Search Results (2,795)

Game meat is increasingly discussed as a nutrient-rich alternative source of animal protein, although its consumption remains constrained by limited availability, consumer familiarity, and practical or perceptual barriers. This study assessed attitudes, knowledge, perceptions, and consumption behaviours related to game meat among respondents recruited through an online convenience survey in Romania. Following exclusion of three respondents who did not meet the predefined age criterion, 640 participants were included in the analysis. Data were analysed using descriptive and inferential statistics, multiple correspondence analysis (MCA) with exploratory clustering, and multivariable binary logistic regression. Overall, 75.8% of respondents (95% CI [72.3–78.9]) reported having previously consumed game meat, although consumption was predominantly infrequent. Having family members or friends involved in hunting showed the strongest adjusted association with previous consumption (OR = 4.81, 95% CI [2.59–8.94]), while older age and higher self-rated information were also associated with higher adjusted odds of previous consumption. Exploratory MCA-based clustering suggested three broad respondent profiles characterised by differing levels of familiarity, previous consumption, purchasing knowledge, and perceptions of game meat. Among non-consumers, 50.0% reported willingness to try game meat in the future, although the corresponding multivariable model had limited explanatory power. The principal reported barriers among non-consumers were lack of opportunity (63.2%), discomfort with the idea of eating wild animals (43.4%), and ethical concerns regarding hunting (34.2%). These findings highlight potential considerations for producers, retailers, and policy makers, including market accessibility, consumer information, culinary guidance, and transparent communication regarding product origin and safety. Given the young, student-dominated convenience sample, the findings primarily reflect the perspectives of younger, highly educated respondents in Romania. Full article

In the post-pandemic era, identifying children who are most susceptible to severe illness and COVID-19-related mortality is essential for guiding public health policies. This study examined the risk factors for COVID-19-related severe illness and mortality from 2023 to mid-2025. We conducted a population-based cohort study using nationwide Brazilian data from patients aged <18 years with laboratory-confirmed SARS-CoV-2 infection between January 2023 and June 2025. The primary outcomes were COVID-19-related severity and death. Separate binary multivariable logistic regression models were developed for each of the outcomes. Among 465,689 children, 1.3% (n = 5963) developed severe illness, and 0.18% (n = 847) died. Factors associated with an increased risk of severe illness included age < 2 years, presence of comorbidities, Indigenous ethnicity, and lack of vaccination. Neurological disorders conferred the highest risk among the clinical conditions (adjusted odds ratio [aOR] = 34.1; 95% CI: 27.9–41.8). Regional differences were also observed; the North and Northeast regions showed higher mortality (aOR = 2.3; 95% CI: 1.8–3.0) than the Central-West region. Compared with White ethnicity, non-White ethnicities had higher mortality: Indigenous (aOR = 23.5; 95% CI: 13.5–39.3), Black (aOR = 1.95; 95% CI: 1.29–2.92), and Brown (aOR = 1.43; 95% CI: 1.18–1.73) ethnicities. Lack of any vaccine dose was associated with a significantly increased risk of severe illness (aOR = 1.39; 95% CI: 1.15–1.67. p < 0.001) and death (aOR = 2.1; 95% CI: 1.3–3.5; p < 0.001). In the post-pandemic era, younger age, comorbidities, sociodemographic disparities, and lack of vaccination were associated with an increased risk of severe illness and COVID-19-related death in the pediatric population. Full article

This study examines recurrent pet care spending, its perceived economic incidence on household budgets, and barriers to e-commerce adoption in Yopal, Colombia. Using a quantitative, cross-sectional, non-experimental design, data were collected from a non-probability convenience sample of 619 pet owners. Descriptive statistics, chi-square and Fisher’s exact tests, and binary logistic regression models were applied; online-channel adoption was analyzed exploratorily. Higher pet food and annual healthcare expenditures and ownership of two pets were associated with greater odds of perceiving moderate-to-high economic incidence, while partial affective justification was also associated with greater perceived economic incidence. Online purchasing remained marginal, with only 31 respondents identifying it as their primary purchasing channel. Among non-adopters, distrust of digital platforms and limited internet access were the most frequent barriers, with distributions differing significantly across age and income groups. Overall, the findings are consistent with an economically active but digitally incomplete market configuration, where recurrent demand coexists with limited digital transactional development. Full article

Background: Although ABO blood groups have been implicated in several vascular and neurological disorders, evidence regarding their association with epilepsy remains limited and inconclusive. We performed the largest and most comprehensive case–control evaluation to date to determine whether ABO/RhD blood groups are associated with epilepsy. Methods: We conducted a retrospective hospital-based case–control study including 806 adults with epilepsy and 14,032 controls from the same institutional population between January 2015 and January 2026. Epilepsy diagnoses were confirmed independently by two neurologists according to International League Against Epilepsy criteria. Associations between epilepsy and ABO/RhD blood groups were evaluated using a comprehensive analytical framework incorporating multivariable-adjusted logistic regression, binary blood group comparisons, age- and sex-matched sensitivity analyses, and epilepsy subtype-specific analyses. Results: No significant association was identified between epilepsy and ABO/RhD blood groups across any analytical approach. Overall ABO blood group (p = 0.777) and RhD status (p = 0.611) distributions were comparable between patients with epilepsy and controls. Binary analyses showed no significant associations for non-O versus O (OR 1.05, 95% CI 0.90–1.22; p = 0.535), non-A versus A (OR 0.93, 95% CI 0.80–1.06; p = 0.297), non-B versus B (OR 1.03, 95% CI 0.85–1.25; p = 0.748), non-AB versus AB (OR 1.05, 95% CI 0.81–1.34; p = 0.723), or RhD-negative versus RhD-positive status (OR 1.06, 95% CI 0.85–1.31; p = 0.611). These findings remained unchanged after multivariable-adjusted logistic regression, 1:4 age- and sex-matched sensitivity analyses (806 patients with epilepsy and 3224 matched controls; ABO p = 0.774, RhD p = 0.740), and comparisons between focal and generalized epilepsy subtypes (ABO p = 0.531; RhD p = 0.995). Conclusions: In this large hospital-based case–control study, no significant association was identified between epilepsy and ABO/RhD blood groups. However, the hospital-based control population and the availability of blood group data should be considered when interpreting these findings. Full article

Background/Objectives: Sleep-related problems are common among university students and are linked to adverse academic and health outcomes. This study evaluated the association between lifestyle medicine adherence and sleep-related problems among first-year Ecuadorian university students. Methods: A cross-sectional study was conducted in Quito, Ecuador, during the 2024–2025 academic year. First-year undergraduate students aged 16–35 years were recruited through a census-based, non-probability strategy (N = 2007). Lifestyle medicine adherence was assessed using the Short Multidimensional Inventory Lifestyle Evaluation for University Students (U-SMILE), and sleep-related problems were defined using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Level 1 Cross-Cutting Symptom Measure sleep domain (score ≥ 2), a symptom screen that is conceptually related to, but not identical with, the U-SMILE sleep quality domain. Multivariable binary logistic regression models were used and adjusted for sociodemographic and health-related covariates. A post-hoc sensitivity analysis recomputed the global U-SMILE score after excluding the sleep quality domain. Results: The median age was 18.0 years, and 51.0% were female. Among participants with Level 1 sleep data (n = 1906), 47.8% were classified as having sleep-related problems. In the fully adjusted model (n = 1893), higher overall U-SMILE scores were associated with lower odds of sleep-related problems (odds ratio (OR) per 1 point = 0.93, 95% Confidence Interval (CI): 0.91–0.94; OR per 1 SD = 0.56, 95% CI: 0.50–0.62). In a post-hoc sensitivity analysis, this association persisted after excluding the sleep quality domain from the global score (OR per 1 point = 0.94, 95% CI: 0.93–0.95; OR per 1 SD = 0.66, 95% CI: 0.60–0.73). Among non-sleep domains, the strongest associations were avoidance of substance use (OR = 0.87), social relationships (OR = 0.90), and nutrition (OR = 0.90); physical activity, nature engagement, and stress management were also significant. Conclusions: Higher lifestyle medicine adherence was associated with lower odds of sleep-related problems, including in post-hoc analyses when the sleep domain was omitted from the U-SMILE total. These findings support multidimensional lifestyle medicine approaches for sleep health promotion in university settings. Full article

Background: The uric acid-to-magnesium (UA/Mg) ratio and frontal QRS-T angle have been associated with coronary artery disease, but their relationships with angiographic coronary disease severity in acute coronary syndrome (ACS) remain incompletely characterized. We investigated their associations with the Gensini score in patients with ACS. Methods: This single-center, retrospective observational study included 146 patients with ACS undergoing coronary angiography, including 85 with ST-segment elevation myocardial infarction (STEMI) and 61 with non-ST-segment elevation myocardial infarction (NSTEMI). The primary adjusted analysis evaluated the continuous Gensini score after natural logarithmic transformation using multivariable linear regression with HC3 robust standard errors. Median quantile regression was performed as a sensitivity analysis. A Gensini score ≥ 60 was evaluated as a secondary exploratory binary endpoint using a parsimonious multivariable logistic regression model, with bootstrap internal validation. Results: The UA/Mg ratio (ρ = 0.332; p < 0.001), uric acid-to-HDL cholesterol ratio (UHR) (ρ = 0.232; p = 0.005), and frontal QRS-T angle (ρ = 0.481; p < 0.001) correlated positively with the Gensini score. In the primary adjusted analysis, both the UA/Mg ratio (β = 0.294 per 1-SD increase; p < 0.001) and frontal QRS-T angle (β = 0.225 per 1-SD increase; p < 0.001) were independently associated with higher log-transformed Gensini scores. These associations remained significant in median quantile regression and after additional adjustment for C-reactive protein. Modeling uric acid and magnesium separately provided better model fit than use of the UA/Mg ratio. In the secondary exploratory analysis of a Gensini score ≥ 60, the UA/Mg ratio (OR = 1.86 per 1-SD increase; 95% CI: 1.22–2.95; p = 0.005) and frontal QRS-T angle (OR = 1.54 per 1-SD increase; 95% CI: 1.05–2.30; p = 0.030) remained independently associated with the endpoint. The parsimonious model had an apparent AUC of 0.787 and an optimism-corrected AUC of 0.765 after bootstrap internal validation. Conclusions: Higher UA/Mg ratio and wider frontal QRS-T angle were independently associated with a higher log-transformed Gensini score in the primary continuous-outcome analysis in patients with ACS. However, the UA/Mg ratio did not demonstrate statistical superiority over its individual components, and the secondary binary model showed only moderate discrimination after internal validation. These findings should be considered exploratory and require prospective external validation. Full article

Background: Women with chronic medical conditions are at increased risk of adverse pregnancy outcomes, making contraceptive counselling an essential component of comprehensive chronic disease management. However, evidence regarding the knowledge and clinical practices of non-obstetric physicians remains limited. This study evaluated physicians’ knowledge, attitudes, and practices regarding contraceptive counselling for women with chronic medical conditions in a tertiary referral hospital in Türkiye. Methods: A cross-sectional Knowledge–Attitude–Practice survey was conducted among 264 non-obstetric physicians at İzmir City Hospital between July and October 2025. The questionnaire assessed contraceptive counselling practices, awareness of the World Health Organization Medical Eligibility Criteria for Contraceptive Use (WHO MEC), postgraduate contraception training, perceived barriers, and educational needs. Categorical associations were examined using chi-square or exact procedures as appropriate, and multivariable binary logistic regression was performed to evaluate factors associated with self-reported routine contraceptive counselling while accounting for potential confounding. Results: Among the 260 physicians who responded to the relevant item, 89.2% agreed that contraceptive method selection may influence the course of chronic disease, whereas 37.9% of the total sample reported routinely providing contraceptive counselling. Awareness of the WHO MEC was limited, with 75.8% reporting no prior awareness, and 18.2% had received postgraduate contraception training. In the adjusted analysis, WHO MEC awareness (aOR = 2.76, 95% CI: 1.39–5.46; p = 0.004), postgraduate contraception training (aOR = 2.38, 95% CI: 1.12–5.07; p = 0.024), seeing ≥30 women of reproductive age per week (aOR = 2.07, 95% CI: 1.15–3.73; p = 0.016), female sex (aOR = 3.81, 95% CI: 1.90–7.65; p < 0.001), and >10 years of clinical practice (aOR = 2.38, 95% CI: 1.23–4.62; p = 0.010) were associated with higher odds of self-reported routine counselling. Specialty was not significantly associated after adjustment. Conclusions: Self-reported routine contraceptive counselling remained limited despite broad recognition of the relevance of contraception in chronic disease care. Guideline awareness, postgraduate training, clinical exposure, sex, and clinical experience were associated with routine counselling after adjustment, although causal relationships cannot be inferred from this cross-sectional study. These findings support further evaluation of educational and organizational strategies for integrating reproductive healthcare into chronic disease management. Full article

Background: Platinum resistance remains a major therapeutic challenge in epithelial ovarian cancer (EOC). The tumour–stroma ratio (TSR) has emerged as a potential histopathological marker of tumour biology, but its clinical significance in different clinical settings remains unclear. We evaluated the association between stromal proportion, assessed using the TSR methodology, platinum resistance, and survival outcomes in patients undergoing primary debulking surgery (PDS) or neoadjuvant chemotherapy followed by interval debulking surgery (NACT+IDS). Methods: This retrospective study included 83 patients with epithelial ovarian cancer (EOC) who underwent either primary debulking surgery (PDS) or neoadjuvant chemotherapy followed by interval debulking surgery (NACT+IDS) between 2017 and 2024. Patients were analysed separately according to treatment strategy. Stromal proportion was assessed on primary surgical specimens in the PDS cohort and on pretreatment diagnostic biopsy specimens in the NACT+IDS cohort. For this retrospective analysis, platinum resistance was operationally defined as recurrence within six months after completion of first-line platinum-based chemotherapy. Survival outcomes were analysed using the Kaplan–Meier method, and univariable binary logistic regression was performed separately within the PDS and NACT+IDS cohorts to explore the association between stromal category and platinum resistance. Results: Platinum resistance occurred in 25.3% of patients. In the PDS cohort, stromal category was not associated with clinicopathological characteristics, platinum resistance, disease-free survival (DFS), or overall survival (OS). In the NACT+IDS cohort, patients in the stroma-high group had a numerically higher rate of platinum resistance than those in the stroma-low group (57.9% vs. 22.2%; Fisher’s exact p = 0.114). Based on univariable logistic regression analysis, the stroma-high group had higher estimated odds of platinum resistance (OR 4.81, 95% CI 0.78–29.40), although this finding did not reach statistical significance (p = 0.090). No significant association was observed between stromal category and survival outcomes in either cohort. Conclusions: In the NACT+IDS cohort, patients in the stroma-high group had a numerically higher rate of platinum resistance than those in the stroma-low group; however, this difference did not reach statistical significance. These results should be interpreted with caution due to the retrospective study design and limited sample size; however, they nonetheless support further investigation of pretreatment TSR as a simple and easily applicable histopathological parameter in EOC. Larger prospective multicentre studies are required to determine whether this exploratory signal is reproducible and clinically relevant. Full article

The clinical integration of artificial intelligence has outpaced the development of robust evaluative frameworks, raising critical safety concerns. This perspective establishes a clear taxonomy distinguishing probabilistic language models from deterministic classifiers and applies a multi-dimensional combinatorial model to calculate the requirements for complete diagnostic coverage. Our analysis demonstrates that comprehensive diagnostic coverage requires between 50,000 and 150,000 distinct, task-specific classifiers under subspecialty-level clinical granularity; conservative aggregated estimates (4500–18,750 binary classifiers) do not reflect the multiplicative expansion introduced by subtype differentiation, severity staging, temporal variants, demographic stratification, and equipment variation, whereas currently cleared devices cover less than one percent of this clinical space. More fundamentally, although population-trained models can generate conditional patient-specific risk estimates when predictors are informative and calibration is adequate, these statistical parameters optimized on population-scale data cannot provide the categorical certainty required for individual diagnostic decisions, which is a gap that clinical judgment must bridge. Because clinical AI tools are inherently statistical and perform reliably only on common, highly represented presentations while failing on rare, atypical cases rare in their training data, attempting to automate routine tasks leaves human clinicians with only the most challenging diagnostics. Furthermore, selective automation of these low-complexity cases introduces severe occupational hazards, including cognitive surrender, diagnostic complacency, and rapid expertise atrophy. Rather than pursuing the computationally and logistically unfeasible goal of complete diagnostic classification, developers should prioritize predictive, prognostic trajectory modeling. This paradigm shift aligns the probabilistic nature of machine learning with clinical utility, reinforcing clinical judgment as the irreplaceable diagnostic integrator. Full article

Background: Recently, artificial intelligence-based tools such as large language models (LLMs) have further transformed health information-seeking practices. This study aimed to assess digital health information-seeking behaviors among healthcare professionals working in İzmir, Türkiye, and to examine individual and environmental factors associated with these behaviors. Methods: A cross-sectional study was conducted among 380 healthcare professionals in İzmir. Data were collected using an online questionnaire comprising sociodemographic and health information-seeking items and the eight-item e-health literacy scale (eHEALS). Descriptive statistics and non-parametric tests were used for unadjusted comparisons. Multivariable binary logistic regression was performed to identify factors independently associated with LLM use, while multivariable linear regression with HC3-robust standard errors was used to identify factors independently associated with e-health literacy. To reduce sparse-data instability, conceptually compatible small categories were collapsed before refitting the multivariable models. Statistical significance was set at p < 0.05. Results: Overall, 73.2% of participants reported using LLMs (e.g., ChatGPT) for health-related information seeking. After multivariable adjustment, daily internet use of 3–6 h was associated with higher odds of LLM use compared with ≤3 h/day (adjusted OR = 2.0437, 95% CI: 1.1467–3.6423, p = 0.0153). E-health literacy was not independently associated with LLM use (adjusted OR = 0.9875, 95% CI: 0.9599–1.0158, p = 0.3825). In the e-health literacy model, the combined divorced/widowed group had lower adjusted scores than married participants (B = −4.4087, 95% CI: −7.4003 to −1.4171, p = 0.0039). Uncertainty about institutional scientific database access was also associated with lower e-health literacy (B = −6.1805, 95% CI: −8.9255 to −3.4356, p < 0.0001), whereas often/always reading online health information was associated with higher scores compared with never/rarely reading it (B = 2.6264, 95% CI: 0.5112–4.7416, p = 0.0149). Conclusion: LLM use was common among healthcare professionals, but it was not independently associated with e-health literacy. Patterns of internet use, marital status, institutional database awareness, and frequency of reading online health information showed independent associations with the study outcomes. These findings support targeted digital health and AI-literacy initiatives. Full article

Background/Objectives: A crucial issue in Japan, as a rapidly aging society, is supporting the quality of life (QOL) of older adults to ensure they do not require long-term care. This study aims to examine the association between subjective symptoms and psychological stress and QOL decline using a large-scale Japanese national statistics database. Methods: Anonymized data were analyzed from 23,649 adults aged ≥ 65 years, obtained from the Comprehensive Survey of Living Conditions carried out in 2019 in Japan. The degree of association of different factors with QOL decline was analyzed using univariate symptom analysis and adjusted odds ratios (ORs) obtained through binary logistic regression. We also compared the reported frequency and mean number of symptoms in a group with poor QOL and one with good/regular QOL. Results: In the group with poor QOL, significantly more individuals were aged ≥ 75 years, had high levels of psychological stress (Kessler Psychological Distress Scale [K6]), and reported subjective symptoms (p < 0.01). The mean number of symptoms was significantly higher in this group (5.77) than in the good/regular QOL group (3.34, p < 0.01). In the binary logistic regression, the variables with the highest adjusted ORs were the K6 group (4.49), impaired limb movement (2.81), and numbness of the limbs (2.01). Conclusions: These findings indicate that different symptoms, including stress, have varying impacts on QOL in older adults. Addressing symptoms associated with reduced QOL in community-dwelling older adults may help promote continued aging in place. Full article

Background: Carbapenem-resistant Acinetobacter baumannii (CRAB) is a major nosocomial pathogen; bacteriophage therapy is a promising alternative, but its principal challenge is the rapid emergence of phage resistance. Cocktails counter this yet they are usually assembled by simply pooling phages active against the bacterium, not designed against the resistant mutants that arise. Methods: Next evolutionary phage typing (NEPT) addresses this by inducing resistance to a primary phage and then selecting secondary phages that lyse the resulting resistant mutant. Because choosing effective secondary phages still relies on qualitative visual reading of plaques (size and clarity), this study aimed to identify a rapid quantitative criterion. Results: Using the clinical strain CRAB 43895 and primary phage ϕ8, we obtained 65 NEPT-derived secondary phages that lyse the ϕ8-resistant mutant (ϕ8R) and combined four quantitative indicators—relative bacterial growth, lytic capability, coverage rate, and plaque morphology—with binary logistic regression to predict effective inhibition by the ϕ8 + secondary-phage cocktail (96-h OD₆₀₀ < 0.1). Of the four, only lytic capability (the titer after 3 h of co-culture) independently predicted effective inhibition (ROC AUC = 0.76; at ≥10⁷ plaque-forming units (PFU)/mL, sensitivity 0.83, specificity 0.69). Conclusions: Lytic capability thus provides a rapid (~8–12 h), quantitative criterion for selecting effective secondary phages within the NEPT framework, improving on conventional qualitative typing. Full article

Digital influencers have become increasingly relevant in tourism communication, particularly in the dissemination of destination-related information and experiences through social media. This study examines the association between selected digital influencer attributes and respondents’ perceived influence of travel influencers. A quantitative survey of social media users who followed digital influencers was conducted, yielding 147 valid responses. The questionnaire measured perceptions of influencer-generated content, credibility, authenticity, influencer experience, interactivity, relationship-related characteristics, and other relevant attributes using seven-point Likert scales. An exploratory principal component analysis (PCA) with Oblimin rotation was conducted to identify the empirical structure of the observed dimensions, followed by binary logistic regression to examine their associations with respondents’ perceived influence by travel influencers. The PCA yielded eight empirical components accounting for 81.188% of the total variance. Among the dimensions included in the estimated regression model, content essence was the only predictor that reached conventional statistical significance (β = 0.556, p = 0.035; Exp(B) = 1.743). The remaining predictors did not reach statistical significance at the 5% level. The findings provide exploratory evidence that content-related characteristics may have particular statistical relevance for respondents’ perceived influence by travel influencers when several influencer-related components are considered simultaneously. However, the results should be interpreted as statistical associations rather than causal effects. The study contributes to the tourism influencer marketing literature by highlighting the relevance of content-related characteristics while emphasizing the need for further research using larger samples, validated measurement models, and clearly specified behavioral outcomes. Full article

This study examines household electricity use patterns and stated acceptance of a voluntary renewable energy contribution among households in the city centres of six Turkish provinces (Adana, Adıyaman, Gaziantep, Mersin, Osmaniye and Şanlıurfa). A cross-sectional questionnaire was administered to 453 households between March and May 2023. The outcome conventionally labelled willingness to pay (WTP) was elicited as a single hypothetical Yes/No item (“If paying such a contribution were voluntary, would you still pay it?”), with no monetary amount, bid sequence or payment card presented; it is therefore analyzed as a binary measure of stated acceptance rather than as a monetary valuation. Descriptive statistics, bivariate tests and hierarchical binary logistic regression were used to characterize household electricity use and to identify the correlates of stated acceptance. Beyond lighting, electricity was widely used for heating, cooling, hot water and small appliances, and most respondents wanted a renewable energy contribution to be itemized clearly on the bill. Nevertheless, a majority did not accept the hypothetical voluntary payment, and stated acceptance varied significantly by province and by income category. In the fully adjusted logistic model, the preference for bill itemization, the belief that the existing bill already included a renewable component, and postsecondary/bachelor education were the strongest positive correlates of stated acceptance, whereas income, bill level, dwelling size and current household renewable energy use were not independently associated. The findings support transparent, verifiable billing practices and targeted energy literacy measures, but should not be read as a monetary WTP estimate or as causal evidence. Full article

Background/Objectives: Exclusive breastfeeding (EBF) is associated with multiple individual, interpersonal, and healthcare-related factors. Identifying potentially modifiable factors associated with EBF across different levels of influence may help inform future breastfeeding research and support strategies. This study aimed to identify individual, interpersonal, and obstetric factors associated with exclusive breastfeeding among Polish mothers, using the Socio-Ecological Model (SEM) as a conceptual framework. Methods: A cross-sectional online survey was conducted among 769 Polish mothers of children aged up to 24 months. The questionnaire included sociodemographic and perinatal characteristics, as well as standardized instruments: Multidimensional Scale of Perceived Social Support (MSPSS), Iowa Infant Feeding Attitudes Scale (IIFAS), and Birth Satisfaction Scale–Revised (BSS-R). Hierarchical binary logistic regression was used to identify factors associated with exclusive breastfeeding. Missing data were handled using multiple imputation by chained equations, with 20 imputed datasets, and estimates were pooled according to Rubin’s rules. Results: Exclusive breastfeeding was reported by 610 participants (79.3%). Across the 20 imputed datasets, the final model showed χ² values ranging from 62.92 to 70.00 and Nagelkerke’s R² values ranging from 0.123 to 0.136. In the final model, mode of delivery (OR = 1.92, 95% CI: 1.32–2.80, p < 0.001), complications/illnesses during pregnancy (OR = 1.73, 95% CI: 1.14–2.64, p = 0.011), and partner encouragement (OR = 2.81, 95% CI: 1.72–4.59, p < 0.001) were significantly associated with exclusive breastfeeding. A nonlinear association between breastfeeding attitudes and exclusive breastfeeding was observed, with the quadratic IIFAS term remaining statistically significant (OR = 0.99, 95% CI: 0.99–1.00, p = 0.002), whereas the linear IIFAS term was not statistically significant in the final model (OR = 1.04, 95% CI: 1.00–1.08, p = 0.078). Birth satisfaction and the MSPSS Friends, Family, and Significant Other subscales were not independently associated with exclusive breastfeeding in the final model. Conclusions: Among the variables included in the final model, partner encouragement showed the strongest association with exclusive breastfeeding. Mode of delivery and complications/illnesses during pregnancy were also associated with exclusive breastfeeding, while the association between breastfeeding attitudes and exclusive breastfeeding was nonlinear. These findings may inform future prospective and intervention studies examining partner support, breastfeeding attitudes, and perinatal factors in relation to exclusive breastfeeding. Further research is warranted to explore the mechanisms underlying the observed associations. Full article