Protective Factors Research Articles

Clinical characteristics and prognosis analysis of gastric cancer patients with bone metastasis

Objectives: To investigate the clinical characteristics and prognosis of bone metastasis of gastric cancer, analyze the influencing factors of bone metastasis and the effects of different treatment methods, and provide a basis for early detection and treatment optimization of bone metastasis of gastric cancer. Methods: A total of 142 gastric cancer patients with bone metastasis admitted to the First Hospital of Lanzhou University from January 2011 to December 2021 were enrolled, including 60 cases of simple bone metastasis and 82 cases of bone metastasis combined with extraosseous metastasis. 142 patients with stage Ⅲgastric cancer without distant metastasis and 142 gastric cancer patients with visceral metastasis admitted to this hospital during the same period were also enrolled for comparison. Logistic regression analysis was used to determine the influencing factors of bone metastasis, and the Cox proportional hazards regression model was used to evaluate the influencing factors of overall survival (OS) of patients with bone metastasis. Results: Among the 142 patients with bone metastasis, poorly differentiated adenocarcinoma was the main type (123 cases), and 45 patients had simultaneous bone metastasis. Rib metastasis (100 cases), spine metastasis (88 cases), and pelvis metastasis (84 cases) were more common. A total of 110 patients had multiple bone metastasis, and 82 patients had extraosseous metastasis. Results of the stage Ⅲ gastric cancer group, the visceral metastasis group, the bone metastasis group, and the bone metastasis with extraosseous metastasis group were compared. There were significant differences in age, degree of differentiation, Borrmann type, alkaline phosphatase, lactate dehydrogenase, serum calcium, alanine aminotransferase, aspartate aminotransferase, creatine kinase isoenzyme, lymphocyte, hemoglobin, platelet, CEA, CA19-9, and CA724 (all P<0.05). Multivariate logistic regression analysis showed that Borrmann type was an independent protective factor of bone metastasis of gastric cancer (type 3: OR=0.07, 95%CI: 0.01-0.64, P=0.018). Alkaline phosphatase (OR=2.54, 95% CI: 1.07-6.01, P=0.034), serum calcium (OR=2.71, 95% CI: 1.15-6.41, P=0.023), creatine kinase isoenzyme (OR=16.33, 95% CI: 1.83-145.58, P=0.012), platelet (OR=10.08, 95% CI:1.89-53.85, P=0.007), and CA19-9 (OR=2.40, 95% CI: 1.14-5.05, P=0.021) were independent risk factors of bone metastasis of gastric cancer. The median OS of the stage Ⅲ gastric cancer group, the visceral metastasis group, the bone metastasis group, and the bone metastasis with extrabony group were 47, 13, 18, and 6 months, respectively, and the difference was statistically significant (P<0.001). The median OS of patients with bone metastasis only who underwent primary tumor surgery was 33 months, better than 6 months of patients without surgery (P=0.048). Multivariate Cox regression analysis showed that extraosseous metastasis (HR=2.45, 95% CI: 1.56-3.85, P<0.001) and decreased hemoglobin (HR=1.54, 95%CI: 1.02-2.34, P=0.042) were independent risk factors of OS of gastric cancer patients with bone metastasis. Conclusions: The prognosis of gastric cancer patients with bone metastasis alone is significantly better than that of other stage Ⅳ patients. For such patients, surgery on the primary site combined with chemotherapy after full evaluation may prolong the survival time.

An Attractive Target: Do Perceptions of Physical Attractiveness Shape Victimization Risks in Women’s Prisons?

ABSTRACT Emerging research suggests that physical attractiveness may yield outcomes beyond preferential treatment, such as increasing the vulnerability to victimization during adolescence. Despite growing awareness of individual and institutional victimization risk factors during incarceration, research has yet to consider the role of physical attractiveness. Drawing on survey data collected from 223 women across two Pennsylvania prisons, this article investigates whether perceptions of physical attractiveness operate as protective or risk factors for victimization experienced while incarcerated. Logistic regression results show a significant positive association between interviewer-assessed perceptions of physical attractiveness and incarcerated women’s self-reported resident-on-resident victimization. Dominance analysis results indicate that perceptions of physical attractiveness ranked nearly as high as histories of abuse in predicting incarcerated women’s risk of victimization. This study uncovers an unintended consequence of physical attractiveness for imprisoned women, demonstrating their heightened susceptibility to in-prison victimization.

Level of perceived social support, and associated factors, in combat-exposed (ex-)military personnel: a systematic review and meta-analysis.

Combat deployment increases exposure to potentially traumatic events. Perceived social support (PSS) may promote health and recovery from combat trauma. This systematic review and meta-analysis aimed to synthesize studies investigating the level of PSS and associated factors among (ex-)military personnel who served in the Iraq/Afghanistan conflicts. Five electronic databases were searched in August 2023 and searches were restricted to the beginning of the Iraq/Afghanistan conflicts in 2001. The search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A quality assessment was carried out, and a meta-analysis and narrative synthesis were performed. In total, 35 papers consisting of 19,073 participants were included. Of these, 31 studies were conducted in the United States (US) and 23 were cross-sectional. The pooled mean PSS score was 54.40 (95% CI: 51.78 to 57.01). Samples with probable post-traumatic stress disorder had a lower mean PSS score (44.40, 95% CI: 39.10 to 49.70). Approximately half of the included studies (n = 19) investigated mental health in relation to PSS, whilst only four explored physical health. The most frequently reported risk factors for low PSS included post-traumatic stress disorder, depression and anxiety, whilst post-traumatic growth and unit support were protective factors. Higher levels of PSS were generally associated with more positive psychosocial and mental health-related outcomes following deployment. PSS should be targeted in psychosocial interventions and education programmes. Future research should investigate PSS in (ex-)military personnel across other countries and cultures, based on the lack of studies that focused on PSS in countries outside of the US.

Thirst symptoms in patients with heart failure: An integrative review.

To identify the risk and protective factors affecting thirst symptoms in patients with heart failure (HF) and intervention strategies to alleviate thirst symptoms. An integrative review. A total of 61 articles were retrieved. Screening yielded a total of 21 articles which were appraised for quality. The quality of studies was assessed using the Mixed Methods Appraisal Tool. Ten electronic databases were searched in October 2023, including Embase, Pubmed, CINAHL, Cochrane, Web of Science, Wiley, CNKI, VIP, CBM and WanFang. In addition, we searched grey databases and manually searched reference lists of included and relevant reviews. In total, 1644 articles were retrieved, of which 21 were included. Eight studies addressed the factors. Six themes emerged as risk factors, including demographics, severity of disease, psycho-environmental, medication, fluid restriction and homeostasis. Conversely, an increase in fluid intake, a high score of sodium restriction diet attitude and using ARB were identified as protective factors. Thirteen studies focus on intervention strategies. Five unique intervention strategies were identified, including Traditional Chinese Medicine, mint-related interventions, sour-flavour interventions, improved water restriction and cluster nursing strategy. This finding identified the factors associated with thirst symptoms in patients with HF, especially concerning the elaboration of risk factors, which suggests that healthcare professionals should focus on the risk factors for thirst in patients with HF and consciously avoid the occurrence of these risk factors. Additionally, there are considerable cultural differences in interventions, therefore, to increase adherence during symptom management, careful selection of appropriate intervention strategies based on the requirements and preferences of patients is required. While there are some therapies, there aren't enough high-quality empirical investigations. Thus, multi-centre, large-sample studies are also required in subsequent research to demonstrate the interventions' effectiveness. The nurse must notice the symptoms of thirst in HF to slow down the disease's progression and improve the patient's physical and emotional well-being. The review complies with the PRISMA guidelines for reporting systematic reviews. No patient or public contribution.

South African nursing students' stress and resilience during the global COVID-19 health crisis

The study aimed to investigate nursing students' psychological distress and their response to stress during the COVID-19 pandemic. Participants were 370 South African nursing students (female= 75%; mean age= 21.9 years, SD = 3.9 years). Students completed the following scales: Compassion Satisfaction and Fatigue, Kessler Psychological Distress, and Response to Stressful Experiences. Findings from the descriptive statistics and inferential statistical analyses indicated that students meeting the criteria for being well were likely to have higher resilience scores. Protective factors such as self-efficacy, active coping, and spirituality suggest higher resilience during COVID-19-related stressful events. Physiological factors such as self-reported medical conditions and lack of sleep were associated with poorer mental well-being. These findings provide a profile of nursing students' coping and adaptation to a community-spread pandemic. From these findings, nursing schools could manage students' well-being by providing needed resources in their current and future work health support programmes.

Skull base surgery for malignant tumors: The 2nd international collaborative study (1995-2015).

The current study presents the effort of a global collaborative group to review the management and outcomes of malignant tumors of the skull base worldwide. A total of 28 institutions contributed data on 3061 patients. Analysis evaluated clinical variables, survival outcomes, and multivariable factors associated with outcomes. The median age was 56 years (IQR 44-67). The open surgical approach was used in 55% (n = 1680) of cases, endoscopic resection was performed in 36% (n = 1087), and the combined approach in 9.6% (n = 294). With a median follow-up of 7.1 years, the 5-year OS DSS and RFS were 65%, 71.7% and 53%, respectively. On multivariable analysis, older age, comorbidities, histology, dural/intracranial involvement, positive margins, advanced stage, and primary site were independent prognostic factors for OS, DSS, and RFS. Adjuvant RT was a protective prognostic factor. The progress across various disciplines may have contributed to improved OS and DSS in this study compared to previous reports.

Endothelial PDGF-D contributes to neurovascular protection after ischemic stroke by rescuing pericyte functions

Ischemic stroke induces neovascularization of the injured tissue as an attempt to promote structural repair and neurological recovery. Angiogenesis is regulated by pericytes that potently react to ischemic stroke stressors, ranging from death to dysfunction. Platelet-derived growth factor (PDGF) receptor (PDGFR)β controls pericyte survival, migration, and interaction with brain endothelial cells. PDGF-D a specific ligand of PDGFRβ is expressed in the brain, yet its regulation and role in ischemic stroke pathobiology remains unexplored. Using experimental ischemic stroke mouse model, we found that PDGF-D is transiently induced in brain endothelial cells at the injury site in the subacute phase. To investigate the biological significance of PDGF-D post-ischemic stroke regulation, its subacute expression was either downregulated using siRNA or upregulated using an active recombinant form. Attenuation of PDGF-D subacute induction exacerbates neuronal loss, impairs microvascular density, alters vascular permeability, and increases microvascular stalling. Increasing PDGF-D subacute bioavailability rescues neuronal survival and improves neurological recovery. PDGF-D subacute enhanced bioavailability promotes stable neovascularization of the injured tissue and improves brain perfusion. Notably, PDGF-D enhanced bioavailability improves pericyte association with brain endothelial cells. Cell-based assays using human brain pericyte and brain endothelial cells exposed to ischemia-like conditions were applied to investigate the underlying mechanisms. PDGF-D stimulation attenuates pericyte loss and fibrotic transition, while increasing the secretion of pro-angiogenic and vascular protective factors. Moreover, PDGF-D stimulates pericyte migration required for optimal endothelial coverage and promotes angiogenesis. Our study unravels new insights into PDGF-D contribution to neurovascular protection after ischemic stroke by rescuing the functions of pericytes.

Investigation of the French Terry structure characteristics on sport-veiling using sustainable eco-materials

Purpose This paper aims to produce sustainable sport-hijab or veiling using cotton and bamboo as renewable and eco-material blending with polyester. Due to the unique characteristics of the knitting fabrics, the research focused on constructing the proposed samples using a circular knitting technique with a French terry structure, to achieve comfort, ease of care, good appearance and sustainability in different climatic conditions. Design/methodology/approach The researchers formed three different knitted samples using yarn count 30/1Ne for cotton and bamboo and 70 dens for polyester yarn, using the same blending ratio of 50:50% (cotton/polyester, bamboo/ polyester and cotton/ bamboo). They tested several mechanical and physical properties (weight, thickness, air permeability, water permeability, electrostatic charges, ultraviolet protection factor, stiffness, pilling resistance and bursting strength). Findings Using different tools, the researchers statistically analyzed the influence of variables on sample properties, including a Chart line, ANOVA test at p-value = 0.05 and the least significant differences values to identify the effect significantly as well as demonstrate the interaction among the samples at each tested property. Finally, radar chart areas to clarify the preferable sample performance. Originality/value The findings declared that blending materials used significantly affected most properties of the produced samples, except for the water permeability and an electrostatic charge. Furthermore, the findings pointed out that blending (cotton or bamboo/polyester) is more efficient and desirable than blending (cotton/ bamboo). Additionally, based on radar charts analysis, the cotton/polyester knitted outperforms other blended materials samples in producing sport-hijab or veiling fabric.

3D virtual model for robot-assisted partial nephrectomy in highly-complex cases (PADUA ⩾ 10).

To compare two cohorts of patients submitted to robot-assisted partial nephrectomy (RAPN) for highly-complex renal masses (PADUA ⩾ 10) with versus without the use of 3DVMs. We screened a prospective consecutive cohort of 152 patients submitted to RAPN with 3DVM and 1264 patients submitted to RAPN without 3DVM between 2019 and 2022. Only PADUA ⩾ 10 cases were considered eligible for analysis. Propensity score matching (PSM) analysis was applied. Primary endpoint was to evaluate whereas RAPNs with 3DVM were superior in terms of functional outcomes at 12-month. Secondary outcomes were to compare perioperative and oncological outcomes. Multivariable logistic regression analyses (MVA) tested the associations of clinically significant eGFR drop and 3DVMs. Subgroups analysis was performed for PAUDA-risk categories. Thirty seven patients for each group were analyzed after PSM. RAPN with 3DVM presented a higher rate of selective/no clamping procedure (32.5% vs 16.2%, p = 0.03) and a higher enucleation rate (43.2% vs 29.8%, p = 0.04). Twelve-month functional preservation performed better within 3DVM group in terms of creatinine serum level (median 1.2 [IQR 1.1-1.4] vs 1.6 [IQR 1.1-1.8], p = 0.03) and eGFR (median 64.6 [IQR 56.2-74.1] vs 52.3 [IQR 49.2-74.1], p = 0.03). MVA confirmed 3DVM as a protective factor for clinically significant eGFR drop in this subgroup of patients. RAPN performed with the use of 3DVM assistance for PADUA ⩾ 10 cases resulted in lower incidence of global ischemia and higher rate of enucleations. The positive impact of such technology was found at 12-month follow-up.

Social Management in The Face of Protection and Risk Factors For Violence in University Students

Objective: to analyze the risk and protective factors against violence associated with resilience and family functionality. Method: A non-experimental, cross-sectional, descriptive design was used with a sample of 335 teenage university students studying psychology, both men and women, from 3 universities in Trujillo. The following instruments were used: The Resilience Scale, by Wagnild and Young, the Family Functioning Assessment Scale – FACES III, and the Family Cohesion and Adaptability Scale by Olson, Porhner and Lavee. Results and discussion: The existence of protective factors against violence in resilience and family cohesion is evident. Regarding the adaptability indicator of family functionality, the flexible and structured family is associated with the protection factor against violence. However, rigid and chaotic families are associated as a risk factor for violence, with the risk factor prevailing for this group in the presence of chaotic families. Implications of the research: it contributes to the understanding of the variable with respect to its descriptive categories in university students, from which greater evidence and new studies aimed at explaining, associating or predicting the variables can be generated. Originality/Value: it was important because it analyzes protective and risk factors against violence, so that subsequent strategies can be used to reduce it and strengthen protective factors.

Complications and survival following percutaneous endoscopic gastrostomy tube placement.

Percutaneous endoscopic gastrostomy (PEG) is considered a safe and effective method for nutritional support in patients with malnutrition and swallowing impairment with an estimated survival of over two months. Some indications, such as advanced cognitive decline, contraindicate the technique. All patients who underwent PEG placement between January 2001 and May 2019 were included. Clinical data, indication, complications, and mortality were retrospectively analyzed. A total of 648 patients (46.5% male, mean age 70±18.5 years) were included. The most common indications for PEG were advanced cognitive decline (31.5%) and cerebrovascular disease (18.8%). The mean follow-up was 12.07 months (IQR 3.27-34.73). 39.5% of patients experienced complications (systemic 17.9%, local 28.5%). The most frequent were bronchoaspiration (9.7%) and rupture/dysfunction (13.9%), respectively. The presence of early complications (HR 1.63 [1.20-2.21]) and age (HR 1.02 [1.01-1.02]) were associated with shorter survival time, while female sex was a protective factor (HR 0.78 [0.66-0.94]). PEG is not without complications, with 39.5% of patients experiencing them. Patients with advanced dementia, male sex, older age, and systemic complications have lower survival following PEG placement.

"COVID-19 and the New Hidden Curriculum of Moral Injury and Compassion Fatigue".

Medical students are educated through two dichotomous curriculums, the formal, planned curriculum and the hidden curriculum unintentionally taught through socialization within the culture of medicine. As a consequence of shared trauma amongst the physician workforce during the COVID-19 pandemic, moral injury (MoI) and compassion fatigue (CoF) have become prevalent within the health care system, including palliative care medicine, with echoing ramifications on the observing trainee population. Thus, it is imperative to determine risk factors, protective factors and targeted interventions to offset MoI and CoF within the health care workforce and trainee population. Methods of strengthening personal and institutional resilience are vital to developing long-term structural change replacing the hidden curriculum of MoI and CoF with one of resilience and support. As palliative care providers are especially vulnerable to MoI and CoF, this article will examine the impact of the COVID-19 pandemic on MoI, CoF, and resilience within the hidden curriculum through the lens of palliative care.

Supplemental Material for Routines and Warmth as Protective Factors on the Relation Between Housing Instability and Child Outcomes

Supplemental Material for Routines and Warmth as Protective Factors on the Relation Between Housing Instability and Child Outcomes

Looking for a preventive approach to sexual harassment in academia. A systematic review

AbstractThe systematic review (PRISMA) on sexual harassment (SH) in academia looks at studies conducted since 2018 with the aim to direct updated research findings toward an effective prevention perspective. The findings confirm that academia is a breeding ground for SH due to power imbalances and that vulnerabilities related to the macro-dynamics of power, social and cultural inequalities are risk factors for SH. It is recommended that SH prevention interventions in academia 1. adopt a socio-ecological perspective; 2. include evidence-based programs such as those dedicated to bystanders; 3. are integrated with each other through valuable networking and multistakeholder involvement and 4. pay attention to support complaints, victim listening and intake activities. Future SH studies should promote: SH standardized definitions, intersectional perspectives, “all targets” surveys, research on protective factors, research on perpetrator perspective. Future interventions should act at the cultural level fighting structural inequality and a greater enhancement of evidence-based programs is required.

Color design for cotton fabric by rapid in-situ synthesis of metal oxides on the fiber surface using organic solvent-assisted method

The coloration of cotton fabric with wild application has attracted extensive attention to cotton fiber, due to the efficient utilization of renewable industrial crops. However, the utilization of rapid in-situ synthesis of metal oxides with color is inadequate. Herein, a rapid strategy for constructing multi-color cotton fabric is designed to propose a rapid in-situ synthesis of metal oxides on the surface of cotton fiber in a high-temperature organic solvent system within 40 s. The colored metal oxide of cuprous oxide (Cu2O), tungsten trioxide (WO3), and cobalt molybdate (CoMoO4) are in-situ synthesis on the surface of cotton fibers by different precursor solutions. The bright-colored cotton fabrics are developed within 40 s as well as satisfactory K/S values of 7.53, 2.67, and 0.98, for Cu2O (Cu2O-Cotton), WO3 (WO3-Cotton), and CoMoO4 (CoMoO4-Cotton), respectively. The stable structure of the various colored cotton fabrics is demonstrated by level 3 of rubbing fastness and washing fastness, and acceptable air permeability. Moreover, assigned to the nature of particles, the colored cotton fabrics are fabricated with thermal stability and better ultraviolet protection factors. The rapid in-situ metal oxides with precursor solutions provide a time- and water-saving method to prepare colored cotton fabrics, which exhibits an ideal efficiency, and practical potential application for coloring and functionalization.

Three-dimensional virtual model for robot-assisted partial nephrectomy: a propensity-score matching analysis with a contemporary control group

PurposeTo compare two cohorts of patients submitted to robot-assisted partial nephrectomy (RAPN) with vs without the use of three-dimensional virtual models (3DVMs).MethodsWe screened a prospective consecutive cohort of 152 patients submitted to RAPN with 3DVM and 1264 patients submitted to RAPN without 3DVM between 2019 and 2022. Propensity score matching analysis (PSMA) was applied. Primary endpoint was to evaluate whereas RAPNs with 3DVM were superior in terms of functional outcomes at 12-month. Secondary endopoints were to compare perioperative and oncological outcomes. Multivariable logistic regression analyses (MVA) tested the associations of clinically significant eGFR drop and 3DVMs. Subgroups analysis was performed for PAUDA-risk categories.Results100 patients for each group were analyzed after PSMA. RAPN with 3DVM presented a higher rate of selective/no clamping procedure (32% vs 16%, p = 0.03) and a higher enucleation rate (40% vs 29%, p = 0.04). As concern to primary endopoint, 12-month functional preservation performed better within 3DVM group in terms of creatinine serum level (median 1.2 [IQR 1.1–1.4] vs 1.6 [IQR 1.1–1.8], p = 0.03) and eGFR (median 64.6 [IQR 56.2–74.1] vs 52.3 [IQR 49.2–74.1], p = 0.03). However, this result was confirmed only in the PADUA ≥ 10 renal masses. Regarding secondary endpoints, no significative difference emerged between the two cohorts. MVA confirmed 3DVM as a protective factor for clinically significant eGFR drop only in high-risk (PADUA ≥ 10) masses.ConclusionsRAPN performed with the use of 3DVM assistance resulted in lower incidence of global ischemia and higher rate of enucleations. The positive impact of such technology was found at 12-month only in high-risk renal masses.

The interaction effect of high social support and resilience on functional connectivity using seed-based resting-state assessed by 7-Tesla ultra-high field MRI

Recent resilience research has increasingly emphasized the importance of focusing on investigating the protective factors in mentally healthy populations, complementing the traditional focus on psychopathology. Social support has emerged as a crucial element within the complex interplay of individual and socio-environmental factors that shape resilience. However, the neural underpinnings of the relationship between social support and resilience, particularly in healthy subjects, remain largely unexplored. With advances in neuroimaging techniques, such as ultra-high field MRI at 7T and beyond, researchers can more effectively investigate the neural mechanisms underlying these factors. Thus, our study employed ultra-high field rs-fMRI to explore how social support moderates the relationship between psychological resilience and functional connectivity in a healthy cohort. We hypothesized that enhanced social support would amplify resilience-associated connectivity within neural circuits essential for emotional regulation, cognitive processing, and adaptive problem-solving, signifying a synergistic interaction where strong social networks bolster the neural underpinnings of resilience. (n = 30). Through seed-based functional connectivity analyses and interaction analysis, we aimed to uncover the neural correlates at the interplay of social support and resilience. Our findings indicate that perceived social support significantly (p&amp;lt;0.001) alters functional connectivity in the right and left FP, PCC, and left hippocampus, affirming the pivotal roles of these regions in the brain’s resilience network. Moreover, we identified significant moderation effects of social support across various brain regions, each showing unique connectivity patterns. Specifically, the right FP demonstrated a significant interaction effect where high social support levels were linked to increased connectivity with regions involved in socio-cognitive processing, while low social support showed opposite effects. Similar patterns by social support levels were observed in the left FP, with connectivity changes in clusters associated with emotional regulation and cognitive functions. The PCC’s connectivity was distinctly influenced by support levels, elucidating its role in emotional and social cognition. Interestingly, the connectivity of the left hippocampus was not significantly impacted by social support levels, indicating a unique pattern within this region. These insights highlight the importance of high social support levels in enhancing the neural foundations of resilience and fostering adaptive neurological responses to environmental challenges.

Risk factor analysis and nomogram development and verification for medullary carcinoma of the colon using SEER database

Medullary Carcinoma of the Colon (MCC) is a rare histological subtype of colon cancer, and there is currently no recognized optimal treatment plan for it, with its prognosis remaining unclear. The aim of this study is to analyze the independent prognostic factors for MCC patients and develop and validate nomograms to predict overall survival (OS). A total of 760 patients newly diagnosed with MCC from 2004 to 2020 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. All patients were randomly allocated to a training group and a validation group in a 7:3 ratio. Univariate and multivariable Cox regression analyses were conducted to identify prognostic factors and construct nomograms. The nomogram prediction model was evaluated and validated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). The study found that elderly women are more susceptible to MCC, and the ascending colon and cecum are the most common sites of involvement. MCC is poorly differentiated, with stages II and III being the most common. Surgery is the primary treatment for MCC. The prognosis for patients with stage IV MCC is poor, with a median survival time of only 10 months. Independent prognostic factors for MCC include age, N stage, M stage, surgery, chemotherapy, and tumor size. Among them, age < 75 years and completion of chemotherapy were protective factors for colon medullary carcinoma, while N2 (HR = 2.18, 95%CI 1.40–3.38), M1 (HR = 3.31, 95%CI 2.01–5.46), no surgery (HR = 27.94, 95%CI 3.69–211.75), and tumor diameter > 7 cm (HR = 1.66, 95%CI 1.20–2.30) were risk factors for colon medullary carcinoma. The results of ROC, AUC, calibration curves, and DCA demonstrate that the nomogram prediction model exhibits good predictive performance. We have updated the demographic characteristics of colon medullary carcinoma and identified age, N staging, M staging, surgery, chemotherapy and tumor size as independent prognostic factors for colon medullary carcinoma. Additionally, we have established nomograms for prognostic prediction. These nomograms can provide personalized predictions and serve as valuable references for clinical decision-making.

Protective and Risk Factors for Suicidal Behaviour in Self-Declared LGBTIQ+ Adolescents

Background: Adolescents who identify as sexual minorities often face social stigmatisation, which can lead to increased adversity and a higher risk of suicidal behaviours. However, there are also protective factors that may promote resilience to these risk behaviours. This study aims to identify factors that predict resilience in sexual minority adolescents with high suicidal vulnerability. Methods: The study sample comprised 78 self-reported LGBTIQ+ adolescents aged between 13 and 18 years old (M = 16.11, SD = 1.56) who had previously attempted suicide. They completed several psychosocial instruments to measure risk and protective variables related to suicidal vulnerability. Results: Entrapment was found to be the most predictive risk variable for suicide attempts. However, protective variables promoting resilience were also found, such as adequate parental communication, life satisfaction, and cognitive reframing. Discussion: The findings related to prevention of suicide attempts are discussed and we highlight the urgent need to enhance certain internal and contextual protective factors to promote resilience in the face of suicidal vulnerability in certain clinical subpopulations exposed to highly adverse situations.

Modifiable protective factors for mental health resilience in the offspring of depressed parents: A high‐risk longitudinal cohort spanning adolescence and adulthood

AbstractBackgroundSeveral protective factors have been identified for mental health (MH) resilience in adolescent offspring of depressed parents. However, it is unclear if these effects persist into adulthood.MethodsDepressed parents and their offspring (N = 188) from the Early Prediction of Adolescent Depression study were assessed four times (mean offspring ages 12.39, 13.77, 14.82, and 23.41). Mental health resilience was examined using residual scores (better‐than‐expected mood‐, behaviour‐, or anxiety‐related MH at mean age 23 given risk exposure), and categorically as sustained good MH across adolescence and young adulthood.ResultsOnly 9.2% of young adults demonstrated sustained good MH. Parents of resilient individuals showed lower comorbidity (anxiety, antisocial behaviour and harmful drinking) and higher depression remission. Considering adolescent protective factors, weak evidence was observed of associations of mood‐resilience with adolescent peer‐relationship quality (β = −0.20, 95%CI:−0.36, −0.04); friendship quality (β = −0.14, 95%CI:−0.31, 0.02); risk adjustment (β = −0.16, 95%CI:‐0.34, 0.03) and dysfunctional attitudes (β = 0.18, 95%CI:0.01, 0.35). There was weak evidence of behavioural‐resilience association with parent positive expressed emotion (β = −0.15, 95%CI:−0.31, 0.02) and offspring exercise (β = −0.37, 95%CI:−0.77, 0.03). No adolescent protective factors showed an association with anxiety‐resilience. For sustained good MH, there was weak evidence of an association with inhibitory control (OR = 0.39, 95%CI:0.14, 1.07). Strong evidence was observed for associations between young adult‐reported peer relationship quality and mood‐resilience (β = −0.35, 95%CI:−0.53, −0.17), behavioural‐resilience (β = −0.33, 95%CI:−0.51, −0.14) and anxiety‐resilience (β = −0.34, 95%CI:−0.53, −0.14), while weak evidence was observed of an association of social activities with anxiety‐resilience (β = −0.51, 95%CI:−0.97, −0.06).ConclusionsWe found limited evidence for the long‐lasting effects of adolescent protective factors on adult MH resilience. Social factors remained protective into young adulthood, while family factors did not. Early preventative intervention might not be sufficient to maintain good long‐term MH, and young people will likely require more prolonged support.