Correlates Of Events Research Articles

Towards the correlates of stressful life events as precipitants of obsessive-compulsive disorder: a systematic review and metanalysis.

Obsessive-compulsive disorder (OCD) is a prevalent condition with multifactorial etiology involving genetic and environmental factors. The present study aims to summarize the correlates of stressful life events (SLEs) in OCD by reviewing studies comparing OCD associated or not with SLEs before its onset. To do so, a systematic review was performed by searching PubMed, Web of Science, Scopus, and PsycINFO databases for studies published between the database's inception and November 27, 2023. Studies including individuals whose OCD was precipitated or not by SLEs (SLEs OCD and NSLEs OCD, respectively) were assessed. Effect sizes or odds ratios were then calculated to identify the strength of association between SLEs and clinical characteristics, such as gender, age of onset, family history of OCD, severity of OCD symptoms, depressive symptoms, and mood comorbidities among patients with OCD. Out of the 4083 records initially identified, 5 studies met the inclusion criteria and 3 were comparable through a meta-analysis. Notably, the analyses were limited by the small number of studies available in the literature. The meta-analysis demonstrated SLEs OCD to be associated with female gender, later OCD onset, and increased comorbidity rates with mood disorders. Despite the cross-sectional nature of the reviewed studies, women may be more vulnerable to develop a later onset of OCD following SLEs, which may also lead to mood disorders. Caution is needed to avoid prematurely classifying this presentation as a distinct subtype of OCD.

Clinical correlates of negative health events and disparities among adults with epilepsy enrolled in a self-management clinical trial

AimsDespite advances in care, people with epilepsy experience negative health events (NHEs), such as seizures, emergency department (ED) visits and hospitalizations. This analysis using baseline data from an epilepsy self-management clinical trial targeting people from rural regions and other underserved populations assessed the relationship between demographic and clinical variables vs. NHEs. MethodsData to evaluate disparities and clinical correlates was collected using patient surveys from a baseline sample of 94 participants in a larger prospective study of 160 individuals with epilepsy who experienced an NHE within the last six months. Demographic characteristics, mental and physical functional status assessed using 36-Item Short Form Health Survey questionnaire version 2 (SF-36v2), depression assessed with the 9-item Patient Health Questionnaire (PHQ-9), quality of life assessed with the 10-item Quality of Life in Epilepsy Inventory (QOLIE-10), self-efficacy assessed the Epilepsy Self-Efficacy Scale (ESES), social support assessed with the Multidimensional Scale of Perceived Social Support (MSPSS), self-management assessed with the Epilepsy Self-Management Scale (ESMS), and stigma assessed with the Epilepsy Stigma Scale (ESS) were all examined in association with past 6-month total NHE frequency as well as NHE sub-categories of past 30-day and 6-month seizure counts, self-harm attempts, ED visits and hospitalizations. An exploratory evaluation of NHE correlates in relation to the Rural Urban Continuum Code (RUCC) residence classification compared 3 subgroups of increasing rurality. Descriptive statistics were generated for demographic and clinical variables and NHEs, and exploratory analyses compared the distribution of demographic, clinical, and NHE variables by RUCC categorization. ResultsThe mean age was 38.5 years (SD 11.9), predominantly female (N= 62, 66.0%) and white (N=81, 86.2%). Just a little under half (N=43, 45.7%) of participants had annual incomes of less than $25,000, and 40% (N=38) were rural residents (RUCC >3). The past 6-month NHEs count was 20.4 (SD 32.0). Seizures were the most common NHE with a mean 30-day seizure frequency = 5.4 (SD 11.8) and 6-month seizure frequency of 18.7 (SD 31.6). Other NHE types were less common with a past 6-month self-harm frequency of 0.16 (SD 1.55), ED visit frequency of 0.72 (SD 1.10), and hospitalization frequency of 0.28 (SD 1.02). There were few significant demographic and clinical correlates for total and sub-categories of NHEs. Worse physical health status, as measured by the physical component summary (PCS) of the SF-36v2, was significantly associated with 6-month seizure counts (p=.04). There were no significant differences between the 3 RUCC subgroups on demographic variables. However, past 30-day seizure count, past 6-month seizure count and total past 6-month NHE counts were all higher among individuals from more rural settings (p-values <.01 for each). ConclusionsRural adults with epilepsy were more likely to have a greater number of seizures and more epilepsy complications in general. Worse physical health function was also associated with more epilepsy complications. However, this analysis found few other demographic and clinical correlates of cumulative NHEs among adults with epilepsy. Additional efforts are needed to investigate health disparities among people with epilepsy who live in rural regions or who have poor physical health function.

Neural correlates of negative life events and their relationships with alcohol and cannabis use initiation.

Negative life events (NLEs), e.g., poor academic performance (controllable) or being the victim of a crime (uncontrollable), can profoundly affect the trajectory of one's life. Yet, their impact on how the brain develops is still not well understood. This investigation examined the National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) dataset for the impact of NLEs on the initiation of alcohol and cannabis use, as well as underlying neural mechanisms. This study evaluated the impact of controllable and uncontrollable NLEs on substance use initiation in 207 youth who initiated alcohol use, 168 who initiated cannabis use, and compared it to 128 youth who remained substance-naïve, using generalised linear regression models. Mediation analyses were conducted to determine neural pathways of NLE impacting substance use trajectories. Dose-response relationships between controllable NLEs and substance use initiation were observed. Having one controllable NLE increased the odds of alcohol initiation by 50% (95%CI [1.18, 1.93]) and cannabis initiation by 73% (95%CI [1.36, 2.24]), respectively. Greater cortical thickness in left banks of the superior temporal sulcus mediated effects of controllable NLEs on alcohol and cannabis initiations. Greater left caudate gray-matter volumes mediated effects of controllable NLEs on cannabis initiation. Controllable but not uncontrollable NLEs increased the odds of alcohol and cannabis initiation. Moreover, those individuals with less mature brain structures at the time of the NLEs experienced a greater impact of NLEs on subsequent initiation of alcohol or cannabis use. Targeting youth experiencing controllable NLEs may help mitigate alcohol and cannabis initiation.

Experimenting ‘In Vivo’ with Dynamic Glottal Parameters: Methodological Issues, Technical Tips &amp; Tricks and Preventable Pitfalls

‘In vivo’ studies pertaining to dynamics of vocal fold vibration motion, to vocal fold contact and collision, to vocal onset and offset and to mechanical efficiency all need valid, sensitive and precise measurements of the different mechanical parameters involved. This is also true for investigating the physiological correlates of particular acoustic events like register breaks or diplophonia. The main physical parameters involved are: vocal fold movement and shaping, particularly the velocity of tissue displacement, glottal area, tissue distortion, intraglottal pressure, transglottal air flow, vocal fold contact and collision stress, etc. This article presents a critical review of the instruments and techniques involved in the direct measurements of the glottal dimensions and movements, the transglottal airflow, the VF contact changes, the pressures and the sound acoustic pressure. In each case are analyzed the methodological aspects that are critical for validly calibrating and synchronizing these signals, and correcting them for time delays. Moreover, it is shown how new parameters, like vocal fold velocity, intraglottal pressure, vocal fold collision stress, can be inferred from these (raw or after differentiation) signals by combining them. Finally, the discussion focuses on weighing advantages and limitations of techniques for monitoring the glottal area, i.e. photometry and the high-speed imaging, the latter involving the relevance in this scope of future developments in endoscopic and external imaging techniques, and in image processing software. Our aim is to facilitate the work of future researchers by showing how to solve important technical pitfalls, how to apply the necessary corrective measures - and which ones - where needed, and how to get the most out of combinatorial measures.

Echocardiographic correlates of major adverse cardiac events at 1 year in patients with apical ballooning takotsubo syndrome.

Takotsubo syndrome (TTS) is characterized by transient left ventricular dysfunction and associated with considerable morbidity and mortality. We sought to evaluate the association between change in cardiac mechanics after diagnosis of TTS with 1-year incidence of major adverse cardiovascular events (MACE). We retrospectively identified 85 patients with apical TTS based on ICD 9/10 codes and chart adjudication, who had a follow-up echocardiogram within 6 months of diagnosis. Echocardiograms were analyzed for left ventricular ejection fraction (LVEF), global longitudinal strain (GLS), GLS ratio, global circumferential strain (GCS), and global radial strain (GRS). Multivariable logistic regression was performed to identify parameters associated with MACE (all-cause mortality, heart failure, stroke, and coronary artery disease [CAD] requiring percutaneous coronary intervention [PCI]) at 1 year. Event-free survival was assessed in patients with GLS (≤-18% vs. >18%) and LVEF (≥53% vs. <53%). Within 1 year of diagnosis, MACE occurred in 15 (18%) patients. Between baseline and follow-up echocardiogram (median 15 [range 1-151] days), there were significant differences in change in LVEF and GLS in patients with versus without incident MACE. In multivariate analysis, change in LVEF (odds ratio [OR]=.93 [.87, .98], p=.013) and change in GLS (OR=1.32 [1.04, 1.67], p=.022) were independently associated with MACE; however, the association with change in GLS was attenuated (odds ratio [OR]=1.13 [.94, 1.36], p=.21) after adjustment for baseline and change in LVEF. Among patients with normalized LVEF at follow-up, there were five (14.7%) MACE; whereas, there were no events among patients with normalized GLS. In patients with apical TTS, recovery in GLS and LVEF at follow-up was associated with significantly lower MACE at 1 year. Normalization of GLS at follow-up was better able to discriminate event-free survival than normalization of LVEF.

Optogenetics and electron tomography for structure-function analysis of cochlear ribbon synapses.

Ribbon synapses of cochlear inner hair cells (IHCs) are specialized to indefatigably transmit sound information at high rates. To understand the underlying mechanisms, structure-function analysis of the active zone (AZ) of these synapses is essential. Previous electron microscopy studies of synaptic vesicle (SV) dynamics at the IHC AZ used potassium stimulation, which limited the temporal resolution to minutes. Here, we established optogenetic IHC stimulation followed by quick freezing within milliseconds and electron tomography to study the ultrastructure of functional synapse states with good temporal resolution in mice. We characterized optogenetic IHC stimulation by patch-clamp recordings from IHCs and postsynaptic boutons revealing robust IHC depolarization and neurotransmitter release. Ultrastructurally, the number of docked SVs increased upon short (17-25 ms) and long (48-76 ms) light stimulation paradigms. We did not observe enlarged SVs or other morphological correlates of homotypic fusion events. Our results indicate a rapid recruitment of SVs to the docked state upon stimulation and suggest that univesicular release prevails as the quantal mechanism of exocytosis at IHC ribbon synapses.

Immunogenomic correlates of immune-related adverse events for anti-programmed cell death 1 therapy.

Despite impressive antitumor efficacy of programmed cell death 1 (PD-1) inhibitors, this inhibition can induce mild to severe autoimmune toxicities, termed immune-related adverse events (irAEs). Yet, predictive pretreatment biomarkers for irAEs development across cancer types remain elusive. We first assessed cellular and molecular factors. To determine factors predicting the risk of irAEs for anti-PD-1 immunotherapy across multiple cancer types, an integrative analysis of cellular and molecular factors from 9104 patients across 21 cancer types and 4865522 postmarketing adverse event reports retrieved from adverse event reporting system was then performed. Accuracy of predictions was quantified as Pearson correlation coefficient determined using leave-one-out cross-validation. Independent validation sets included small cell lung cancer and melanoma cohorts. Out of 4865522 eligible adverse events reports, 10412 cases received anti-PD-1 monotherapy, of which, 2997 (28.78%) exhibited at least one irAE. Among established immunogenomic factors, dendritic cells (DC) abundance showed the strongest correlation with irAEs risk, followed by tumor mutational burden (TMB). Further predictive accuracy was achieved by DC and TMB in combination with CD4+ naive T-cells abundance, and then validated in the small cell lung cancer cohort. Additionally, global screening of multiomics data identified 11 novel predictors of irAEs. Of these, IRF4 showed the highest correlation. Best predictive performance was observed in the IRF4 - TCL1A - SHC-pY317 trivariate model. Associations of IRF4 and TCL1A expression with irAEs development were verified in the melanoma cohort receiving immune checkpoint inhibitors. Collectively, pretreatment cellular and molecular irAEs-associated features as well as their combinations are identified regardless of cancer types. These findings may deepen our knowledge of irAEs pathogenesis and, ultimately, aid in early detection of high-risk patients and management of irAEs.

Brain-correlates of processing local dependencies within a statistical learning paradigm

Statistical learning refers to the implicit mechanism of extracting regularities in our environment. Numerous studies have investigated the neural basis of statistical learning. However, how the brain responds to violations of auditory regularities based on prior (implicit) learning requires further investigation. Here, we used functional magnetic resonance imaging (fMRI) to investigate the neural correlates of processing events that are irregular based on learned local dependencies. A stream of consecutive sound triplets was presented. Unbeknown to the subjects, triplets were either (a) standard, namely triplets ending with a high probability sound or, (b) statistical deviants, namely triplets ending with a low probability sound. Participants (n = 33) underwent a learning phase outside the scanner followed by an fMRI session. Processing of statistical deviants activated a set of regions encompassing the superior temporal gyrus bilaterally, the right deep frontal operculum including lateral orbitofrontal cortex, and the right premotor cortex. Our results demonstrate that the violation of local dependencies within a statistical learning paradigm does not only engage sensory processes, but is instead reminiscent of the activation pattern during the processing of local syntactic structures in music and language, reflecting the online adaptations required for predictive coding in the context of statistical learning.

1432P Incorporating psycho-social factors in cancer treatment adverse events studies

Cancer patients and survivors dealing with adverse events due to cancer treatment, experience impairments in their overall quality of life. In particular, literature reports the potential cardiotoxic effects of cancer therapies, clinically observable up to 10 years after the completion of interventions. However, even though associations between psycho-social factors and cardiovascular diseases have been appreciated in literature, less attention has been given to psycho-social features as correlates of cancer treatment adverse events.

Outcomes of Patients Undergoing Cardiac Catheterization After a Three-Day Holiday Weekend Versus a Two-Day Weekend.

The study aim is to determine whether invasive cardiac procedures following a 3-day (holiday) weekend have worse outcomes compared with procedures following a 2-day (normal) weekend. Catheterization laboratory schedules after 3-day holiday weekends tend to be overloaded with urgent procedures for patients who have waited up to 3 days. We hypothesized that this would be reflected by more procedural complications in patients undergoing procedures after a 3-day weekend. Invasive cardiac procedures that occurred after a weekend at Geisinger Medical Center from July 2012 to December 2019 were included. Baseline characteristics, presentation, periprocedural variables, adverse events, and clinical outcomes were compared between catheterizations on the day following a 2-day weekend and catheterizations following a 3-day weekend. Independent correlates of adverse events were identified by logistic regression analysis. We identified 13,704 invasive cardiac procedures performed after a weekend, of which 722 occurred after a 3-day (holiday) weekend. Baseline demographics, presentation, and case volumes were similar between the 2 groups. Procedures after a 3-day weekend were not associated with any differences in in-hospital mortality, myocardial infarction, or stroke compared with those after a standard 2-day weekend. By univariate analysis, procedural complications were more frequent after a 3-day weekend (15.1% vs 12.3%; P=.03), but this difference was not significant on multivariate analysis (odds ratio, 1.22; P=.30). Cardiac catheterization procedures performed after a 3-day weekend were not associated with differences in in-patient mortality, myocardial infarction, stroke, or procedural complications.

Personality differences in the occurrence and affective correlates of daily positive events.

Previous research shows that Neuroticism predicts exposure and affective reactivity to daily stressors. Zautra and colleagues extended this work to daily positive events. Building on these frameworks, we examined the Big Five personality traits as predictors of the occurrence and affective correlates of daily positive events. Participants in two national U.S. daily diary studies (NSDE 2: N=1,919 and NSDE Refresher: N=778; aged 25-84) reported daily positive events, emotions specific to the events, and daily affect for 8 consecutive days. In parallel analyses in both samples, Extraversion and in the NSDE Refresher sample only Openness (but not Neuroticism, Conscientiousness, or Agreeableness) predicted more frequent positive event occurrence. All Big Five traits were associated with one or more emotional experiences (e.g., calm, proud) during positive events. Neuroticism predicted greater event-related positive affect in the NSDE 2 sample, whereas Agreeableness was related to more event-related negative affect in the NSDE Refresher sample. The Big Five personality traits each provided unique information for predicting positive events in daily life. The discussion centers on potential explanations and implications for advancing the understanding of individual differences that contribute to engagement in positive experiences.

Comorbidities and psychosocial factors as correlates of self-reported falls in a nationwide sample of community-dwelling people aging with HIV in Germany

BackgroundFalls are a frequent health problem with potentially severe consequences among the elderly. Due to the aging HIV population, there is a growing interest in falls as a geriatric syndrome in HIV research and clinical practice. Previous studies found rather high prevalences of falls in this population and focused on biomedical and demographic risk factors for falls. Psychosocial risk factors like stigma, social support or loneliness were not previously assessed as correlates of fall events in this population.MethodsWe assessed self-reported fall frequency in the past 12 months in a nationwide sample of 897 community-dwelling people aged 50 years or older living with HIV in Germany using a cross-sectional study design. We calculated odds of any fall for sociodemographic and HIV-related variables in bivariate analyses and for comorbidities, and psychosocial variables in bivariate and adjusted analyses.ResultsEighteen percent of our participants reported at least one fall in the preceding 12 months, 12 % reported recurring falls. A lower socioeconomic status, being single and living alone were significantly associated with a higher risk for falling. An AIDS diagnosis was related to fall risk, but time since diagnosis and a detectable viral load were not. Reporting at least one comorbidity increased fall risk in our sample 2.5 times (95% CI: 1.59; 3.97). The strongest association with fall risk was found for diseases of the central nervous system, heart disease, rheumatism, osteoporosis, and chronic pain. Experienced HIV stigma (AOR: 2.11; 95% CI: 1.58; 2.83) and internalized HIV stigma (AOR: 1.43; 95% CI: 1.12; 1.85), as well as social support (AOR: .92; 95% CI: .86; .99) and loneliness (AOR: 1.51; 95% CI: 1.22; 1.87) were significantly related to fall risk in bivariate and adjusted analyses.ConclusionsWe found a low prevalence of falls in our sample of community-dwelling people aging with HIV. Our results show evidence for a strong association between comorbidity and falling, and between psychosocial factors and falling. Especially the strong association between experienced HIV stigma and fall risk is noteworthy and adds falls to the list of health outcomes affected by HIV stigma.

MO522BIOMARKERS OF KIDNEY FUNCTION AS POTENTIAL PROGNOSTIC FACTORS FOR CARDIOVASCULAR DISEASE IN TYPE 2 DIABETIC PATIENTS

Abstract Background and Aims Developing risk predictive models in high-risk populations, such as patients with type 2 diabetes (T2DM), might provide an individualized risk prediction. During the past decade, the studies assessing carotid intima media thickness (cIMT) as a novel risk factor for cardiovascular (CV) disease, produced controversial results. In this study, we assessed the prognostic value of various risk factors, including cIMT and biomarkers of kidney function, to predict incident CV events in T2DM patients. Method A total of 158 adults, with a history of type 2 diabetes for&amp;gt;10 years were recruited. At baseline, urinary albumin to creatinine ratio (UACR), eGFR and cIMT were evaluated. All patients were followed for a period of 7 years with fatal or nonfatal CV events as the primary endpoint. By adopting the Fine and Gray model, which takes into account the competitive risk of death, we assessed the associations between CV events and various candidate prognostic factors collected at baseline. In multiple Cox Fine and Gray models, we included all variables that were correlated with the study outcome in univariate analysis, (full model with 9 variables). The prognostic performance of the full model was compared with that of a simpler (nested) model based only on three prognostic variables (simplified model). To compare the data fitting of the 2 models, we used −2 log likelihood (−2 log L) statistics. The calibration and the discrimination abilities of both models were assessed by Hosmer-Lemeshow test and by receiver operating characteristic (ROC) curve, respectively. Results During the follow-up period (median 57.5 months, range 7–84 months), 75 patients experienced CV events (33 fatal, 42 nonfatal), and 13 died of causes other than CV. In univariate competitive risk analysis, hemoglobin (SHR 0.85, 95% CI 0.74–0.98, P = 0.02), female sex (SHR 0.50, 95% CI 0.30–0.82, P = 0.006), eGFR (SHR 0.98, 95% CI 0.97–0.99, P &amp;lt;0.0001), serum albumin (SHR 0.43, 95% CI 0.26–0.74, P = 0.002), and HDL cholesterol (SHR 0.97, 95% CI 0.95–0.99, P = 0.02) were inversely associated with the incident rate of CV events, whereas the duration of type 2 diabetes (SHR 1.03, 95% CI 1.00–1.06, P = 0.04), background CVD (SHR 5.47, 95% CI 2.45–12.23, P &amp;lt;0.0001), UACR (SHR 1.01, 95% CI 1.00–1.01, P &amp;lt;0.0001), and cIMT (SHR 7.45, 95% CI 3.46–16.04, P &amp;lt;0.0001) were directly related to the same endpoint. In a multivariate Fine and Gray model including all 9 univariate correlates of CV events (full model), only history of CVD (SHR 5.86, 95% CI 2.15–13.36, P &amp;lt;0.0001), eGFR (SHR 0.99, 95% CI 0.98–0.99, P = 0.009), UACR (SHR 1.01, 95% CI 1.00–1.01, P &amp;lt;0.0001), and cIMT (SHR 3.92, 95% CI 1.24–12.35, P = 0.02) remained significantly associated to the study outcome. In the simplified model only history of CVD (SHR 6.47, 95% CI 2.69–15.55, P &amp;lt;0.0001), UACR (SHR 1.01, 95% CI 1.00–1.01, P &amp;lt;0.0001), and eGFR (SHR 0.98, 95% CI 0.97–0.99, P &amp;lt;0.0001) maintained an independent relationship with CV outcomes. The data fitting of the two models did not significantly differ (χ2 = 9.48, 6 Df, P = 0.15) and the assessment of the areas under the ROC curves (Figure 1) confirmed that the two models had almost identical accuracy to predict the study outcome (full model 87%, 95% CI 0.81–0.92, P &amp;lt;0.001, simplified model 84%, 95% CI 0.78–0.90, P &amp;lt;0.001). Moreover, the Hosmer-Lemeshow test showed that the simplified model was better calibrated than the full model, because the P value of this test in the simplified model is farther from statistical significance (χ2 = 9.24, P = 0.32) than that of the full model (χ2 = 11.09, P = 0.20). Conclusion We propose a simple model for CV event prediction that includes only three easy-to-measure variables. eGFR, albuminuria, and history of CVD can be used for prognosis of CVD, whereas cIMT adds little to the accuracy of this prediction.

Adolescents’ Exposure to Online Risks: Gender Disparities and Vulnerabilities Related to Online Behaviors

In the last decade, readily available electronic devices have created unprecedented opportunities for teens to access a wide variety of information and media-both positive and negative-on the internet. Despite the increasing number of initiatives taking place worldwide intended to assess and mitigate the online risks encountered by children and adolescents, there is still a need for a better understanding of how adolescents use the internet and their susceptibility to exposure to risks in the online space. We conducted a cross-sectional online survey of a convenience sample of 733 8th and 9th grade students in Utah. The survey contained eight questions regarding students' exposure to three types of online risk scenarios: content risk, contact risk, and criminal risk. Independent variables included students' online behaviors, use of social media and private messaging apps, and adult supervision of online activities. Logistic and negative binomial regression models indicated that gender, social media use, and chatting with strangers were associated with exposure to multiple risky online scenarios. Our results provide critical information to educators involved in the development of initiatives focusing on the reduction of youth online risk by identifying correlates of risky online events, allowing them to tailor their initiatives to meet the needs of potentially vulnerable populations.

Adolescents' Exposure to Online Risks: Gender Disparities and Vulnerabilities Related to Online Behaviors.

In the last decade, readily available electronic devices have created unprecedented opportunities for teens to access a wide variety of information and media–both positive and negative–on the internet. Despite the increasing number of initiatives taking place worldwide intended to assess and mitigate the online risks encountered by children and adolescents, there is still a need for a better understanding of how adolescents use the internet and their susceptibility to exposure to risks in the online space. We conducted a cross-sectional online survey of a convenience sample of 733 8th and 9th grade students in Utah. The survey contained eight questions regarding students’ exposure to three types of online risk scenarios: content risk, contact risk, and criminal risk. Independent variables included students’ online behaviors, use of social media and private messaging apps, and adult supervision of online activities. Logistic and negative binomial regression models indicated that gender, social media use, and chatting with strangers were associated with exposure to multiple risky online scenarios. Our results provide critical information to educators involved in the development of initiatives focusing on the reduction of youth online risk by identifying correlates of risky online events, allowing them to tailor their initiatives to meet the needs of potentially vulnerable populations.

Rates and Independent Correlates of 10-Year Major Adverse Events and Mortality in Patients Undergoing Left Main Coronary Arterial Revascularization

Patients who underwent myocardial revascularization for significant left main coronary artery disease (LMCA) are at high risks of ischemic events and death during follow-up. We sought to determine the independent correlates for very long-term outcomes after LMCA revascularization, which would be clinical value for risk stratification in such high-risk patients. The 10-year rates of clinical outcomes and independent correlates of adverse events were evaluated in 2,240 patients with LMCA disease in the MAIN-COMPARE registry, including 1,102 patients who underwent stenting and 1,138 who underwent coronary artery bypass grafting. The primary outcome was the composite of all-cause death, Q-wave myocardial infarction, or stroke. Secondary outcomes were all-cause mortality and target-vessel revascularization (TVR). The 10-year rates of the primary composite outcome, all-cause mortality, and TVR were 24.7%, 22.2%, and 13.6%, respectively. Age >65 years, diabetes, previous heart failure, cerebrovascular disease, peripheral arterial disease, chronic renal failure, atrial fibrillation, ejection fraction <40%, and distal LMCA bifurcation disease were independent correlates of the primary outcome in the overall population. Several clinical and anatomic parameters were also identified as independent correlates of all-cause death and TVR. Interaction analysis showed no heterogeneities of the effects of variables depending on revascularization type. These clinical descriptors can assist clinicians in identifying high-risk patients within the broad range of risk for patients who underwent LMCA revascularization.

Incident arterial vascular events in a cohort of Puerto Ricans with rheumatoid arthritis.

Objective:The increased morbidity and mortality associated with cardiovascular events in patients with rheumatoid arthritis has been linked to traditional and nontraditional factors. However, these factors vary among different ethnicities. Few studies have described these features in Hispanic populations. Thus, we determined the clinical correlates of arterial vascular events in Hispanics from Puerto Rico.Methods:A cross-sectional study was performed in a cohort of 405 Puerto Ricans with rheumatoid arthritis. Demographic parameters, health-related behaviors, clinical manifestations, disease activity (per Disease Activity Score 28), functional status (per Health Assessment Questionnaire), comorbidities, and pharmacotherapy were compared in patients with and without incident arterial vascular events. The latter was defined as the occurrence of myocardial infarction, angina pectoris, vascular procedures for coronary artery disease, stroke, or peripheral artery disease. Study groups were analyzed using bivariate and multivariate analyses.Results:Of the total study population, 87.2% were woman. The mean age at study visit was 56.1 ± 13.9 years, and the mean disease duration was 15.0 ± 13.2 years. Arterial vascular events occurred in 43 patients (10.6%). In the multivariate analysis adjusted for age and sex, arterial hypertension, dyslipidemia, metabolic syndrome, extra-articular manifestations, higher Health Assessment Questionnaire score, and number of hospitalizations were associated with arterial cardiovascular events.Conclusion:In this cohort of Puerto Ricans with rheumatoid arthritis, traditional and nontraditional factors, particularly extra-articular manifestations and functional disability, were associated with arterial vascular events. Awareness of these associations may help to implement clinical strategies in this group of rheumatoid arthritis patients at risk of arterial vascular events.

Predictors of colony extinction vary by habitat type in social spiders.

Many animal societies are susceptible to mass mortality events and collapse. Elucidating how environmental pressures determine patterns of collapse is important for understanding how such societies function and evolve. Using the social spider Stegodyphus dumicola, we investigated the environmental drivers of colony extinction along two precipitation gradients across southern Africa, using the Namib and Kalahari deserts versus wetter savanna habitats to the north and east. We deployed experimental colonies (n = 242) along two ~ 800-km transects and returned to assess colony success in the field after 2 months. Specifically, we noted colony extinction events after the 2-month duration and collected environmental data on the correlates of those extinction events (e.g., evidence of ant attacks, no. of prey captured). We found that colony extinction events at desert sites were more frequently associated with attacks by predatory ants as compared with savanna sites, while colony extinctions in wetter savannas sites were more tightly associated with fungal outbreaks. Our findings support the hypothesis that environments vary in the selection pressures that they impose on social organisms, which may explain why different social phenotypes are often favored in each habitat.

Most frequent mutational events of home box 13 gene in prostatic adenocarcinoma and correlation with tumor characteristics

The home box transcription factor gene (HOXB13) plays a certain role in human development and prostate tumorgenesis. Genetic alterations of HOXB13 help to explore the suspected role in prostate cancer. To determine the prevalence and clinical correlates of high-frequent mutational events in home box transcription factor (HOXB13); DNA samples from 50 men treated at the military hospital in Rabat, Morocco, were genotyped and confirmed by Sanger sequencing. The frequency and distribution of high frequent mutations were determined according to patient pathological characteristics. Within coding region of HOXB13; the Frameshift mutation: c.575delG (p.Gly192Valfs) with frequency of 5/50 (10%), and nonsense mutation: c.261C > A (p.Tyr87Ter), frequency: 6/50 (12%) and Missense mutations: c.665C > G (p.Pro222Arg), c.643C > T (p.Arg215Cys), c.776A > C (p.Gln259Pro), c.757A > C (p.Thr253Pro) with frequency rates: 10/50 (20%), 9/50 (18%), 8/50 (16%), and 7/50 (14%) respectively, were the most frequent mutations. Patients carrying one or more high frequent mutation at the same time treated with radical prostatectomy were: 9/35(26%), and 8/35 (23%) of them have pathological Gleason score >7 [p values (carriers vs. non carriers) were: 0.199266 and 0.75873 respectively]. The previously described germline mutation G84E was not found in this population. No significant differences between common mutations carriers and noncarriers, regarding selected tumor characteristics of prostate cancer. The clinical significance of Novel mutations detected on prostate cancer development still unknown. Our findings provide insight into the most common mutations of HOXB13 in prostate cancer and highlight prospective opportunities to analyze its clinical significance.

Passively-sensed Behavioral Correlates of Discrimination Events in College Students.

A deep understanding of how discrimination impacts psychological health and well-being of students could allow us to better protect individuals at risk and support those who encounter discrimination. While the link between discrimination and diminished psychological and physical well-being is well established, existing research largely focuses on chronic discrimination and long-term outcomes. A better understanding of the short-term behavioral correlates of discrimination events could help us to concretely quantify such experiences, which in turn could support policy and intervention design. In this paper we specifically examine, for the first time, what behaviors change and in what ways in relation to discrimination. We use actively-reported and passively-measured markers of health and well-being in a sample of 209 first-year college students over the course of two academic quarters. We examine changes in indicators of psychological state in relation to reports of unfair treatment in terms of five categories of behaviors: physical activity, phone usage, social interaction, mobility, and sleep. We find that students who encounter unfair treatment become more physically active, interact more with their phone in the morning, make more calls in the evening, and spend more time in bed on the day of the event. Some of these patterns continue the next day. Our results further our understanding of the impact of discrimination and can inform intervention work.