Factor In Recovery Research Articles

Social support and resilience as moderators of the relationship between COVID-19 pandemic-related trauma and posttraumatic growth in U.S. adults

Previous research has established a positive association between COVID-19-related trauma and posttraumatic growth (PTG), but few studies have examined the factors that influence the strength of that relationship. The current study used an electronic survey to investigate the relationship between U.S. adults’ COVID-19-related trauma and PTG and the degree to which their perceived social support and psychological resilience served as moderators of that relationship. Data (n = 378) were gathered through a crowdsourcing platform in April, 2023. Analyses indicated a significant positive relationship between COVID-19-related trauma and PTG. In addition, both perceived social support and psychological resilience were supported as significant moderators of that relationship. Not only did higher levels of each variable predict a stronger relationship between trauma and growth, but they also had an interactive effect where having higher levels of both predicted the strongest relationship of all. This research establishes perceived social support and psychological resilience as key moderators of the relationship between COVID-19-related trauma and PTG. These results hold implications for how future research and therapeutic practice might benefit from focusing on perceived social support and psychological resilience as key factors in the psychological recovery from COVID-19.

Influencing Factors of Hypoparathyroidism After Thyroidectomy in Children.

Objective: Hypoparathyroidism (HP) is the most common complication after total thyroidectomy. The purpose of this study was to summarize the recovery of HP in children after total thyroidectomy for thyroid cancer and to explore the related influencing factors. Methods: HP was identified in children who underwent total thyroidectomy for thyroid cancer between 2016 and 2020. Clinical characteristics, tumor stage, intraoperative parathyroid identification, and protection, lymph node metastasis, etc, were retrospectively analyzed. All patients were followed up for more than 1 year, and the recovery time of the parathyroid gland was recorded. The independent risk factors for HP recovery were determined by multivariate regression analysis. Results: In 121 cases of total thyroidectomy for thyroid cancer, 34 cases (28.1%) of HP occurred after surgery. The average age was 10.34 ± 3.01. Twenty-five cases of pattern of parathyroid hormone (PTH; 73.5%) recovered within half a year after surgery, 2 cases (5.9%) recovered after 1 year, and 2 cases (5.9%) were still not recovered after 2 years of follow-up. Univariate analysis suggested that PTH ≤ 1 on the first day after surgery and bilateral VI region lymph node metastasis were risk factors affecting the recovery of HP (P < .05). Multivariate regression analysis showed that PTH≤1 on the first day after surgery was an independent risk factor for HP recovery (OR = 0.092, 95% CI: 0.009-0.966, P = .047). Conclusion: Bilateral central lymph node metastasis and PTH ≤ 1 on the first day after surgery were the risk factors for HP recovery. In addition, HP may still recover more than 6 months after surgery, so the timing of diagnosis of permanent HP still needed to be discussed.

Characterization of risk factors for early ambulation in paraplegic dogs with absent pain perception undergoing decompressive surgery for thoracolumbar intervertebral disk extrusions

BackgroundCurrent literature warrants surgical decompression in paraplegic dogs with absent pain perception (APP), but the rate of ambulatory dogs with APP following thoracolumbar (TL) IVDE surgery in a clinical setting remains unknown. Furthermore, the outcome of paraplegic APP French Bulldogs (FBs) is anecdotally considered poor. The aims of this study were threefold within a large population of TL-IVDE paraplegic dogs with APP undergoing decompressive surgery: (1) to characterize early spontaneous pelvic limb movement and ambulation following surgery; (2) to identify risk factors for the recovery of ambulation; and (3) to compare the outcome of FBs and Dachshunds presenting with APP.MethodsA single-center, retrospective case series of dogs with paraplegia and APP diagnosed with TL-IVDE based on CT or MRI, all undergoing surgical decompression (hemilaminectomy ± durotomy). Two main groups were defined: ambulatory and non-ambulatory. These were further characterized depending on the presence of pain perception and spontaneous movement. The outcome was obtained at 4–8 weeks postoperatively. Statistical analysis was performed comparing ambulatory and non-ambulatory dogs and comparing rates of ambulation on FBs vs. Dachshunds.ResultsA total of 127 cases were included, with 77 out of 127 (60.6%) being ambulatory at recheck and 9 out of 127 (7.1%) being ambulatory despite APP. The remaining case distribution of non-ambulatory cases was: with APP (32 out of 127; 25.2%), with pain perception (5 out of 127; 3.9%), and with spontaneous movement (5 out of 127; 3.9%). Multivariate analysis revealed two negative factors for the recovery of ambulation: dogs undergoing hemilaminectomy alongside durotomy (p = 0.003) and dogs presenting with spinal shock (lower motor neuron signs with a lesion higher than the L3–L4 intervertebral disk) characterized by reduced/absent withdrawal reflex (p = 0.008). No difference was found between Dachshunds (n = 41, 73.2% ambulatory) and FBs (n = 33, 63.6% ambulatory) in terms of recovery of ambulation, with only 2 out of 33 (6.1%) FBs developing myelomalacia.ConclusionEarly recovery of ambulation alone (60.6%) and ambulation alongside pain perception (53.5%) occurred in the majority of surgically managed TL-IVDE-affected dogs with APP. Negative prognostic factors for recovery of ambulation were durotomy performed alongside hemilaminectomy, and dogs presenting with spinal shock with reduced/absent withdrawal reflexes, the latter translating to a reduced/absent withdrawal reflexes with a lesion higher than L3–L4 intervertebral disk. Finally, no indications of a worse prognosis for recovery of ambulation or a higher rate of development of myelomalacia in FBs when compared to Dachshunds were found.

ДЕРЖАВНА ПІДТРИМКА МОЛОДІЖНОГО ПІДПРИЄМНИЦТВА В УМОВАХ ВОЄННОГО СТАНУ

The article highlights the peculiarities of youth entrepreneurship in Ukraine and state support for students under martial law. Youth entrepreneurship is seen as a key factor in the economic recovery of post-war Ukraine. Various initiatives aimed at supporting youthentrepreneurship are discussed, involving both government agencies and non-governmental organisations. In addition, the potential for young entrepreneurs to continuously update their skills and knowledge to meet modern standards is highlighted.

Postconcussive symptom severity, risk factors for prolonged recovery, and mental health history: Pathways of influence in a diverse pediatric sample

Postconcussive symptom severity, risk factors for prolonged recovery, and mental health history: Pathways of influence in a diverse pediatric sample

Prognostic Factors of Recovery and Discharge Outcome in Adults after Moderate Traumatic Brain Injury

Abstract Background Traumatic brain injury (TBI) is a leading cause of mortality and morbidity particularly among young people. Identification of prognostic factors can be considerably helpful for clinical decision-making and prediction of outcome. Objective The aim of this study was to identify prognostic factors supposed to be of value in predicting functional outcome in moderate TBI patients. Materials and Methods This was a prospective case series study conducted from March 2023 to January 2024 involving 72 TBI patients with a Glasgow Coma Scale (GCS) score of 9 to 13. Demographic, clinical, laboratory, and management data were collected, analyzed, and correlated with patient outcomes. Based on the Extended Glasgow Outcome Scale (GOSE), patients were assigned to have either favorable outcome (GOSE score: 5–8) or poor outcome (GOSE score: 1–4). Results The mean age was 38.76 ± 18.30 years. The mean GCS score on admission was 11.68 ± 1.27. Surgical intervention was indicated in 29 patients (40.3%). The average length of hospital stay was 9.01 ± 7.88 days. Sixty-five patients (90.3%) had a favorable outcome and 7 patients (9.7%) had a poor outcome. Prognostic factors with significant impact on outcome included the GCS score on admission (p = 0.002); pupillary responses (p = 0.011); blood pressure (p = 0.005); acute subdural hematoma (ASDH) as a primary lesion (p = 0.049); and time to admission, comorbidities, blood glucose, hemoglobin%, oxygen saturation, coagulation profile, endotracheal intubation, and tracheostomy (p &lt; 0.001). Conclusion In moderate TBI patients, delayed hospital arrival, low GCS score, unequal pupils, pretrauma comorbidities, hypotension, hypoxia, anemia, endotracheal intubation, tracheostomy, and ASDH were associated with unfavorable functional recovery and could be considered as poor prognostic factors.

Spontaneous recovery of active shoulder external rotation in patients with brachial plexus birth injury.

Brachial plexus birth injuries (BPBI) occur as a result of a difficult delivery. External rotation of shoulder (ER) is usually one of the last movements which may recover. There is no consensus about the predicting factors for spontaneous recovery or the optimal timing for surgical treatment of ER in BPBI patients. The aim of our retrospective study was to describe spontaneous recovery of active ER and evaluate predicting factors for the recovery. We screened 562 patients and identified a consecutive cohort of 103 BPBI patients, who had no active ER at the age of 3 months. We systematically collected clinical data on recovery. In addition, we assessed whether early recovery of elbow flexion, shoulder abduction or Narakas grade at 1 month predicts ER recovery. Fifty-two (51%) patients spontaneously recovered ER, 44% of whom were recovered by the age of 1 year, 83% by 1.5 years, 92% by 2 years and 98% by 3 years. A breakpoint in the slope of the curve showing proportion of recovered patients occurred at 2 years of age. Recovery of active ER was significantly associated with early elbow flexion and Narakas grade at 1 month, but not with early active shoulder abduction. Most spontaneous recovery of ER in patients with BPBI occurs until 2 years of age, which thus can be considered a meaningful follow-up period for spontaneous recovery of ER. This information should be considered when making decision about peripheral nerve transfer surgery to improve ER in BPBI.

The prognostic value of cystography-measured bladder capacity on very early continence rates after radical prostatectomy.

To assess the utility and reliability of cost-effective cystography-measured bladder capacity as a prognostic tool for predicting very early continence recovery following radical prostatectomy. Additionally, the study aims to discuss the clinical implications of the findings, including their potential impact on patient management, postoperative rehabilitation strategies, and the development of personalized care pathways for prostate cancer patients. In this prospective monocentric study, we analyzed 223 patients who underwent either robot assisted radical prostatectomy (RARP) or open radical prostatectomy (ORP) between January 2022 and January 2024. Postoperative cystography was routinely performed 5 days after robot-assisted radical prostatectomy and 7 days after open radical prostatectomy. Very early continence rates were determined using a standardized pad-test conducted on the first day following catheter removal. The bladder capacity during cystography was measured and documented for every patient. The correlation between the rate of continence recovery and the bladder capacity was then assessed. To determine other predictive factors for recovery of continence, several parameters were analyzed using multivariate logistic regression analysis, including age, prostate volume, nerve-sparing technique and surgical procedure. Urinary continence rates at day 1 after catheter removal were 73.5% for patients who underwent RARP and 72.6% for patients who underwent ORP. A strong prognostic value of cystography-measured bladder capacity on very early continence rates was reported (p < 0.001), with a cut-off value calculated to be 140 ml of bladder capacity. After adjusting for additional variables such as age, surgical procedure, prostate volume and nerve-sparing technique, multivariate linear model analysis still found a strong correlation between cystography-measured bladder capacity and very early continence rates (p < 0.001). The cystography-measured bladder capacity may be a good predictor of the recovery of post-prostatectomy urinary continence.

Predisposing factors for incomplete spontaneous recovery after Parsonage-Turner Syndrome.

Parsonage-Turner Syndrome (PTS) is a rare idiopathic brachial neuritis that classically presents with sudden onset upper extremity pain followed by upper limb weakness, sensory disruption, and muscle atrophy. We hypothesized that the type of antecedent event before symptom onset would determine the degree of spontaneous recovery after PTS. We retrospectively reviewed all patients who presented with PTS to a single tertiary referral center from January 2002 to December 2021. Each medical record was reviewed to exclude patients with any other identifiable neurologic etiology. The primary outcome was improved muscle strength measured by a modified British Medical Research Council (mBMRC) grading system. The spontaneous recovery cohort included patients with appreciable or full recovery (mBMRC 4 and 5). In contrast, patients with little to no recovery (mBMRC 0 to 3) were included in the incomplete recovery group. Antecedent events, demographic variables, affected upper extremity region, time between symptom onset and final visit, and presence of nerve surgery were analyzed. Two-tailed T-test and Fisher exact tests were used to compare continuous and categorical variables. Multivariable logistic regression was modeled to identify variables associated with spontaneous recovery. 100 patients with 144 extremities met the inclusion criteria. The average time from symptom onset to the final clinic visit was 3.5 years. 65 extremities (57.0%) spontaneously recovered without surgical intervention, whereas 49 extremities (43.0%) incompletely recovered. The spontaneous recovery cohort was younger (mean [SD] age, 47.4 [18.1] vs. 56.5 [18.7]; p = 0.02) and had fewer bilateral cases (count[%], 4 [6.5%] vs. 10 [26.3%]; p = 0.008). Multivariable logistic regression revealed that each year of increased age was associated with a 3% decreased chance of spontaneous recovery (OR[95%CI] 0.97[0.95, 0.99], p = 0.046). Bilateral involvement was associated with 93% decreased chance of recovery (OR[95%CI] 0.07[0.01, 0.39], p = 0.002), each additional muscle affected was associated with 10% decreased chance of recovery (OR[95%CI] 0.90[0.83, 0.97], p = 0.01), and traumatic antecedent events were associated with increased chance of recovery (OR[95%CI] 27.3[2.59, 287.5], p = 0.006). Younger patients with unilateral symptoms and fewer muscle involvement have a greater chance of spontaneous recovery after PTS. PTS precipitated by trauma may have better spontaneous recovery than those precipitated by other causes.

Abstract 4134777: Predictive Factors for Early Recovery from Mechanical Circulatory Support in Patients with Fulminant Myocarditis

Background: Fulminant myocarditis (FM) requiring veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is fatal and has a complicated clinical course. In such FM cases, predicting which cases are likely to achieve early recovery is crucial for developing acute-phase treatment strategies. We aimed to examine the factors predicting early recovery in fatal cases of FM requiring VA-ECMO using multicenter cohort of patients with myocarditis. Methods: We retrospectively analysed 343 patients with FM requiring VA-ECMO between April 2012 and March 2017. The early recovery group was defined as patients who were successfully weaned off mechanical circulatory support (MCS) within 7 days from MCS deployment and discharged with favorable outcomes. We divided patients into early recovery group and non-early recovery group. Predictors of early recovery were investigated by performing a multivariate analysis, including significant variables ( p &lt;0.05) identified from a univariate analysis of baseline clinical parameters and meaningful variables from previous reports. Results: Among the eligible patients, 71 were assigned to the early recovery group, whereas 272 were assigned to the non-early recovery group. The baseline patient demographics showed the early recovery group was significantly younger (45 [30-63] years vs. 56.5 [40-67] years, p =0.003), had higher WBC counts (11,400 [8,500-16,000] /μL vs. 9,900 [7,162.5-13,297.5] /μL, p =0.009), and had lower CK-MB levels (38.5 [18.0-75.3] U/L vs. 73.0 [42.5-137.0] U/L, p &lt;0.001), than the non-early recovery group. In the histological diagnosis, the proportions of lymphocytic and eosinophilic myocarditis were similar between the two groups, whereas the proportions of giant cell myocarditis tended to be higher in the non-early recovery group. Multivariate analysis showed the independent predictors of early recovery were age ≤40 years (OR: 3.25; 95% CI: 1.42-7.44), WBC ≥ 11,000 /μL (OR: 3.10; 95% CI: 1.39-6.86) and CK-MB ≤ 61 U/L (OR: 2.46; 95% CI: 1.06-5.72), and if all conditions were fulfilled, the early recovery rate increased to 61.5%. Conclusions: Early recovery group had higher inflammatory parameter levels but lower myocardial damage marker levels on admission in addition to age ≤40 years, suggesting that patients having a strong acute-phase inflammatory response with a lower degree of myocardial damage, could recover earlier.

Does snake-eye appearance affect the clinical outcome of ACDF in treating cervical myelopathy.

To explore the impact of the snake-eye appearance (SEA) on the efficacy of anterior cervical discectomy and fusion (ACDF) in treating Degenerative Cervical Myelopathy (DCM). A total of 316 Patients were divided into three groups, those with SEA were in the SEA group, and those with the absence of SEA were in the non-SEA group. Meanwhile, in the non-SEA group, patients with grade 1 or 2 increased signal intensity (ISI) on T2-weighted MRI were in the ISI group, and the remaining patients without ISI were in the non-ISI group. The modified Japanese Orthopaedic Association scale (mJOA) and the neurologic functional improvement rate (IR) were measured. The number of patients who achieved upper-limb motor weakness improvement was recorded and compared. Propensity score matching (PSM) was used among the three groups. The postoperative JOA and IR were similar in the SEA and non-SEA group; however, they were significantly lower than in the non-ISI group after PSM(P < 0.05). Besides, only 32.1% of patients in the SEA obtained an improvement of upper-limb motor weakness, which was the lowest in three groups after PSM (60.7% in the non-SEA group and 78.6% in the non-ISI group, P < 0.05). We suggested that patients with SEA tend to achieve an inadequate neurological recovery after ACDF. Besides, a SEA may be an unfavorable prognostic factor for upper extremity motor function recovery.

Impact of Intraoperative Prognostic Factors on Urinary Continence Recovery Following Open and Laparoscopic Radical Prostatectomy.

Background and Objectives: Radical prostatectomy (RP) stands as the predominant instigator of postoperative stress urinary incontinence. Techniques such as the preservation of the neurovascular bundles, bladder neck preservation, and ensuring longer postoperative urethral length have shown positive impacts on continence. The posterior reconstruction is another method that aids in early continence recovery. Anterior suspension as simulator of puboprostatic ligaments is another factor. Materials and Methods: This study was conducted in the Clinic of Urology, University Clinical Center of Serbia, between December 2014 and January 2020, employing a prospective, non-randomized comparative design. Data were meticulously gathered from 192 consecutive patients. The process of regaining continence was monitored at intervals of 1, 3, 6, 12, and 24 months after surgery. The main criterion for assessing the level of urinary continence was the number of pads used daily. Results: The distribution of overall continence rates in the BNP vs. no-BNP group at 3, 6 and 12 months was 86% vs. 60% (p < 0.0001), 89% vs. 67% (p < 0.0001), 93% vs. 83% (p = 0.022). Continence rates in non-posterior reconstruction group (10%, 22%, 34%, and 54% at 1, 3, 6, and 12 months) were statistically significantly lower (p < 0.0001). The patients who underwent urethral suspension exhibited significantly higher rates of overall continence at 1 mo (73% vs. 29%, p < 0.0001), 3 mo (85% vs. 53%, p < 0.001), 6 mo (89% vs. 62%, p < 0.0001), 12 mo (95% vs. 76%, p < 0.0001), and 24 mo (93% vs. 81%, p = 0.007). Patients who underwent urethral suspension had a four-fold greater likelihood of regaining continence (p = 0.015). Conclusions: Patients who underwent urethral suspension or BNP or posterior reconstruction had higher continence rates. Only the urethral suspension was found to be a significant prognostic factor of continence recovery.

Efficient periplasmic expression of active lysyl endopeptidase and optimizing the purification methods

Recombinant production of lysyl endopeptidase (Lys-C) which is frequently used in proteomics is still challenging due to its complex structure. Herein, periplasmic expression and determining effective factors for recovery of the active enzyme were investigated. The codon-optimized Lys-C gene was cloned into pET26b (+) for periplasmic expression in E. coli Rosetta (DE3). The following parameters affecting expression level and activity of Lys-C were investigated including IPTG concentration (0.05–1 mM), cell density (OD600: 0.45–0.8) at induction time, presence of reducing agents (glutathione or cysteine, 0–10 mM) in culture medium or periplasmic extraction buffers, and harvesting time (6 or 20 h). Lys-C was then purified by DEAE and Ni-NTA chromatography methods. The highest expression level was obtained at 0.05 mM IPTG (5.49 %), also 8 mM cysteine, induction at OD600: 0.45 and 6 h incubation increased enzyme activity to 23.5 %, 13.3 %, and 76.4 %, respectively. The enzyme activity of Lys-C in the presence of 4 mM glutathione and extraction buffers containing 2 mM 2-mercaptoethanol (2 ME) was 81.6 % higher than the condition without reducing agents. Also, 8 mM cysteine in the culture medium and 2 mM 2 ME in extraction increased the activity up to 29.7 %. Moreover, optimization of purification process enhanced the enzyme activity from 0.217 mU to 1.76 mU. Statistical analysis showed the examined parameters significantly affected enzyme activity (p < 0.05). The presence of the reducing agents in the culture medium and extraction buffers presumably improves the Lys-C folding and increases the enzyme activity.

Determination of Recovery by Total Restitution or Compensation Using Multifrequency Vestibular Tests and Subjective Functional Scales in a Human Model of Vestibular Neuritis.

Vestibular Neuritis (VN) can induce unilateral acute vestibular syndrome (AVS). This study aimed to identify predictive factors of recovery from vestibular neuritis considering total restitution and/or compensation. In this longitudinal study, 40 patients were included. The initial assessment, performed within 36 to 72 h from the onset (T0), included medical history taking (general and specific), including screening for cardiovascular risk factors (CVRFs), and a battery of diagnostic vestibular tests, comprising the bithermal caloric test (BCT), video head impulse test (VHIT), and skull vibration-induced nystagmus (SVIN) test. All patients also completed a Dizziness Handicap Inventory (DHI). All assessments were repeated 90 ± 15 days later (T3). Subjective compensation criteria were based on the DHI total score, and objective compensation criteria were based on laboratory test results. Four groups of patients (A, B, C, D) were delineated by combining patients with normal vs. abnormal vestibular tests and patients with normal vs. abnormal DHI. CVRFs (but not age or body mass index (BMI)) were associated with a poorer recovery of symptoms. The BCT (lateral semicircular canal paresis %), VHIT (lateral semicircular canal gain), and SVINT (nystagmus slow phase velocity) recovered to normal values in 20%, 20%, and 27% of patients, respectively, at T3. Vascular risk factors (hypercholesterolemia) are correlated with patients who do not recover their symptoms via either total restitution or compensation. There was no significant difference between high- and low-frequency vestibular tests in patients recovering from their symptoms. Some patients with objective recovery may continue to have persistent subjective symptoms.

Predictors of self-care in kidney transplant patients according to preoperative dialysis: A comparative study

BackgroundPreemptive kidney transplantation (PKT) is associated with reduced dialysis-related morbidity and improved graft survival, which has led to an increase in the prevalence of PKT. The distinct clinical pathways of PKT and non-preemptive kidney transplantation (NPKT) patients may affect their ability to perform self-care, a key factor in post-transplant recovery. However, there is ongoing controversy regarding which group demonstrates better self-care abilities, highlighting the need to explore the factors influencing self-care in each group. ObjectivesThis study aims to identify and compare predictors of self-care in PKT and NPKT groups. MethodsWe collected data from 209 KT recipients, consisting of 101 PKT and 108 NPKT patients, using self-administered questionnaires. These questionnaires assessed general and disease-specific characteristics, stress, social support, and self-care behaviors. Data were analyzed using descriptive statistics, t-tests, ANOVA, and multiple regression analysis. ResultsThe study identified significant predictors of self-care among both PKT and NPKT patients. For PKT patients, marital status (β =.19, p=.033) and family support (β =.28, p=.006) are key predictors of self-care, with those having spousal support and strong family networks reporting better self-care levels. Conversely, in NPKT patients, significant predictors of self-care included marital status (β =.31, p=.001), employment status (β =.29, p=.007), post-transplantation duration (less than 36 month) (β =.-.22, p=.015), post-transplantation duration (36-72 month) (β =.-.33, p=.001), and stress levels (β =-.20, p=.028). ConclusionsThe study provides valuable insights into the predictors of self-care based on preoperative dialysis status, illustrating distinct predictors between the growing population of PKT and NPKT patients. These findings emphasize the need for personalized nursing strategies to enhance post-transplant self-care, tailored to individual patient characteristics.

Risk factors for recovery from oculomotor nerve palsy after aneurysm surgery: a meta-analysis.

Risk factors for recovery from oculomotor nerve palsy (ONP) after aneurysm surgery explored by meta-analysis. The PubMed, Embase, web of science, Cochrane library, China Knowledge, Wan fang, and VIP databases were searched for case-control or cohort studies on risk factors of oculomotor nerve palsy recovery after aneurysm surgery, with a cut-off date of 14 February 2024, and data were analyzed using Stata 15. A total of 12 articles involving 866 individuals were included, meta-analysis results suggesting that gender (OR = 0.75, 95% CI [0.51-1.10]), age (OR = 1.00, 95% CI [0.93-1.07]), aneurysm size (OR = 0.85, 95% CI [-0.71 to 1.01]), treatment time (OR = 1.01, 95% CI [0.91-1.13]) is not a risk factor for recovery of motor nerve palsy after aneurysm surgery. Preoperative complete ONP (OR = 2.27, 95% CI [1.07-4.81]), surgery (OR = 9.88, 95% CI [2.53-38.57]), subarachnoid hemorrhage (OR = 1.29, 95% CI [1.06-1.56]) is a risk factor for recovery of motor nerve palsy after aneurysm surgery. Based on the results of the studies we included, we found that complete ONP before surgery led to poorer recovery, but patients with post-operative and subarachnoid hemorrhage had better recovery.

3.Y.2. Road traffic injuries, disability burden and implications for compensation schemes in Europe

Abstract Reducing traffic fatalities and injuries is a complex challenge, but it is one that is of paramount importance for public health and safety worldwide. In recent years, there have been improvements in trauma care and injury prevention efforts, which reduced mortality rates and increased survival after serious injury. However, an increased heterogeneity in recovery times is observed with survivors of road traffic injuries differing in their adjustment compared to other traumas in terms of symptoms’ onset, variability and chronicity. The recovery trajectory seems to vary widely with a large percentage of survivors in need of extensive time periods for full recovery. Attention has now been shifted towards the adverse effects of non-fatal injuries on functional, mental health, economic and societal outcomes. The capacity of a person to continue functioning, inability to work, sickness absence and reliance on welfare benefits to compensate for loss of income are some of the injury-related long-term consequences, causing great concern for health and social security systems across Europe, as they have been shown to account for more than one third of total road traffic incident costs. These figures fail to include individuals who sustain “minor” injuries, which do not require hospitalisation, yet still impair their ability to work. Despite the rapidly growing epidemiological and clinical attention, there are still several issues missing from research, policy and practice. A universal definition of recovery after a road traffic injury is still missing, and this has been seen as critical for improved understanding of risk factors of poor recovery as well as improved identification of those in need of welfare benefits. Furthermore, long-term sickness absence and disability following road traffic injury in Europe is still understudied and evidence on the different return to work pathways and compensation schemes is scarce. Evidence is still limited on the context in which return to work occurs, the injury profiles most dependent on long term compensation schemes and the policy settings of injury compensation schemes that impact return to work outcomes post injury. Data availability and data linkage issues often cause misclassification errors when granting disability pensions and this remains unattended long after an injury. Welfare benefits are often poorly connected with the injury or other medical diagnoses and this makes it difficult to assess the contribution of injuries on disability pensions and other welfare benefits, especially in comorbid and multimorbid conditions. The current workshop aims to improve our understanding of the long-term consequences and the challenges faced by those injured in road traffic injuries and aid the development of interventions that seek to enable sustained recovery, and help inform policy and practice of healthcare and injury compensation systems. Key messages • Timely access to quality healthcare, rehabilitation therapies, and assistive technologies can significantly improve outcomes and reduce the strain on social security and compensation systems. • Ensuring equitable access to social security benefits for injured individuals, requires efficient compensation schemes that recognize the full impact of the disability on individuals’ life.

Long-term prognostic value of heart rate recovery in patients with left bundle branch block without inducible ischemia and without known coronary artery disease

Abstract Background Heart rate recovery (HRR) has been shown to predict cardiovascular and all-­cause morbidity and mortality. Left bundle branch block (LBBB) is often associated with significant heart disease and is often the result of underlying coronary artery disease (CAD), myocardial injury, strain or hypertrophy. However, there are insufficient data on the prognostic value of HRR in patients with LBBB without inducible ischemia and without known CAD. Aim The aim of this study was to determine the long-term prognostic value of HRR in patients with LBBB without inducible ischemia and without known CAD. Methods This retrospective study included 182 patients (64, 35.2% male gender, average age 63 ± 10 years) with LBBB and without known CAD who were referred to the SECHO test for chest pain. All the patients had negative SECHO test according the Bruce protocol. Risk factors for CAD (diabetes, smoking, hypertension, high cholesterol and positive family history of CAD), functional capacity (Metabolic Equivalents - METs) and heart rate recovery (HRR) were recorded in all patients. HRR was calculated as the difference between heart rate at the peak stress and heart rate in the first minute of rest. Slow HRR was defined as ≤18 beats/min. Median follow up of the patients was 102.5 months (IQR 68-146 months) for the occurrence of MACE (all-cause mortality, non-fatal myocardial infarction (MI), coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI)). Results Overall, 16pts (8.8%) had slow HRR. During the follow-up period 34 out of 182 patients (18.7%) had an adverse event (16 deaths, 10 non-fatal MI, 1 CABG and 7 PCI). Using the Cox regression analysis, univariate predictors of MACE were age (B=0.050, HR 1.051 [95% CI 1.011-1.093], p=0.012), hypertension (B=-1.219, HR 3.385 [95% CI 1.071-10.699], p=0.038), MET (B=-0.183, HR 0.833 [95% CI 0.706-0.982], p=0.030), diabetes (B=0.981, HR 2.667 [95% CI 1.267-5.612], p=0.010) and slow HRR (B=1.171, HR 3.225 [95% CI 1.307-7.959], p=0.011). However, in the multivariate analysis only slow HRR remained the independent predictor of MACE (B=0.974, HR 2.648 [95% CI 0.980-7.151], p=0.048). Using the Kaplan-Meier survival curve we see that the patients with slow HRR had much shorter event-free time compared to the patients with normal HRR (106.9 ± 14.9 months vs 157.9 ± 24 months, Log Rank 7.227, p=0.007) (Figure 1.). Conclusion Slow HRR is an independent long-term predictor of adverse events in patients with left bundle branch block without inducible ischemia and without known coronary artery disease.Kaplan-Meier survival curve for the MACE

Family Functioning and Child Participation Following Early Childhood Traumatic Brain Injury

Family functioning and child participation are critical factors in recovery from traumatic brain injury (TBI) and academic and social outcomes. Using mixed methods, we investigated these factors in children who experienced early childhood TBIs and then entered formal schooling. Caregivers completed interviews and scales of family functioning and child participation. Their scores did not reflect problematic family functioning, but showed participation across settings was below average. Themes from interviews included: (1) early childhood TBIs can affect family functioning even years after the injury; (2) learning, academic, and social-emotional issues impact participation and family functioning following early childhood TBI; and (3) appropriate supports and accessible environments are critical for both family functioning and child participation across settings. Mixed methods analyses indicated convergence, divergence, and expansion between qualitative and quantitative results. Results enhance our understanding of challenges encountered after early childhood TBI and provide directions for future interventions.

Recovery rate and predictors among children aged 6-59 months with severe acute malnutrition in Addis Ababa, Ethiopia: a retrospective follow-up study.

Severe acute malnutrition (SAM) is a critical public health concern in Ethiopia, contributing to high morbidity and mortality rates among children. Despite the improvement in hospital coverage and the development of standardized WHO treatment guidelines, recent reviews indicated a wide range in recovery rates (34%-88%) due to several context-specific factors. Understanding the factors influencing the recovery time can help inform targeted interventions and improve the overall management of SAM cases. Therefore, this study aimed to assess the time to recovery and predictors of children aged 6-59 months with severe acute malnutrition in Addis Ababa, Ethiopia, in 2023. An institutional-based retrospective follow-up study was conducted among children aged 6-59 months who were admitted to Tirunesh Beijing Hospital (TBH), Addis Ababa, Ethiopia, from July 2019 to June 2023. The Kaplan-Meir estimate and survival curve were used to compare the time to recovery using a log-rank test among different characteristics. A Cox proportional hazard regression analysis model was used to identify significant predictors of time to recovery. Finally, a p-value of <0.05 was used to declare a significant association. The median survival time to recovery was 17 (95% CI: 16.39-17.60) days, and the incidence rate of recovery from SAM was 37.8 per 1,000 child days. Moreover, exclusive breastfeeding [adjusted hazard ratio (aHR): 1.97, 95% CI: 1.45-2.68], amoxicillin provision (aHR = 1.62, 95% CI: 1.11-2.35), and deworming (aHR = 2.14, 95% CI: 1.48-3.09) were protective factors. However, complications at admission (aHR = 0.41, 95% CI: 0.23-0.73) and diarrhea during admission (aHR = 0.64, 95% CI: 0.45-0.91) were identified as risk factors of recovery from SAM. The time to recovery among the current study participants was low compared with the sphere standard. Besides, exclusive breastfeeding, complications at admission, diarrhea, amoxicillin provision, and deworming were independent predictors. Therefore, appropriate provision of routine medication and early management of medical comorbidity as per the national SAM management protocol can reduce the mortality of children with severe acute malnutrition significantly.