Differential Association Research Articles

Polymorphism in F pocket affects peptide selection and stability of type 1 diabetes-associated HLA-B39 allotypes.

HLA-B*39:06, HLA-B*39:01, and HLA-B*38:01 are closely related HLA allotypes differentially associated with type 1 diabetes (T1D) risk and progression. B*39:06 is highly predisposing, while B*39:01 and B*38:01 are weakly predisposing and protective allotypes, respectively. Here, we aimed to decipher molecular mechanisms underlying the differential association of these allotypes with T1D pathogenesis. We addressed peptide binding and conformational stability of HLA-B allotypes using computational and experimental approaches. Computationally, we found that B*39:06 and B*39:01 allotypes had more rigid peptide-binding grooves and were more promiscuous in binding peptides than B*38:01. Peptidomes of B*39:06 and B*39:01 contained fewer strong binders and were of lower affinity than that of B*38:01. Experimentally, we demonstrated that B*39:06 and B*39:01 had a higher capacity to bind peptides and exit to the cell surface but lower surface levels and were degraded faster than B*38:01. In summary, we propose that promiscuous B*39:06 and B*39:01 may bind suboptimal peptides and transport them the cell surface, where such unstable complexes may contribute to the pathogenesis of T1D.

Profiles of Intimate Partner Violence and Their Differential Association With Gender Hostility Among Men Seeking Help

Intimate partner violence (IPV) perpetrated by men has been associated with men’s hostility toward women (HTW). However, no study that has examined HTW has considered every main form of IPV as well as the severity of the acts perpetrated. The purpose of the present study was to identify distinct profiles of IPV perpetration based on the severity of physical, psychological, and sexual IPV and coercive control acts and to examine potential differences in HTW between the resulting profiles in a sample of 969 men seeking help for anger management or domestic violence. In addition, given the association previously found between HTW and IPV perpetration in women, we also investigated whether hostility toward men (HTM) could also be linked to men’s profiles of IPV perpetration. The results of the latent profile analysis suggested four profiles of IPV perpetrators: minor psychological IPV and severe control, severe IPV and control, minor IPV and control, and no/minor psychological IPV. Results also indicated significant differences between the profiles in terms of both HTW and HTM. Specifically, greater HTW was observed among the profiles characterized by the highest proportion of physical IPV perpetration, whereas greater HTM was observed among the profiles characterized by the highest proportions of severe coercive IPV. Findings will contribute to guide intervention strategies tailored to these different subgroups of men.

Diffusion time-related structure-function coupling reveals differential association with inter-individual variations in body mass index

Body mass index (BMI) is an indicator of obesity, and recent neuroimaging studies have demonstrated that inter-individual variations in BMI are associated with altered brain structure and function. However, the mechanism underlying the alteration of structure-function correspondence according to BMI is under-investigated. In this study, we studied structural and functional connectivity derived from diffusion MRI tractography and inter-regional correlations of functional MRI time series, respectively. We combined the structural and functional connectivity information using the Riemannian optimization approach. First, the low-dimensional principal eigenvectors (i.e., gradients) of the structural connectivity were generated by applying diffusion map embedding with varying diffusion times. A transformation was identified so that the structural and functional embeddings share the same coordinate system, and subsequently, the functional connectivity matrix was simulated. Then, we generated gradients from the simulated functional connectivity matrix. We found the most apparent cortical hierarchical organization differentiating between low-level sensory and higher-order transmodal regions in the middle of the diffusion time, indicating that the hierarchical organization of the brain may reflect the intermediate mechanisms of mono- and polysynaptic communications. Associations between the functional gradients and BMI were strongest when the hierarchical structure was the most evident. Moreover, the gradient-BMI association map was related to the microstructural features, and the findings indicated that the BMI-related structure-function coupling was significantly associated with brain microstructure, particularly in higher-order transmodal areas. Finally, transcriptomic association analysis revealed the potential biological underpinnings specifying gene enrichment in the striatum, hypothalamus, and cortical cells. Our findings provide evidence that structure-function correspondence is strongly coupled with BMI when hierarchical organization is the most apparent and that the associations are related to the multiscale properties of the brain, leading to an advanced understanding of the neural mechanisms related to BMI.

CT-derived body composition: Differential association with disease, age and inflammation in a retrospective cohort study.

Low skeletal muscle mass and density, as assessed by CT-body composition (CT-BC), are recognised to have prognostic value in non-cancer and cancer patients. The aim of the present study was to compare CT-BC parameters between non-cancer (abdominal aortic aneurysm, AAA) and cancer (colorectal cancer, CRC) patients. Two retrospective multicentre cohorts were compared. Thresholds of visceral fat area (VFA, Doyle), skeletal fat index (SFI, Ebadi), skeletal muscle index (SMI, Martin), and skeletal muscle density (SMD, Martin) were applied to these cohorts and compared. The systemic inflammatory response (SIR) was measured by the systemic inflammatory grade (SIG). 1695 patients were included; 759 patients with AAA and 936 patients with CRC. Low SMD (33% vs. 66%, p <0.001) was more prevalent in the CRC cohort. Low SMI prevalence was similar in both cohorts (51% vs. 51%, p = 0.80). Compared with the AAA cohort, the CRC cohort had a higher prevalence of raised SIG (p <0.001). Increasing age (OR 1.54, 95% CI 1.38-1.72, p < 0.001) and elevated SIG (OR 1.23, 95% CI 1.09-1.40, p = 0.001) were independently associated with increased odds of low SMI. Increasing age (OR 1.90, 95% CI 1.66-2.17, p < 0.001) CRC diagnosis (OR 5.89, 95% CI 4.55-7.62, p < 0.001), ASA > 2 (OR 1.37, 95% CI 1.08-1.73, p = 0.01), and elevated SIG (OR 1.19, 95% CI 1.03-1.37, p = 0.02) were independently associated with increased odds of low SMD. Increasing age and systemic inflammation appear to be important determinants of loss of skeletal muscle mass and quality irrespective of disease.

Abstract 26: Types of Adverse Childhood Experiences and Association With Sleep Duration in Children: Analysis of 2020-2021 National Survey of Children’s Health

Background: The number of adverse childhood experiences (ACEs) is associated with suboptimal sleep duration in children; however, the differential association of types of ACEs with sleep duration in youth is unknown. Given the known associations of both ACEs and sleep duration with cardiovascular health, such an investigation will provide insights for targeted clinical intervention. Objective: We investigated the most frequently reported ACE types and the association between each type of ACE and sleep duration among U.S. children aged 6-17 years. Methods: We used data from the 2020-2021 National Survey of Children’s Health, the most recent publicly available dataset. Parents or guardians were asked whether their child had ever experienced ten different types of ACEs. Multinomial logistic regression was used to assess the association of sleep duration with each of ACEs. We used the American Heart Association (AHA) Life Essential 8 scoring algorithm to calculate scores for sleep duration (range 0 [lowest] to 100 [highest]). Participants were categorized into three subgroups: (1) meeting age-appropriate optimal sleep duration; (2) ≥1-&lt;2 hour below or ≥ 1 hour above optimal sleep duration; and (3) ≥ 2 hours below optimal sleep duration. Analyses controlled for child’s sex, age, race/ethnicity, household poverty level, regular bedtime, physical activity, and caregiver’s level of education. Results: Parental divorce was the most frequently reported ACE (28.1%) followed by financial hardship (12.9%) and drug abuse (10.1%) among U.S. children aged 6 to 17 years. Adjusting for covariates, 5 of 10 ACEs (parental divorce, parental imprisonment, domestic violence, living with someone who had a problem with alcohol or drugs, unfair treatment because of their sexual orientation or gender identity) were significantly associated with suboptimal sleep category 2. All 10 ACEs were significantly associated with suboptimal sleep category 3. Conclusions: These findings support that ACE type is differentially associated with suboptimal childhood sleep duration and suggests that certain traumatic events experienced during childhood could amplify the adverse effects of poor sleep on cardiovascular health. Healthcare providers should consider screening for ACE type concurrent with sleep duration to better understand aspects contributing to cardiovascular health in childhood.

Abstract P252: Baseline Cognitive and Physical Function and Subsequent Occupational Status in Chinese Adults

Background: Declines in cognitive and physical function in later adulthood can have an impact whether or not individuals remain in the workforce, although the relationship is complex and often bidirectional. Little is also known about how this relationship differs in rural versus urban populations. We capitalized on longitudinal data in an urbanizing population to estimate the differential impact of urbanization level with cognitive and physical function on remaining in the work force. Methods: We used longitudinal data from 5,228 adults in the China Health and Nutrition Survey aged 58+ to assess the association between cognitive and physical function at the 2015 survey with whether older adults remained in the work force, based on self-report of either formal or informal work, in 2018. We defined cognitive function using a global cognitive score based on a subset of the modified Telephone Interview for Cognitive Status (TICS) and physical function using limitations as measured by instrumental activities of daily living (IADLs). Given differences in demographics of working status in urban (urban areas or small towns) versus rural villages, we included an interaction term for cognitive function by urban versus rural village residence. In minimally adjusted models, we controlled for age and gender and in fully adjusted models we additionally adjusted for birth cohort, education, region, marital status, and income. Results: In 2018, 48% of adults lived in rural villages and 41% were currently working. In rural villages, we found individuals with any (versus no) physical limitations in 2015 in were more likely to be working in 2018: Any IADL limitations versus no limitations: (OR=0.47 [95% confidence interval (CI) of 0.34-0.65). However, in urban areas, individuals with any (versus no) physical limitations in 2015 were more likely to be working in 2018: Any IADL limitations versus no limitations: OR=2.44 (1.18,5.03). We found no evidence of differential association between cognitive function and subsequent working status in the total sample or by rural village residence in the minimally or fully adjusted models. Conclusion: Physical (but not cognitive) function at baseline impacts future occupational status differently for those in rural versus urban areas which could reflect differences in the types of work being done as well as differences in the availability of economic resources between rural versus urban areas.

The relationship between alexithymia, rumination and binge drinking among university students

The current study aimed to examine the differential association of alexithymia and rumination facets with binge drinking. Two-hundred and ninety-two university students participated in this cross-sectional study, and we analyzed the data of those who reported alcohol use in the past 30 days (N = 247, Mage = 23.32). Self-report measures were used to assess the levels of alexithymia and rumination. Participants reported binge drinking in the past 30 days. Logistic regression analysis showed a significant positive association between the Difficulties in Identifying Feelings (DIF) component of alexithymia and binge drinking, but brooding – the maladaptive component of rumination – did not explain binge drinking in this sample. Our results draws the attention of investigating emotional processing and emotion regulation in relation to substance use.

Local rental market dynamics and homelessness rates among unaccompanied youths, single adults, and people in families

ABSTRACT This study examines how local rental market factors differentially influence community-level homelessness rates among unaccompanied youths, single adults, and people in families with the U.S. Department of Housing and Urban Development’s point-in-time estimates in January 2020, right before the COVID-19 pandemic hit the United States. The results from seemingly unrelated regressions for 270 metropolitan Continua of Care suggest that higher community-level rental vacancy rates were associated with lower homelessness rates among people in families but not among single adults and unaccompanied youths. Further, higher community-level crowded rates in rental units were associated with higher homelessness rates among single adults and unaccompanied youths but not among people in families. These findings suggest the differential association between rental market dynamics and homelessness among the homeless subgroups should inform subgroup-specific policy interventions and investment strategies.

Differential association between physical activity behaviours and dynapenia by comorbid diseases in community-dwelling Korean older adults

BackgroundPhysical activity (PA) behaviours and comorbid diseases are associated with muscle strength. However, the association between dynapenia and detailed PA behaviours, including participation in aerobic and resistance exercises and sedentary behaviour (SB), in relation to comorbid diseases has not yet been investigated. Using nationwide data, this study aimed to evaluate the independent association of dynapenia with detailed PA behaviour (participation in aerobic and resistance exercises and SB), and assess the differential associations of detailed PA behaviour with dynapenia according to comorbid diseases with prevalent sarcopenia.MethodsA total of 7,558 community-dwelling older adults aged ≥ 65 years who were included in the Korea National Health and Nutrition Examination Survey from 2014 to 2019 were included in the present study. Cross-sectional associations between PA behaviours (participation in aerobic exercise, participation in resistance exercise, and SB) and dynapenia were analysed using complex-sample multivariable-adjusted logistic regression models according to the type of comorbid disease (cardiovascular disease [CVD], diabetes mellitus [DM], and chronic lung disease [CLD]).ResultsSufficient aerobic exercise, sufficient resistance exercise, and low sedentary time of < 420 min/day showed independent negative associations with dynapenia (odds ratio [OR], 0.71; 95% confidence interval [CI], 0.60–0.83; OR, 0.54; 95% CI, 0.42–0.69; and OR, 0.84; 95% CI, 0.72–0.97, respectively). Among the participants with CVD or CLD, the associations of sufficient resistance exercise (OR, 0.46; 95% CI, 0.26–0.82 and OR, 0.51; 95% CI, 0.35–0.75 for CVD and CLD, respectively) and low sedentary time (OR, 0.66; 95% CI, 0.45–0.98 and OR, 0.71; 95% CI, 0.55–0.93 for CVD and CLD, respectively) with dynapenia were significant, whereas the association of sufficient aerobic exercise with dynapenia was insignificant. Meanwhile, in participants with DM, sufficient aerobic exercise (OR, 0.70; 95% CI, 0.52–0.94) and sufficient resistance exercise (OR, 0.45; 95% CI, 0.29–0.70) were independently associated with dynapenia, whereas no association between SB and dynapenia was found.ConclusionWe observed an independent inverse association between PA behaviours and dynapenia. Disease-specific associations between each PA behaviour (sufficient aerobic exercise, sufficient resistance exercise, and low sedentary time) and dynapenia differed in the older adults. Therefore, these differences should be acknowledged during interventions for this population.

Profile of serum microRNAs in heart failure with reduced and preserved ejection fraction: Correlation with myocardial remodeling

Background and aimsCardiomyocyte hypertrophy and interstitial fibrosis are key components of myocardial remodeling in Heart Failure (HF) with preserved (HFpEF) or reduced ejection fraction (HFrEF). MicroRNAs (miRNAs) are non-coding, evolutionarily conserved RNA molecules that may offer novel insights into myocardial remodeling. This study aimed to characterize miRNA expression in HFpEF (LVEF ≥ 45%) and HFrEF (LVEF < 45%) and its association with myocardial remodeling. MethodsProspectively enrolled symptomatic HF patients (HFpEF:n = 36; HFrEF:n = 31) and controls (n = 23) underwent cardiac magnetic resonance imaging with T1-mapping and circulating miRNA expression (OpenArray system). Results13 of 188 miRNAs were differentially expressed between HF groups (11 downregulated in HFpEF). Myocardial extracellular volume (ECV) was increased in both HF groups (HFpEF 30 ± 5%; HFrEF 30 ± 3%; controls 26 ± 2%, p < 0.001). miR-128a-3p, linked to cardiac hypertrophy, fibrosis, and dysfunction, correlated positively with ECV in HFpEF (r = 0.60, p = 0.01) and negatively in HFrEF (r = −0.51, p = 0.04). miR-423-5p overexpression, previously associated HF mortality, was inversely associated with LVEF (r = − 0.29, p = 0.04) and intracellular water lifetime (τic) (r = −0.45, p < 0.05) in both HF groups, and with NT-proBNP in HFpEF (r = −0.63, p < 0.01). ConclusionsmiRNA expression profiles differed between HF phenotypes. The differential expression and association of miR-128a-3p with ECV may reflect the distinct vascular, interstitial, and cellular etiologies of HF phenotypes.

Tramadol Abuse Among Adolescents: Analysis Based on Differential Association Theory in Tasikalaya Regency

Adolescents in Tasikalaya District show a tendency to be susceptible to Tramadol protection, a type of opioid analgesic commonly used to reduce moderate to severe pain. This phenomenon is a resource for the medical community, health practitioners, local governments and other related parties. Serious attention is needed to this problem to prevent negative impacts on the health and welfare of adolescents in the region. Coordinative efforts between the health, education and government sectors need to be strengthened to develop effective prevention and intervention strategies. A deep understanding of the factors driving Tramadol is key in designing appropriate preventive measures. This research examines the use of the drug tramadol among teenagers in Tasikalaya Regency using a qualitative approach and Differential Association Theory. The results of the study showed that adolescents' support for tramadol was caused by social and environmental factors, including interactions with peers and family members who also used the drug. Teenagers often rationalize their behavior and have certain attitudes that influence their decision to take tramadol. Apart from that, the easy availability of tramadol medication and affordable prices also influences teenagers' choices. This study provides a deeper understanding of the problem of tramadol among adolescents and suggests comprehensive preventive measures.

Pentingnya Peran Komunikasi Keluarga Dalam Mengatasi Penyalahgunaan Narkotika Pada Remaja

In the beginning, a high sense of curiosity, drug abuse usually occurs, especially in Indonesia, drug abuse is still very important to be discussed, especially in adolescents. Youth is the young generation of the nation's hope. However, we are still worried about the behavior of adolescents whose associations tend to lead to things that violate social and religious norms and violate the rule of law. Even to the emergence of negative behavior among adolescents such as student fights, free sex and consuming drugs. By taking drugs means they are endangering their lives and their future and destroying all hopes. Lack of parental supervision and the failure of their parental relationships causes adolescents to become trapped in deviant behavior, using drugs as a way out for them. The healing condition is on the other hand; the role of the family is very important. The research method used is an observational and descriptive analytical method using differential association theory which is used to explain criminal behavior, namely evil behavior as a person's way of life.

He Who Seeks Finds (Bodily Signals): German Validation of the Interoceptive Attention Scale (IATS) and its Relationship with Subclinical Psychopathology

Alterations in interoception have been linked to psychopathology. Recent findings suggest that both the attention to and the accuracy of, interoceptive perceptions may be oppositely related to subclinical symptomatology. Thus, providing well-validated tools that tap into these interoceptive processes is crucial for understanding the relation between interoceptive processing and subclinical psychopathology. In the current study (N = 642), we aimed to (1) validate the German version of the Interoceptive Attention Scale (IATS; Gabriele et al., 2022), and (2) test the differential association of self-reported interoceptive attention and accuracy with subclinical symptomatology, including alexithymia, depressive, and anxious symptomatology. We observed that a one-factor solution is a well-fitting model for the IATS. Further, the IATS showed good internal consistency, convergent, and divergent validity, but poor test-retest reliability. Self-reported interoceptive attention and accuracy were unrelated to each other. However, IATS scores were positively related to all measures of psychopathology (except depressive symptomatology), whereas self-reported interoceptive accuracy scores showed negative or nonsignificant relations with these. Our data suggest that the IATS is a good instrument to measure self-report interoceptive attention in the German population. Further, we highlight the need to distinguish between constructs of interoception to better understand the relation between interoception and psychopathology.

Protective effect of height on long-term survival of resectable lung cancer: a new feature of the lung cancer paradox

IntroductionUnlike most malignancies, higher body mass index (BMI) is associated with a reduced risk of lung cancer and improved prognosis after surgery. However, it remains controversial whether height, one of...

Impact of COVID-19 Infection on Health-Related Quality of Life in the Japanese Population: A Large Health-Insurance-Based Database Study.

Evidence for acute or long-term coronavirus disease 2019 (COVID-19) infection is relatively limited. We aimed to evaluate the impact of COVID-19 infection on health-related quality of life (HRQoL) in the Japanese population. Eligible study participants were 13,365 employees and their dependents who answered questionnaires at baseline and 18 months later and who had at least 6 months of continuous enrolment before and after baseline. Of the 711 study participants who developed COVID-19 infection, 29.0% reported a decline in HRQoL, whereas 25.2% of uninfected participants reported a decline. The adjusted odds ratios (95% confidence intervals) for the association between COVID-19 infection and declines in HRQoL in the age categories of less than 30 years, 30s, 40s, 50s, and 60 years or higher were 0.54 (0.15-1.92), 1.70 (1.03-2.81), 1.14 (0.82-1.57), 1.05 (0.77-1.42), and 0.87 (0.46-1.64), respectively. This study demonstrates a differential association between COVID-19 infection and declines in HRQoL by age group. A 1.7-fold increase in the odds of negative changes in HRQoL was observed in only those in their 30s. Further studies are needed to elucidate differences in the impact of COVID-19 infection on HRQoL between younger people such as those in their 30s and the older population.

“We Want You!” Applying Social Network Analysis to Online Extremist Communities

ABSTRACT Current literature on online criminal and deviant groups recognizes the role of online forums in the transfer of knowledge and socialization of members, but debates on the role of the Internet in the socialization and radicalization processes in the context of online extremist groups. This study contributes to the discussion by examining online radicalization process through the use of social learning theory and social network analysis. This innovation allows for assessment on the impact of online interactions with forum members on radicalization process. Findings found strong support of differential association and differential reinforcement, but showed the possibility of other mechanisms, such as self-radicalization, at play. Findings from the study highlight the need to for theory integration, the inclusion of online peer association, and replication to address the complex phenomenon of online radicalization.

Analisis Kriminologi Kasus Kristen Gray: Pelanggaran Peraturan Pandemi dan Penyalahgunaan Izin Tinggal Keimigrasian di Indonesia

This journal tries to discuss the Kristen Gray case from the perspective of a criminological approach. Criminology is a scientific discipline that is used to understand and overcome crimes that occur in society by studying the origins, causes and impacts of criminal behavior as well as the justice system for these criminal acts. Kristen Gray is a foreign citizen who comes from the United States, she became controversial because of statements on her personal social media which promoted and invited other foreign nationals to follow her, where she lives in Bali cheaply but can feel luxury in the midst of the COVID-19 Pandemic crisis and stating that Indonesia is a country that is friendly to the LGBT community or people, meanwhile in Indonesia itself, this issue is still very taboo. After being checked by immigration officers, it was discovered that he was also working in Indonesia, namely selling electronic books and opening a consulting service on how to enter Indonesia in the midst of the COVID-19 pandemic illegally, at which time human movement was strictly restricted to reduce the spread of this virus. Based on this, he and his LGBT partner were finally deported from Indonesia for allegedly violating Article 75 paragraph (1) of Law no. 6 of 2011 concerning Immigration, which in essence he is suspected of not complying with the laws currently in force in Indonesia and disrupting public notifications. The case of Kristen Gray was studied using theories in criminology, namely Opportunity Theory, Hedonistic Psychology Theory, and Differential Association Theory. Differential Association Theory is used as the reason why Kristen Gray's case must be immediately handled by local immigration authorities.

The Association of Guideline-Directed Prophylaxis With Postoperative Nausea and Vomiting in Adult Patients: A Single-Center, Retrospective Cohort Study.

Consensus guidelines for postoperative nausea and vomiting (PONV) prophylaxis recommend a risk-based approach in which the number of antiemetics administered is based on a preoperative estimate of PONV risk. These guidelines have been adapted by the Multicenter Perioperative Outcomes Group (MPOG) to serve as measures of clinician and hospital compliance with guideline-recommended care. However, the impact of this approach on clinical outcomes is not known. We performed a single-center, retrospective study of adult patients undergoing general anesthesia from 2018 to 2021. Risk factors for PONV were defined using MPOG definitions: female sex, history of PONV or motion sickness, nonsmoker, inhaled anesthesia >60 minutes, high-risk procedure (cholecystectomy, laparoscopic, gynecologic), and age <50 years. Adequate prophylaxis was defined using the MPOG PONV-05 metric: at least 2 agents for patients with 1 to 2 risk factors and at least 3 agents for patients with 3+ risk factors. PONV was defined as documented PONV or receipt of rescue antiemetics. To estimate the association between adequate prophylaxis and PONV, we used Bayesian binomial models with overlap propensity score weighting. We included 76,703 cases (43% receiving adequate prophylaxis) with PONV occurring in 19%. In unadjusted and unweighted comparison, adequate prophylaxis was associated with increased incidence of PONV: median odds ratio 1.21 (95% credible interval [1.16-1.25]). However, after propensity score weighting and multivariable adjustment, adequate prophylaxis was associated with reduced relative and absolute risk for PONV: weighted marginal median odds ratio 0.90 [0.84-0.98] and absolute risk reduction (ARR) 1.6% [0.6%-2.6%]. There was evidence for a differential effect of adequate prophylaxis across the guideline-defined risk spectrum, with benefit seen in patients with 1 to 5 risk factors (conditional probabilities of benefit >0.81), but not in those at high predicted risk. Patient-specific, covariate-adjusted ARR was heterogeneous, with a median patient-specific conditional probability of benefit of 0.84 (95% credible interval, 0.73-0.90). Guideline-directed PONV prophylaxis is associated with a modest reduction in PONV, although this effect is small and heterogeneous on the absolute scale. We found evidence for a differential association between adequate prophylaxis and PONV across the guideline-defined risk spectrum, with diminution in patients at very high predicted preoperative risk. While patient-specific benefit was heterogenous, most patients had reasonably high predicted probabilities of absolute benefit from a guideline-directed strategy. Further assessment of these associations in a multicenter setting, with more robust investigation of risk prediction methods will allow for better understanding of the optimal approach to PONV prophylaxis.

Buskers to Tourists in Bukittinggi City

This study discusses the unpleasant actions of buskers towards tourists in the city of Bukittinggi. The purpose of this study was to see the unpleasant actions of buskers towards tourists in the city of Bukittinggi. The research method used is qualitative research. Data collection techniques include field observations, interviews, and documentation. The theory used is the theory of differential association by Sutherland. The findings in this study are several unpleasant actions towards tourists in the tourist attraction area, as for the factors behind these actions are, the lack of busker education levels, environmental factors and low economic levels. Unpleasant actions against tourists such as forcing visitors to give money, and acts of harassment against tourist visitors in the city of Bukittinggi. This incident is often experienced by tourists who are on vacation in Jam Gadang, to overcome this, the security of the city of Bukiitinggi immediately intervened to the tourist site, to overcome these cases, so that tourists present in the city of Bukittinggi feel more safe and peaceful while traveling to the city of Bukittinggi.

Association of Peripartum Lactate Levels With Infection Outcomes

ObjectiveTo determine whether lactate levels were associated with maternal infection and infection-related outcomes in the antepartum, intrapartum, and early postpartum periods. DesignRetrospective, observational cohort. SettingEleven hospitals from a single health system. ParticipantsWomen (N = 783) with at least one lactate and blood culture test for obstetric sepsis screening in the antepartum period (n = 154), intrapartum period (n = 348), and early postpartum period (n = 281) from January 2, 2018, to October 21, 2020. MethodsWe reported the proportion of participants with adverse outcomes by lactate cut points (≤2.0 and >2.0 mmol/L). We used logistic regression to model the association of infection-related outcomes with lactate levels and calculated receiver operating characteristic curves. ResultsLactate was associated with bacteremia among participants in the antepartum period (odds ratio [OR] = 1.60, 95% confidence interval [CI] [1.00, 2.56]) but not among participants in the intrapartum and early postpartum periods. Higher lactate levels were significantly associated with a composite measure of infection-related outcomes (OR = 1.41, 95% CI [1.14, 1.81]), with no differential association by antepartum, intrapartum, or early postpartum periods. Lactate levels were positively associated with intraamniotic infection in the antepartum period (OR = 1.57, 95% CI [1.06, 1.81]) but not in the intrapartum period. The receiver operating characteristic curve indicated that the lactate threshold of 2.0 mmol/L has poor sensitivity. Overall, participants in the antepartum period had lower lactate values than participants in the intrapartum and early postpartum periods. ConclusionLactate levels were not consistently associated with infection-related measures across all periods. We suggest caution when interpreting lactate levels when sepsis is suspected.