Factor In Recovery Research Articles

Clinical Evolution of Acute Vestibular Syndrome: Longitudinal Retrospective Analysis of Epidemiological Data and Prognostic Factors for Recovery

We evaluated the clinical features of patients admitted to the ED with acute vertigo, verifying symptoms after one month and one year to establish epidemiological factors and predictors of resolution. We reviewed 233 records of patients admitted to ED for acute vertigo (125 F and 85 M, mean age 56.12 years). We analyzed the correlation between time of resolution (at one month and one year) and symptoms duration (subjective and/or objective vertigo, instability, cervical pain, audiological, neurological, and neurovegetative symptoms), comorbidities, and therapies, the result of the clinical and instrumental vestibular examination. Resolution of acute vertigo occurred in 81.1%, while persistence of vertigo one year after ED access was reported in 18.8%. There were 135 patients who recovered in one month. The presence of instability, auditory and neurovegetative symptoms, and neck pain represents a significant factor for recovery within one year. Age over 65 and a history of hypertension are associated with a worst recovery. Patients with spontaneous Nystagmus or positive HIT showed a significant difference in symptoms recovery within one month and one year. Presence of positional Nystagmus represents a positive prognostic factor. Our findings emphasize the importance of clinical evaluation of the acute vertigo, helping the clinicians to define central or peripheral diagnosis and predict the resolution of vertigo.

Quantifying the contributions of climate factors and human activities to variations of net primary productivity in China from 2000 to 2020

Net primary productivity (NPP) plays a vital role in the globe carbon cycle. Quantitative assessment of the effects of climate changes and human activities on net primary productivity dynamics is vital for understanding the driving mechanisms of vegetation change and sustainable development of ecosystems. This study investigates the contributions of climatic factors and human activities to vegetation productivity changes in China from 2000 to 2020 based on the residual trend analysis (RESTREND) method. The results showed that the annual average net primary productivity in China was 325.11 g C/m2/year from 2000 to 2020 and net primary productivity showed a significantly increasing trend (p<0.05) at a rate of 2.32 g C/m2/year. Net primary productivity increased significantly (p<0.05) across 40.90% of China over the study period, while only 1.79% showed a significantly declining trend (p<0.05). The contributions of climatic factors and human activities to net primary productivity increase were 1.169 g C/m2/year and 1.142 g C/m2/year, respectively. Climate factors contributed positively mainly in Sichuan Basin, the Loess Plateau, the Mongolian Plateau, and Northeast China Plain. Positive contributions of human activities to net primary productivity mainly occurred in the Loess Plateau, Central China, and the Greater Khingan Mountains. The effects of climatic factors and human activities on net primary productivity changes varied among sub-regions. In Tropical Monsoon Climate Region and Subtropical Monsoon Climate Region, human activities had greater impacts on net primary productivity increase than climate factors, while climate factors were the dominant factor for net primary productivity recovery in other sub-regions. In addition, during 2000–2020, net primary productivity was dominated by both climate factors and human activities in 49.84% of China, while areas dominated solely by climate factors and human activities accounted for 13.67% and 10.92%, respectively. Compared to changed land cover types, the total net primary productivity as well as the increase of total net primary productivity in China was mostly contributed by unchanged land cover types, which contributed more than 90%.

Early surgical outcomes and influencing factors of high tibial osteotomy.

To investigate the influencing factors of functional recovery after high tibial osteotomy (HTO). A retrospective research was carried on 98 patients who underwent HTO between January 2018 and December 2020. In each case, the medial proximal tibial angle (MPTA), joint line convergence angle (JLCA), femoral tibial angle (FTA), hip-knee-ankle (HKA), weight bearing line (WBL) ratio of the knee joint, opening gap, opening angle, American knee society knee score (KSS), US Hospital for Special Surgery (HSS) score, Lysholm score, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were measured to determine postoperative function and influential factors of pain through logistic regression analysis. The follow-up time was between 18 and 42 months after operation with an average of 27.66 ± 12.9 per month. Overall functional scores were significantly improved. The influencing factors that may affect the postoperative effect of HTO include age and preoperative WBL ratio of the knee joint (WBL%). After incorporating these two factors into the multivariate logistic regression analysis, for every 1 unit increase in the preoperative WBL%, the probability of postoperative HSS being superior is 1.06 times higher than before [Exp(β): 1.062, 95% CI: 1.01-1.1, p = 0.018]. For every year increase in age, the probability of an excellent HSS score after surgery was 0.84 times higher than that before surgery [Exp(β): 0.843, 95% CI: 0.718-0.989, p = 0.036]. Preoperative WBL% ≥ 14.37 was 17.4 times more likely to be rated as excellent postoperative HSS than that <14.37 [Exp(β): 17.406, 95% CI: 1.621-186.927, p = 0.018]. The postoperative functional scores of the patients significantly improved. Patients with preoperative WBL% ≥ 14.37% had better function after surgery.

The Role of Resilience on Stress and Recovery of Elite Athletes in Nigeria

Resilience is an important psychological factor in sport that contributes greatly to the ability to overcome and adapt positively to difficult and challenging situations. Elite athletes face a lot of pressure, stressor and adversity from sport and non-sport milieu which affect their psychological well-being and sport performance. Ability of the elite athletes to cope, overcome and adapt to various sources of pressures, stressors, adversities and recover quickly will make them to attain optimal health, peak performance and achieve success. The purpose of this study was to examine the role of resilience on stress and recovery of elite athletes in Nigeria. Participants were 187 subjects (118 males; 69 females), age ranged between 18years and 42years (mean=26.4; SD=4.82) were selected from various sports using purposive sampling technique to select elite athletes who participated in 2021 National Sports Festival in Nigeria. Connor-Davidson Resilience Scale-10 (CD-RISC-10) and Stress-Recovery Questionnaire for Athletes (RESTQ-52 Sport) were used for data collection. Shapiro-Wilk Test, Pearson Product Moment Correlation (PPMC) and Structural Equation Modelling (SEM) were employed for data analysis. Results of the study showed that resilience correlated with the factors of stress and recovery. Structural equation modelling results showed that resilience had significant direct effect on stress and recovery with variability of 26% and 55% respectively. Resilience negatively predicted stress and positively predicted recovery. The model invariant was not significant to gender and sport-type of the participants. It was therefore concluded that resilience plays an immense role in coping, overcoming and positively adapting to situations of stress and recovery of elite athletes. Keywords: resilience, stress, recovery, adversity, elite athlete

Self-Reported Symptoms in U.S. Marines Following Blast- and Impact-Related Concussion.

Recent research on traumatic brain injury (TBI) has suggested that the mechanism of injury (i.e., whether the TBI was caused by high-level blast [HLB] vs. direct physical impact to the head) may be an important factor in injury severity, symptomology, and recovery because of differences in physiological effects of each type of injury on the brain. However, differences in self-reported symptomology resulting from HLB- vs. impact-related TBIs have not been thoroughly examined. This study tested the hypothesis that HLB- and impact-related concussions result in different self-reported symptoms in an enlisted Marine Corps population. All records of 2008 and 2012 Post-Deployment Health Assessment (PDHA) forms completed by enlisted active duty Marines between January 2008 and January 2017 were examined for self-reported concussion, mechanism of injury, and self-reported symptoms experienced during deployment. Concussion events were categorized as either blast- or impact-related; individual symptoms were categorized as neurological, musculoskeletal, or immunological. A series of logistic regressions were performed to examine associations between self-reported symptoms experienced by healthy controls and Marines who endorsed (1) any concussion (mTBI), (2) a probable blast-related concussion (mbTBI), and (3) a probable impact-related concussion (miTBI); analyses were also stratified by PTSD. To determine if there were significant differences between odds ratios (ORs) for mbTBIs vs. miTBIs, 95% CIs were examined for overlap. Marines with a probable concussion, regardless of the mechanism of injury, were significantly more likely to report all symptoms (OR range: 1.7-19.3). Overall, mbTBIs, compared with miTBIs, resulted in higher odds of symptom reporting for eight symptoms on the 2008 PDHA (tinnitus, trouble hearing, headache, memory problems, dizziness, dim vision, trouble concentrating, and vomiting) and six symptoms on the 2012 PDHA (tinnitus, trouble hearing, headaches, memory problems, balance problems, and increased irritability), all of which were in the neurological symptom category. Conversely, odds of symptom reporting were higher for Marines experiencing miTBIs (vs. mbTBIs) for seven symptoms on the 2008 PDHA (skin diseases or rashes, chest pain, trouble breathing, persistent cough, red eyes, fever, and other) and one symptom on the 2012 PDHA (skin rash and/or lesion), all of which were in the immunological symptoms category. mbTBI (vs. miTBI) was consistently associated with greater odds of reporting tinnitus, trouble hearing, and memory problems, regardless of PTSD status. These findings support recent research suggesting that the mechanism of injury may play an important role in symptom reporting and/or physiological changes to the brain after concussion. The results of this epidemiological investigation should be used to guide further research on the physiological effects of concussion, diagnostic criteria for neurological injuries, and treatment modalities for various concussion-related symptoms.

Predictive factors for improvement of symptomatic cerebral vasospasm following subarachnoid hemorrhage by selective intra-arterial administration of fasudil hydrochloride.

Symptomatic cerebral vasospasm after subarachnoid hemorrhage (SAH) is a significant cause of delayed cerebral ischemia that leads to poor outcomes. Selective intra-arterial administration of fasudil hydrochloride (IAF) has been adopted for its vasodilatory effect on spasm arteries to prevent delayed cerebral ischemia. However, its effect on clinical outcomes and predictive factors for good recovery are not fully understood. This study aimed to investigate the outcomes of selective IAF and identify predictive factors for good outcomes in patients with cerebral vasospasm after SAH. A retrospective study of 36 patients with cerebral vasospasm following SAH who underwent selective IAF at our institution between January 2014 and May 2022 was conducted. We evaluated the improvements in neurological findings before and after selective IAF. Statistical analyses were performed to determine factors associated with good outcomes. Selective IAF improved the neurological findings in 26 patients (72.2%). Pre-therapeutic absence of cerebral infarction in more than 1/3 of the spasm artery perfusion area was significantly associated with an improvement in neurological findings (p < 0.0001). Furthermore, there was a tendency for a good outcome when the age was younger (p = 0.093), and the spasm was limited to peripheral vessels (p = 0.065). Our study indicates that selective IAF has a promising effect in improving symptomatic vasospasm, except when a large cerebral infarction exists in the spasm artery perfusion area. Early consideration of selective IAF could be recommended once patients experience symptomatic cerebral vasospasm after SAH.

Influence of Acupuncture and Other Clinical Factors on the Recovery of Limb Motor Function in Patients After Stroke: A Retrospective Study.

Limb motor disorders after stroke are very common, and the clinical related factors of improving limb motor function are still unclear. As a part of comprehensive rehabilitation strategy, acupuncture has been widely used in rehabilitation after stroke in China. But more evidence is needed for the influence of acupuncture and some other clinical factors on post-stroke motor disorders. A retrospective study was conducted using the database of patients with post-stroke motor disorders admitted to the Neurological Rehabilitation Unit of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine. The included patients were grouped according to whether NIHSS improved or muscle strength improved. The positive logistic regression was used to analyze the influencing factors of possible NIHSS improvement. Combined with the influencing factors of NIHSS improvement and muscle strength improvement, the influencing factors of limb motor function recovery after stroke were obtained. When analyzing the baseline of the included patients, it was found that patients with NIHSS improvement had earlier acupuncture intervention time (M, (IQR):13.5 (14), OR=0.716, 95% CI [0.591-0.869], p=0.001), more cumulative acupuncture treatment times (M,(IQR):29 (12), OR=0.744, 95% CI [0.608-0.910], p=0.004), and less hypertension history (OR=0.256, 95% CI [0.082-0.801], p=0.019). Smoking history only has positive significance in univariate and multivariate analysis of NIHSS, not muscle strength (OR=0.274, 95% CI [0.097-0.779], p=0.015). The earlier acupuncture intervention and the more cumulative acupuncture treatment times are, the more beneficial the limb function of stroke patients with motor disorders will be. The previous history of hypertension is the influencing factor of limb motor function not improving in patients with limb motor disorder after a stroke. The effect of smoking history on limb movement function of patients with limb motor disorder after stroke needs further study.

Factor structure of post-operative quality of recovery questionnaire (QoR-15): An Italian adaptation and validation.

The Quality of Recovery questionnaire (QoR-15) is an English instrument for measuring quality of recovery in surgical patients, not yet translated and validated in Italian when the Enhanced Recovery After Surgery (ERAS) Piemonte studies were planned. To produce the Italian version of the QoR-15 questionnaire, to evaluate its factorial structure and to assess the invariance between two types of surgery. The Italian version (QoR-15I) was obtained translating and adapting the original version to the Italian context. The validation was performed suppling the QoR-15I to 3,784 patients enrolled in two parallel stepped wedge cluster randomised trials (ERAS Colon-rectum Piemonte; ERAS Gyneco Piemonte). The factor structure and its invariance between types of surgery was tested using confirmatory bifactor model and multi-group analysis. Comparative fit index (CFI), root mean square error of approximation (RMSEA), and standardized root mean square residual (SRMR) fit indices and their changes between nested models were used to assess the factor structure and the invariance. The bifactor model showed good fit (RMSEA = 0.049, CFI =0.957, SRMR = 0.036) and provided a general recovery factor and two specific factors for physical and mental recovery. Eighty-four percent of the common variance is attributable to the general factor, and thus the QoR-15I is sufficiently 'one-dimensional' with an adequate reliability (ωh = 0.70). The ωs values for the physical and mental recovery factors were 0.01 and 0.13, respectively. Multigroup analysis supported configural (RMSEA = 0.053, CFI = 0.950, SRMR = 0.035) and metric invariance (ΔRMSEA = -0.004; ΔCFI = -0.002; ΔSRMR = 0.014), whereas the intercept constraint was removed from item 15 to obtain partial scalar invariance (ΔRMSEA = 0.002; ΔCFI = 0.007; ΔSRMR = 0.004). Construct validity was supported by a negative association of QoR-15I scores with all variables related to worse patient condition and more complex surgery. Our results support the use of the QoR-15I as a valid, reliable, and clinically feasible tool for measuring the quality of recovery after surgery. The results of the confirmatory factor analyses suggest that a unique recovery score can be calculated and support measurement invariance of the QOR-15I across the two type of surgery, suggesting that the questionnaire has the same meaning and the same measurement parameters in colorectal and gynaecologic patients.

Symptom Profile of Patients With Post-COVID-19 Conditions and Influencing Factors for Recovery.

The aim of the study was to examine the factors that influence the improvement of post-coronavirus disease 2019 (COVID-19) symptoms. We investigated the biomarkers and post-COVID-19 symptoms status of 120 post-COVID-19 symptomatic outpatients (44 males and 76 females) visiting our hospital. This study was a retrospective analysis, so we analyzed the course of symptoms only for those who could follow the progress of the symptoms for 12 weeks. We analyzed the data including the intake of zinc acetate hydrate. The main symptoms that remained after 12 weeks were, in descending order: taste disorder, olfactory disorder, hair loss, and fatigue. Fatigue was improved in all cases treated with zinc acetate hydrate 8 weeks later, exhibiting a significant difference from the untreated group (P = 0.030). The similar trend was observed even 12 weeks later, although there was no significant difference (P = 0.060). With respect to hair loss, the group treated with zinc acetate hydrate showed significant improvements 4, 8, and 12 weeks later, compared with the untreated group (P = 0.002, P = 0.002, and P = 0.006). Zinc acetate hydrate may improve fatigue and hair loss as symptoms after contracting COVID-19.

Mental health professionals’ expectations and efforts to include employment for people with moderate to severe mental illness in treatment settings

BackgroundResearch suggests that employment is an important factor for recovery and improved quality of life for people with mental illnesses. Mental health professionals often serve as gatekeepers for employment interventions, yet little is known about their expectations about employment for people with mental illness in Norway. The purpose of this study is to examine mental health professionals’ expectations and efforts to include employment for people with moderate to severe mental illness in treatment settings.MethodsTwo hundred seven mental health professionals were recruited from municipal mental health services, specialized clinics, social media, and professionals’ networks across Norway. Participants completed a survey package comprising demographic questions, current practices and a revised version of the self-reported measure Expectations for the Employability of People with Serious Mental Illness (EESMI), a validated measure consisting of three subscales.ResultsResults suggested overall favorable expectations of employment for people with moderate to severe mental illness. Analyses revealed that patients participating more frequently in collaborative meetings predicted more favorable expectations about employment among mental health professionals compared to less frequent meetings. In addition, findings suggest that psychiatrist hold more negative expectations about employment in comparison to the other educational groups. Lastly, more than half of mental health professionals reported that they have integrated discussions about employment, and routines to address work-oriented activity in consultations with patients, however, there are substantial variations in routines for addressing work or work-oriented activity as a topic in consultations with patients.ConclusionsThese results suggest that efforts are being made to integrate employment in treatment settings for people with mental illness in Norway; however, more work is needed to remove barriers and facilitate evidence-based approaches.

Predictive factors for microvascular recovery after treatments for diabetic retinopathy

BackgroundTo identify factors associated with microvascular recovery after intravitreal bevacizumab or panretinal photocoagulation (PRP) in diabetic retinopathy (DR).MethodsWe retrospectively reviewed 320 eyes/patients with DR treated with intravitreal bevacizumab and/or PRP. Two consecutive fluorescein angiographies (FAs) of each eye were compared. The number of microaneurysms and the area of capillary non-perfusion were calculated automatically using ImageJ software. Microvascular recovery was defined as a marked reduction in the numbers of microaneurysms (< 20%) or a marked reduction in the area of capillary non-perfusion (< 50%) in 45-degree fields or a complete regression of new vessels in ETDRS 7 standard fields. Baseline FA findings and changes in the ocular and systemic factors were analyzed.ResultsTwenty-eight (8.8%) of the 320 total eyes were found to meet the criteria of microvascular recovery after the treatments. Multivariate analysis revealed the presence of diffuse capillary telangiectasis (P = .003) and late disc leaking (P = .007) on baseline FA and a reduction of glycated hemoglobin (P = .005) during the follow-up period were predictive factors of microvascular recovery after the treatments. Although the microvascular recovery group presented with a significant improvement of BCVA after the treatments, the baseline BCVA could not predict the microvascular recovery after the treatments.ConclusionsDiffuse capillary telangiectasis or late disc leaking on baseline FA and improved glycemic control positively predicted the microvascular recovery after treatments for DR.

Bell's Palsy in Pregnancy and Postpartum: A Retrospective Case-Control Study of 182 Patients.

To assess the incidence of Bell's palsy in pregnant and postpartum women. Additionally, to compare facial outcomes in terms of Sunnybrook score following Bell's palsy with regard to corticosteroid treatment and other confounding factors. Retrospective case-control study. University Hospital, Stockholm, Sweden. All women with Bell's palsy in pregnancy or postpartum (6 weeks after birth) with a computerized medical chart in the Stockholm Region 2005 to 2015 were included. The total number of births in the region during this period was retrieved from the Swedish Medical Birth Register. Nonpregnant age-matched women with Bell's palsy served as controls. Characteristics, medication, and Sunnybrook scores were collected. Risk factors for incomplete recovery (Sunnybrook score <96) at 3 months were calculated by logistic regression. In total, 182 pregnant and postpartum women with Bell's palsy were identified. The estimated incidence among pregnant and postpartum women was 60.5/100,000 person-years. The mean Sunnybrook score at 3 months was 74 among pregnant and postpartum women and 83 for controls (p = .002). At 12 months, Sunnybrook score was 81 and 89, respectively (p = .017). Only one-third of the pregnant women received corticosteroid treatment. The incidence of Bell's palsy in pregnancy and postpartum was 60.5 per 100,000 women and year in the Stockholm Region. Sunnybrook score was poorer in pregnant women compared with postpartum and nonpregnant women throughout. Corticosteroid treatment had little effect on any patients, however, only one-third of the pregnant women received this treatment.

Characteristics and risk factors for renal recovery after acute kidney injury in critically ill patients in cohorts of elderly and non-elderly: a multicenter retrospective cohort study

Background The purpose of this study was to explore the risk factors for renal nonrecovery among elderly and nonelderly patients with acute kidney injury (AKI) in critically ill patients. Methods A multicenter retrospective cohort of 583 critically ill patients with AKI was examined. We found the best cutoff value for predicting renal recovery by age was 63 years old through logistic regression. All patients were divided into two cohorts, age <63 and age ≥63-years old; on the basis of renal recovery at 30 days after AKI, the two patient cohorts were further divided into a renal recovery group and a renal nonrecovery group. Multivariate logistic regression was used to analyze the risk factors affecting renal recovery in the two cohorts. Results The 30-day renal recovery rate of patients aged <63 years was 70.0% (198/283), multivariate analysis showed that the independent risk factors affecting renal nonrecovery in age <63 years old included AKI stage, blood lactate level and hemoglobin level. The 30-day renal recovery rate of patients aged ≥63 years was 28.7% (86/300), multivariate analysis showed that the independent risk factors for renal nonrecovery in age ≥63-years old included diabetes mellitus, surgery with general anesthesia, AKI stage, APACHE II score, eGFR, and hemoglobin level. Conclusions The renal nonrecovery after AKI in critically ill patients in patients aged ≥63 years was more strongly affected by multiple risk factors, such as diabetes mellitus, surgery with general anesthesia, eGFR, and APACHE II score, in addition to hemoglobin and AKI stage.

Improved cloudy-sky snow albedo estimates using passive microwave and VIIRS data

Land surface albedo (LSA) is an essential component of the surface radiation budget, and has been retrieved extensively as a basic remote sensing product; however, daily LSA products suffer from extensive data gaps primarily caused by cloud cover. Accordingly, several gap-filling methods were developed (e.g., spatiotemporal interpolation and data fusion with albedo climatology), although the traditional methods are limited by cloud scale and surface heterogeneity. Further, as the largest varying surface landscape feature, seasonal snow cover substantially influences LSA and represents a major uncertainty factor of gap recovery because previous studies failed to employ actual surface signals to capture such ephemeral but intense albedo changes under cloud cover. To address this issue, a three-step framework was proposed for estimating 1 km cloudy-sky LSA using passive microwave (PMW) data, albedo climatology, and Visible Infrared Imaging Radiometer Suite (VIIRS) clear-sky albedo: (1) All-sky snow albedo was estimated from PMW brightness temperatures using a statistical model, (2) Continuous albedo dynamics were generated by combining the all-sky snow albedo with snow-free climatological albedo, and (3) The 1 km cloudy-sky LSA was predicted after filtering 1 km VIIRS clear-sky LSA by the albedo dynamic series. PMW-derived snow albedo was assessed over the Contiguous US (CONUS), and the final 1 km cloudy-sky LSA was validated across 10 sites from SURFRAD and Core AmeriFlux in 2013. Based on the comparison with high-quality MODIS pixels, the estimated snow albedo yielded an overall RMSE of 0.064 over CONUS, with a bias of −0.010 (R2 = 0.845). The recovered 1 km cloudy-sky LSA produced RMSEs of 0.074 (0.137) for all (snow) samples, a significant improvement over the Global Land Surface Satellite (GLASS) gap-free albedo products especially on snow cases (p-value = 0.027). Corresponding RMSE in calculating surface net radiation was also decreased by 38.91 W·m−2; and anomalous snow samples were corrected as well. The temporal analysis and all-sky LSA mapping suggest that the recovered LSA has satisfactory spatiotemporal continuity, and successfully captured details of spatiotemporal variability, especially for ephemeral snow events. This study provides an innovative solution to recover gaps in LSA data, and considerably improves the LSA accuracy under cloud cover, which can inform snow melting modeling, hazard forecasting, and irrigation management.

A retrospective study to evaluate the effect of preoperative hormonal therapy on continence recovery.

To evaluate whether different preoperative hormonal therapy options affect postoperative continence and to identify risk/protective factors for continence recovery. This is a retrospective analysis of several clinical trials (NCT04356430, NCT04869371, NCT04992026 and NCT05406999). Data from patients treated with hormonal therapy followed by RARP were collected and analyzed. Continence was defined as 0 pad/day or one safety pad. The study included 230 patients with adequate information. The median time to continence recovery is 8 weeks. A total of 216 (93.9%) participants recovered to urinary continence within 12 months after surgery. 21 (9.1%) participants achieved immediate continence. 69, 85, 27 and 14 participants restored continence at 1 month, 1-3 month, 3-6 month, 6-12 month, accounting for 30.0%, 40.0%, 11.7% and 6.1% accordingly. No difference in continence recovery was found among different preoperative hormonal treatment options (p=0.821). Cox regression showed that membranous urethral length (MUL) was the only independent factor influencing urinary continence recovery either in the univariate analysis (OR=1.13, 95%CI: 1.04-1.22, p=0.002) or in the multivariate analysis (OR=1.12, 95%CI: 1.04-1.20, p=0.002). Different preoperative treatment options were not associated with urinary recovery. More advanced preoperative T stage (OR=0.46, 95%CI: 0.24-0.85, p=0.014) delayed the recovery of immediate continence. MUL was associated with continence restoring at 1 month (OR=1.20, 95%CI: 1.03-1.39, p=0.017), 3 month (OR=1.27, 95%CI: 1.07-1.51, p=0.006), 6 month (OR=1.34, 95%CI: 1.07-1.67, p=0.011) and 12 month (OR=1.36, 95%CI: 1.01-1.84, p=0.044). There is no difference in postoperative continence recovery among ADT, ADT+Docetaxel and ADT+Abiraterone preoperative treatment options. More advanced T stage indicated poor immediate continence recovery. Longer membranous urethral length was a promotional factor for both short-time and long-time continence recovery.

Landscape-scale forest cover drives the predictability of forest regeneration across the Neotropics.

Abandonment of agricultural lands promotes the global expansion of secondary forests, which are critical for preserving biodiversity and ecosystem functions and services. Such roles largely depend, however, on two essential successional attributes, trajectory and recovery rate, which are expected to depend on landscape-scale forest cover in nonlinear ways. Using a multi-scale approach and a large vegetation dataset (843 plots, 3511 tree species) from 22 secondary forest chronosequences distributed across the Neotropics, we show that successional trajectories of woody plant species richness, stem density and basal area are less predictable in landscapes (4 km radius) with intermediate (40-60%) forest cover than in landscapes with high (greater than 60%) forest cover. This supports theory suggesting that high spatial and environmental heterogeneity in intermediately deforested landscapes can increase the variation of key ecological factors for forest recovery (e.g. seed dispersal and seedling recruitment), increasing the uncertainty of successional trajectories. Regarding the recovery rate, only species richness is positively related to forest cover in relatively small (1 km radius) landscapes. These findings highlight the importance of using a spatially explicit landscape approach in restoration initiatives and suggest that these initiatives can be more effective in more forested landscapes, especially if implemented across spatial extents of 1-4 km radius.

A retrospective clinical study of dolutegravir- versus efavirenz-based regimen in treatment-naïve patients with advanced HIV infection in Nanjing, China.

Currently, there are limited data related to the efficacy and safety of ART regimens, as well as factors influencing immune recovery in antiretroviral therapy (ART)-naïve patients with advanced HIV infection, especially in China. We designed a single-center, retrospective cohort study from March 1, 2019, to May 31, 2022, at The Second Hospital of Nanjing, China. ART-naïve adults with advanced HIV infection (CD4+ T-cell count < 200 cells/μL) who met the study criteria were included. The plasma viral load (VL), CD4+ T-cell count, CD4/CD8 ratio, treatment discontinuation, and immune reconstitution inflammatory syndrome (IRIS) events were collected to compare the efficacy and safety of the dolutegravir (DTG) and the efavirenz (EFV) regimens. Factors of immune recovery were analyzed using the Cox regression model. Study enrolled 285 ART-naïve adults with advanced HIV-1 infection, of which 95 (33.3%) started regimens including DTG and 190 (66.7%) were treated with EFV. After ART initiation, the proportion of patients with HIV-1 RNA < 50 copies/mL was higher (22.5% versus 6.5%, P < 0.001) in those on DTG-based regimens at month 1, but no significant difference at other follow-up points. Compared to the baseline, the median CD4+ T-cell count and CD4/CD8 ratio increased significantly during follow-up both in the EFV and the DTG groups. However, the CD4+ T-cell count increased greater in patients on DTG-based regimens at months 6, 12, 24, and 36 (P < 0.05). A total of 52 (18.2%) patients discontinued treatment, with no significant difference between ART regimens in treatment discontinuation rates. Only 7 patients reported IRIS, without significant difference between ART regimens (P=0.224). Overall, 34.0% (97/285) achieved a CD4+ T-cell count ≥ 350 cells/μL during follow-up. Age (P < 0.001), baseline CD4+ T-cell count (P < 0.001), baseline VL (P < 0.001) and ART regimens (P = 0.019) were associated with the CD4+ T-cell count ≥ 350 cells/μL after adjusting for potential confounders. Among ART-naïve adults with advanced HIV infection, it appeared that DTG-based regimens were better options for initial therapy compared to regimens including EFV; in addition, ART regimens, age, baseline VL and CD4+ T-cell count were associated with immune recovery.

Estimates of dairy herd health indicators of mastitis, ketosis, inter-calving interval, and fresh cow replacement in the Piedmont region, Italy

Test-day milk analysis has largely been used to study health and performance parameters in dairy cows. In this study, we estimated four health indicators of dairy cows using test-day data. Our purpose was to estimate (1) mastitis incidence rate, prevalence, and the probability of recovery; (2) the incidence proportion of ketosis; (3) the duration of inter-calving interval; and (4) the risk of a fresh cow being replaced, in a large cohort of dairy herds in the Piedmont region (Italy).We retrospectively analysed test day records of 261,121 lactating cows and 1315 herds during five years (2015–2020). Mastitis was defined by somatic cell count and ketosis by fat-to-protein ratio. Calving dates were used to calculate ICI and to estimate the removal of a fresh cow from the herd. Mixed-effect generalized linear models were used to adjust for unmeasured herd-level risk factors.The risk of mastitis increased by 120% with parity (Odds ratio [OR] = 2.20, confidence interval [CI]: 2.17 – 2.23), by 7% by months in milking (OR = 1.07, CI: 1.07 – 1.07), and even more if the cow was already affected during the same lactation (OR = 8.74, CI: 8.67 – 8.82). Lactose concentration on the previous test day was the best positive prognostic factor for mastitis recovery (OR = 1.12, CI: 1.08 – 1.17). Ketosis risk was the highest between 3rd and 4th lactations and itself increased the risk of having ICI longer than 440 days (OR = 1.12, CI: 1.02 – 1.22), and fresh-cow removal (OR = 1.75, CI: 1.58 – 1.93). Also, the removal of fresh cows was more likely when mastitis (OR = 1.31, CI: 1.19 – 1.45) or long ICI (OR = 1.34, CI: 1.22 – 1.48) occurred. For each health indicator, herd-level risk factors had an important role (18–56% of within-herd covariance).Our results indicate that milk analysis could be also useful for predicting mastitis, its cure rate, and ketosis. Cow-level risk factors are not enough to explain the risk of these issues. By studying a large population over a long period, this study provides an updated estimate of dairy cow health indicators in Piedmont (north-western Italy), useful for benchmarking dairy herds.

Sentimental analysis of female entrepreneurs based on public tweets

After the declaration of the COVID 19 pandemic, jobs and occupations had to return to normal, however many people lost their main source of resources, so the incorporation of women in different ventures has been a flag to get ahead with work for their families, so the objective of this work is to identify opinions about entrepreneurs, using the technique of sentimental analysis to classify unstructured information from public tweets using for data processing, the Rstudio software with the retweet, word cloud and emo libraries collecting the feelings that people have through the microblogging platform Twitter in the period from June 20 to July 10, 2022. The results show that 74.53% of users perceive positive and very positive feelings toward women entrepreneurs, so it can be concluded that the impact of the incorporation of women entrepreneurs, which although at this time is still uncertain is perceived as an important factor for the economic recovery.

Facilitating and hindering factors of personal recovery in the context of Soteria-A qualitative study among people with (early episode) psychosis.

The objective of this study was to gain insight into patients' experiences of how personal recovery (PR) is facilitated or hindered in the context of an early episode psychosis setting (Soteria). We thereby aimed to contribute to the understanding of how care settings may promote or hinder the process of PR in people with (acute) psychosis. This study used a qualitative method, consisting of semi-structured in-depth interviews with people who had been admitted to a Soteria house in the Netherlands. Interview transcripts were analyzed following the Grounded Theory approach. Five themes emerged from the data illustrating how Soteria facilitated or impeded PR. The experience of togetherness in contact with staff and peers, feeling at home, and being active facilitated PR, while the emphasis put on medication by staff was experienced as hindering, and attention to spirituality was missed. In addition to the literature that identified factors associated with PR in psychosis, the current study gives a sense of how this can be put into practice. By offering treatment within a normalizing, holding environment, with emphasis on equality, close contact, optimism, active structured days, open-mindedness toward spirituality, and the role of medication, PR can be facilitated without detracting from guideline-based treatment aimed at symptomatic recovery. Similarities with existing concepts are discussed.