Future Outcomes Research Articles

Risk of adverse birth outcomes after adolescent and young adult cancer.

Many women diagnosed with cancer as adolescents and young adults (AYAs, age 15-39 years) want biological children after cancer but lack information on the potential impact of their cancer history on future reproductive outcomes. We investigated the risk of adverse birth outcomes among AYA cancer survivors. We identified insured women diagnosed with AYA breast cancer, thyroid cancer, gynecologic cancers, lymphoma, or melanoma from 2003 to 2016 in the state of North Carolina or the Kaiser Permanente health care systems in northern and southern California. Post-diagnosis births to cancer survivors were each matched with up to 5 births to women without cancer. Risk ratios for preterm birth (<37 completed weeks), very preterm birth (<34 completed weeks), low birth weight (<2500 g), and small for gestational age (SGA, <10th percentile of weight for gestational age) were estimated using modified Poisson regression. Analyses included 1648 births to 1268 AYA cancer survivors and 7879 births to 6066 women without cancer. Overall, risk of preterm birth, very preterm birth, low birth weight, and SGA did not significantly differ between births to women with and without cancer. However, births to women with gynecologic cancers had a significantly increased risk of low birth weight (risk ratio = 1.82; 95% confidence interval: 1.03 to 3.21) and suggested increased risk of preterm birth (risk ratio = 1.59; 95% confidence interval: 0.99 to 2.54). Chemotherapy exposure was not associated with increased risk of adverse birth outcomes. Women with gynecologic cancers, but not other cancers, had an increased risk of adverse birth outcomes compared to women without cancer.

People are less myopic about future than past collective outcomes.

Myopia involves giving disproportionate weight to outcomes that occur close to the present. Myopia in people's evaluations of political outcomes and proposals threatens effective policymaking. It can lead to inefficient spending just before elections, cause inaction on important future policy challenges, and create incentives for government interventions aimed at boosting short-term performance at the expense of long-term welfare. But, are people generally myopic? Existing evidence comes mostly from studies that disregard either the future or collective outcomes. Political science characterizes people as myopic based on how they retrospectively evaluate collective outcomes, such as the state of the economy. Behavioral economics and psychology find that people make myopic choices involving future individual outcomes, such as money or personal health. To characterize myopia more generally, we offer two innovations: First, we adapt measurement approaches from behavioral economics and psychology to precisely gauge myopia over politically relevant collective outcomes. Second, we estimate myopia using the same approach for collective political outcomes in both past and future. We conduct two surveys on three different samples (including a large probability-based sample) asking respondents to evaluate national conditions randomly described as past or future while holding constant the domain, information about conditions, and the elicitation method. Results show that prospective evaluations are significantly less myopic than retrospective evaluations. People are often not myopic at all when looking to the future. This surprising pattern calls for more research to probe its robustness and spell out how low prospective myopia might lead to forward-looking policy.

Di-(2-ethylhexyl) phthalate exacerbates abnormalities of testicular development in F1 males via inhibition the Wnt/β-catenin signaling pathway

The theory of “Developmental Origins of Health and Disease (DOHaD)” espouses that environmental exposures to toxicants during critical developmental stages can affect health outcomes in adulthood. Di (2-ethylhexyl) phthalate (DEHP) is a plasticizer that can be transferred to developing organisms via the placenta and breast milk as an environmental endocrine disruptor. We herein implemented a cross-fostering model to decipher the contributions of prenatal vs. postnatal exposure to low or high dose DEHP (30 or 500 mg/kg-bw•d) on reproductive outcomes in male offspring and the underlying mechanism of action. Unexpectedly, we observed that postnatal DEHP exposure programmed weight gain in a dose-dependent manner, in-utero exposure to high dose DEHP appeared to constitute a significant factor in the weight loss of male offspring. Moreover, in the low dose group, offspring of control that were suckled by DEHP dams (CC-DE) generated a considerable number of adverse reproductive outcomes compared with the offspring of DEHP that were suckled by control dams (DE-CC), based on histopathologic alterations in the testis, blockage of sex hormone secretion, and transcriptional inhibition of steroid-hormone-related factors in the hypothalamic-pituitary-testicular (HPT) axis. However, DE-CC group affected reproductive dysfunction in male offspring more so than CC-DE in the high dose group. Mechanistically, DEHP contributed to the inhibition of steroidogenesis by perturbing the Wnt/β-catenin-signaling pathway. These studies confirm the sensitivity window in which future reproductive outcomes in offspring are influenced following developmental exposure to DEHP at two different dosages, and reveals a critical role for the Wnt/β-catenin signaling pathway in DEHP-induced male reproductive disorders.

Psychosocial Care for People With Diabetic Neuropathy: Time for Action.

Psychological factors and psychosocial care for individuals with diabetic neuropathy (DN), a common and burdensome complication of diabetes, are important but overlooked areas. In this article we focus on common clinical manifestations of DN, unremitting neuropathic pain, postural instability, and foot complications, and their psychosocial impact, including depression, anxiety, poor sleep quality, and specific problems such as fear of falling and fear of amputation. We also summarize the evidence regarding the negative impact of psychological factors such as depression on DN, self-care tasks, and future health outcomes. The clinical problem of underdetection and undertreatment of psychological problems is described, together with the value of using brief assessments of these in clinical care. We conclude by discussing trial evidence regarding the effectiveness of current pharmacological and nonpharmacological approaches and also future directions for developing and testing new psychological treatments for DN and its clinical manifestations.

EXPERIENCE OF MEDICAL REHABILITATION OF CHILDREN WITH PERINATAL LESIONS OF THE CENTRAL NERVOUS SYSTEM AT THE STAGE OF CATAMNETIC OBSERVATION IN POLTAVA REGION

Introduction. According to World Health Organization statistics, perinatal lesion of the central nervous system is one of the main causes of childhood disability. The development and scientific substantiation of new non-medicinal technologies for the medical rehabilitation of children with perinatal lesions of the central nervous system is one of the priority tasks. Timely identification of developmental delays and early intervention are particularly crucial for premature infants, ultimately enhancing their future health outcomes.&#x0D; The purpose of this work is to determine the structure of morbidity and disability of children with perinatal lesion of the central nervous system at the stage of catamnetic observation and to assess the effectiveness of the early intervention program. Results and Discussion. The study included 4.118 children, 1.711 of them were children with a birth weight of more than 2.500 g, 1.812 with a low birth weight (1.500-2.499 g), 452 children with a very low birth weight (1.000-1.499 g), and 134 children with extremely low birth weight (&lt;1000) registered in the catamnetic observation office of the Center of Specialized Pediatric Care at M.V. Sklifosovsky Poltava Regional Clinical Hospital according to the statistical and reporting documentation over the period for 2012 – 2022. During the last year, 282 children of the first year of life and 131 children from one to three years old, who had delayed motor and psycho-speech development, were referred to the rehabilitation center "Dolon’ka Dobra" for inclusion in the early intervention program. Conclusion. Timely identification of children with developmental disorders, the creation of personalized early intervention programs, their implementation, and the ongoing assessment of effectiveness continue to serve as the fundamental principles guiding the catamnestic office and the Children's Rehabilitation Center.

Gold Nanoparticles in Nanomedicine: Unlocking Therapeutic Potential for Precision Diagnosis and Treatment

Nanomedicine is a relatively new interdisciplinary field that combines medicine and nanotechnology. It offers remarkable opportunities for precise diagnosis and treatment. Because of the unique physicochemical properties that they possess, Gold Nanoparticles (GNPs) are used extensively in the field of nanomedicine. This study aims to introduce a novel approach known as Gold Nanoparticles in Nanomedicine (GNP-NM), which uses GNPs to enhance the precision of diagnosis and treatment for patients. Several noteworthy qualities are associated with GNP-NM, including therapeutic efficacy, considerable nanoparticle aggregation, controlled drug discharge, and remarkable biocompatibility. According to the data, the drug is delivered at an average rate of 9.99 µg/h, there is a high concentration of nanoparticles at 1.66E+11 particles/mL, the therapy is highly successful with therapeutic effectiveness of 92.1%, and the cells continue to be highly viable at 92.1% throughout the process. These findings demonstrate the robustness and dependability of the technique, suggesting that it can revolutionize nanomedical treatments significantly. Due to the many benefits that GNP-NM offers, it has the potential to become a platform for the expansion of precision medicine. This highlights the relevance of GNP-NM in defining the future outcomes of nanomedicine applications.

Associations Between Family History of Alcohol and/or Substance Use Problems and Frontal Cortical Development From 9 to 13 Years of Age: A Longitudinal Analysis of the ABCD Study

BackgroundPrevious investigations that have examined associations between family history (FH) of alcohol/substance use and adolescent brain development have been primarily cross-sectional. Here, leveraging a large population-based sample of youths, we characterized frontal cortical trajectories among 9- to 13-year-olds with (FH+) versus without (FH−) an FH and examined sex as a potential moderator. MethodsWe used data from 9710 participants in the Adolescent Brain Cognitive Development (ABCD) Study (release 4.0). FH+ was defined as having ≥1 biological parents and/or ≥2 biological grandparents with a history of alcohol/substance use problems (n = 2433). Our primary outcome was frontal cortical structural measures obtained at baseline (ages 9–11) and year 2 follow-up (ages 11–13). We used linear mixed-effects models to examine the extent to which FH status qualified frontal cortical development over the age span studied. Finally, we ran additional interactions with sex to test whether observed associations between FH and cortical development differed significantly between sexes. ResultsFor FH+ (vs. FH−) youths, we observed increased cortical thinning from 9 to 13 years across the frontal cortex as a whole. When we probed for sex differences, we observed significant declines in frontal cortical thickness among boys but not girls from ages 9 to 13 years. No associations were observed between FH and frontal cortical surface area or volume. ConclusionsHaving a FH+ is associated with more rapid thinning of the frontal cortex across ages 9 to 13, with this effect driven primarily by male participants. Future studies will need to test whether the observed pattern of accelerated thinning predicts future substance use outcomes.

Proteomic prediction of incident heart failure and its main subtypes.

To examine the ability of serum proteins in predicting future heart failure (HF) events, including HF with reduced or preserved ejection fraction (HFrEF or HFpEF), in relation to event time, and with or without considering established HF-associated clinical variables. In the prospective population-based Age, Gene/Environment Susceptibility Reykjavik Study (AGES-RS), 440 individuals developed HF after their first visit with a median follow-up of 5.45 years. Among them, 167 were diagnosed with HFrEF and 188 with HFpEF. A least absolute shrinkage and selection operator regression model with non-parametric bootstrap were used to select predictors from an analysis of 4782 serum proteins, and several pre-established clinical parameters linked to HF. A subset of 8-10 distinct or overlapping serum proteins predicted different future HF outcomes, and C-statistics were used to assess discrimination, revealing proteins combined with a C-index of 0.80 for all incident HF, 0.78 and 0.80 for incident HFpEF or HFrEF, respectively. In the AGES-RS, protein panels alone encompassed the risk contained in the clinical information and improved the performance characteristics of prediction models based on N-terminal pro-B-type natriuretic peptide and clinical risk factors. Finally, the protein predictors performed particularly well close to the time of an HF event, an outcome that was replicated in the Cardiovascular Health Study. A small number of circulating proteins accurately predicted future HF in the AGES-RS cohort of older adults, and they alone encompass the risk information found in a collection of clinical data. Incident HF events were predicted up to 8 years, with predictor performance significantly improving for events occurring less than 1 year ahead, a finding replicated in an external cohort study.

Cost Effectiveness of Tofacitinib for the Treatment of Active Ankylosing Spondylitis in Greece.

Ankylosing spondylitis is a chronic, progressive, inflammatory, multidimensional, musculoskeletal disease primarily involving the axial skeleton. In addition, ankylosing spondylitis is associated with increased morbidity and mortality, significantly affecting productivity and overall quality of life. The aim of the present study was to evaluate the cost effectiveness of tofacitinib compared to currently marketed biologic treatment in patients with active ankylosing spondylitis who have responded inadequately to conventional therapy (biologic-naïve population) or previous biologic therapy (biologic-experienced population) in Greece. A published model comprising a decision tree and a three-state Markov model was adapted from a public payer perspective over a lifetime horizon. Adalimumab and secukinumab, having the highest market shares among biologics for the treatment of ankylosing spondylitis in Greece (standard practice), were selected as comparators in the analysis. Clinical parameters captured treatment response defined per Assessment of Spondyloarthritis International Society 20 response, short-term and long-term changes in Bath Ankylosing Spondylitis Disease Activity Index and Bath Ankylosing Spondylitis Functional Index scores, long-term biologic treatment discontinuation, and adverse events. Efficacy, safety data, and utility values were elicited from the published literature. Direct costs pertaining to drug acquisition, monitoring, adverse events, and disease management costs were considered in the analysis (€2022). Model outcomes were patients' quality-adjusted life-years, total costs, and incremental cost-effectiveness ratios. All future outcomes were discounted at 3.5% per annum. A probabilistic sensitivity analysis was conducted to account for model uncertainty. In a biologic-naïve population, compared with adalimumab, tofacitinib produced an estimated 0.06 additional quality-adjusted life-years [QALYs] (10.67 vs 10.73), at additional costs of €2403 (€147,096 vs €149,500) resulting in an incremental cost-effectiveness ratio of €41,378 per QALY gained. In a biologic-experienced population, the total cost per patient for tofacitinib and secukinumab was estimated to be €151,371 and €145,757, respectively. In terms of health outcomes, tofacitinib was associated with a 0.13 increment in QALYs compared with secukinumab resulting in an incremental cost-effectiveness ratio of €42,784 per QALY gained. The probabilistic sensitivity analysis confirmed the deterministic results for both populations. Tofacitinib was estimated to be a cost-effective option for the treatment of active ankylosing spondylitis in Greece for both biologic-naive and biologic-experienced patients.

Impact of Invisalign G-series Updates on Improving Predicted Outcomes: A Retrospective Study.

Understanding the real-world implications of periodic changes to orthodontic appliances can provide valuable insights for future treatment strategies and patient outcomes. This study aimed to investigate the impact of the latest updates added to the G7 and G8 Invisalign series on actual versus predicted outcomes and the percentage accuracy of the treatment. This retrospective study was conducted in private orthodontic practices in Riyadh, Saudi Arabia. Orthodontists carried out Invisalign® treatment using the latest updates added to the G7 and G8 Invisalign series. The study group comprised patients with different malocclusion types who received non-extraction Invisaligntreatment. The Invisalign treatment plan was provided by the ClinChecks program (Invisalign, San Jose, United States) for patients treated throughout the years (2016-2022). Different dimensions were assessed to record predicted and actual treatment outcomes with the aid of iTero® (Align Technology,San Jose, United States) and ClinCheck® (Invisalign, San Jose, United States). The percentage accuracy was determined using the formula (100%-((Predicted-Actual)/Predicted) *100%). A total of 108 patients (male = 34 (31.5%) and female = 74 (68.5%)) treated with Invisalign G7 and G8 series were considered in this study. The overall mean and standard deviation values of vertical distance (2.91±1.42), intermolar distance in the lower arch (52.68±3.15), overjet (2.71±1.06), and inter-incisal angle (138.24±12.18) were higher than the predicted model. However, the predicted model showed higher mean and standard deviation values for intercanine distances in the upper (36.94±1.57) and lower arches (28.48±1.40) and upper intermolar distances (57.21±2.91). The G7 versus G8 intercanine distance in lower (61.28±47.67 vs. 80.51±38.32), intermolar distance in upper (61.72±47.67 vs. 69.95±44.11), and intermolar distance in lower (100.68±3.80 vs. 100.89±2.52) were relatively higher in the G8 series than the G7. The accuracy percentage was higher with the G8 series than with the G7 regarding the intercanine distance in the upper arch. In contrast, the G7 series showed a higher mean percentage accuracy of vertical distance (91.11±84.83 vs. 76.76±65.45), overjet (58.44±35.17 vs. 53.71±45.87), and inter-incisal angle (34.47±44.06 vs. 27.53±37.98) than the G8 series. The percentage accuracy of aligner therapy administered using the Invisalign G7 and G8 series demonstrated no significant variation.

Связь раннего образовательного и семейного опыта с академическими результатами детей в младшем школьном возрасте

&lt;p&gt;This article focuses on the issues of low academic results. Research on the role of children&amp;rsquo;s early educational experiences highlights the important role of kindergartens, socioeconomic status (SES[1]), cultural capital (CC[2]), and other family characteristics for future educational outcomes. The goal of this paper is to investigate the relationship of SES and CC with academic achievement of children in elementary school, using a sample of 5235 students of the first (&lt;em&gt;n&lt;/em&gt;=2574) and fourth (&lt;em&gt;n&lt;/em&gt;=2661) grades of secondary schools from the Nizhny Novgorod region of Russia. The academic results were measured using the &amp;ldquo;Start&amp;rdquo; and &amp;ldquo;Progress&amp;rdquo; tests; the information about family and educational experiences was collected using family surveys. The results suggest that children with low academic achievement typically reside in in rural areas and mostly come from families with low SES. The results indicated that in the fourth grade, the academic results of the children who didn&amp;acute;t attend a kindergarten are higher than the results of the children who did. Nevertheless, this result refers only to a sample of fourth graders with medium and high academic achievement, coming from families with high SES and CC. These results contradict the findings from Russian and foreign studies on the role of early educational experiences. Therefore, the results from this study should be interpreted with caution and require additional rigorous examination. [1] Socio-economic status includes such indicators as level of education of parents, place of residence, family wealth, etc. [17; 19]. [2] Cultural capital includes social attitudes, values, knowledge and educational qualifications [10].&lt;/p&gt;

An evolutionary view of foresight in the field of artificial intelligence

The article analyzes the task of scientific foresight in the field of artificial intelligence (AI) and assesses the possibility of predicting AI development in the coming decades. Based on an evolutionary model of AI, the authors hypothesize that AI fits into the evolutionary development of humans. Drawing on the ideas of nomogenesis, first introduced by biologist L.S. Berg in 1922, they argue that embracing the concept of stable evolutionary patterns creates a fundamental possibility to predict a certain range of forthcoming changes as a result. The question of transferring the function of foresight from humans to AI is also examined, particularly in areas of science and technology where decision-making necessitates complex analysis of future potential outcomes. Strong arguments are presented in favor of the possibility of predicting AI development in principle, although with some degree of probability. This optimistic view aligns with researchers across various domains of human activity in which AI has already found or will yet find its application.

Language use on Twitter reflects social structure and social disparities

Large-scale mental health assessments increasingly rely upon user-contributed social media data. It is widely known that mental health and well-being are affected by minority group membership and social disparity. But do these factors manifest in the language use of social media users? We elucidate this question using spatial lag regressions. We examined the county-level (N = 1069) associations of lexical indicators linked to well-being and mental health, notably depression (e.g., first-person singular pronouns, negative emotions) with markers of social disparity (e.g., the Area Deprivation Index–3) and ethnicity, using a sample of approximately 30 million content-coded tweets (U.S. county-level aggregation). Results confirmed most expected associations: County-level lexical indicators of depression are positively linked with county-level area disparity (e.g., economic hardship and inequity) and percentage of ethnic minority groups. Predictive validity checks show that lexical indicators are related to future health and mental health outcomes. Lexical indicators of depression and adjustment coded from tweets aggregated at the county level could play a crucial role in prioritizing public health campaigns, particularly in socially deprived counties.

Distinct developmental changes in regional gray matter volume and covariance in individuals with attention-deficit hyperactivity disorder: A longitudinal voxel-based morphometry study

BackgroundVery few studies have investigated longitudinal clinical cohorts of attention-deficit/hyperactivity disorder (ADHD). Moreover, how baseline brain changes could affect the development of ADHD symptoms later in life remains elusive. Therefore, we aimed to fill this gap by exploring brain and clinical changes in youth with ADHD using a longitudinal design. MethodsThis prospective study consisted of 74 children and adolescents with ADHD and 50 age-, sex-, intelligence-matched typically developing controls (TDC), evaluated at baseline (aged 7–19 years) and re-evaluated 5.3 years later (a mean follow-up latency). We applied voxel-based morphometry to characterize brain structures, followed by both mass-univariate and multivariate structural covariance statistics to identify brain regions with significant diagnosis-by-time interactions from late childhood/adolescence to early adulthood. We used the cross-lagged panel model to investigate the longitudinal association between structural brain metrics and core ADHD symptoms. ResultsThe mass-univariate statistic revealed significant diagnosis-by-time interactions in the right striatum and the sixth lobule of the cerebellum. This was expressed by increased striatal and decreased cerebellar volume in ADHD, while TDC showed inverse volume changes over time. The multivariate method showed significant diagnosis-by-time interactions in a structural covariance network consisting of the regions involved in the functional sensory-motor and default-mode networks. Higher baseline right striatal and cerebellar volumes were associated with elevated ADHD symptoms at follow-up. ConclusionsOur findings suggest a temporal association between the divergent development of striatal and cerebellar regions and dynamical ADHD phenotypic expression through young adulthood. These results highlight a potential brain marker of future outcomes.

Tax Avoidance and Firm Risk: New Insights from a Latent Class Mixture Model

ABSTRACT We examine the relations between tax avoidance and two components of firm risk (priced risk and idiosyncratic risk) using latent class mixture models. OLS regressions suggest that tax avoidance is negatively related to both priced risk and idiosyncratic risk. However, results from latent class mixture models reveal that 35.6 (58) percent of the sample exhibits a significant positive association between tax avoidance and priced (idiosyncratic) risk and firm characteristics are strikingly different across the latent classes. We use these differences to develop parsimonious models to predict latent class assignments, which we then use to demonstrate that firms predicted to have a positive relation between tax avoidance and priced risk or idiosyncratic risk have more negative future tax outcomes, including higher relative cash tax rate volatility, larger additions to tax reserves, larger payouts to tax authorities, and more negative tax-related news coverage over the following three years. Data Availability: Data are available from the public sources cited in the text. JEL Classifications: M41; G12; D81.

Transitioning beyond single-use plastic drinks cups: an emergent social marketing case study in Scotland

Purpose This study aims to investigate whether consumers and small businesses can transition from disposable to reusable coffee cups, using a community social marketing intervention, led by a Social Purpose Organisation. Design/methodology/approach An emergent case study approach using multiple sources of data developed an in-depth, multifaceted, real-world context evaluation of the intervention. The methodology draws on citizen science “messy” data collection involving multiple, fragmented sources. Findings Moving from single-use cups to reusables requires collective commitment by retailers, consumers and policymakers, despite the many incentives and penalties applied to incentivise behaviour change. Difficult post-COVID economics, austerity and infrastructure gaps are undermining both reusable acceptance and interim solutions to our dependence upon disposables. Research limitations/implications Although the non-traditional methodology rendered gaps and omissions in the data, the citizen science was democratising and inclusive for the community. Practical implications Our practical contribution evaluates a whole community intervention setting to encourage reusable cups, integrating multiple stakeholders, in a non-controllable, non-experimental environment in contrast to previous research. This paper demonstrates how small community grants can foster impactful collaborative partnerships between an SPO and researchers, facilitate knowledge-exchange beyond the initial remit and provide a catalyst for possible future impact and outcomes. Originality/value To assess the impact at both the outcome and the process level of the intervention, we use Pawson and Tilley’s realist evaluation theory – the Context Mechanism Outcome framework. The methodological contribution demonstrates the process of citizen science “messy” data collection, likely to feature more frequently in future social science research addressing climate change and sustainability challenges.

Impact of acute silent ischemic lesions on clinical outcomes of carotid revascularization.

Previous literature has established an association between acute silent ischemic lesions (ASILs) and elevated susceptibility to future adverse clinical outcomes. The present study endeavors to scrutinize the prognostic significance of preprocedural ASILs, as detected through diffusion-weighted imaging and apparent diffusion coefficient metrics, in relation to subsequent adverse events-namely, stroke, myocardial infarction, and all-cause death-following carotid revascularization in a cohort of patients with symptomatic carotid stenosis. Subjects were extracted from a comprehensive retrospective dataset involving symptomatic carotid stenosis cases that underwent carotid revascularization at a tertiary healthcare institution in China, spanning January 2019 to March 2022. Of the 2663 initially screened patients (symptomatic carotid stenosis=1600; asymptomatic carotid stenosis=1063), a total of 1172 individuals with symptomatic carotid stenosis were retained for subsequent analysis. Stratification was implemented based on the presence or absence of ASILs. The primary endpoint constituted a composite measure of in-hospital stroke, myocardial infarction, or all-cause death. Both carotid endarterectomy (CEA) and carotid artery stenting (CAS) treatment modalities were individually subjected to propensity score-matched analyses. Among the 584 subjects who underwent CEA, 91 ASIL-positive and 91 ASIL-negative (NASIL) cases were propensity score-matched. Notably, the ASIL cohort demonstrated a statistically significant augmentation in the risk of primary outcomes relative to the NASIL group [10.99 vs. 1.10%; absolute risk difference, 9.89% (95% CI: 3.12-16.66%); RR, 10.00 (95% CI: 1.31-76.52); P =0.01]. Similarly, within the 588 CAS-treated patients, 107 ASIL-positive and 107 NASIL cases were matched, revealing a correspondingly elevated risk of primary outcomes in the ASIL group [9.35 vs. 1.87%; absolute risk difference, 7.48% (95% CI: 1.39-13.56%); RR, 5.00 (95% CI: 1.12-22.28); P =0.02]. ASILs portend an elevated risk for grave adverse events postcarotid revascularization, irrespective of the specific revascularization technique employed-be it CEA or CAS. Thus, ASILs may serve as a potent biomarker for procedural risk stratification in the context of carotid revascularization.

(In)Congruence in Perceived Mother-child Cohesion and Informants' Depressive Symptoms: A Dyadic Response Surface Analysis.

Mother-child cohesion, reflecting the emotional connection between mothers and children, is a protective factor for individuals' mental health. The Modified Operations Triad Model suggests that children and mothers hold either congruent or incongruent views of their perceived cohesion, which reflects family functioning and is an indication of future mental health outcomes for family members. Despite increasing research on the impact of (in)congruence in perceived family functioning on children's mental health, few studies concurrently address the mental health of both mothers and children, overlooking their interdependence. This longitudinal study with multi-informant reports explored the long-term and developmental effects of (in)congruence in perceived mother-child cohesion on informants' depressive symptoms. A total of 577 families participated at the first time point, comprising 577 children (52.34% girls, Mage = 10.11 years) and 577 mothers (Mage = 37.32 years). The Dyadic Response Surface Analysis revealed that mother-child congruence at high levels of cohesion (versus low levels) predicted fewer depressive symptoms in mothers and children after three and nine months, as well as decreased depressive symptoms over nine months. Children who reported higher levels of cohesion than their mothers experienced fewer depressive symptoms after three months. Mothers with higher levels of cohesion than their children reported fewer depressive symptoms after three months. The current findings emphasize the importance of identifying and resolving discrepancies in perceived mother-child cohesion between mothers and children to promote a healthy family environment.

Healthy life skills and related factors among university students: a cross-sectional study in Istanbul, Turkey

BackgroundChronic non-communicable diseases (NCDs) are the leading cause of global deaths. University students with unhealthy lifestyle constitute a high-risk group for NCDs. Evaluating and developing healthy behaviors during this period is very important for future health outcomes. This study was conducted to determine healthy life skills in university students.MethodsA cross-sectional study was conducted at a university, and data were collected between January and March 2023 in Istanbul. Data were collected using the healthy living skills scale in University Students and the Personal Information Form. Normal distribution conditions of the data were checked with the Kolmogorov–Smirnov test. According to data distribution, data with normal distribution were analyzed using parametric statistics including t-test, ANOVA and Chi-square tests and data with non-normal distribution were analyzed using non-parametric tests including Mann–Whitney U-test and Fisher’s exact test. Logistic regression test was used to determine predictor variables.ResultsThe average score for healthy life skills was 63.5 out of 84. Significant differences were found in the scores based on marital status, economic income, social security insurance coverage, and educational grade (p = 0.03, p = 0.001, p = 0.004, p = 0.04, respectively). Students who reported alcohol and smoking consumption had lower scores (60.8 ± 12) out of 84.ConclusionThe study revealed that university students in Istanbul possess a satisfactory level of healthy life skills. By providing social support, such as expanding the coverage of social security insurance and establishing conducive educational environments, while also paying attention to the influence of peers on students, we can contribute to the development of healthy life skills in university students.

Deep Learning-Based Extraction of Biomarkers for the Prediction of the Functional Outcome of Ischemic Stroke Patients.

Accurately predicting functional outcomes in stroke patients remains challenging yet clinically relevant. While brain CTs provide prognostic information, their practical value for outcome prediction is unclear. We analyzed a multi-center cohort of 743 ischemic stroke patients (<72 h onset), including their admission brain NCCT and CTA scans as well as their clinical data. Our goal was to predict the patients' future functional outcome, measured by the 3-month post-stroke modified Rankin Scale (mRS), dichotomized into good (mRS ≤ 2) and poor (mRS > 2). To this end, we developed deep learning models to predict the outcome from CT data only, and models that incorporate other patient variables. Three deep learning architectures were tested in the image-only prediction, achieving 0.779 ± 0.005 AUC. In addition, we created a model fusing imaging and tabular data by feeding the output of a deep learning model trained to detect occlusions on CT angiograms into our prediction framework, which achieved an AUC of 0.806 ± 0.082. These findings highlight how further refinement of prognostic models incorporating both image biomarkers and clinical data could enable more accurate outcome prediction for ischemic stroke patients.