Main Independent Factors Research Articles

Prevalence Rates of Abdominal Obesity, High Waist-to-Height Ratio and Excess Adiposity, and Their Associated Cardio-Kidney-Metabolic Factors: SIMETAP-AO Study.

In addition to obesity, adiposity and abdominal obesity (AO) are parameters included in the cardiovascular-kidney-metabolic (CKM) syndrome. However, their prevalence and association with the other CKM factors have been less studied. Our study aimed to determine the prevalence rates of AO, high waist-to-height ratio (WtHR), and excess adiposity (EA), and to compare their associations with CKM factors. A cross-sectional observational study was conducted with a random population-based sample of 6,588 study subjects between 18 and 102 years of age. Crude and sex- and age-adjusted prevalence rates of AO, high-WtHR, and EA were calculated, and their associations with CKM variables were assessed by bivariate and multivariate analyses. The adjusted prevalence rates for AO, high-WtHR, and EA were 39.6% (33.6% in men; 44.9% in women), 30.6% (31.1% in men; 30.6% in women), and 65.6% (65.6% in men; 65.3% in women), respectively, and they increased with age. The main independent factors associated with AO, high-WtHR, and EA were hypertension, diabetes, prediabetes, low HDL-C, hypercholesterolaemia, hypertriglyceridemia, physical inactivity, hyperuricemia, and chronic kidney disease. Two-thirds of the adult population have EA, one-third have AO, and one-third have high-WtHR. These findings support that the other factors of CKM syndrome, in addition to hyperuricemia and physical inactivity, show an independent association with these adiposity-related variables.

Factors associated with the rabies vaccination status of dogs in households in Beni City, D.R. Congo.

Human rabies transmitted by dogs still kills thousands of people each year worldwide. Dog bites are common in the city of Beni (Democratic Republic of Congo), which shows low rabies vaccination coverage. This study aimed to determine the factors associated with the rabies vaccination status of dogs. A cross-sectional analytical study was conducted in the town of Beni among dog owners, during a household survey selected using a multistage sampling. The information sought concerned the knowledge and characteristics of the dog owners as well as the vaccination status of these dogs. Logistic regression was used to investigate associations between the vaccination status of the dogs and the main independent factors. Rabies vaccination coverage in Beni was 26% (95% confidence interval [CI]: 22% - 30%). The main factors associated with the rabies vaccination status of the dog were primary education level of household head (adjusted odds ratio [aOR]:4.8; 95% CI: 1.2- 19.8); university education level of household head (aOR: 5.9; 95% CI: 1.6-22); perceived rabies severity (aOR: 44. 4; 95% CI: 10.4-188), having more than one dog in the household (aOR: 2.6; 95% CI: 1.6-4.3); age range 7-12 months (aOR: 0.2; 95% CI: 0.1-0.6) and confined dog breeding (aOR: 3.9; 95% CI: 1.1-14.9). The low vaccination coverage in Beni requires mass vaccination campaigns against canine rabies targeting the dog owners with low education levels, those raising more than one dog, with stray dogs or dogs less than 12 months old.

Atrial Fibrillation Prevalence Rates and Its Association with Cardiovascular-Kidney-Metabolic Factors: SIMETAP-AF Study.

Background and Objectives: Atrial fibrillation (AF) is the most frequent arrhythmia and the main cause of hospital admissions for cardioembolic stroke. The SIMETAP research project aims to update the prevalence rates of cardiovascular, renal, or metabolic factors and to evaluate their respective associations with factors that could be related. The present study aims to assess the AF prevalence rates in an adult population and its association with cardiovascular-kidney-metabolic (CKM) factors. Materials and Methods: This cross-sectional observational study was conducted in a primary care setting, with a population-based random sample of 6588 people aged 18.0-102.8 years. Crude and adjusted prevalence rates of AF were calculated. The associations of CKM factors with AF were assessed using bivariate and multivariate analysis. Results: The age- and sex-adjusted prevalence rates of AF were 2.9% in the overall adult population, 6.1% in the population aged ≥50 years, and 12.9% in the population aged ≥70 years, with no significant differences by sex. AF prevalence in the population under 50 years of age barely reached 1‰. Heart failure (HF), hypertension, chronic kidney disease (CKD), stroke, low HDL-cholesterol, and prediabetes were independent CKM factors associated with AF in the overall population, as were the same factors, except prediabetes, in the population ≥50 years old (p < 0.001). High or very high vascular risk was present in 92.4% [95% CI: 89.1-95.7]) of the population with AF. Conclusions: The adjusted prevalence rate of AF in the population aged 50 years or older was 6.1%, twice that of the overall adult population and half that of the population aged 70 years or older. The main independent CKM factors associated with AF were HF, stroke, CKD, hypertension, and low HDL-cholesterol.

Compliance with antibiotic therapy guidelines in french paediatric intensive care units: a multicentre observational study

BackgroundBacterial infections (BIs) are widespread in ICUs. The aims of this study were to assess compliance with antibiotic recommendations and factors associated with non-compliance.MethodsWe conducted an observational study in eight French Paediatric and Neonatal ICUs with an antimicrobial stewardship programme (ASP) organised once a week for the most part. All children receiving antibiotics for a suspected or proven BI were evaluated. Newborns < 72 h old, neonates < 37 weeks, age ≥ 18 years and children under surgical antimicrobial prophylaxis were excluded.Results139 suspected (or proven) BI episodes in 134 children were prospectively included during six separate time-periods over one year. The final diagnosis was 26.6% with no BI, 40.3% presumed (i.e., not documented) BI and 35.3% documented BI. Non-compliance with antibiotic recommendations occurred in 51.1%. The main reasons for non-compliance were inappropriate choice of antimicrobials (27.3%), duration of one or more antimicrobials (26.3%) and length of antibiotic therapy (18.0%). In multivariate analyses, the main independent risk factors for non-compliance were prescribing ≥ 2 antibiotics (OR 4.06, 95%CI 1.69–9.74, p = 0.0017), duration of broad-spectrum antibiotic therapy ≥ 4 days (OR 2.59, 95%CI 1.16–5.78, p = 0.0199), neurologic compromise at ICU admission (OR 3.41, 95%CI 1.04–11.20, p = 0.0431), suspected catheter-related bacteraemia (ORs 3.70 and 5.42, 95%CIs 1.32 to 15.07, p < 0.02), a BI site classified as “other” (ORs 3.29 and 15.88, 95%CIs 1.16 to 104.76, p < 0.03), sepsis with ≥ 2 organ dysfunctions (OR 4.21, 95%CI 1.42–12.55, p = 0.0098), late-onset ventilator-associated pneumonia (OR 6.30, 95%CI 1.15–34.44, p = 0.0338) and ≥ 1 risk factor for extended-spectrum β-lactamase-producing Enterobacteriaceae (OR 2.56, 95%CI 1.07–6.14, p = 0.0353). Main independent factors for compliance were using antibiotic therapy protocols (OR 0.42, 95%CI 0.19–0.92, p = 0.0313), respiratory failure at ICU admission (OR 0.36, 95%CI 0.14–0.90, p = 0.0281) and aspiration pneumonia (OR 0.37, 95%CI 0.14–0.99, p = 0.0486).ConclusionsHalf of antibiotic prescriptions remain non-compliant with guidelines. Intensivists should reassess on a day-to-day basis the benefit of using several antimicrobials or any broad-spectrum antibiotics and stop antibiotics that are no longer indicated. Developing consensus about treating specific illnesses and using department protocols seem necessary to reduce non-compliance. A daily ASP could also improve compliance in these situations.Trial RegistrationClinicalTrials.gov: number NCT04642560. The date of first trial registration was 24/11/2020.

Revealing the role of early peripancreatic bacterial contamination and Enterococcus faecalis in pancreatic fistula development after pancreaticoduodenectomy: Implications for useful antibiotic prophylaxis–An observational cohort study

BackgroundPeripancreatic bacterial contamination (PBC) is a critical factor contributing to the development of clinically relevant postoperative pancreatic fistula (CR-POPF) following pancreaticoduodenectomy (PD). Controlling pathogenic bacteria is essential in preventing CR-POPF; however, the precise relationship between specific bacteria and CR-POPF remains unclear. This study aimed to investigate the relationship between PBC and CR-POPF after PD, with a focus on identifying potentially causative bacteria. MethodsThis prospective observational study enrolled 370 patients who underwent PD. Microbial cultures were routinely collected from peripancreatic drain fluid on postoperative days (PODs) 1, 3, and 6. Predictive factors for CR-POPF and the bacteria involved in PBC were investigated. ResultsCR-POPF occurred in 86 (23.2%) patients. In multivariate analysis, PBC on POD1 (Odds ratio [OR] = 3.59; P = 0.005) was one of the main independent predictive factors for CR-POPF, while prophylactic use of antibiotics other than piperacillin/tazobactam independently influenced PBC on POD1 (OR = 2.95; P = 0.010). Notably, Enterococcus spp., particularly Enterococcus faecalis, were significantly isolated from PBC in patients with CR-POPF compared to those without CR-POPF on PODs 1 and 3 (P < 0.001), and they displayed high resistance to all cephalosporins. ConclusionsEarly PBC plays a pivotal role in the development of CR-POPF following PD. Prophylactic antibiotic administration, specifically targeting Enterococcus faecalis, may effectively mitigate early PBC and subsequently reduce the risk of CR-POPF. This research sheds light on the importance of bacterial control strategies in preventing CR-POPF after PD.

Automated and app-based activation of first responders for prehospital cardiac arrest: an analysis of 16.500 activations of the KATRETTER system in Berlin

BackgroundBystander CPR is one of the main independent factors contributing to better survival after out-of-hospital cardiac arrest. Simultaneously, the rate of bystander CPR in Germany is below the European average. First responder applications (apps) contribute to reducing the time period without CPR (no-flow time) until professional help can arrive on-scene.MethodsThe KATRETTER app was introduced in Berlin as one of the first apps in Europe which do not require any medical qualifications to register as a first responder. The activation of volunteer first responders for suspected cardiac arrest cases through the Berlin Emergency Medical Services integrated control center was evaluated based on data collected between 16 Oct 2020 and 16 Oct 2022. Our descriptive analysis includes the number of registered first responders, number of activations, the number and percentages of accepted activations, as well as all reports where first responders arrived at the scene.ResultsAs of 15 Oct 2022, a total of 10,102 first responders were registered in the state of Berlin. During this specified period, there were 16.505 activations of the system for suspected out-of-hospital cardiac arrest. In 38.4% of the accepted cases, first responders documented patient contact, and in 34.6% of cases with patient contact, CPR was performed. Only 2% of registered first responders did not have any medical qualifications.ConclusionsSmartphone-based first responder applications should not be understood as a means of alerting professional help, but rather like a digitally amplified “call for help” in the vicinity of an emergency location. A large number of first responders can be recruited within 24 months, without large-scale public relations work necessary. No qualifications were required to become a first responder, contributing to a low-threshold registration process with the effect of a more widespread distribution of the app and cost reduction during implementation.

Predictive factors of non-completion of cytoreductive surgery in colorectal peritoneal metastasis

IntroductionCytoreductive surgery (CRS) ± hyperthermic intraperitoneal chemotherapy (HIPEC) is the only potentially curative treatment that can improve the survival prognosis for patients with peritoneal metastasis (PM) of colorectal origin. The main independent prognostic factors are extent of disease, as measured by the Peritoneal Cancer Index (PCI), and completion of CRS (CC-0 or R1). Despite thorough preoperative work-up for selection of surgical candidates, 20%–25 % of CRS procedures are stopped after exploration during laparotomy. These patients undergo “open-and-close” procedures associated with a risk of complications and without any benefit.The aim of this study was to identify preoperative predictors of non-resectability and/or non-completion of CRS in patients with colorectal PMs who were candidates for surgery. Materials and methodsRetrospective, monocentric study including patients admitted for CRS ± HIPEC at the Jules Bordet Institute between January 01, 2010 and December 31, 2021. The preoperative epidemiological, pathological, clinical, radiological, and biological features of patients with unresectable disease were compared with those of patients treated with CRS. ResultsOne hundred nineteen patients were included, 60 men and 59 women (median age 61 years). Twenty-one CRS procedures (17.65 %) were stopped during exploratory laparotomy. Statistically significant factors associated with non-completion were age (p = 0.0183), PCI (p = 0.0001), presence of sub/occlusive episode(s) prior to CRS (p = 0.0012), and multifocal-diffuse uptakes on PET-scan (p = 0.0017). ConclusionAlmost 18 % of patients had an “open-and-close” procedure. PCI was the major determinant of non-completion of CRS. Other predictive factors of unresectability of colorectal PM were age, the presence of sub/occlusive episodes, and PET/CT with multiple peritoneal uptakes.

Investigation of constructive and technological parameters of an energy-efficient screw oil press

The article presents the investigation of constructive and technological parameters of an energy-efficient screw oil press. It is outlined the principle of operation of an energy-efficient screw oil press. The construction of the oil press is improved by the steam atomizer that is installed in the receiving hopper under the rifled rollers for moisture-thermal treatment with steam, which is completed with the heat exchanger, heating element, expansion tank and hydro group. Also, a steam generator connected to a steam atomizer which is embodied into the receiving hopper. It was analyzed the influence of the optimization criteria (oil yield, energy consumption and press productivity) on the efficiency of the technological process. These optimization criteria depend on the main independent factors: the length of the reception and preparation chamber, the material (sunflower pulp) moisture; the heating temperature, the screw rotation speed, the linear speed of movement of screw shaft turns. The optimal constructive and technological parameters of energy-efficient screw oil press are considered. The energy-efficient screw oil press refers to the equipment of the oil enterprises of small productivity and due to its design, it allows to use a simple technological scheme of oil pressing and to reduce the amount of energy and resources spent on the technological process in the context of use in sustainable food systems.

Metu Students’ College Life Satisfaction

The research was conducted to identify the factors that influence college students' satisfaction with their college experience. Firstly, the study was focused on the literature review to determine relevant factors that have been previously studied in the literature. Then, the survey analysis examined three main independent factors that have been found to be related to college students' satisfaction: Major Satisfaction, Social Self-Efficacy, and Academic Performance. The findings of the study suggested that the most important factor affecting students' satisfaction with their college experience is their satisfaction with their chosen major. This means that students who are satisfied with the major they have chosen are more likely to be overall satisfied with their college experience. It's worth noting that, while the study found that major satisfaction is the most crucial factor, it doesn't mean that other factors such as Social Self-Efficacy, Academic Performance, and Campus Life Satisfaction are not important. Based on these findings, it is recommend that students prioritize their major satisfaction when making college choices in order to maximize their overall satisfaction with their college experience.

Sex, cognitive state and falls as factors associated with malnutrition: a cross-sectional study of institutionalized older adults living in a rural area of Portugal

BackgroundMalnutrition is an underestimated geriatric problem, with a high prevalence in institutionalized older adults. The identification of risk factors for malnutrition in elderly individuals must be a priority for governmental organizations worldwide.MethodsA total of 98 institutionalized seniors were enrolled in a cross-sectional study. For the assessment of risk factors, sociodemographic characteristics and health-related information were collected. The Mini-Nutritional Assessment Short-Form test was used to assess malnutrition in the sample population.ResultsA significantly greater proportion of women than men were malnourished or at risk of malnutrition. In addition, the comparative analysis revealed that comorbidity, arthritis, balance impairment, dementia and fall episodes with serious injuries were significantly more frequent in the older adults categorized as malnourished or at risk of malnutrition than in those categorized as well-nourished.ConclusionsMultivariable regression analysis revealed that being female, having a poor cognitive status and experiencing falls with injuries are the main independent factors influencing nutritional status in institutionalized older adults living in a rural area of Portugal.

A Comparison between Postoperative Troponin Elevation in An Off-pump Versus Conventional Coronary Artery Bypass Graft in Predicting The Short-term Outcome

Background: Although, advancements in techniques and perioperative management in coronary artery bypass surgery the elevation of postoperative troponin still occurs commonly. In this regard, we aimed to assess the degree of myocardial injury by measuring and comparing the levels of cardiac troponin I in the postoperative period of conventional versus off-pump coronary artery bypass graft and identify the most associated factors. Patients and methods: This prospective cohort study included the patients who underwent conventional coronary artery bypass surgery (46 patients) and off-pump coronary artery bypass surgery (34 patients), at Azadi heart Center in Duhok province during the period between 25th November 2021 and 25th May 2022. Results: The total amount of cardiac troponin release was significantly higher in the conventional than in the off-pump group. At one hour, the conventional means was 7.13 ng/ml while the off-pump was 1.56 ng/ml, p &lt; 0.0001and at 24 hours, the convention mean was 5.51 ng/ml while the off-pump was 1.24 ng/ml, p &lt; 0.001. The most associated factors in the conventional compared to the off-pump were advanced age, male gender, hypertension, renal impairment, Previous myocardial infarction, and timing of surgery. the main independent factors associated with cardiac troponin I elevation within 24 hours following conventional coronary artery bypass surgery were overweight, chronic renal failure, Smoking, and urgent procedure status. Conclusion: This study showed that the patients who underwent the conventional group had significantly higher levels of troponin I at 1 hour and 24 hrs, postoperatively. The higher postoperative troponin I among patients who underwent the conventional group was associated with being overweight, smoking, having chronic renal failure, and using urgent procedure status

Design of Axially Symmetric Fluid–Spring Vibration Absorber with Five DOFs Based on Orthogonal Experiment

The strong and complex vibration from a manipulator for anchor drilling will damage the key components of the manipulator and produce noise at the same time. According to its vibration characteristics, a fluid–spring vibration absorption approach with five degrees of freedom (DOFs) is proposed, which has perfect symmetry, and a vibration absorber was designed with a symmetrical structure. Employing the generalization formula of the Bernoulli equation and dynamic equation, a fluid–spring coupling damping coefficient equation was constructed. Vibration transmissibility was used as the evaluation index of vibration absorption performance. The elastic coefficients of the tension spring and torsion spring, the area ratio of circular through-holes to the vibration-absorbing plate, and the radius of circular through-holes were the main independent factors influencing the damping coefficients. An orthogonal experiment with four factors and four levels was designed. Using FLUENT and SIMULATION to implement joint simulations, the distribution law of the flow fields and the damping coefficients of each approach were obtained, and then the best combination of factors was selected. Taking a manipulator used for anchor drilling in Huainan of China as a case study, using the designed fluid–spring vibration absorber, the vibration displacements in the five DOFs were reduced by 68.32%, 49.82%, 52.17%, 49.01%, and 57.09% respectively, indicating a good vibration absorption performance with symmetry about the z→-axis.

Real life long-term efficacy and safety of rhGH therapy in children with SHOX deficiency.

This Italian survey aims to evaluate real-life long-term efficacy and safety of rhGH therapy in children with short stature homeobox-containing gene deficiency disorders (SHOX-D) and to identify potential predictive factors influencing response to rhGH therapy. This is a national retrospective observational study collecting anamnestic, anthropometric, clinical, instrumental and therapeutic data in children and adolescents with a genetic confirmation of SHOX-D treated on rhGH. Data were collected at the beginning of rhGH therapy (T0), yearly during the first 4 years of rhGH therapy (T1, T2, T3, T4) and at near-final height (nFH) (T5), when available. 117 SHOX-D children started rhGH therapy (initial dose 0.23 ± 0.04 mg/kg/week) at a mean age of 8.67 ± 3.33years (74% prepubertal), 99 completed the 1st year of treatment, and 46 reached nFH. During rhGH therapy, growth velocity (GV) SDS and height (H) SDS improved significantly. Mean H SDS gain from T0 was +1.14±0.58 at T4 and +0.80 ± 0.98 at T5. Both patients carrying mutations involving intragenic SHOX region (group A) and ones with regulatory region defects (group B) experienced a similar beneficial therapeutic effect. The multiple regression analysis identified the age at the start of rhGH treatment (β -0.31, p = 0.030) and the GV during the first year of rhGH treatment (β 0.45, p = 0.008) as main independent predictor factors of height gain. During rhGH therapy, no adverse event of concern was reported. Our data confirm the efficacy and safety of rhGH therapy in SHOX-D children, regardless the wide variety of genotype.

Head-and-neck dermatofibrosarcoma protuberans: Survival analysis and Clinically relevant immunohistochemical indicators.

Head and neck dermatofibrosarcoma protuberans (HNDFSP) is extremely rare and not entirely understood. To investigate the clinicopathological features of HNDFSP and identify the expression of its clinically relevant indicators, with the expectation of improving the existing treatment strategies. A long-term follow-up of patients with HNDFSP who received treatment between 2000 and 2021 at Shanghai Ninth People's Hospital was conducted. The clinical, histological, and immunohistochemical data of the patients were retrieved and analyzed. The endpoint of the study was the incidence of significant disease-related clinical events (recurrences or metastasis). A total of 49 patients with HNDFSP were included in the study, with males (92.7%) predominating than females (7.3%). Eighteen patients developed recurrent disease (36.8%) after surgery, and the median time of recurrence was 48months (interquartile, 20-74months). Metastasis occurred in two cases (4.1%). Two patients died during follow-up, both with local recurrence, and one of them with intestinal metastasis. Post-operation radiotherapy was administered to eight patients (16.3%) and the effect in local control was remarkable. Age, tumor size, and negative margins with sufficient safety width were the main independent factors affecting the disease-free survival. Several potential targeted therapeutic indicators, including EZH2 (80.0%), EGFR (91.4%), PDGF (97.1%), PD-L1 (77.1%), and VEGF (77.1%), were positively expressed in most tumor samples. HNDFSP is rare, significantly challenging to control locally, and has a worse prognosis with current treatment strategies. Wide local excision and long-term follow-up are needed. Radiotherapy could improve the prognosis of patients with HNDFSP.

Constructing and Verifying an Alexithymia Risk-Prediction Model for Older Adults with Chronic Diseases Living in Nursing Homes: A Cross-Sectional Study in China.

Alexithymia is a critical global public health concern. This questionnaire-based cross-sectional study explored the risk factors of alexithymia in older adults living in nursing homes with chronic diseases. It also developed and evaluated an alexithymia risk-prediction model. A total of 203 older adults with chronic diseases were selected from seven nursing homes in Changsha, China, using simple random and cluster sampling. The participants were surveyed using the Toronto Alexithymia Scale (TAS-20), Geriatric Depression Scale-15 (GDS-15), Connor-Davidson Resilience Scale (CD-RISC), Perceived Social Support Scale (PSSS), and a socio-demographic characteristics questionnaire. The alexithymia total score was 43.85 ± 9.570, with an incidence rate of 8.9%. Alexithymia had a partial mediating effect on the relationship between social support and psychological resilience (the effect value was 0.12), accounting for 19.04% of the total effect. Gender, depression, and psychological resilience were the main independent influencing factors of alexithymia (p &lt; 0.05). The area under the receiver operating characteristic (AUC-ROC) curve of the risk-prediction model was 0.770. The participants, especially those who were male and depressed, exhibited a certain degree of alexithymia. Additionally, it partially mediated the association between social support and psychological resilience, which is a protective factor against alexithymia. The risk-prediction model showed good accuracy and discrimination. Hence, it can be used for preliminary screening of alexithymia in older adults with chronic diseases living in nursing homes.

Steroid Hormones as Modulators of Emotional Regulation in Male Urogenital Cancers

BackgroundTumors develop within an organism operating in a specific social and physical environment. Cortisol and dehydroepiandrosterone (DHEA), two of the most abundant steroid hormones in humans, are involved in both emotional regulation and the tumor progression. Several studies reported preclinical findings that DHEA can have preventive and therapeutic efficacy in treating major age-associated diseases, including cancer, although the mechanisms of action are not yet defined. The main aim of current study was to investigate the relationship between psychological and physiological emotional regulation and cancer development.MethodThis study assessed the quality of life of urogenital cancer male patients using several validated tools, including the Functional Assessment of Cancer Therapy-General and the Profile of Mood States. Saliva samples were collected to monitor peripheral activity of both cortisol and DHEA. It was hypothesized that patients with a better quality of life would have higher levels of the DHEA/cortisol ratios.ResultsWe found that the quality of life was positively related to DHEA, but not cortisol levels. Negative mood increases were related to lower levels of DHEA. Logistic regression of the predictors of metastases indicated three main independent factors involved: DHEA, age, and cortisol. In other words, the higher the DHEA levels in comparison to cortisol levels, controlling for age, the lower the probability of metastases.ConclusionOur results appear to support the hypothesis that emotional dysregulation mediated by DHEA/cortisol activity is a key factor in the probability of metastasis in urogenital cancers.

Does global longitudinal strain improve stratification risk in heart failure with preserved ejection fraction?

Background: Heart Failure with Preserved Ejection Fraction (HFPEF) accounts for more than half of the cases of heart failure. Long regarded as an abnormality of left ventricular diastolic function, recent studies using longitudinal strain (two-dimensional speckle tracking mode) have suggested that left ventricular longitudinal systolic function is altered in HFPEF. Despite these interesting pathophysiological perspectives, the data in the literature on the prognostic value of the alteration of longitudinal strain are controversial. Given these conflicting results, it is difficult to confirm the magnitude and prevalence of impaired LV longitudinal systolic function in patients with HFPEF and its prognostic relevance. Purposes: This work aims to study the prognostic value of Global the left ventricle’s Global Longitudinal Strain (GLS) Algerian cohort of patients with HFPEF. Patients and methods: We conducted a monocentric prospective observational study from April 2018 to April 2020, with a minimum follow-up of 1 year for each recruited patient. We included patients over the age of 18 referred to the echocardiography laboratory for chronic or acute HFpEF, defined according to the criteria of ESC 2016. 153 consecutive patients underwent clinical examination, biological tests, and echocardiography with measurement of GLS at rest, in addition to routine management by the attending physicians. Results: 153 patients were collected. The average age of our patients is 73 +/- 11 years ranging from 42 to 91 years old. The female population is predominant with a rate of 67%. Comorbidities are predominant mainly by arterial hypertension (86%) and diabetes (64%), with a history of atrial fibrillation (46%). 63% of patients have impaired GLS (&lt; 16%). Contrary to our hypothesis, GLS was not shown to be a powerful predictor of cardiovascular events in HFPEF patients either in dichotomous analysis (OR = 0.79; p = 0.64) or in continuous analysis (OR = 0.97; p = 0.69).We were able to identify that congestive venous signs, anemia, and pulmonary hypertension, are the main independent prognostic factors in our Algerian population study. Conclusion: We were unable to demonstrate the prognostic role of mpaired GLS in our population of patients with HFPEF.

Platelet Aggregation Before Aspirin Initiation in Pediatric Patients With Congenital Heart Disease at High Risk of Thrombosis.

BackgroundAspirin following unfractionated heparin is the most common anticoagulation strategy for pediatric patients who experienced cardiac surgery at high risk of thrombosis. The platelet aggregation test is the golden method to evaluate the aspirin effect on platelet function. However, the platelet aggregation basal status before postoperative aspirin initiation and the related clinical influencing factors hasn't been investigated systemically in this population.MethodsIn a prospective cohort of 247 children, arachidonic acid-induced platelet aggregation (PAG-AA) was measured by means of light transmission aggregometry (LTA) before the first dose of aspirin after cardiac surgical procedure and the perioperative variables were also collected. Distribution of this population's PAG-AA basal status was described. Univariate and multivariate logistic regression analysis were performed to identify the main influencing factors of PAG-AA.ResultsThe median time of aspirin administration was 2 (1–27) days after surgery and the corresponding median value of basal PAG-AA was 20.70% (1.28–86.49%), with 67.6% population under 55% and 47.8% population under 20%. Patients undergoing cardiopulmonary bypass (CPB) had a significantly lower basal PAG-AA than those without (30.63 ± 27.35 vs. 57.91 ± 27.58, p = 0.013). While patients whose test done within 3 days after CPB had a significantly lower PAG-AA than those out of 3 days (25.61 ± 25.59 vs. 48.59 ± 26.45, p = 0.001). Univariate analysis implied that the influencing factors of the basal PAG-AA including CPB use, test time point, cyanosis, and platelet count. Multivariate regression analysis indicated that only CPB use, test time point, and platelet count were the main independent influencing factors for the basal PAG-AA.ConclusionThe majority of children have impaired basal platelet aggregometry responses before postoperative aspirin initiation. The main influencing factors are CPB use, test time point, and platelet count. To establish the platelet aggregometry baseline prior to commencement of aspirin therapy, testing should be performed 3 days later following the procedure when effect of CPB is basically over.

Covid-19 Related Stressors and Performance: The Case of Lebanese Employees During the Pandemic

In the aftermath of Covid-19 and the national lockdown, various firms and companies were obliged to operate remotely from work. This provided several challenges and opportunities to both employees and employers. The reason for carrying this study goes to this new stressful and challenging subject that took over the globe. In this study, the results for the effect of job stress related to the Covid-19 pandemic and employees’ performance in Lebanon will be discussed. The effect of the three main independent stress-building factors were measured that includes: perception of safety, job insecurity, and financial loss, which in return reflect on the dependent variable or factor: employees’ performance in Lebanon. The measurement of inferences of these independent job stressors was accomplished by a Google-form survey, with a structured questionnaire. SPSS was the appropriate procedure used to make the inferences of the outcome. The revelation of the analysis depicts that there was no relationship between the perception of safety and the employees’ performance while there was a significance relationship between job insecurity, financial loss, and performance. The study shows and indicates that to reduce the stress and enhance the performance of employees, wherever possible, specifically during a crisis, working operations need to be organized by employers.

Removal of the industrial azo dye crystal violet using a natural clay: Characterization, kinetic modeling, and RSM optimization

Natural clay (NC) was employed as a natural adsorbent for the elimination of an azo dye Crystal Violet (CV) from aqueous media. The characterization of the clay was performed by X-ray diffractometry (XRD), X-ray fluorescence (XRF), scanning electron microscopy (SEM) equipped with an X-ray energy dispersion spectrometer (EDS) and Brunauer–Emmett–Teller (BET) specific surface area analysis. The Box–Behnken design (BBD) was used as a powerful tool to determine the stationary points of the main independent factors: initial CV concentration, initial pH, temperature, and adsorbent dose on the adsorption efficiency. The significance and adequacy of the model were investigated using analysis of variance (ANOVA). The obtained results indicated an optimal dye removal of 99.1% at pH = 3, initial CV concentration of 11.767 mg/L, adsorbent load of 3.075 g/L, and T = 298.0 K. The kinetic study was evaluated using three models: a pseudo-first-order (PFO), a pseudo-second-order (PSO), and an intraparticle diffusion model. The observed kinetics is in excellent agreement with the PSO kinetic model. Therefore, both isotherms Langmuir and Freundlich fitted well the adsorption equilibrium data. The thermodynamic study revealed that the main parameters including (ΔG°, ΔH°, and ΔS°) indicated that the adsorption of CV onto NC was an endothermic and spontaneous process.