Primary Predictor Research Articles

Analysing the Influence of Augmented Reality on Organization Performance via Supply and Logistics Value Chain Functions: A Hybrid ANN-PLS Model Assessment in the Gulf Cooperation Council Region

Background: Despite the resurgence of interest in augmented reality (AR) due to Industry 4.0 and its ability to resolve several challenges faced by current business models, comprehensive research examining the capabilities of AR in supply chain management (SCM) and logistics remains limited. This article aims to investigate the potential effects of AR technology on organizational performance through the mediation role of SCM and logistics value chain functions to address the existing knowledge gap. Methods: This research employed a cross-sectional design and an explanatory survey as a deductive approach for hypothesis development. The primary data collection method involved the self-administration of a questionnaire to furniture suppliers located in the Gulf Cooperation Council (GCC), including six countries. Of the 656 questionnaires submitted to suppliers, 483 were considered usable, yielding a response rate of 73.6%. The research utilized partial least squares structural equation modelling (PLS-SEM) and artificial neural network (ANN) techniques to evaluate the gathered data. Results: The current paper’s statistical evidence demonstrates that AR implementation has a positive impact on the supply and logistics value chain activities and organizational performance of furniture suppliers in the GCC region. Moreover, it illustrates that the design and planning variable of supply chain value dominates as the primary predictor of organization performance. The results indicated that the ANN strategy provided a more comprehensive explanation of internally generated constructs compared to the PLS-SEM technique. Conclusions: This study demonstrates its usefulness by advising furniture industry decision-makers on what to avoid and what aspects to consider when creating plans and regulations. The report also suggests operations managers apply machine learning (ANN) for prediction and decision-making in supply and operations value chains. This essay looks at how the AR and resource-based supply value chain view may affect company performance across countries, firm sizes, and ages.

Effect of sleep quality on wound healing among patients undergoing emergency laparotomy: an observational study.

To study the association between sleep-quality, total sleep duration and wound-healing among adult patients having good sleep-quality at the time of admission in hospital, undergoing laparotomy for various reasons. In this observational study , consecutive adult subjects undergoing emergency laparotomy were followed up until the eighth postoperative day. The primary outcome (wound healing) was assessed using the Southampton Wound Grading System. Sleep quality (assessed by the single item sleep quality scale) was the primary predictor. Pain was assessed using visual analogue pain scale. We studied the effect of postoperative sleep quality on wound healing on postoperative day 8. Secondary analyses assessed the effect of total sleep time, severity of pain and markers of systemic inflammation on wound healing. In this study 110 participants were included. The average age of participants was 41.7±16.2 years. On postoperative day 8, 34.5% rated their sleep quality as "poor to fair" and rest as "good". Postoperative poor sleep quality was associated with impaired wound healing, starting from third postoperative day (P<0.001 for each subsequent day). Multiple logistic regression was overall significant (χ2= 118.40; df=9; P<0.001), classified 92.7% cases correctly and explained 88% variance to the outcome. This model showed that shorter total-sleep-time (P=0.009), higher total leukocyte count (P=0.005), presence of comorbidities (P=0.01) and poor sleep quality during the postoperative week (OR=78.14; P=0.005) increased odds for impaired healing of wound. Poor sleep quality during the healing phase is associated with wound complications, a surrogate marker of impaired wound healing.

Probing Neurophysiological Processes Related to Self-Referential Processing to Predict Improvement for Depressed Adolescents Receiving Cognitive Behavioral Therapy

BACKGROUNDCognitive Behavior Therapy (CBT) is a gold standard approach for treating major depressive disorder (MDD) among adolescents. However, nearly half of adolescents receiving CBT do not improve. In order to personalize treatment, it is essential to identify objective markers that predict treatment responsiveness. Toward addressing this aim, this study investigated neurophysiological processes related to self-referential processing that predicted CBT response among depressed, female adolescents. METHODSAt baseline, female adolescents ages 13-18-years-old (N=80) completed a comprehensive clinical assessment, and a self-referential encoding task was administered while electroencephalogram (EEG) data were recorded. Baseline EEG data were utilized to identify oscillatory differences between healthy (HC, n=38) and depressed (MDD, n=42) adolescents. Following the baseline assessment, depressed youth received up to 12-weeks of CBT. Baseline differences in EEG oscillations between healthy and depressed youth were used to guide CBT prediction analysis. Cluster-based event-related spectral perturbation analysis (ERSP) probed theta and alpha event-related synchronization/desynchronization (ERS/ERD) response to negative and positive words. RESULTSBaseline analyses showed that, relative to the healthy adolescents, depressed youth exhibited higher levels of frontal theta ERS and a greater posterior alpha ERD. Multilevel modeling identified primary neural pre-treatment predictors of treatment response: greater theta ERS in the right prefrontal cortex (PFC) after the onset of negative words and lower alpha ERD in both the right PFC and posterior cingulate cortex (PCC). ERS and ERD associations with treatment response remained significant, with baseline depressive and anxiety symptoms included as covariates in all analyses. CONCLUSIONSConsistent with prior research, results highlighted that relative to healthy youth, depressed adolescents are characterized by prominent theta synchronization and alpha desynchronization over PFC and PCC, respectively. Cluster-based ERSP analysis also identified key mechanisms underlying depression-related self-referential processing that predicted improved symptoms during the CBT course. Ultimately, a better characterization of the neural underpinnings of adolescent depression and its treatment may lead to more personalized interventions.

PREDICTORS AND COMPONENTS OF INPATIENT ASTHMA HOSPITAL COST: A CROSS SECTIONAL STUDY

Asthma, a chronic respiratory condition, continues to impose a significant economic burden on healthcare systems worldwide. Objective: The main objective of the study is to find the predictors and components of inpatient asthma hospital cost. Methods: This cross-sectional study was conducted at a tertiary care hospital from January 2024 to June 2024. Data were collected from 245 patients suffering from asthma. Patients were selected based on the International Classification of Diseases (ICD) codes related to asthma documented in their medical records. Patients aged &gt;18 years with complete medical and billing records available were included in the study. Results: The results show that gender did not significantly affect hospital costs, with males averaging $7,400 and females $7,000 (p = 0.12). Age was a significant predictor, as older patients (65+ years) incurred higher costs ($9,800) compared to younger groups (p &lt; 0.01). Socioeconomic status also impacted costs, with lower-income patients averaging $8,100 compared to $6,200 for higher-income patients (p &lt; 0.05). Age (65+ years) increased costs by $1,800 in univariate analysis and by $1,500 in multivariate analysis (p &lt; 0.01). Asthma severity had the strongest effect, with severe cases adding $5,500 in univariate analysis and $4,800 in multivariate analysis (p &lt; 0.001). Comorbidities increased costs by $4,000 univariately and $3,500 in multivariate models (p &lt; 0.01).Conclusion: It is concluded that asthma severity, comorbidities, and socioeconomic status are the primary predictors of inpatient asthma hospital costs.

TM6SF2-rs58542926 genotype has opposing effects on incidence of hepatic and cardiac events in a community cohort: TM6SF2 effects on liver and cardiac outcomes.

TM6SF2-rs58542926-T is associated with increased cirrhosis and modestly decreased coronary artery disease prevalence. However, relative effects of TM6SF2 genotype on major adverse cardiovascular events (MACE) vs. liver-related events (LRE) is not known. We utilized the UK Biobank, a prospective cohort with genetic and inpatient diagnosis data. The primary predictor was TM6SF2-rs58542926 genotype and the primary outcomes were MACE and LRE. Effects were reported as subhazard ratios (sHR) and 10-year cumulative incidence by Fine-Gray competing risk analyses. >430,000 individuals met inclusion criteria. TM6SF2-rs58542926-TT genotype (vs. CC) was associated with higher incidence of LRE (adjusted sHR 3.16, 95% confidence interval [CI] 1.86-5.37) and lower incidence of MACE (adjusted sHR for TT vs. CC genotype 0.76, 95% CI 0.63-0.91 ). In individuals with Fibrosis-4 (FIB4) <1.3, 1.3-2.67, and >2.67, 10-year LRE incidence in TM6SF2-rs58542926-TT vs. CC individuals was 0.08% vs. 0.06% (p>0.05), 0.81% vs. 0.20% (p<0.0001), and 10.5% vs. 3.4% (p=0.00094), respectively. The corresponding values for MACE were 3.8% vs. 5.1% (p=0.032), 6.4% vs. 8.2% (p=0.040), and 17.1% vs. 12.4% (p>0.05). The absolute decrease in MACE with rs58542926-TT (vs. CC) genotype exceeded the absolute increase in LRE in all groups but FIB4>2.67. Associations of TM6SF2 genotype with LRE/MACE were significant in men but not women. TM6SF2-rs58542926-T allele was also associated with increased hepatic steatosis and corrected T1 time by magnetic resonance imaging, with greater effect sizes in men than women. TM6SF2 genotype has opposite effects on LRE vs. MACE incidence, and absolute effects on MACE were greater except in those with highest FIB4 scores. Effects were strongest in men. These findings clarify implications of TM6SF2 genotype based on personalized clinical risk.

Contribution of environmental and biological factors to bacterial community structure and stability in a subalpine lake

AbstractBacterial community play an essential role in regulating water quality and the global biogeochemical cycle in aquatic ecosystems. However, how trophic interactions (i.e., biotic factors) regulate the diversity and composition of bacterial community in lake ecosystems remains unknown. Here, we employed DNA meta-barcoding of water samples to explore the impact of bacterivorous protozoans on the bacterial community. The results showed significant seasonal variations in the diversity and composition of both bacterial and protist communities. The composition of bacterivorous protozoans was identified as the primary predictor for the bacterial community alpha diversity in spring and summer, and for beta diversity in spring and autumn, indicating that biotic interactions play a greater role in driving the diversity of bacterial community across different seasons. Biological factors were more important than environmental factors for explaining the variations in the relative abundance of several bacterial genera (i.e., Pseudoxanthomonas, hgcI_clade, and Pseudorhodobacter). Network analyses showed that bacterial networks differed among seasons, and the autumn network exhibited the highest stability. Our findings indicated that the bacterial community stability was significantly affected by environmental factors, specifically SO42–and PO43–, rather than bacterivorous protozoans. Overall, our findings provide new perspectives on the role of trophic interactions in maintaining the structure of bacterial community in different seasons, and enhance our understanding of the bacterial community assembly in lake ecosystems.

The influence of dark personality and pornography on sexual aggression beliefs

IntroductionViolence against women, particularly sexual violence, poses a significant public health concern. Predispositions toward perpetrating such acts often stem from the acceptance of myths that justify or deny these behaviours. This study aimed to explore how dark personality traits (narcissism, Machiavellianism, psychopathy, and sadism) and pornography consumption relate to the acceptance of these myths.MethodsSurveying 598 participants, the research employed Latent Profile Analyses (LPA) to identify distinct population profiles, Additionally, regression analyses were employed to further explore the relationships among variables.ResultsThree profiles emerged, showcasing varying degrees of acceptance of sexual aggression myths. The most concerning profile, encompassing 9.2% of participants, displayed the highest alignment with these myths, alongside elevated scores in dark personality traits and pornography consumption. Notwithstanding the three profiles showed significant differences in the acceptance of these myths. Interestingly, the regression analysis highlighted that Machiavellianism stood out as the primary predictor for accepting sexual aggression myths, overshadowing the influence of pornography consumption.ConclusionThis emphasizes the role of personality traits in influencing attitudes towards sexual aggression myths. Moreover, implications for tailored prevention strategies, focusing on high-risk profiles, are discussed, highlighting the potential for targeted interventions to address harmful beliefs and behaviours.

CMR characterisation of patients with heart failure and left bundle branch block

Abstract Introduction Cardiac magnetic resonance (CMR) is recommended internationally for tissue characterisation, volumetric assessment and assessment of prior myocardial infarction (1). Patients with left bundle branch block (LBBB) form a significant sub-group of individuals, however, there is limited data available to accurate determine whether LBBB is associated with any CMR-definable phenotypes. Aim We aimed to identify the distinctive cardiac magnetic resonance (CMR) features of patients with left bundle branch block (LBBB) and heart failure with reduced ejection fraction (HFrEF) of presumed non-ischaemic aetiology. Methods Participants from the MATCH (MyocArdial Tissue CHaracteristics in patients with heart failure according to glycaemic status) registry were prospectively enrolled. Exclusion criteria included: LVEF &amp;gt;40% at initial evaluation, established diagnosis of coronary artery disease, known presence of structural heart disease, suspected myocarditis, congenital heart disease and significantly impaired renal function. Following identification of HF, guideline-directed medical therapy was initiated based on the decision of the treating physician. LV recovery was defined as achieving ≥10% absolute improvement to a level of 40% or greater of LVEF from baseline evaluation upon the date of CMR quantification. Electrocardiograms were analysed to establish the presence or absence of LBBB. Results A total of 391 patients were recruited including 115 (29.4%) presenting with LBBB. Compared to controls, LBBB patients exhibited larger left ventricles and smaller right ventricles, but no differences were observed with respect to LVEF (35.8±12 vs. 38± 12 %, p=0.105) or right ventricular ejection fraction (RVEF). The prevalence of ischaemic scar (18.3% vs 21%, p=0.54), non-ischaemic fibrosis (25.2% vs 32.6%, p=0.15) and inducible ischaemia (6.1% vs. 7.6%, p=0.6) was comparable in patients with LBBB and those without. The overall rate of LV recovery was not significantly different between LBBB and non-LBBB patients (27.8% vs. 33%, p=0.32) from their baseline evaluation to the time of CMR assessment (70 [42 - 128] days). In the multivariate logistic regression, reduced LVEF remained an independent predictor of LV non-recovery in patients with LBBB, even after adjusting for gender and QRS duration (OR 0.93, 95%CI 0.87 – 0.99, p=0.03). In contrast, this association was not observed among patients without LBBB, whereas ischaemic scar was the primary predictor of LV non-recovery (OR 4.31, 95%CI 1.85 – 10.04, p=0.0007). Conclusion In this study patients presenting with a combination of HFrEF and LBBB had a larger LV cavity and smaller RV cavity than those without LBBB. However, there were no differences in the prevalence of ischaemic scar, non-ischaemic scar of inducible ischaemia according to the presence of absence of LBBB. Rates of LV recovery were similar between LBBB and non-LBBB patients.Clinical CMR ParametersSegmental Distributions

Local Treatment (Primary Tumor and Metastases) in Metastatic Prostate Cancer

For patients with low-volume de novo metastatic hormone-sensitive prostate cancer, addition of an androgen receptor pathway inhibitor and prostate radiotherapy to the standard (SOC) improves survival in comparison to the next most effective strategy (SOC + ARPI). For the subgroup with prior definitive treatment of the primary tumor, long-term outcomes and genomic predictors of response to metastasis-directed therapy suggest that this might be a reasonable option in selected patients.

Socioeconomic status, linguistic skills and language background differentially relate to preschoolers' emotional and behavioural profile.

Proximal and distal factors interact to shape children's development and well-being. The present study aimed to examine socioeconomic status (SES), linguistic skills, and language background as concurrent predictors of socio-emotional and behavioural outcomes in heritage bilingual and monolingual children attending preschool. Parents of 1810 children (mean age = 63.42 months ± 7.36), attending preschool in Italy, completed the Four Factor Index of SES and the Strengths and Difficulties Questionnaire (SDQ). Teachers (n = 99) completed a questionnaire on children's linguistic skills and emotional and behavioural profiles. A subsample of 995 children was administered an expressive vocabulary task in Italian. Regression analyses showed that linguistic skills were the only concurrent predictor of conduct problems, as well as the dominant predictor of hyperactivity/impulsivity, peer problems, and better prosocial behaviour. SES was negatively related to ADHD traits, peer problems, and prosocial behaviour. Finally, heritage bilingualism background was associated, although not as a primary predictor, with increased emotional problems, peer relationship problems, and lower teacher-rated emotional and behavioural skills. However, it was the main factor positively associated with prosocial behaviour. The implications of these findings for research in this area and for educational policy are discussed, highlighting the need for a multidimensional perspective that includes linguistic skills and SES in the assessment of children's emotional and behavioural outcomes.

Obesity and Left Ventricular Function in American Indian Adolescents: Strong Heart Family Study.

Obesity is a known risk factor for developing cardiovascular disease (CVD). American Indian (AI) children have the highest obesity rates of all racial/ethnic groups in the United States (US). However, cardiometabolic health among AI adolescents is understudied. The purpose of this study was to describe the cardiometabolic characteristics of AI adolescents enrolled in the Strong Heart Family Study (SHFS), a longitudinal study of CVD from 12 AI communities, and associations with the development of abnormal left ventricular mass index (LVMI) and ejection fraction (EF). This study included AI youth ages 14-22years. Primary outcome variables were depressed EF (< 55%) and abnormal LVMI at 6-year follow-up. The primary predictor variable was BMI. Covariates included sex, cholesterol levels, blood pressure, and hemoglobin A1c. Wilcoxon signed-rank test for matched pairs evaluated cardiometabolic trends over time. Stratified univariate logistic regression by obese/nonobese categories evaluated associations with depressed EF and abnormal LVMI. There were 384 subjects, 58% of whom were overweight (n = 87) or obese (n = 122) at baseline. Among overweight/obese subjects, cholesterol and triglyceride levels were elevated. At 6-year follow-up, BMI increased while EF decreased among overweight/obese males, with 3.6 times the odds of having depressed EF (95% CI 1.22-10.98, p = 0.021) compared to normal-weight males. There were no significant cardiometabolic associations with LVMI. This is one of the largest longitudinal evaluations of CVD in AI adolescents. Concerning trends in BMI and depressed EF among AI males suggest the importance of culturally competent interventions to promote healthy weight and reduce cardiometabolic risk.

Perceptions of Cancer Risk and Gear Decontamination Among Aircraft Rescue and Firefighting Firefighters: Insights from a Mixed Methods Study.

Characterize Aircraft Rescue and Firefighting (ARFF) firefighters' perceptions of occupational exposure, health impacts, and decontamination practices, and describe barriers to effective gear cleaning. A convergent parallel mixed methods design was employed, collecting and analyzing quantitative survey data (n = 81) and qualitative focus group data (n = 52) from ARFF firefighters at three Florida airports. ARFF firefighters expressed concerns about chronic exposure to hazardous materials and perceived a heightened cancer risk. Despite acknowledging the importance of gear decontamination, they reported infrequent cleaning behaviors due to persistent contamination and barriers, including lack of a second set of gear. Firefighters' perceived norms emerged as the primary predictor of gear-cleaning behavior. Targeted interventions and policies are needed to address the unique challenges faced by ARFF firefighters in reducing occupational exposure risks and improving gear decontamination practices.

Stress in social and health care professionals working with people with intellectual disabilities: risk and protective factors

Objectives Those working in the field of intellectual disabilities are confronted with a multitude of stressors, which can give rise to considerable psychological difficulties. The objective of this study was to identify the key predictors of perceived and relational stress among professionals working in intellectual disability centers. Methods A cross-sectional design was employed, with 726 professionals participating (mean age = 43.35 years, SD = 11.19), predominantly women (78.6%). The variables assessed included perceived stress, relational stress, emotional balance, life satisfaction, social support, empathy, and counseling training. The analysis was conducted using structural equation modeling and qualitative-comparative analysis of fuzzy data (QCA). Results The study revealed that the stress levels of the study participants were moderate to low. The relationship between emotional balance and stress was mediated by life satisfaction. In both structural equation models, negative affect and life satisfaction were identified as primary predictors, significantly influencing perceived and relational stress. Additionally, QCA highlighted that empathy and social support, along with these factors, contribute to explaining stress levels. Conclusions Our findings highlight the necessity of implementing preventive strategies and support systems to mitigate stress among healthcare professionals who work with individuals with intellectual disabilities. These findings contribute to the existing body of knowledge regarding stress management in this specialized healthcare context.

Serial Liver Stiffness Measurement and Fibrosis-4 Scores in Metabolic Dysfunction-Associated Steatotic Liver Disease.

In patients with metabolic dysfunction-associated steatotic liver disease (MASLD), there are limited data on how changes in FIB4 and liver stiffness measurement (LSM) correlate in non-biopsy cohorts. Our objective was to evaluate associations between changes in FIB4 and LSM in MASLD patients. We included MASLD patients with serial VCTE from 2015-2022. The primary predictors were change in FIB4 and presence of diabetes, obesity, and high alanine aminotransferase (ALT). The primary outcome, applied only to patients with LSM1 < 8kPa, was incident significant fibrosis (SF) defined as a ≥ 20% increase in LSM2 vs. LSM1 and LSM2 ≥ 8kPa. A secondary outcome was LSM progression with a similar definition but applied to all participants, not only those with LSM1 < 8kPa. Of 285 included patients, 216 had LSM1 < 8kPa and were included in the primary analysis; of these, 34 (16%) had incident SF. Changes in FIB4 correlated with changes in LSM (R = 0.16, p = 0.016). Independent predictors of incident SF included comorbid diabetes mellitus (OR 2.43, 95% CI 1.04-6.56), obesity (OR 3.88, 95% CI 1.63-9.25), and baseline ALT ≥ 30 (OR 8.55, 95% CI 1.10-66.29). A model including ALT, diabetes, and obesity outperformed a model with FIB4 change alone. Among patients with MASLD, changes in FIB4 correlated with changes in LSM but more significant correlates of incident significant fibrosis included diabetes mellitus, obesity, and high baseline ALT.

Characteristics of Lumbar Pars Interarticularis and Pedicle Stress Injuries by Sport in 902 Pediatric and Adolescent Athletes: A Retrospective Study.

Recent studies utilizing magnetic resonance imaging (MRI) for the evaluation of symptomatic lumbar spondylolysis in pediatric and adolescent athletes have indicated that upper level lumbar involvement has a higher incidence than previously reported. There has been a paucity of literature evaluating sport-specific patterns of lumbar spondylolysis, specifically upper versus lower level involvement. To assess the potential risk factors for upper level stress injuries of the lumbar spine in pediatric and adolescent athletes. Cross-sectional study; Level of evidence, 3. The medical records of 902 pediatric and adolescent athletes (364 female, 538 male; mean age, 14.5 ± 2.1 years) diagnosed with symptomatic pedicle and pars interarticularis stress injuries at 2 academic medical centers (July 2016 to June 2021) were reviewed. All patients had undergone MRI at the time of diagnosis. Only patients with pars/pedicle edema on MRI were included. Data regarding single-sport specialization, sport participation, sport category by biomechanics (axial rotation vs extension/axial loading), and vertebral level of injury over the 5-year period were analyzed. Stress reaction or active spondylolysis (SRAS) was the terminology used to designate grade 1, 2a, or 3 stress injuries according to the adapted Hollenberg classification system on MRI. Upper level vertebrae were defined as L3 or superior, whereas lower level vertebrae included L4 or inferior. Of the 902 patients with SRAS injuries, most (n = 753 [83.5%]) had exclusively single-level lower stress injuries, while 67 (7.4%) had multilevel stress injuries. There were 82 athletes (9.1%) who had single-level upper stress injuries. Athletes with upper level pars/pedicle stress injuries were older at the time of diagnosis (15.8 ± 1.9 vs 14.3 ± 2.1 years, respectively; P < .001), had a shorter duration of low back pain before presentation (2.50 ± 2.70 vs 4.14 ± 6.73 months, respectively; P < .001), were more likely to specialize in a single sport (43.9% vs 32.3%, respectively; P = .046), and had a lower incidence of active spondylolysis on MRI at the time of diagnosis (42.7% vs 59.8%, respectively; P = .004) compared with athletes with lower level stress injuries. Athletes with lumbar stress injuries who specialized in a single sport had nearly twice the odds of having upper level involvement compared with multiple-sport athletes (adjusted odds ratio, 1.80 [95% CI, 1.06-3.04]; P = .03). Athletes with active spondylolysis on MRI at the time of diagnosis had nearly half the odds of having upper level involvement (adjusted odds ratio, 0.55 [95% CI, 0.33-0.91]; P = .02). Age at the time of diagnosis, duration of low back pain, single-sport specialization, and presence/absence of active spondylolysis on MRI at the time of diagnosis were primary predictors of whether an athlete's lumbar stress injury was classified as either upper or lower level involvement. Overall, the variables included in multivariate analysis were modest predictors, explaining only 15.1% of the variance in the rates of lumbosacral stress injuries classified by spinal level. These specific biomechanical factors and other potential contributors to these findings warrant further investigation.

Comparison of Echocardiographically-Calculated Fontan Fenestration Gradient and Catheter-Based Measurement.

Patients born with single ventricle anatomy typically undergo surgical palliation in three stages, culminating in the Fontan procedure. Assessment of flow across a Fontan fenestration by Doppler ultrasound theoretically allows for non-invasive estimation of the transpulmonary gradient (TPG). Our objective was to determine the relationship between Doppler-derived mean fenestration gradient (mFG) and direct catheter-based measurements of TPG in patients with fenestrated Fontans. We performed a single-center retrospective cohort study of 59 patients with fenestrated Fontans completed between 2000 and 2022. The primary outcome was catheter-based measurement of TPG and the primary predictor was mFG from echo performed within 6 months of the catheterization. Linear regression and R2 were used to determine the relationship between predictors and outcomes. Catheter-based measurements of TPG and mFG were weakly correlated (R2 = 0.382, p < 0.001); the regression coefficient was 0.550, with a standard error of 0.09 for every increase in mFG (Cath TPG = 0.55 [mFG] + 1.92). mFG had a slightly better predictive relationship with cath-derived TPG in patients with systemic left ventricles with R2 of 0.47, p < 0.004. mFG accounts for approximately 38% of the variance in catheter-derived TPG. Although mFG is non-invasive and intuitive, mFG in Fontan patients should be interpreted with caution and direct measurement by cardiac catheterization should be considered.

Artificial Intelligence-Enhanced OCT Biomarkers Analysis in Macula-off Rhegmatogenous Retinal Detachment Patients.

To identify optical coherence tomography (OCT) biomarkers for macula-off rhegmatogenous retinal detachment (RRD) with artificial intelligence (AI) and to correlate these biomarkers with functional outcomes. Patients with macula-off RRD treated with single vitrectomy and gas tamponade were included. OCT volumes, taken at 4 to 6 weeks and 1 year postoperative, were uploaded on an AI-derived platform (Discovery OCT Biomarker Detector; RetinAI AG, Bern, Switzerland), measuring different retinal layer thicknesses, including outer nuclear layer (ONL), photoreceptor and retinal pigmented epithelium (PR + RPE), intraretinal fluid (IRF), subretinal fluid, and biomarker probability detection, including hyperreflective foci (HF). A random forest model assessed the predictive factors for final best-corrected visual acuity (BCVA). Fifty-nine patients (42 male, 17 female) were enrolled. Baseline BCVA was 0.5 logarithmic minimum angle of resolution (logMAR) ± 0.1, significantly improving to 0.3 ± 0.1 logMAR at the final visit (P < 0.001). Average thickness analysis indicated a significant increase after the last follow-up visit for ONL (from 95.16 ± 5.47µm to 100.8 ± 5.27µm, P = 0.0007) and PR + RPE thicknesses (60.9 ± 2.6µm to 66.2 ± 1.8µm, P=0.0001). Average occurrence rate of HF was 0.12 ± 0.06 at initial visit and 0.08 ± 0.05 at last follow-up visit (P=0.0093). Random forest model revealed baseline BCVA as the most critical predictor for final BCVA, followed by ONL thickness, HF, and IRF presence at the initial visit. Increased ONL and PR-RPE thickness associate with better outcomes, while HF presence indicates poorer results, with initial BCVA remaining a primary visual predictor. The study underscores the role of novel biomarkers like HF in understanding visual function in macula-off RRD.

Prognostic Value of Coronary Artery Calcification in Patients with COVID-19 and Interstitial Pneumonia: A Case-Control Study.

Background: Patients suffering from coronavirus disease-19 (COVID-19)-related interstitial pneumonia have variable outcomes, and the risk factors for a more severe course have yet to be comprehensively identified. Cohort studies have suggested that coronary artery calcium (CAC), as estimated at chest computed tomography (CT) scan, correlated with patient outcomes. However, given that the prevalence of CAC is gender- and age-dependent, the influence of baseline confounders cannot be completely excluded. Methods: We designed a retrospective, multicenter case-control study including patients with COVID-19, with severe course cases selected based on death within 30 days or requiring invasive ventilation, whereas controls were age- and sex-matched patients surviving up to 30 days without invasive ventilation. The primary outcome was the analysis of moderate-to-severe CAC prevalence between cases and controls. Results: A total of 65 cases and 130 controls were included in the study. Cases had a significantly higher median pulmonary severity score at chest CT scan compared to controls (10 vs. 8, respectively; p = 0.0001), as well as a higher CAC score (5 vs. 2; p = 0.009). The prevalence of moderate-to-severe CAC in cases was significantly greater (41.5% vs. 23.8%; p = 0.013), a difference mainly driven by a higher prevalence in those who died within 30 days (p = 0.000), rather than those requiring invasive ventilation (p = 0.847). White blood cell count, moderate-to-severe CAC, the need for antibiotic therapy, and severe pneumonia at CT scan were independent primary endpoint predictors. Conclusions: This case-control study demonstrated that the CAC burden was higher in COVID-19 patients who did not survive 30 days or who required mechanical ventilation, and CAC played an independent prognostic role.

Epidemiological changes and outcomes of people living with HIV admitted to the intensive care unit: a 14-year retrospective study.

Since 2016, the World Health Organization has recommended universal antiretroviral therapy (ART) for all people living with Human Immunodeficiency Virus (PLHIV). This recommendation may have influenced the characteristics and outcomes of PLHIV admitted to the Intensive Care Unit (ICU). This study aims to identify changes in the epidemiological and clinical characteristics of PLHIV admitted to the ICU, and their short- and medium-term outcomes before and after the implementation of universal ART (periods 2006-2015 and 2016-2019). This retrospective, observational, single-center study included all adult PLHIV admitted to the ICU of a University Hospital in Barcelona from 2006 to 2019. The study included 502 admissions involving 428 patients, predominantly men (75%) with a median (P25-P75) age of 47.5years (39.7-53.9). Ninety-one percent were diagnosed with HIV before admission, with 82% under ART and 60% admitted from the emergency department. In 2016-2019, there were more patients on ART pre-admission, reduced needs for invasive mechanical ventilation (IMV) and fewer in-ICU complications. ICU mortality was also lower (14% vs 7%). Predictors of in-ICU mortality included acquired immunodeficiency syndrome defining event (ADE)-related admissions, ICU complications, higher SOFA scores, IMV and renal replacement therapy (RRT) requirement. ART use during ICU admission was protective. Higher SOFA scores, admission from hospital wards, and more comorbidities predicted one-year mortality. The in-ICU mortality of critically ill PLHIV has decreased in recent years, likely due to changes in patient characteristics. Pre- and ICU admission features remain the primary predictors of short- and medium-term outcomes.

Outcomes in infective endocarditis among adults with CHD: a comparative national study.

Given increased survival for adults with CHD, we aim to determine outcome differences of infective endocarditis compared to patients with structurally normal hearts in the general population. We conducted a retrospective cross-sectional study identifying infective endocarditis hospitalisations in patients 18 years and older from the National Inpatient Sample database between 2001 and 2016 using International Classification of Disease diagnosis and procedure codes. Weighting was used to create national annual estimates indexed to the United States population, and multivariable logistic regression analysis determined variable associations. Outcome variables were mortality and surgery. The primary predictor variable was the presence or absence of CHD. We identified 1,096,858 estimated infective endocarditis hospitalisations, of which 17,729 (1.6%) were adults with CHD. A 125% increase in infective endocarditis hospitalisations occurred for adult CHD patients during the studied time period (p < 0.001). Adults with CHD were significantly less likely to experience mortality (5.4% vs. 9.5%, OR 0.54, CI 0.47-0.63, p < 0.001) and more likely to undergo in-hospital surgery (31.6% vs. 6.7%, OR 6.49, CI 6.03-6.98, p < 0.001) compared to the general population. CHD severity was not associated with increased mortality (p = 0.53). Microbiologic aetiology of infective endocarditis varied between groups (p < 0.001) with Streptococcus identified more commonly in adults with CHD compared to patients with structurally normal hearts (36.2% vs. 14.4%). Adults with CHD hospitalised for infective endocarditis are less likely to experience mortality and more likely to undergo surgery than the general population.