Important Predictor Research Articles

Spatio‐temporal integrated Bayesian species distribution models reveal lack of broad relationships between traits and range shifts

AbstractAimClimate change and habitat loss or degradation are some of the greatest threats that species face today, often resulting in range shifts. Species traits have been discussed as important predictors of range shifts, with the identification of general trends being of great interest to conservation efforts. However, studies reviewing relationships between traits and range shifts have questioned the existence of such generalized trends, due to mixed results and weak correlations, as well as analytical shortcomings. The aim of this study was to test this relationship empirically, using analytical approaches that account for common sources of bias when assessing range trends.LocationTanzania, East Africa.Time period1980–1999 and 2000–2020.Major taxa studied57 savannah specialist birds found in Tanzania, belonging to 26 families and 11 orders.MethodsWe applied recently developed integrated spatio‐temporal species distribution models in R‐INLA, combining citizen science and bird Atlas data to estimate ranges of species, quantify range shifts, and test the predictive power of traditional trait groups, as well as exposure‐related and sensitivity traits. We based our study on 40 years of bird observations in East African savannahs, a biome that has experienced increasing climatic and non‐climatic pressures over recent decades. We correlated patterns of change with species traits using linear regression models.ResultsWe find indications of relationships identified by previous research, but low average explanatory power of traits from an ecological perspective, confirming the lack of meaningful general associations. However, our analysis finds compelling species‐specific results.Main conclusionsWe highlight the importance of individual assessments while demonstrating the usefulness of our analytical approach for analyses of range shifts.

Results of the Italian Collaborators for Evar Registry on Acute Kidney Injury After Elective Endovascular Aortic Repair of Infrarenal Abdominal Aortic Aneurysm.

To analyze the incidence and predictive factors of postoperative acute kidney injury (AKI) after elective standard endovascular aortic repair (EVAR) in a large recent, multicenter cohort. This is a multicenter, retrospective, financially unsupported physician-initiated observational cohort study. Between January 2018 and March 2021, only patients treated with elective standard EVAR for infrarenal non-infected abdominal aortic aneurysm were analyzed. Patients already on hemodialysis (HD) were excluded. AKI was defined as an increase in serum creatinine (sCr) ≥0.3 mg/dL within 48 hours or an increase in sCr to ≥1.5 times baseline known or presumed to have occurred within 7 days, or a urine volume of <0.5 mL/kg/h for 6 hours. Primary outcomes of interest were AKI incidence at 30 days and freedom from HD at 1-year follow-up. Secondary outcomes were freedom from severe postoperative complication, and freedom from aorta-related mortality (ARM) at 1 year. The final cohort analyzed 526 (29.8%). There were 489 (93%) males and 37 (7%) females: the median age was 76 years (interquartile range [IQR], 71-81). Chronic kidney disease (CKD) was present in 86 (16.3%) patients. Early mortality was observed in 8 (1.5%) patients, none was aorta-related. Complication rate was 17.1% (n=89). AKI was observed in 17 (3.2%). Renal replacement therapy was needed in 4 (0.8%). HD was transitory in 2 cases and definitive in 1. Binary logistic regression analysis identified CKD (odds ratio [OR]: 4.68, 95% confidence interval [CI]: 2.10-10.45, p<0.001), and the presence of renal artery stenosis (OR: 3.80, 95% CI: 1.35-10.66, p=0.011) to be associated with an increased risk of postoperative AKI. Estimated freedom from ARM was 94.9% at 1 year. Estimated freedom from HD rate at 1 year was 94%: This was significantly different between patients with preoperative CKD and those who did not have preoperative CKD (log-rank, p=0.042). AKI after elective standard EVAR still occurs but with an acceptably low incidence rate. Preoperative CKD is the most important predictor for postoperative AKI, which was not associated with the need for HD at 1-year follow-up but with a higher propensity of mortality. This "real world" experience confirm that EVAR performed with standard contrats agent protocol remains safe for acute kidney injury development. Therefore, only patients presenting with preoperative borderline or ascertained chronic kidney disease will take the most advantage from the use of carbon dioxide contrast.

Maternal education prospectively predicts child neurocognitive function: An environmental influences on child health outcomes study.

A large body of research has established a relation between maternal education and children's neurocognitive functions, such as executive function and language. However, most studies have focused on early childhood and relatively few studies have examined associations with changes in maternal education over time. Consequently, it remains unclear if early maternal education is longitudinally related to neurocognitive functions in children, adolescents, and young adults. In addition, the associations between changes in maternal education across development and more broadly defined neurocognitive outcomes remain relatively untested. The current study leveraged a large multicohort sample to examine the longitudinal relations between perinatal maternal education and changes in maternal education during development with children's, adolescents', and young adults' neurocognitive functions (N = 2,688; Mage = 10.32 years; SDage = 4.26; range = 3-20 years). Moreover, we examined the differential effects of perinatal maternal education and changes in maternal education across development on executive function and language performance. Perinatal maternal education was positively associated with children's later overall neurocognitive function. This longitudinal relation was stronger for language than executive function. In addition, increases in maternal education were related to improved language performance but were not associated with executive functioning performance. Our findings support perinatal maternal education as an important predictor of neurocognitive outcomes later in development. Moreover, our results suggest that examining how maternal education changes across development can provide important insights that can help inform policies and interventions designed to foster neurocognitive development. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The impact of subjective consumer knowledge on consumer behavioral loyalty through psychological involvement and perceived service quality: sports clubs

PurposeThe study advances an enhanced model encompassing psychological involvement, denoted as the psychological continuum model (PCM) and perceived customer service quality as intermediaries in the association between subjective customer knowledge (SCK) and behavioral loyalty. The purpose of this study is to assess the mediating role of psychological engagement and consumers' perceived service quality in the relationship between SCK and behavioral loyalty among members of nonprofit sports service organizations. Additionally, the study aims to examine the impact of membership duration on the relationship between consumer knowledge and behavioral loyalty.Design/methodology/approachThe study used a quantitative research design, and primary data were collected through a structured questionnaire from 527 members of nonprofit Chinese sports clubs who were selected using a simple random sampling technique. A 5-point Likert scale questionnaire was developed to measure all constructs in the intended research model. The suitability of the measurement model was analyzed by performing confirmatory factor analysis (CFA). Structural equation modeling (SEM) was used to analyze the data using AMOS-24.FindingsThe results of the overall direct effect indicate a significant influence of subjective knowledge on perceived service quality, perceived service quality significantly and positively influences psychological engagement; psychological engagement was found to be an important predictor of consumer behavioral loyalty.Originality/valueThe results offer information for nonprofit sports club (NPSC) managers who seek to increase the attractiveness and retention of their clubs' members by establishing the importance of subjective consumer knowledge.

The interaction between socioeconomic status and personality traits in predicting parental warmth among parents in Lebanon

ABSTRACT Parents’ socioeconomic status and personality traits are important predictors of parental warmth. The aim of the present study was to examine the multiplicative relations between parents’ socioeconomic status and personality traits in predicting parental warmth. Parents’ education was used as the indicator for parent’s socioeconomic status. Building on the resource substitution hypothesis, we expected that the associations between parents’ personality traits and parental warmth will be stronger among parents of lower socioeconomic status. Our sample comprised of 378 Lebanese parents who completed an online survey. We found significant interactions between parents’ socioeconomic status and three personality traits, which are agreeableness, conscientiousness, and neuroticism. Generally, we found evidence that personality traits compensate for low socioeconomic status in predicting parental warmth. Our findings call for further investigations of the complex relations between socioeconomic status and the different determinants of parenting, and allay concerns about the negative influence of socioeconomic status on parental warmth.

Early gesture use predicts children's language development in South Korea: New evidence supporting the cross-cultural importance of pointing.

Research in the U.S. and other Western countries shows that children's early gesture use, which starts prior to verbal communication, is an important predictor of children's later language development. Despite increasing efforts to study gesture use in diverse contexts, most of our knowledge on the role of gesture is largely based on populations of Western countries. In this study, we add to the growing body of international research by examining gesture use by 31 mothers and their 14-month-old infants (12 girls) in South Korea and investigate the gestures used during interaction, and whether early gesture use at 14months predicts Korean children's later language skills at 36months. The results showed that in addition to using gestures observed in other cultural contexts, Korean mother-child dyads used culturally specific gesture (i.e., bowing), showing an early sign of socialization that starts with preverbal children. In addition, Korean infants' index-finger pointing, but not showing and giving, predicted their later receptive and expressive vocabulary skills at 36months, providing additional support for the importance of pointing in early language development.

Clinical predictors of severe forms of influenza A(H1N1)pdm09 in adults and children during the 2009 epidemic in Brazil.

The World Health Organization (WHO) raised the global alert level for the A(H1N1) influenza pandemic in June 2009. However, since the beginning of the epidemic, the fight against the epidemic lacked foundations for managing cases to reduce the disease lethality. It was urgent to carry out studies that would indicate a model for predicting severe forms of influenza. This study aimed to identify risk factors for severe forms during the 2009 influenza epidemic and develop a prediction model based on clinical epidemiological data. A case-control of cases notified to the health secretariats of the states of Rio de Janeiro, São Paulo, Minas Gerais, Paraná, and Rio Grande do Sul was conducted. Cases had fever, respiratory symptoms, positive confirmatory test for the presence of the virus associated with one of the three conditions: (i) presenting respiratory complications such as pneumonia, ventilatory failure, severe acute respiratory distress syndrome, sepsis, acute cardiovascular complications or death; or respiratory failure requiring invasive or non-invasive ventilatory support, (ii) having been hospitalized or (iii) having been admitted to an Intensive Care Unit. Controls were individuals diagnosed with the disease on the same date (or same week) as the cases. A total of 1653 individuals were included in the study, (858 cases/795 controls). These participants had a mean age of 26 years, a low level of education, and were mostly female. The most important predictors identified were systolic blood pressure in mmHg, respiratory rate in bpm, dehydration, obesity, pregnancy (in women), and vomiting (in children). Three clinical prediction models of severity were developed, for adults, adult women, and for children. The performance evaluation of these models indicated good predictive capacity. The area values under the ROC curve of these models were 0.89; 0.98 and 0.91 respectively for the model of adults, adult women, and children respectively.

Predictors of COVID-19 vaccine uptake among people who use substances: a case study in Tehran

BackgroundVaccination is one of the most effective ways to manage infectious disease epidemics such as Covid-19. However, the low rates of vaccination in populations at risk including people using illicit substances, hinders the effectiveness of preventive vaccines in reducing transmission. The aim of this study was to investigate the rate of Covid-19 vaccination and its related factors among people who use substances in Tehran, Iran.MethodsBetween July and December 2022, 386 people who use substances aged ≥ 18 years old were recruited by convenience street-based sampling in Tehran. The outcome variable in this study was self-reported completion of at least two doses of the Covid-19 vaccine. Logistic regression was used to investigate the factors related to Covid-19 vaccination. Data were analyzed using SPSS software version 20 at the 0.05 level of significance. As a measure of risk, 95% Confidence interval (CI) was used. The level of significance was considered at 0.05.ResultsAlmost three-quarters (n = 286) of the participants reported receiving at least two doses of the Covid-19 vaccine (95% CI, 70.2–79.3). Those participants with high school diplomas were 1.17 times more likely than less educated participants to report having had 2 vaccinations (OR of 1.17, CI 95%: 1.03–1.81). Participants with a higher mean score of having a positive attitude towards Covid-19 vaccination were more likely to have received a vaccination (OR of 1.12, CI 95%: 1.08–1.17). Ethnicity was also an influential variable, people with non-Fars ethnicity were less likely to be vaccinated than those of Fars ethnicity (OR of 0.33, CI 95%: 0.13–0.81). People with higher-than-average monthly income were more likely to report vaccination than those with low monthly incomes (OR of 1.27, CI 95%: 1.09–1.8). Also, participants reporting less access to vaccination centers had a lower chance of reporting having been vaccinated than those who reported high access to vaccination centers (OR of .17, CI 95%: .08-.36).ConclusionsCovid-19 vaccine uptake was found to be relatively high among people using illicit substances in this study. Higher levels of education, Fars ethnicity, higher income levels, having a positive attitude towards vaccination and access to vaccination centers were the most important predictors of Covid-19 vaccination in this study.

Surgical management of ventrally located cervical epidural abscess: A comparative analysis between patients aged 18–64 years and ≥65 years

BackgroundWe aimed to compare the clinical course of patients aged 18–65 years and ≥65years who underwent anterior cervical discectomy and fusion (ACDF) or corpectomy for ventrally located CSEA. MethodsClinical and imaging data were retrospectively collected from the institutional database between September 2005 and December 2021. ResultsA total of 35 and 26 patients aged 18–64 and ≥ 65 years, respectively who were diagnosed with ventrally located CSEA were included. The overall mean age was 63.9 ± 3.2 years, with a predominance of the male sex (n = 43/61, 70.5%). Patients aged ≥65 years presented with significantly higher rates of comorbidities (10.3 ± 2.8), as indicated by the CCI, than their younger counterparts (18–64 years: 6.2 ± 2.6; p < 0.001). No differences in the surgical approach or characteristics were observed among the groups. Notably, patients aged ≥65 years had a significantly longer intensive care unit as well as overall hospital stay. In-hospital and 90-day mortality were similar across both groups. Following both types of surgery, a significant improvement was observed in the blood infection parameters and neurological status at discharge compared with the baseline measurements. Older age, higher rates of comorbidities, and higher grades of disability were significant predictors for mortality. ConclusionsEmergency surgical evacuation should be undertaken for CSEA in the presence of acute neurological deterioration regardless of the age. Factors, such as age, comorbidities, and neurological status on admission appear to be important predictors of disease outcomes. However, the risk profile of younger patients should not be underestimated.

High prevalence of zero-dose children in underserved and special setting populations in Ethiopia using a generalize estimating equation and concentration index analysis

BackgroundGlobally, according to the World Health Organization (WHO) 2023 report, more than 14.3 million children in low- and middle-income countries, primarily in Africa and South-East Asia, are not receiving any vaccinations. Ethiopia is one of the top ten countries contributing to the global number of zero-dose children.ObjectiveTo estimate the prevalence of zero-dose children and associated factors in underserved populations of Ethiopia.MethodsA cross-sectional vaccine coverage survey was conducted in June 2022. The study participants were mothers of children aged 12–35 months. Data were collected using the CommCare application system and later analysed using Stata version 17. Vaccination coverage was estimated using a weighted analysis approach. A generalized estimating equation model was fitted to determine the predictors of zero-dose children. An adjusted odds ratio (AOR) with 95% confidence interval (CI) and a p-value of 0.05 or less was considered statistically significant.ResultsThe overall prevalence of zero-dose children in the study settings was 33.7% (95% CI: 34.9%, 75.7%). Developing and pastoralist regions, internally displaced peoples, newly formed regions, and conflict-affected areas had the highest prevalence of zero-dose children. Wealth index (poorest [AOR = 2.78; 95% CI: 1.70, 4.53], poorer [AOR = 1.96; 95% CI: 1.02, 3.77]), single marital status [AOR = 2.4; 95% CI: 1.7, 3.3], and maternal age (15–24 years) [AOR = 1.2; 95% CI: 1.1, 1.3] were identified as key determinant factors of zero-dose children in the study settings. Additional factors included fewer than four Antenatal care visits (ANC) [AOR = 1.3; 95% CI: 1.2, 1.4], not receiving Postnatal Care (PNC) services [AOR = 2.1; 95% CI: 1.5, 3.0], unavailability of health facilities within the village [AOR = 3.7; 95% CI: 2.6, 5.4], women-headed household [AOR = 1.3; 95% CI:1.02, 1.7], low gender empowerment [AOR = 1.6; 95% CI: 1.3, 2.1], and medium gender empowerment [AOR = 1.7; 95% CI: 1.2, 2.5].ConclusionIn the study settings, the prevalence of zero-dose children is very high. Poor economic status, disempowerment of women, being unmarried, young maternal age, and underutilizing antenatal or post-natal services are the important predictors. Therefore, it is recommended to target tailored integrated and context-specific service delivery approach. Moreover, extend immunization sessions opening hours during the evening/weekend in the city administrations to meet parents’ needs.

Preoperative serum level of CA153 and a new model to predict the sub-optimal primary debulking surgery in patients with advanced epithelial ovarian cancer

ObjectiveThe aim of this study was to establish a preoperative model to predict the outcome of primary debulking surgery (PDS) for advanced ovarian cancer (AOC) patients by combing Suidan predictive model with HE4, CA125, CA153 and ROMA index.Methods76 AOC Patients in revised 2014 International Federation of Gynecology and Obstetrics (FIGO) stage III-IV who underwent PDS between 2017 and 2019 from Yunnan Cancer Hospital were included. Clinical data including the levels of preoperative serum HE4, CA125, CA153 and mid-lower abdominal CT-enhanced scan results were collected. The logistics regression analysis was performed to find factors associated with sub-optimal debulking surgery (SDS). The receiver operating characteristic curve was used to evaluate the predictive performances of selected variables in the outcome of primary debulking surgery. The predictive index value (PIV) model was constructed to predict the outcome of SDS.ResultsOptimal surgical cytoreduction was achieved in 61.84% (47/76) patients. The value for CA125, HE4, CA153, ROMA index and Suidan score was lower in optimal debulking surgery (ODS) group than SDS group. Based on the Youden index, which is widely used for evaluating the performance of predictive models, the best cutoff point for the preoperative serum HE4, CA125, CA153, ROMA index and Suidan score to distinguish SDS were 431.55 pmol/l, 2277 KU/L, 57.19 KU/L, 97.525% and 2.5, respectively. Patients with PIV≥5 may not be able to achieve optimal surgical cytoreduction. The diagnostic accuracy, NPV, PPV and specificity for diagnosing SDS were 73.7%, 82.9%, 62.9% and 72.3%, respectively. In the constructed model, the AUC of the SDS prediction was 0.770 (95% confidence interval: 0.654-0.887), P<0.001.ConclusionPreoperative serum CA153 level is an important non-invasive predictor of primary SDS in advanced AOC, which has not been reported before. The constructed PIV model based on Suidan's predictive model plus HE4, CA125, CA153 and ROMA index can noninvasively predict SDS in AOC patients, the accuracy of this prediction model still needs to be validated in future studies.

Predicting COVID-19 cases in Belo Horizonte-Brazil taking into account mobility and vaccination issues.

The pandemic caused millions of deaths around the world and forced governments to take drastic measures to reduce the spread of Coronavirus. Understanding the impact of social distancing measures on urban mobility and the number of COVID-19 cases allows governments to change public policies according to the evolution of the pandemic and plan ahead. Given the increasing rates of vaccination worldwide, immunization data may also represent an important predictor of COVID-19 cases. This study investigates the impact of urban mobility and vaccination upon COVID-19 cases in Belo Horizonte, Brazil using Prophet and ARIMA models to predict future outcomes. The developed models generated projections fairly close to real numbers, and some inferences were drawn through experimentation. Brazil became the epicenter of the COVID-19 epidemic shortly after the first case was officially registered on February 25th, 2020. In response, several municipalities adopted lockdown (total or partial) measures to minimize the risk of new infections. Here, we propose prediction models which take into account mobility and vaccination data to predict new COVID-19 cases.

Association of carotid atherosclerosis markers with all-cause and cardiovascular disease-specific mortality in persons with type 2 diabetes: a causal mediation analysis with glucose variation.

Glucose variation (GV) is independently associated with mortality in patients with diabetes. However, no study has examined the effects of carotid atherosclerosis markers on mortality after considering GV. Our purpose is to investigate the independent effects of carotid atherosclerosis markers in persons with type 2 diabetes (T2DM) after considering GV and the mediation effects of carotid atherosclerosis markers on associations between GV with cardiovascular disease (CVD) mortality. This study is a retrospective cohort study including 3628 persons with T2DM who were admitted to a medical center between January 01, 2001 and October 31, 2021. GV was defined as a coefficient of variation (CV) of repeated measurements within a year before the index date (date of first IMT assessment). Carotid atherosclerosis markers included intima-media thickness (IMT), plaque, and stenosis. The outcomes consisted of all-cause and expanded cardiovascular disease (CVD) mortality. Cox proportional hazards models were applied. Among the participants, 286 (7.9%) had IMT ≥ 2mm, 2834 (78.1%) had carotid plaque, and 464 (12.8%) had carotid stenosis ≥ 50%. When GV was considered, IMT, carotid plaque, and carotid stenosis were significant factors for all-cause mortality (except IMT considering HbA1c-CV) and expanded CVD mortality. IMT was a significant mediator in the associations of fasting plasma glucose (FPG)-CV with all-cause and expanded CVD mortality (2 and 3.19%, respectively), and carotid stenosis was a significant mediator in the association between FPG-CV and expanded CVD mortality (3.83%). Our statistical evaluations show suggests that carotid atherosclerosis markers are important predictors of CVD mortality in persons with T2DM if GV is considered. In addition, IMT and carotid stenosis were significant mediators in the association between GV and mortality.

Outcomes Following Pelvic Exenteration for Locally Recurrent Rectal Cancer With and Without En Bloc Sacrectomy.

Extended radical resection is often the only chance of cure for locally recurrent rectal cancer. Recurrence in the posterior compartment often necessitates en bloc sacrectomy as part of pelvic exenteration to obtain clear resection margins and provide survival benefit. To compare oncological outcomes, morbidity, and quality-of-life outcomes following pelvic exenteration with and without en bloc sacrectomy for recurrent rectal cancer. Comparative cohort study with retrospective analysis of prospectively collected data. This study was conducted at a high-volume pelvic exenteration center. Patients who underwent pelvic exenteration for locally recurrent rectal cancer between 1994 and 2022. Overall survival, postoperative morbidity, R0 resection margin, and quality-of-life outcomes. Of 965 patients, 305 (31.6%) underwent pelvic exenteration for locally recurrent rectal cancer. Among these patients, 64.3% were men and the median age was 62 years (range, 29-86). One hundred eighty-five patients (60.7%) underwent en bloc sacrectomy, 65 (35.1%) underwent high transection, and 119 (64.3%) had sacrectomy below S2. R0 resection was achieved in 80% of patients with sacrectomy and 72.5% of patients without sacrectomy. Sacrectomy patients experienced more postoperative complications without increased mortality. The median overall survival was 52 months; median survival was 47 months with sacrectomy and 73 months without ( p = 0.059). Quality-of-life scores were not significantly different across physical component ( p = 0.346), mental component ( p = 0.787), or Functional Assessment of Cancer Therapy-Colorectal ( p = 0.679) scores at 24-month follow-up. The generalizability of these findings may be limited outside of subspecialist exenteration units. Selection bias exists in a retrospective analysis. Patients undergoing pelvic exenteration with and without en bloc sacrectomy for locally recurrent rectal cancer experience similar rates of R0 resection, survival, and quality-of-life outcomes. As R0 remains the most important predictor of survival, the requirement of sacral resection should prompt referral to a subspecialist center that performs sacrectomy routinely. See Video Abstract . ANTECEDENTES:La resección radical ampliada es generalmente la única posibilidad de curación para el cáncer de recto con recurrencia local. La recurrencia en el compartimento posterior generalmente requiere sacrectomía en bloque como parte de la exenteración pélvica para obtener márgenes de resección claros y proporcionar un beneficio de supervivencia.OBJETIVO:Comparar los resultados oncológicos, de morbilidad y de calidad de vida después de la exenteración pélvica con y sin sacrectomía en bloque para el cáncer de recto recurrente.DISEÑO:Estudio de cohorte comparativo con análisis retrospectivo de datos recopilados prospectivamente.AMBIENTE AJUSTE:Estudio realizado en un centro de exenteración pélvica de alto volumen.PACIENTES:Aquellos sometidos a exenteración pélvica por cáncer de recto con recurrencia local entre 1994 y 2022.PRINCIPALES MEDIDAS DE RESULTADO:Supervivencia general, morbilidad posoperatoria, margen de resección R0 y resultados de calidad de vida.RESULTADOS:305 (31,6%) de 965 pacientes se sometieron a exenteración pélvica por cáncer de recto con recurrencia local. El 64,3% de los pacientes eran hombres con una mediana de edad de 62 años (rango 29-86). 185 pacientes (60,7%) fueron sometidos a sacrectomía en bloque, 65 (35,1%) fueron sometidos a transección alta, 119 (64,3%) tuvieron sacrectomía por debajo de S2. La resección R0 se logró en el 80% de los pacientes con sacrectomía y en el 72,5% sin ella. Los pacientes de sacrectomía experimentaron más complicaciones postoperatorias sin aumento de la mortalidad. La mediana de supervivencia global fue de 52 meses, 47 meses con sacrectomía y 73 meses sin sacrectomía ( p = 0,059). Las puntuaciones de calidad de vida no fueron significativamente diferentes entre las puntuaciones del componente físico ( p = 0,346), componente mental ( p = 0,787) o la evaluación funcional de la terapia contra el cáncer - colorrectal ( p = 0,679) a los 24 meses de seguimiento.LIMITACIONES:La generalización de estos hallazgos puede estar limitada fuera de las unidades de exenteración de subespecialistas. Existe un sesgo de selección en un análisis retrospectivo.CONCLUSIONES:Los pacientes sometidos a exenteración pélvica con y sin sacrectomía en bloque por cáncer de recto con recurrencia local experimentan tasas similares de resección R0, supervivencia y resultados de calidad de vida. Como R0 sigue siendo el predictor más importante de supervivencia, la necesidad de resección sacra debe provocar la derivación a un centro subespecialista que realice sacrectomía de forma rutinaria. (Traducción-Dr. Fidel Ruiz Healy ).

1 km of living area: age differences in the association between neighborhood environment perception and self-rated health among Chinese people

ObjectivesThis study aimed to explore the age differences in the relationship between neighborhood environment perception and self-rated health among Chinese people.Study designThis is cross-sectional study.MethodsThe participants were 2,631 residents aged 18 and above from 2021 Chinese General Social Survey (CGSS). Self-rated health was reported by residents. Neighborhood environment was measured by respondents’ subjective perception of 1 km living area. Ordered logit regression models were used to examine the relationship between neighborhood environment perception and self-rated health.ResultsIn summary, 42.08% were classified as young adults, and 57.92% were classified as middle-aged and older adults. Young adults with higher perception of neighborhood social environment were more likely to perceive good health. Neighborhood built environment was significantly associated with self-rated health among middle-aged and older adults.ConclusionThe neighborhood environment is an important predictor of the health of its residents. Neighborhood environmental modifications should be tailored to meet the needs of different age groups, promoting health equity.

The impact of contrast retention on thrombus formation risks in patients with atrial fibrillation: A numerical study

BackgroundContrast retention (CR) is an important predictor of left atrial appendage thrombus (LAAT) and stroke in patients with non-valvular atrial fibrillation (AF). We sought to explore the underlying mechanisms of CR using computational fluid dynamic (CFD) simulations. MethodsA total of 12 patients with AF who underwent both cardiac computed tomography angiography (CTA) and transesophageal echocardiography (TEE) before left atrial appendage occlusion (LAAO) were included in the study. The patients were allocated into the CR group or non-CR group based on left atrial appendage (LAA) angiography. Patient-specific models were reconstructed to evaluate time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), relative residence time (RRT), and endothelial cell activation potential (ECAP). Additionally, the incidence of thrombosis was predicted using residence time (RT) at different time-points. ResultsTAWSS was lower [median (Interquartile Range) 0.27 (0.19–0.47) vs 1.35 (0.92–1.79), p < 0.001] in LAA compared to left atrium. In contrast, RRT [1438 (409.70–13869) vs 2.23 (1.81–3.14), p < 0.001] and ECAP [122.70 (30.01–625.70) vs 0.19 (0.16–0.27), p < 0.001)] was higher in the LAA. The patients in the CR group had significantly higher RRT [(mean ± SD) 16274 ± 11797 vs 639.70 ± 595.20, p = 0.009] and ECAP [610.80 ± 365.30 vs 54.26 ± 54.38, p = 0.004] in the LAA compared to the non-CR group. Additionally, patients with CR had a wider range of thrombus-prone regions [0.44(0.27–0.66)% vs 0.05(0.03–0.27)%, p = 0.009] at the end of the 15th cardiac cycle. ConclusionsThese findings suggest that CR might be an indicator of high-risk thrombus formation in the LAA. And CT-based CFD simulation may be a feasible substitute for the evaluation of LAA thrombotic risk in patients with AF, especially in patients with CR.

COVID-19 and COVID-19 vaccination experiences and perceptions and their predictors among community members during the COVID-19 pandemic in Ebonyi state, Nigeria: an analytical cross-sectional study

BackgroundCOVID-19 is still a disease of global public health importance which requires long term application of control measures as millions of new infections or re-infections and thousands of related deaths still occur worldwide and the risk of an upsurge from new strains of the virus continues to be a threat. The decrease in the use of and non-use of preventive public health measures are among the factors fuelling the disease. The (previous) experiences and perceptions of people regarding the COVID-19 pandemic, COVID-19 vaccination, and the vaccination process are factors that will influence subsequent use of preventive/control measures. We explored the COVID-19 and COVID-19 vaccination and the vaccination process experiences and perceptions, and their predictors, among the community members in Ebonyi state, Nigeria.MethodsWe conducted an analytical cross-sectional study between March 12 and May 9, 2022 among all consenting/assenting community members aged 15 years and above in 28 randomly selected geographical clusters. A structured interviewer-administered electronic questionnaire in KoBoCollect installed in android devices was used to collect data which was analysed using descriptive statistics and bivariate and multivariate generalized estimating equations.ResultsOf the 10,825 community members surveyed: only 31.6% had strong COVID-19 experience and perception, 72.2% had good COVID-19 vaccination expectation and perception, and only 54.2% had positive COVID-19 vaccination process experience and perception. The most important predictors of the extent/level of COVID-19 and COVID-19 vaccination and the vaccination process experiences and perceptions were level of attitude towards COVID-19 and COVID-19 vaccination and level of knowledge about COVID-19. Other important predictors were marital status, educational level, and main occupation.ConclusionsThis study’s evidence, including the identified predictors, will inform subsequent policy actions regarding COVID-19 in the strategies to improve the COVID-19 and COVID-19 vaccination and the vaccination process experiences and perceptions of community members (and their use of preventive/control measures) in Ebonyi state and Nigeria, and other similar contexts. It will also inform future policy actions/strategies regarding similar diseases.

Unraveling the Influence of Age, IQ, Education, and Negative Symptoms on Neurocognitive Performance in Schizophrenia: A Conditional Inference Tree Analysis.

The complex nature of neurocognitive impairment in schizophrenia has been discussed in light of the mixed effects of antipsychotic drugs, psychotic symptoms, dopamine D2 receptor blockade, and intelligence quotient (IQ). These factors have not been thoroughly examined before. This study conducted a comprehensive re-analysis of the CATIE data using machine learning techniques, in particular Conditional Inference Tree (CTREE) analysis, to investigate associations between neurocognitive functions and moderating factors such as estimated trough dopamine D2 receptor blockade with risperidone, olanzapine, or ziprasidone, Positive and Negative Syndrome Scale (PANSS), and baseline IQ in 573 patients with schizophrenia. The study reveals that IQ, age, and education consistently emerge as significant predictors across all neurocognitive domains. Furthermore, higher severity of PANSS-negative symptoms was associated with lower cognitive performance scores in several domains. CTREE analysis, in combination with a genetic algorithm approach, has been identified as particularly insightful for illustrating complex interactions between variables. Lower neurocognitive function was associated with factors such as age>52 years, IQ<94/95,<12/13 education years, and more pronounced negative symptoms (score<26). These findings emphasize the multifaceted nature of neurocognitive functioning in patients with schizophrenia, with the PANSS-negative score being an important predictor. This gives rise to a role in addressing negative symptoms as a therapeutic objective for enhancing cognitive impairments in these patients. Further research must examine nonlinear relationships among various moderating factors identified in this work, especially the role of D2 occupancy.

Burnout and attachment in oncology and palliative care healthcare professionals

ObjectivesExamine the prevalence of burn-out in health professionals working in a hospital dedicated to patients with cancer. Explore the relationship between attachment style and burn-out in healthcare professionals working in...

Determinants of non-alcoholic fatty liver disease in young people: Maternal, neonatal, and adolescent factors.

To assess the impact of maternal, neonatal, and adolescent factors on the development of non-alcoholic fatty liver disease (NAFLD) in a cohort of 14- to 19-year-old adolescents. This study is part of the Early Vascular Ageing in the YOUth study, a single-center cross-sectional study conducted in western Austria. Maternal and neonatal factors were extracted from the mother-child booklet, adolescent factors were evaluated by a face-to-face interview, physical examination, and fasting blood analyses. Liver fat content was assessed by controlled attenuation parameter (CAP) using signals acquired by FibroScan® (Echosense, Paris, France). The association of maternal, neonatal, and adolescent factors with CAP values was analyzed using linear regression models. In total, 595 adolescents (27.2% male) aged 17.0 ± 1.3 years were included. 4.9% (n = 29) showed manifest NAFLD with CAP values above the 90th percentile. Male sex (p < 0.001), adolescent triglyceride levels (p = 0.021), Homeostatic Model Assessment for Insulin Resistance index and BMI z-score (p < 0.001, each) showed a significant association with liver fat content in the multivariable analysis. Maternal pre-pregnancy BMI was associated with CAP values after adjustment for sex, age, and birth weight for gestational age (p < 0.001), but this association was predominantly mediated by adolescent BMI (indirect effect b = 1.18, 95% CI [0.69, 1.77]). Components of the metabolic syndrome were the most important predictors of adolescent liver fat content. Therefore, prevention of NAFLD should focus on lifestyle modification in childhood and adolescence.