups. The period effect showed that mortality increased over time. Furthermore, the cohort effect showed that mortality increased in more recent birth cohorts, especially among men.

Incidence of Dental Caries and Associated Factors in the School Period in a Municipality in Southern Brazil

Abstract Objective: To estimate the incidence of dental caries and associated factors in the school period from six/seven to ten years of age. Material and Methods: A longitudinal study involving 168 children was followed up between 2015 and 2019 in the municipality of Palhoça, Brazil. The dependent variable was the caries incidence rate in the mixed dentition. The independent variables included information regarding demographic and socioeconomic status. Multivariate analyzes were carried out using Poisson Regression with a robust estimator. Variables with p <0.20 in the bivariate analysis were included in the adjusted model. Relative risks were estimated, as well as 95% confidence intervals. Results: Of 168 followed schoolchildren, 32 developed the disease, providing an incidence rate of 19.0%. Female children had a 10% higher risk [RR = 1.10 (95% CI 1.03; 1.18)] of developing caries than males. Also, children born from fathers with ≤ 8 years of schooling at baseline had a 9% higher risk [RR = 1.09 (95% CI 1.01; 1.16)] of developing dental caries compared to fathers with higher education. Conclusion: The incidence of dental caries in a four-year period was 19.0%. Females and children born from fathers with a lower level of education showed higher incidence rates.

Salivary Changes, Systemic Conditions, and Medication Use in Independently-Living Aged: A Cross-Sectional Study

ABSTRACT Objective: To determine the unstimulated salivary flow, pH, and buffering capacity and their associations with systemic conditions and medication use in independently living aged. Material and Methods: This cross-sectional study included 72 participants with a minimum of 60 years recruited in Belo Horizonte, Brazil. A questionnaire was used to collect age, sex, presence of systemic diseases, and medications in continuous use. Salivary data collection was performed to determine unstimulated salivary flow, pH, and buffering capacity. Descriptive, bivariate, and multivariate analyses were performed (p<0.05). Results: Most of the sample had at least one systemic disease (81.9%) and used at least one medication (79.2%). Female participants (p=0.01), those with five or more systemic diseases (p<0.01), and hypertension (p=0.04) had reduced salivary flow. Participants with systemic diseases (p=0.02), taking any medication (p=0.04), in a polypharmacy regimen, and presenting hypertension (p=0.02) had more acidic salivary pH. Participants with diabetes had average salivary buffering capacity (p=0.02). In the adjusted multiple regression models, no explanatory variable was significantly associated with the salivary outcomes. Conclusion: Systemic alterations and medication use appear to be related to salivary changes in older adults. Integrative assessment of older adults is fundamental to identifying and controlling the factors that may modify their salivary characteristics.

Food consumption according to the degree of industrial food processing in Brazilian graduates (CUME Project): A hierarchical analysis of associated factors / Consumo alimentar segundo o grau de processamento industrial dos alimentos em brasileiros graduados (Projeto CUME): uma análise hierarquizada dos fatores associados

ABSTRACT Objective Evaluate the food consumption of the participants of the Cohort of Universities of Minas Gerais, according to the degree of processing, and its relationship with socioeconomic, behavioral, and individual factors. Methods A total of 4,124 individuals from the baseline of the Cohort of Universities of Minas Gerais (2016 and 2018) participated in this study. Food consumption was self-reported by completing an online Food Frequency Questionnaire. The foods were divided into 3 groups: Group 1, in natura, minimally processed foods, culinary ingredients and culinary preparations; Group 2, processed foods; Group 3, ultra-processed foods. A hierarchical multiple linear regression model was used to verify the associated factors. Results Regarding the factors associated with food consumption, it is noteworthy that Group 1 was positively associated with the practice of physical activity, female gender, age, "non-white" skin color, and the presence of diabetes Mellitus; and negatively with "not married/without stable union" marital status, alcohol abuse, tobacco use, obesity, and depression. Considering Group 2, it was positively associated with alcohol abuse, tobacco use, and age; and negatively with physical activity, female gender, and "non-white" skin color. As for Group 3 it was positively associated with a marital status of "not married/without stable union", obesity, and depression; and negatively with physical activity, age, "non-white" skin color, and presence of diabetes Mellitus. Conclusion The factors that are in at least one of the final hierarchical linear regression models stand out: marital status, physical activity, alcohol abuse, tobacco use, sex, age, skin color, obesity, diabetes mellitus, and depression.

RESUMO Objetivo Avaliar o consumo alimentar dos participantes da Coorte de Universidades Mineiras, de acordo com grau de processamento, e sua relação, com fatores socioeconômicos, comportamentais e individuais. Método Participaram desse estudo 4.124 indivíduos da linha de base da Coorte de Universidades Mineiras (2016 e 2018). O consumo alimentar foi autorrelatado por um questionário online de frequência de consumo alimentar. Os alimentos foram divididos em: Grupo 1: alimentos in natura, minimamente processados, ingredientes culinários e preparações culinárias; Grupo 2: alimentos processados; e Grupo 3: alimentos ultraprocessados. Foi utilizado modelo de regressão linear múltipla hierarquizada para verificar os fatores associados. Resultados O Grupo 1 se associou positivamente à prática de atividade física, sexo feminino, idade, cor da pele "não branca" e presença de diabetes Mellitus; e negativamente ao estado civil "não casado/sem união estável", consumo abusivo de álcool, uso do tabaco, obesidade e depressão. O Grupo 2 se associou positivamente ao consumo abusivo de álcool, uso do tabaco e idade; e negativamente à prática de atividade física, sexo feminino e cor da pele "não branca". O Grupo 3 se associou positivamente ao estado civil "não casado/sem união estável", obesidade e depressão; e negativamente à prática de atividade física, idade, cor da pele "não branca" e presença de diabetes Mellitus. Conclusão Destacam-se os fatores que estão em pelo menos um dos modelos de regressão linear hierarquizada final: estado civil, atividade física, consumo abusivo de álcool, uso do tabaco, sexo, idade, cor da pele, obesidade, diabetes mellitus e depressão.