Factor In Recovery Research Articles

Association between the initial physical activity and functional recovery after 1 month of inpatient rehabilitation for subacute stroke: stratified analysis by nutritional status.

Objectively measured physical activity volume serves as a predictive factor for functional recovery in patients with stroke. Malnutrition, a frequent complication of stroke, may influence the relationship between physical activity and functional recovery. This study aimed to examine the association between physical activity volume and functional recovery in patients with stroke, stratified by their nutritional status. This multicenter prospective observational study included 209 patients with stroke admitted to two Japanese convalescent rehabilitation hospitals. Participants were categorized based on the geriatric nutritional risk index (GNRI) at admission [≥92, high GNRI group ( n = 133); <92, low GNRI group ( n = 76)]. Physical activity levels were measured as the duration of total physical activity (TPA), which is the sum of light-intensity physical activity and moderate-to-vigorous physical activity, using a triaxial accelerometer during the first 7 days after admission. Outcome measures are represented as the relative gain of the motor score on functional independence measure (M-FIM effectiveness) during the first month after admission. The multiple regression analysis, adjusting for age, sex, comorbidity, onset to admission intervals, motor paralysis, initial M-FIM, and cognitive FIM, showed that the duration of TPA in the first 7 days was significantly associated with the M-FIM effectiveness over the first month in both low GNRI [ B = 0.12, 95% confidential intervals (CI) = 0.01; 0.24, P = 0.049] and high GNRI group ( B = 0.11, 95% CI = 0.01; 0.21, P = 0.027). This study demonstrates a positive predictive association between early TPA level and functional recovery in stroke patients, irrespective of their nutritional status.

The Effect of 12 Weeks of Rebound Therapy Exercise Training on Walking Ability of Spinal Cord Injury Patients.

Walking ability is a crucial factor for recovery and rehabilitation of spinal cord injury (SCI) patients. The aim of this study was to investigate the effect of 12 weeks of rebound therapy on walking parameters in SCI patients. Thirty members of Isfahan Spinal Cord Injury Association participated in this experimental study using a convenience sampling method. This study was approved by the ethics committee of the University of Isfahan (IR.UI.REC.1400.118). The participants were randomly assigned to control and rebound groups using a matched randomization method. Data were collected before and after 12 weeks of rebound therapy exercise (three sessions per week) in the walking laboratory, using a seven-camera 3D motion capturing system (Qualisys motion analysis). The final data were analyzed using repeated measures ANOVA in SPSS software (significance level p < .05). Rebound therapy training significantly improved all dependent variables (p < .05) except hip rotation, indicating its effectiveness for enhancing walking ability. Given the importance of walking function, we recommend the use of rebound therapy training as an exercise rehabilitation method for spinal cord injury patients.

Predictors of nutritional recovery time in children aged 6-59months with severe acute malnutrition in Sofala Province, Mozambique: survival analysis approach.

Malnutrition is a public health problem that affects physical and psychosocial well-being. It manifests as a rapid deterioration in nutritional status and bilateral edema due to inadequate food intake or illness. This study is a retrospective cohort of 1208 children with severe acute malnutrition (SAM) in Sofala Province from 2018 to 2022. It includes hospitalized children aged 6-59months with SAM and related complications. The dependent variable is recovery, and the independent variables include age, sex of the child, vomiting, dehydration, hypoglycemia, nutritional edema and anthropometry. Survival curves were plotted using the Kaplan-Meier method, and bivariable and multivariable Cox regression analyses were performed. The crude analysis revealed significant factors for nutritional recovery in children with SAM, including age, weight, height, malaria, diarrhea and dehydration. Children under 24months had a 28% lower likelihood of recovery. Weight below 6.16kg decreased the likelihood by 2%, and height above 71.1cm decreased it by 20%. Conversely, malaria, diarrhea and dehydration increased the likelihood of recovery. However, after adjustment, only diarrhea remained a significant predictor of nutritional recovery. This study found that diarrhea is a predictor of nutritional recovery in children with SAM.

Passive shoulder abduction range of motion at 3 months postoperatively is the most important prognostic factor for achieving full recovery of range of motion at 6 months after arthroscopic rotator cuff repair

BackgroundAfter arthroscopic rotator cuff repair (ARCR), it is crucial for clinicians to predict the functional recovery in the early postoperative period for considering rehabilitation strategies. The aim of this study was to identify the prognostic factors in the early postoperative period for achieving full recovery of range of motion (ROM) at six months after ARCR. MethodsThis study included 184 patients who underwent ARCR. Patients were divided into the full recovery and nonrecovery groups using the Constant ROM score at six months postoperatively. The area under the curve (AUC) for predicting the full recovery group was calculated for all independent variables such as demographic data, ROM, shoulder functional scores at preoperative and three months postoperative using receiver operating characteristic (ROC) curve analysis. Multivariable logistic regression analysis was then performed using candidate variables with an AUC of 0.7 or greater to determine prognostic factors for full recovery at six months postoperatively. The same analysis as above was also performed by dividing the patients into groups according to their preoperative ROM. ResultsMultivariable logistic regression analysis revealed that preoperative active flexion, three months postoperative passive abduction, and internal rotation at 90° abduction ROM were significant prognostic factors of achieving full ROM recovery at six months postoperatively. Only passive abduction ROM at three months postoperatively was significantly extracted in the preoperative ROM limitation group. ConclusionsThis study demonstrated that passive abduction ROM at three months postoperatively was a significant prognostic factor of achieving full recovery of ROM at six months after ARCR.

COVID-19 patient satisfaction and associated factors in telemedicine and hybrid system.

The quality assessment of the home-based isolation and care program (HBIC) relies heavily on patient satisfaction and length of stay. COVID-19 patients who were isolated and received HBIC were monitored through telephone consultations (TC), in-person TC visits, and a self-reporting application. By evaluating patient satisfaction and length of stay in HBIC, healthcare providers could gauge the effectiveness and efficiency of the HBIC program. A cross-sectional study design enrolled 444 HBIC patients who answered a structured questionnaire. A binary logistic regression model assessed the association between independent variables and patient satisfaction. The length of stay in HBIC was analyzed using Cox regression analysis. The data collection started on April (1-30), 2022, in Addis Ababa, Ethiopia. The median age was 34, and 247 (55.6%) were females. A greater proportion (313, 70.5%) of the participants had high satisfaction. Higher frequency of calls (>3 calls) (AOR = 2.827, 95% CI = 1.798, 4.443, p = 0.000) and those who were symptomatic (AOR = 2.001, 95% CI = 1.289, 3.106, p = 0.002) were found to be significant factors for high user satisfaction. Higher frequency of calls (>3 calls) (AHR = 0.537, 95% CI = 0.415, 0.696, p = 0.000) and more in-person visits (>1 visit) (AHR = 0.495, 95% CI = 0.322, 0.762, p = 0.001) had greater chances to reduce the length of stay in the COVID-19 HBIC. 70.5% of the participants had high satisfaction with the system, and frequent phone call follow-ups on patients' clinical status can significantly improve their satisfaction and length of recovery. An in-person visit is also an invaluable factor in a patient's recovery.

Predictive factors of the postoperative proptosis recovery in surgery of spheno-orbital meningiomas.

This study aimed to identify factors affecting proptosis recovery in spheno-orbital meningioma (SOM) surgery and assess functional and oncological outcomes. Data from 32 consecutive SOM surgery cases (2002-2021) were analyzed. Clinical, radiological, operative, and oncological parameters were examined. Proptosis was assessed using the exophthalmos index (EI) on MRI or CT scans. Statistical analyses were performed to identify predictive factors for proptosis recovery. Proptosis improved in 75% of patients post-surgery (EI decreased from 1.28 ± 0.16 to 1.20 ± 0.13, p = 0.048). Patients with stable or worsened EI had higher body mass index (28.5 ± 7.9 vs. 24.1 ± 4.7, p = 0.18), Simpson grade (IV 75% vs. 65%, p = 0.24), and middle sphenoid wing epicenter involvement (63% vs. 38%, p = 0.12), but no significant factors were associated with unfavorable exophthalmos outcomes. The improvement group had higher en plaque morphology, infratemporal fossa invasion, and radiation treatment for cavernous sinus residual tumor (88% vs. 75%, p = 0.25; 51% vs. 25%, p = 0.42; 41% vs. 25%, p = 0.42, respectively), but without statistical significance. Visual acuity remained stable in 78%, improved in 13%, and worsened in 9% during follow-up. Surgery had a positive impact on preoperative oculomotor nerve dysfunction in 3 of 4 patients (75%). Postoperative oculomotor nerve dysfunction was observed in 25%, of which 75% fully recovered. This occurrence was significantly associated with irradiation of an orbital tumor residue (p = 0.04). New postoperative trigeminal hypoesthesia was observed in 47%, of which 73% recovered. All SOMs were classified as WHO grade 1, and complementary treatments achieved oncological control, requiring gamma-knife radiosurgery in 53% and standard radiotherapy in 6%. Surgery effectively improves proptosis in SOM, though complete resolution is rare. The absence of predictive factors suggests multifactorial causes, including body mass index and tumor resection grade. Postoperative oculomotor nerve dysfunction and trigeminal hypoesthesia are common but often recover. Gamma-knife radiosurgery maintains long-term oncological control for evolving tumor residue.

WCN24-391 Predictive Factors of Renal Recovery and Progression to End-Stage Kidney Disease in Patients with ANCA-Associated Vasculitis with Severe Kidney Disease

WCN24-391 Predictive Factors of Renal Recovery and Progression to End-Stage Kidney Disease in Patients with ANCA-Associated Vasculitis with Severe Kidney Disease

Effect of chemical or organic fertilizers in mining remnant substrate on forage production and marandu grass morphogenesis

Mining drives economic development, but it frequently alters the fertility of remaining soil or substrates. Increasing organic matter in these substrates has been a critical factor for the successful recovery and establishment of plants. In this study, the development of ‘Marandu’ Urochloa brizantha in a Cambisol substrate, a remnant of bauxite mining, was assessed in the municipality of Poços de Caldas-MG, in response to chemical and organic fertilizers derived from vermicomposting of residues from the production of shimeji mushrooms. An experiment was conducted in a greenhouse, where six treatments, namely: conventional fertilizers (FertConv; FertConv + micro and Cal) and exclusively with the use of vermicompost (20, 40 and 60 t ha-1) were evaluated in a completely randomized design in four replications. Fertilization with vermicompost resulted in significant increases in nutrients. Stem and leaf elongation rates, leaf appearance rate, phyllochron, tiller density and dry matter were influenced by both organic and conventional fertilization. However, the greatest benefits were observed with the application of vermicompost. After 90 days of growth, using conventional fertilization, there were no significant increases in the mentioned variables. The use of vermicompost is effective in improving the fertility conditions of the post-mining substrate, with significant impacts on the development of ‘Marandu’ grass, a fact that can contribute to the recovery of areas impacted by mining. Chemical fertilization based only on chemical fertilizers did not result in increases in TAlC, TAlF, TApF, DPP and DM until 90 days of initial growth of ‘Marandu’ grass.

Origin and significance of leucine-rich glioma-inactivated 1 antibodies in cerebrospinal fluid.

Whether antibodies against leucine-rich glioma-inactivated 1 (LGI1-Abs) in cerebrospinal fluid (CSF) are partially transferred from serum and the impact of CSF-LGI1-Ab positivity on clinical features and prognosis are unclear. Therefore, we aim to investigate the differences in serum titers, clinical features, and outcomes between LGI1-Ab CSF-positive and LGI1-Ab CSF-negative patients. Retrospective analysis of serum titers and clinical features according to CSF LGI1-Ab status. In addition, univariate and multivariate logistic regression were performed to identify predictors of worse outcomes. A total of 60 patients with anti-LGI1 encephalitis and positive serum LGI1-Abs were identified, of whom 8 (13.3%) patients were excluded due to the absence of CSF LGI1-Ab testing. Among the remaining 52 patients, 33 (63.5%) were positive for LGI1-Abs in CSF. CSF-positive patients were more likely to have high serum titers (≥ 1:100) than CSF-negative patients (p = 0.003), and Spearman's correlation analysis showed a positive correlation between CSF and serum titers in CSF-positive patients (r2 = 0.405, p = 0.019). Psychiatric symptoms and hyponatremia were more frequent in CSF-positive patients (p < 0.05). Both univariate and multivariate logistic regression analyses showed that CSF LGI1-Ab positivity and delayed immunotherapy are independent risk factors for incomplete recovery (modified Rankin Scale (mRS) > 0 at last follow-up). LGI1-Ab CSF-positive patients have higher serum titers, and their CSF titers are positively correlated with serum titers, indicating a possible peripheral origin of CSF LGI1-Abs. CSF-positive patients more often present with psychiatric symptoms, hyponatremia, and worse outcomes, suggesting more severe neuronal damage.

Stakeholder interfaces for excess heat-based urban heat supply— Input from Swedish cases

Excess heat is generated from different industrial processes and from urban infrastructure (sewage water, transport, datacentres and buildings). Thirty-five percent of the European energy demand for heating and cooling could be met by excess heat. Today, however, this energy reserve is barely exploited. There are known barriers to excess heat recovery but limited information on stakeholder interactions in the early stages of excess heat collaborations and on successful collaborations. Sweden is world champion in terms of excess heat recovery into district heating systems, and the country has a long tradition in this field (dating back to the 1970 s). By studying two cases, we shed light on success factors in the early stages and in successful collaborations. We identify that the main success factors for excess heat recovery are (i) trust between the collaborating partners, (ii) the involvement of as many stakeholders across the DH (District Heating) value chain as possible (in the decision-making process), (iii) the establishment of joint goals, and (iv) the identification of a business model allowing for a win-win solution that prioritizes excess heat recovery and secures funding for the necessary investments. Excess heat recovery investments have features similar to those of other investments in climate change mitigation, making the success factors relevant to applications beyond the case of excess heat recovery.

Intensive Longitudinal Social Sensing in Patients With Psychosis Spectrum Disorders: An Exploratory Pilot Study.

Psychosis spectrum disorders are characterized by significant alterations in social functioning, which is a major factor for patient recovery. Despite its importance, objectively quantifying the complex day-to-day social behavior in real-life settings has rarely been attempted. Here, we conducted a pilot study with wearable sensors that passively and continuously register interactions with other participants. We hypothesized that the amount and pattern of social interaction was associated with the severity of psychotic symptoms. We recruited 7 patients with psychosis spectrum disorders and 18 team members from a Soteria-style ward. Each participant wore a radio frequency identification badge, sending and receiving signals from nearby badges, allowing passive quantification of social interactions. In addition, symptom severity was assessed weekly by the Positive and Negative Syndrome Scale (PANSS). During an 11-week period, we identified 17970 interactions among patients and staff. On average, patients spent 2.6h per day interacting, capturing relevant aspects of daily social life. Relative daily interaction time, average interaction duration, and clustering coefficient, a measure of local network integration, were significantly associated with lower PANSS scores. Self-reported interaction time did not correlate with measured interaction time or with PANSS, indicating the importance of objective markers. This pilot study demonstrates the feasibility of passively recording social interaction of patients and staff at high resolution and for a long observation period in a real-life setting in a psychiatric department. We show links between quantified social interaction and psychopathology that may facilitate development and personalization of targeted treatments.

Risk factors for complicated perioperative recovery in dogs undergoing staphylectomy or folded flap palatoplasty: Seventy-six cases (2018-2022).

To analyze risk factors for complicated perioperative recovery of dogs undergoing either staphylectomy or folded flap palatoplasty. Retrospective study. Seventy-six client-owned dogs. Medical records of dogs that underwent either staphylectomy or folded flap palatoplasty were reviewed for signalment, brachycephalic risk (BRisk) score, history of gastrointestinal signs, laryngeal collapse grade, presence of preoperative aspiration pneumonia, intraoperative respiratory and cardiovascular complications, length of general anesthesia, number of corrected brachycephalic obstructive airway syndrome (BOAS) components, and gastrointestinal and respiratory postoperative complications. Complicated recovery was defined as requirement for prolonged oxygen treatment and/or tracheostomy or perioperative death. Penalized logistic regression was used to identify risk factors. Seventy-six dogs were enrolled in the study. Multivariate penalized logistic regression identified four risk factors for complicated recovery. These include surgery type (p = .0002), age (p = .0113), laryngeal collapse grade >2 (p < .0001) and length of general anesthesia (p = .0051). In this population, dogs that had staphylectomy, increasing age, laryngeal collapse grade >2 and increasing length of general anesthesia were at increased risk for perioperative complicated recovery. The results of this study identified risk factors for perioperative complicated recovery in dogs undergoing elongated soft palate correction and may assist in surgical planning and early prediction of complications.

Trajectories and predictive factors of weight recovery in patients with anorexia nervosa completing treatment. Alatent class mixed model approach.

Treatment of anorexia nervosa (AN) sometimes requires hospitalisation, which is often lengthy, with little ability to predict individual trajectory. Depicting specific profiles of treatment response and their clinical predictors could be beneficial to tailor inpatient management. The aim of this research was to identify clusters of weight recovery during inpatient treatment, and their clinical predictors. A sample of 181 inpatients who completed a treatment programme for AN was included in a retrospective study. A latent class mixed model approach was used to identify distinct weight-gain trajectories. Clinical variables were introduced in a multinomial logistic regression model as predictors of the different classes. A four-class quadratic model was retained, able to correctly classify 63.7% of the cohort. It encompassed a late-rising, flattening, moderate trajectory of body mass index (BMI) increase (class 1), a late-rising, steady, high trajectory (class 2), an early-rising, flattening, high trajectory (class 3) and an early-rising, steady, high trajectory (class 4). Significant predictors of belonging to a class were baseline BMI (all classes), illness duration (class 2), and benzodiazepine prescription (class 3). Predicting different kinetics of weight recovery based on routinely collected clinical indicators could improve clinician awareness and patient engagement by enabling shared expectations of treatment response.

Efficient Recovery of Lithium from Spent Lithium Ion Batteries Effluent by Solvent Extraction Using 2-Ethylhexyl Hydrogen {[Bis(2-Ethylhexyl) Amino]methyl} Phosphonate Acid

In order to overcome the interface emulsification problem of TBP-FeCl3 systems and the instability of β-diketone systems in high-concentration alkaline medium, it is necessary to design and synthesize some new extractants. By introducing amino groups into a phosphorus extractant, a new 2-ethylhexyl hydrogen {[bis(2-ethylhexyl)amino]methyl} phosphonate acid (HA) extractant was synthesized. In this study, an efficient method of recovering lithium from the effluent of spent lithium-ion batteries (LIBs) is proposed. Experiments were conducted to assess the influential factors in lithium recovery, including the solution pH, saponification degree, extractant concentration, and phase ratio. Over 95% of lithium in the effluent was extracted into the organic phase, and nearly all lithium in the organic phase could be stripped into the aqueous phase using a 3 mol/L HCl solution. There was no significant decrease in extraction capacity after 10 cycles. The experimental results indicated that the extraction mechanism was a cation exchange process, and the extractive complex was proposed as LiA. Importantly, after three months of stable operation, the process demonstrated excellent stability and extraction efficiency, with rapid phase separation and a clear interface. This study offers an efficient, cost-effective, and environmentally friendly method for lithium extraction from the effluent of spent LIBs.

Lower cognitive reserve is related to worse working memory performance in older adults after mTBI. An ERP study

ABSTRACT Objective Older adults (OA) after mild traumatic brain injury (mTBI) have a high risk of developing persistent post-injury cognitive impairments. Lower pre-morbid cognitive reserve (CR) is increasingly investigated as a risk factor for cognitive dysfunction in OA. However, how CR protects against effects of mTBI at the brain level remains largely understudied. Methods We examined 22 OA who sustained mTBI (mean 67.69 years, SD 5.11) in the sub-acute phase and 15 age- and CR-matched healthy OA (mean 68 years, SD 5.55) performing a three-level visual N-back task using electroencephalography. We calculated inverse efficiency scores of performance from accuracy and reaction times. Event-related potentials served as neurocognitive correlates of attentional (P2) and working memory (P3) processing. Results Overall, mTBI OA performed worse than healthy OA (p = 0.031). Lower CR generally decreased performance (p < 0.001). Furthermore, with increasing task difficulty, task performance was more affected by CR (p = 0.004). At the brain level, P2 amplitude was lower in mTBI OA than in healthy OA (p = 0.05). There was no clear effect of CR on P2 or P3 measures. Conclusion As mTBI OA with lower CR performed worse on a working-memory task, lower CR may be a risk factor for worse recovery after mTBI in this group.

Wet events increase tree growth recovery after different drought intensities

Understanding the dynamics of tree recovery after drought is critical for predicting the state of tree growth in the context of future climate change. While there has been a great deal of researches showing that drought events can cause numerous significant negative effects on tree growth, the positive effects of post-drought wetting events on tree growth remain unclear. Therefore, we analyzed the effect of wet and dry events on the radial growth of trees in Central Asia using data on the width of tree rings. The results showed that 1) Drought is the main limiting factor for radial growth of trees in Central Asia, and that as the intensity and sensitivity of drought increases, tree resistance decreases and recovery rises, and more frequent droughts reduce tree resistance. 2) Tree radial growth varied significantly with wet and dry conditions, with wet events before and after drought events significantly enhancing tree radial growth. 3) When drought is followed by a wetting event, the relationship between tree resistance and recovery is closer to the “line of full resilience”, with a significant increase in recovery, and compensatory growth is more likely to occur. Thus, wetting events have a significant positive effect on tree radial growth and are a key factor in rapid tree growth recovery after drought.

Twelve-month recovery following road trauma: Results from an inception cohort in Vancouver, Canada

BackgroundInjury-related disability following road trauma is a major public health concern. Unfortunately, outcome following road trauma and risk factors for poor recovery are inadequately studied, especially for road trauma survivors with minor injuries that do not require hospitalization. ObjectivesThis manuscript reports 12-month recovery outcomes for a large cohort of road trauma survivors. MethodsThis was a prospective, observational inception cohort study of 1,480 road trauma survivors recruited between July 2018 and March 2020 from 3 trauma centres in British Columbia, Canada. Participants were aged ≥16 years and arrived in a participating emergency department within 24 h of a motor vehicle collision. Data on baseline health and injury severity were collected from structured interviews and medical records. Outcome measures, including the SF-12, were collected during follow-up interviews at 2, 4, 6 and 12 months. Predictors of recovery outcomes were identified using Cox proportional hazards models and summarized using hazard ratios. ResultsOnly 42 % of participants self-reported full recovery and only 66 % reported a return to usual daily activities. Females, older individuals, pedestrians, and those who required hospital admission had a poorer recovery than other groups. Similar patterns were observed for the SF-12 physical component. For the SF-12 mental component, no significant differences were observed between participants admitted to hospital and those discharged home from the ED. Return to work was reported by 77 % of participants who had a paying job at baseline, with no significant differences between sex and age groups. ConclusionsIn a large cohort of road trauma survivors, under half self-reported full recovery one year after the injury. Poor mental health recovery was observed in both participants admitted to hospital and those discharged home from the ED. This finding may indicate a need for early intervention and continued mental health monitoring for all injured individuals, including for those with less serious injuries.

Postoperative pain trajectories in total hip arthroplasty.

Total hip arthroplasty (THA) is a common procedure to address pain and enhance function in hip disorders such as osteoarthritis. Despite its success, postoperative patient recovery exhibits considerable heterogeneity. This study aimed to investigate whether patients follow distinct pain trajectories following THA and identify the patient characteristics linked to suboptimal trajectories. This retrospective cohort study analyzed THA patients at a large academic centre (NYU Langone Orthopedic Hospital, New York, USA) from January 2018 to January 2023, who completed the Patient-Reported Outcomes Measurement Information System (PROMIS) pain intensity questionnaires, collected preoperatively at one-, three-, six-, 12-, and 24-month follow-up times. Growth mixture modelling (GMM) was used to model the trajectories. Optimal model fit was determined by Bayesian information criterion (BIC), Vuong-Lo-Mendell-Rubin likelihood ratio test (VLMR-LRT), posterior probabilities, and entropy values. Association between trajectory groups and patient characteristics were measured by multinomial logistic regression using the three-step approach. Among the 1,249 patients, a piecewise GMM model revealed three distinct pain trajectory groups: 56 patients (4.5%) in group 1; 1,144 patients (91.6%) in group 2; and 49 patients (3.9%) in group 3. Patients in group 2 experienced swift recovery post-THA and minimal preoperative pain. In contrast, groups 1 and 3 initiated with pronounced preoperative pain; however, only group 3 exhibited persistent long-term pain. Multinomial regression indicated African Americans were exceedingly likely to follow trajectory groups 1 (odds ratio (OR) 2.73) and 3 (OR 3.18). Additionally, odds of membership to group 3 increased by 12% for each BMI unit rise, by 19% for each added postoperative day, and by over four if discharged to rehabilitation services (OR 4.07). This study identified three distinct pain trajectories following THA, highlighting the role of individual patient factors in postoperative recovery. This emphasizes the importance of preoperatively addressing modifiable risk factors associated with suboptimal pain trajectories, particularly in at-risk patients.

Predictive Factors of Renal Recovery and Progression to End-Stage Kidney Disease in Patients With Antineutrophil Cytoplasmic Autoantibody-Associated Vasculitis With Severe Kidney Disease

IntroductionA significant number of patients with anti-neutrophil cytoplasmic antibodies (ANCA) associated vasculitis (AAV) with glomerulonephritis (AAV-GN) still progress to end-stage kidney disease (ESKD, eGFR<15mL/min/1.73m2) despite advances in remission-induction treatment. MethodsA retrospective cohort study on MPO- or PR3-ANCA positive patients with AAV (MPA or GPA) and eGFR<15 ml/min/1.73 m2 or ESKD at presentation. Renal recovery, dialysis discontinuation and persistence of end-stage kidney disease (ESKD) after standard remission-induction, with or without the use of PLEX were analyzed. ResultsWe analyzed 166 patients with biopsy proven active AAV-GN and eGFR <15mL/min/1.73m2 at the time of diagnosis. Patients received glucocorticoids with CYC (n=84) or with RTX (n=72) for remission-induction, and 49 also received PLEX. The predictors for renal recovery were erythrocyte sedimentation rate, serum creatinine (SCr) at diagnosis and minimal or mild chronicity changes. We further analyzed 71 patients who started dialysis with or without PLEX within 4 weeks of AAV-GN diagnosis. The predictors for dialysis discontinuation were minimal chronicity changes in kidney biopsy at diagnosis (OR=6.138,[95%CI,1.389-27.118],p=0.017). Predictors for persistence of ESKD within 12 months included higher serum creatinine (SCr) at diagnosis (IRR=1.086,[95%CI,1.005-1.173],p=0.037), and moderate (IRR=3.797,[95%CI,1.090-13.225],p=0.036), or severe chronicity changes in kidney biopsy (IRR=5.883,[95%CI,1.542–22.439],p=0.009). ConclusionIn our cohort, kidney recovery, dialysis discontinuation, and persistence of ESKD in patients with AAV-GN and eGFR<15mL/min/1.73m2 depended on SCr and histologic findings on kidney biopsies at the time of diagnosis and was not affected by the addition of PLEX.

The Role of Religion and Ethnic Factors in My Recovery From 10 Years of Schizophrenia and Severe Depression.

The Role of Religion and Ethnic Factors in My Recovery From 10 Years of Schizophrenia and Severe Depression.