Potential Variables Research Articles

History of Chronic Energy Deficiency (CED) during Pregnancy and the Incidence of Stunting among Children Aged 0-59 Months in East Jakarta

Based on SSGI data (2021), the prevalence of stunting among under-five children in DKI Jakarta Province was 16.8%. Meanwhile, based on the Ministry of Health Republic of Indonesia Performance Report for 2021, there were 3.1% of pregnant women with Chronic Energy Deficiency (CED) in DKI Jakarta Province. This study aims to determine the correlation between a history of Chronic Energy Deficiency (CED) during pregnancy and the incidence of stunting among children aged 0-59 months in East Jakarta. This study involved secondary data derived from the e-PPGBM application for the City of East Jakarta in 2021 with a sample size of 2,688 people and data were analyzed using Cox-regression. Based on the results of data analysis, it was found that the proportion of pregnant women with a history of CED was 3.7% and the proportion of under-five children with stunting was 21.1%. The multivariate analysis on the correlation between a history of CED during pregnancy and the incidence of stunting after being controlled by the potential confounder variable obtained a PR of 1.354 (95% CI: 0.922-1.988). It can be concluded that there was no significant correlation between a history of CED during pregnancy and the incidence of stunting in the East Jakarta area in 2021 after being controlled by the potential confounder variable. However, there are still possible confounder factors that should be analyzed further.

Change in Sleep Latency as a Mediator of the Effect of Physical Activity Intervention on Executive Functions Among Children with ADHD: A Secondary Analysis from a Randomized Controlled Trial.

This study aimed to explore the potential mediating role of sleep quality in the effect of physical activity (PA) intervention for improving executive functions (EFs) in children with attention-deficit hyperactivity disorder (ADHD). Participants aged 6 to 12years old with a formal ADHD diagnosis were recruited from a local hospital. A total of 80 eligible children with ADHD were randomized to an intervention group for 12 consecutive weeks of PA training (three times per week, 60min per session) (n = 40; Mage = 8.37, 75% boys) or a wait-list control group (n = 40; Mage = 8.29, 80% boys). Three core EFs (inhibitory control, working memory, and cognitive flexibility) were assessed by neurocognitive tasks, and sleep quality was measured by the Chinese version of the Pittsburgh Sleep Quality Index. The bootstrapping method was used to test PA intervention effects on EFs and on potential variables of sleep quality after intervention and to test whether there were indirect effects of the intervention on EFs via mediators of sleep. The results showed that the PA intervention had a direct effect on sleep latency reduction (β = -0.26, 95%CI -0.47 to -0.06) and cognitive flexibility improvement (decrease in completion time) (β = -0.30, 95%CI -0.50 to -0.09). Furthermore, change in sleep latency significantly mediated the effects of PA intervention on cognitive flexibility (β = -0.084, 95%CI -0.252 to -0.001). The findings suggest that sleep latency could be a crucial behavioral mediator of PA intervention in improving cognitive flexibility among children with ADHD.

The effect of confounding variables on the relationship between anthropometric and physiological features in 2000-m rowing ergometer performance.

Background: Anthropometric and physiological characteristics are often considered as potential variables that are significantly related with motor performance. Aim: The aim of this study was to identify and weigh the key anthropometric and physiological characteristics that are associated with 2000-m rowing ergometer performance in male and female athletes. Methods: The study involved 70 best female and 130 best male rowers from the seven largest Hungarian rowing clubs, classified into one of the following age categories: juniors (36 women and 55 men, age range: 15-16years), older juniors (26 women and 52 men, age range: 17-18years), and seniors (8 women and 23 men, age range: over 18years). Anthropometric and body composition measurements were determined by the bioelectrical impedance method proposed by Weiner and Lourie (1969), and skin fold measurements were conducted to estimate relative body fat content. The countermovement jump test and the 2000-m maximal rowing ergometer test were used for physiological measurements. Results: An increase in skeletal muscle mass was correlated (r = -.39, p <.001) with a significant decrease in rowing time over a distance of 2000m, whereas a significant increase in rowing time was noted with an increase in sitting height (only in men, r = .33, p <.001), body mass (in women and men: r = .24, p = .013 and r = .31, p = .009), and body fat percentage (r = .26, p < .030). Rowing time was also bound by a significant correlation with maximal force (r = -.79 and -.90, p <.001) and relative maximal power (r = -.54 and -.78, p <.001) in both sexes, with relative peak power in males (r = -.51, p < .001), and with estimated relative maximal aerobic capacity in females (r = -.43, p <.001). Conclusion: Rowing performance over a distance of 2000m is significantly negatively correlated with the skeletal muscle mass, maximal force, relative maximal power, relative peak power, and estimated relative maximal aerobic capacity.

Prediction of the Duration to Next Admission for an Acute Affective Episode in Patients with Bipolar I Disorder

Predicting disease relapse and early intervention could reduce symptom severity. We attempted to identify potential indicators that predict the duration to next admission for an acute affective episode in patients with bipolar I disorder. We mathematically defined the duration to next psychiatric admission and performed single-variate regressions using historical data of 101 patients with bipolar I disorder to screen for potential variables for further multivariate regressions. Age of onset, total psychiatric admissions, length of lithium use, and carbamazepine use during the psychiatric hospitalization contributed to the next psychiatric admission duration positively. The all-in-one found that hyperlipidemia during the psychiatric hospitalization demonstrated a negative contribution to the duration to next psychiatric admission; the last duration to psychiatric admission, lithium and carbamazepine uses during the psychiatric hospitalization, and heart rate on the discharge day positively contributed to the duration to next admission. We identified essential variables that may predict the duration of bipolar I patients' next psychiatric admission. The correlation of a faster heartbeat and a normal lipid profile in delaying the next onset highlights the importance of managing these parameters when treating bipolar I disorder.

0420 Sleep onset misperception in youths with insomnia: Correlates and implications for treatment

Abstract Introduction Individuals with insomnia often show subjective-objective sleep discrepancy, especially an overestimation of their sleep onset latency (SOL) while the factors associated with such discrepancy remained unclear. Whilst cognitive behavioral therapy for insomnia (CBT-I) has been recommend as the first-line treatment for insomnia, there has been limited research to investigate the effects of CBT-I on sleep onset perception in youths with insomnia. The present study aimed to identify potential variables related to sleep onset misperception and explore the effects of CBT-I on sleep onset misperception among youths with insomnia. Methods Sixty treatment-seeking youths with insomnia (mean: 19.74 ±2.42, female: 55%) were recruited to assess for their sleep and clinical characteristics using self-report questionnaires and 7-days sleep diary and actigraphy (T1). A subset of the sample (N=19) further completed an 8-week CBT-I programme and assessed at one-week post-treatment (T2) and 6-month follow-up (T3). Sleep misperception index was computed by subtracting actigraphy-measured SOL from sleep diary reported SOL, where a higher value indicates a higher degree of SOL overestimation. Demographic, clinical and sleep-related variables were compared between high versus low sleep onset misperception groups as divided by the mean of the sample. Changes in sleep onset misperception after CBT-I were analyzed using repeated measures ANOVA. Results High sleep onset misperception group demonstrated a significantly higher degree of anxiety symptoms (t(28)=-3.92, p&amp;lt;.01) and pre-sleep cognitive arousal (t(28)=-0.49, p&amp;lt;.05) as compared to low sleep onset misperception group. Participants who completed CBT-I showed a significant decrease in subjective-objective SOL discrepancy (T1=19.52, T2=6.96, T3=-1.37). A post-hoc pairwise comparison using the Bonferroni correction suggested a significant decrease in subjective-objective SOL discrepancy from T1 to T3 (p&amp;lt;.05). Significant improvement in pre-sleep cognitive arousal was found from T1 to T3 (&amp;lt;.001) and such an improvement was found to be significantly correlated with the reduction in sleep onset misperception (r=0.16, p&amp;lt;.05). Conclusion Sleep onset misperception is associated with anxiety symptoms and pre-sleep cognitive arousal in youths with insomnia. Preliminary evidence supports that CBT-I is effective in improving sleep onset misperception in youths with insomnia. Future research should explore the neurophysiological mechanism underlying sleep onset misperception and the changes of such a discrepancy upon intervention. Support (if any)

Molybdenum is not a risk factor for changes in serum testosterone

Molybdenum is a bio-essential trace nutrient, and elevated urinary molybdenum has been implicated as correlating with lower testosterone levels in men. To properly address the contention that molybdenum constitutes a potential health risk factor, we reviewed statistical research findings on molybdenum exposure and somatic levels in humans in a biological plausibility context, which is an indispensable component of reliable risk factor determination. Our analysis applied advanced nonparametric statistical modeling that expands linear regressions to include more potential variables and common confounders. The analysis shows that previously published negative molybdenum-testosterone associations no longer retain statistical relevance. In place of molybdenum as a stressor responsible for lowered testosterone levels, body mass index, age, related hormone variability, and underlying global downward trends in testosterone are shown to be the factors responsible for this effect.

Conflict Management in MSME: An Empirical Study

This research focuses on the three project management facets of the iron triangle that the project manager must handle. Cost is one major issue that causes conflict in the project management triangle. Our research indicates that proactively addressing salary-related issues within the constraints can resolve many possible conflicts and improve team dynamics. Micro, small, and medium enterprises (MSMEs) play a crucial role in the development and growth of the IT solutions industry. The study was conducted at IT solutions under MSMEs, and the sample comprised 109 IT professionals: business analysts, developers, testers, cloud-based jobs, data engineers and leads. The salary was identified as one of the potential variables of the source of conflict. The study confirmed a meaningful relationship between salary perceptions and job roles. Data analysis was conducted using ANOVA, and a contrast test was carried out using IBM SPSS 25 for specific comparisons among the job roles.

Perceptions of professional social media interaction with patients and faculty members – a comparative survey among dental students from Malaysia and Finland

BackgroundProfessional and personal boundaries are blurred with the wide application of social media (SM) in the health professions line of work. Little is known about practice of extending friend requests to patients and faculty members among dental students, which encompass a part of E-professionalism. The aim of this study is to assess the factors associated with the perceptions and practices of interactions with patients and faculty on SM among dental students from Malaysia and Finland.MethodsDental students from 4 institutions in Malaysia and Finland completed self-administered questionnaires on the practices and perceptions of SM use. The main variables assessed were the perceptions and practices of student-patient and student-faculty communication on SM, between the two countries. Students’ country, age, gender, time spent on SM and perceived importance of communicating dental related aspects over SM were analysed as potential explanatory variables. Crosstabulation was used to estimate the distributions of the response variables by the background characteristics. Multivariate analyses were performed using a dichotomous logistic regression model to investigate relevant associations between the responses and the explanatory variables independent from other factors.ResultsA total of 643 students completed the survey in March-April 2021. More Malaysian students agreed with “guiding patients online is a new responsibility for dentists in the digital age” compared to Finnish students (86.4% vs. 73.4%). Similarly, significantly more Malaysian students befriended patients (14.1% vs. 1%) and invited faculty to be friends on SM (73.6% vs. 11.8%). Expectedly, clinical year students befriended patients more than pre-clinical (13.8% vs. 6.8%). Significantly more students who felt ‘communication of dental related issues over SM’ were likely to extend friend requests to faculty rather than accept patient friend requests.ConclusionsSocial media regulations and socio-cultural practices contribute to dental students’ attitudes and behaviour when befriending patients and faculty members on social media. Future dental curriculum should incorporate guidelines for professional communication on social media based on local and cultural needs. Students’ should be encouraged to interact with their patients using professional identities on social media.

Cognitive impairment in long-COVID and its association with persistent dysregulation in inflammatory markers.

To analyze the potential impact of sociodemographic, clinical and biological factors on the long-term cognitive outcome of patients who survived moderate and severe forms of COVID-19. We assessed 710 adult participants (Mean age = 55 ± 14; 48.3% were female) 6 to 11 months after hospital discharge with a complete cognitive battery, as well as a psychiatric, clinical and laboratory evaluation. A large set of inferential statistical methods was used to predict potential variables associated with any long-term cognitive impairment, with a focus on a panel of 28 cytokines and other blood inflammatory and disease severity markers. Concerning the subjective assessment of cognitive performance, 36.1% reported a slightly poorer overall cognitive performance, and 14.6% reported being severely impacted, compared to their pre-COVID-19 status. Multivariate analysis found sex, age, ethnicity, education, comorbidity, frailty and physical activity associated with general cognition. A bivariate analysis found that G-CSF, IFN-alfa2, IL13, IL15, IL1.RA, EL1.alfa, IL45, IL5, IL6, IL7, TNF-Beta, VEGF, Follow-up C-Reactive Protein, and Follow-up D-Dimer were significantly (p<.05) associated with general cognition. However, a LASSO regression that included all follow-up variables, inflammatory markers and cytokines did not support these findings. Though we identified several sociodemographic characteristics that might protect against cognitive impairment following SARS-CoV-2 infection, our data do not support a prominent role for clinical status (both during acute and long-stage of COVID-19) or inflammatory background (also during acute and long-stage of COVID-19) to explain the cognitive deficits that can follow COVID-19 infection.

When the time is right: testing for dynamic effects in collaborative performance

ABSTRACT Evaluations of public service collaborations tend to ignore time and timing as potential explanatory variables. Drawing on theories of environmental dynamism, organizational inertia, accountability ‘drift’, and isomorphism, we test whether the timing of inter-municipal cooperation, and its duration, affect financial performance for solid waste collection inter-municipal partnerships in the Spanish region of Catalonia over the period 2000–2019. Though still present and significant, the cost advantages of cooperation declined over this period due to population growth and reduced interdependence between municipalities. Timing of cooperation has no effect on savings; although early-adopter and follower groups differ in policy objectives.

The problem of cross risk of arterial hypertension progression, obstructive sleep apnea syndrome and COVID-19

This review considers the risk factors for arterial hypertension (AH) progression, obstructive sleep apnea syndrome (OSAS) and novel coronavirus infection (COVID-19) as potential variables for the prognostic models of estimating the probability of destabilization of the mentioned conditions. The most published studies consider AH and OSAS as the risk factors influencing the course of COVID-19, while moderate and mild COVID-19 can be destabilizing factor regarding to AH and OSAS. In addition, COVID-19, AH and OSAS are interrelated with sleep quality. The worsening of sleep quality often can be both a consequence of these diseases and a factor aggravating their course, and also can cause the increased vulnerability to acute diseases. An increased body mass index is a universal risk factor for many diseases and clinical conditions, and the monitoring of body mass increases the degree of the control of the diseases associated with obesity. In addition, the worsening of sleep quality can be both a consequence of any of above-mentioned conditions and a factor aggravating their course. Also, a promising direction for improving prognostic models is the analysis of autonomic dysfunction in patients.

Testability design of memristive digital circuits based on Knowm memristor

A multi-function memristive logic test unit based on Knowm memristor is designed and implemented to the memristive digital circuits testability design in this article. The single fault memristive digital circuit is analyzed, Boolean difference algorithm is applied to the memristive digital circuits to generate test patterns and determine the location of the fault nodes. The multi-function memristive logic test unit can realize different functions, combining Boolean difference to solve the problem of uncertain faults with the same test patterns, and improve the controllability and observability of memristive digital circuits. It is a new exploration in testability design of memristive digital circuits, which provides new ideas and development directions, and lays a foundation for the research on the testability design of multi fault memristor digital circuits.

Using machine learning to predict outcomes following carotid endarterectomy

ObjectivePrediction of outcomes following carotid endarterectomy (CEA) remains challenging, with a lack of standardized tools to guide perioperative management. We used machine learning (ML) to develop automated algorithms that predict outcomes following CEA. MethodsThe Vascular Quality Initiative (VQI) database was used to identify patients who underwent CEA between 2003 and 2022. We identified 71 potential predictor variables (features) from the index hospitalization (43 preoperative [demographic/clinical], 21 intraoperative [procedural], and 7 postoperative [in-hospital complications]). The primary outcome was stroke or death at 1 year following CEA. Our data were split into training (70%) and test (30%) sets. Using 10-fold cross-validation, we trained six ML models using preoperative features (Extreme Gradient Boosting [XGBoost], random forest, Naïve Bayes classifier, support vector machine, artificial neural network, and logistic regression). The primary model evaluation metric was area under the receiver operating characteristic curve (AUROC). After selecting the best performing algorithm, additional models were built using intra- and postoperative data. Model robustness was evaluated using calibration plots and Brier scores. Performance was assessed on subgroups based on age, sex, race, ethnicity, insurance status, symptom status, and urgency of surgery. ResultsOverall, 166,369 patients underwent CEA during the study period. In total, 7749 patients (4.7%) had the primary outcome of stroke or death at 1 year. Patients with an outcome were older with more comorbidities, had poorer functional status, and demonstrated higher risk anatomic features. They were also more likely to undergo intraoperative surgical re-exploration and have in-hospital complications. Our best performing prediction model at the preoperative stage was XGBoost, achieving an AUROC of 0.90 (95% confidence interval [CI], 0.89-0.91). In comparison, logistic regression had an AUROC of 0.65 (95% CI, 0.63-0.67), and existing tools in the literature demonstrate AUROCs ranging from 0.58 to 0.74. Our XGBoost models maintained excellent performance at the intra- and postoperative stages, with AUROCs of 0.90 (95% CI, 0.89-0.91) and 0.94 (95% CI, 0.93-0.95), respectively. Calibration plots showed good agreement between predicted and observed event probabilities with Brier scores of 0.15 (preoperative), 0.14 (intraoperative), and 0.11 (postoperative). Of the top 10 predictors, eight were preoperative features, including comorbidities, functional status, and previous procedures. Model performance remained robust on all subgroup analyses. ConclusionsWe developed ML models that accurately predict outcomes following CEA. Our algorithms perform better than logistic regression and existing tools, and therefore, have potential for important utility in guiding perioperative risk mitigation strategies to prevent adverse outcomes.

Livestock producers' knowledge, attitude, and behavior (KAB) regarding antimicrobial use in Ethiopia.

Inappropriate antimicrobial use (AMU) in livestock production is an important aspect of the global burden of antimicrobial resistance (AMR). In Ethiopia, a low-income country with a large and increasing livestock population, AMU in food animals is not properly regulated. Hence, farmers are fully free to use antimicrobials to their (perceived) benefit. Therefore, understanding farmers' mindsets is important to improve antimicrobial stewardship in the livestock sector. This cross-sectional study was conducted to assess livestock disease management practices and knowledge, attitude, and behavior (KAB) among livestock producers regarding AMU, residues, and resistance, as well as factors potentially explaining differences in KAB. We determined the KAB of livestock owners of three selected districts of central and western Ethiopia (n = 457), using a pretested questionnaire administered through face-to-face interviews. Logistic regression was used to evaluate the association between potential explanatory variables and the KAB scores of the respondents. The results showed that 44% of the farmers used antimicrobials in the past few years, where antibiotics (21%) and trypanocides (11%) were most widely used to manage livestock diseases. Furthermore, most farmers showed poor knowledge about AMU, residues, and AMR (94%) and unfavorable attitudes (<50% correct answers) toward contributing factors for AMR (97%). On the contrary, 80% of the respondents had overall good behavior scores (≥50% correct answers) related to AMU. Multivariate analysis results showed that having good knowledge, keeping ≥2 animal species, and the occurrence of ≥4 livestock diseases on the farm in a year were strong predictors of bad behavior scores (p < 0.05). The findings of the current investigation also revealed that the incidence of livestock diseases on the farm and a higher level of formal education significantly contributed to better knowledge and desirable attitudes but bad AMU behavior. A low level of awareness about and undesirable attitudes toward AMU and AMR could potentially affect farmers' behavior toward judicious AMU, thus requiring awareness creation efforts on livestock disease management practices.

When do I feel good when I am nice? A diary study about the relationship between prosocial behavior and well‐being

AbstractPrevious research has shown that prosocial behavior not only benefits the person being helped, but also promotes the well‐being of the person helping. Still, several specific characteristics of the helping situation have not yet been considered in one single study. Thus, we examined under which circumstances the helper's well‐being is more or less positively influenced. We carried out a 7‐day diary study with 363 participants who reported on their everyday prosocial behavior as well as their well‐being. We examined the effect of 13 potential moderation variables based on theoretical assumptions of self‐determination theory and theories about reciprocity and altruism, as well as invested resources. Overall, the results replicated the positive effect of prosocial behavior on well‐being. However, the helper's autonomy, the recipient's gratitude and low responsibility for the situation, the improvement of the situation through helping, and low expected self‐blame (when not helping) on the side of the helper were necessary conditions. Moreover, taking within‐subject effects into consideration, significant random effects in multilevel models showed that the effect of prosocial behavior on well‐being can highly differ from person to person, emphasizing that not all people under all circumstances are happier when they help others.

DNA methylation profile of human dura and leptomeninges.

Healthy meninges are used as control tissue in meningioma studies usually without specification of the exact meningeal layer or macroanatomical origin but the DNA methylation profile of human meninges has not been investigated on a macroanatomical level. We undertook a proof-of-principle analysis to determine whether (1) meningeal tissues show sufficiently homogenous DNA methylation profiles to function as normal control tissue without further specification and (2) if previously described location-specific molecular signatures of meningiomas correspond to region-specific DNA methylation patterns. Dura mater and arachnoid membrane specimens were dissected from 5 anatomical locations in 2 fresh human cadavers and analyzed with the Illumina Infinium MethylationEPIC array. Dura and leptomeninges showed marked differences in global DNA methylation patterns and between rostral and caudal anatomical locations. These differences did not reflect known anatomical predilection of meningioma molecular signatures. The highest numbers of differentially methylated probes were annotated to DIPC2 and FOXP1. Samples from foramen magnum showed hypomethylation of TFAP2B compared to those from remaining locations. Thus, the DNA methylation profiles of human meninges are heterogenous in terms of meningeal layer and anatomical location. The potential variability of DNA methylation data from meningiomas should be considered in studies using meningeal controls.

HPV-infection status and urinary incontinence: a population-based analysis of the NHANES 2005-2016.

Urinary incontinence is a common condition and reduces the quality of life. The purpose of this study was to assess the association between HPV infection and urinary incontinence among adult women in the USA. We examined a cross-sectional study using the National Health and Nutrition Examination Survey database. Women who had valid HPV DNA vaginal swab test results and answered the questionnaire about urinary incontinence were selected from six consecutive survey cycles (2005-2006 to 2015-2016). The association between HPV status and urinary incontinence was analyzed using weighted logistic regression. Models adjusted for potential variables were established. In total, 8348 females aged between 20 and 59years old were enrolled in this study. 47.8% of participants had a history of urinary incontinence and 43.9% of women were HPV DNA positive. After adjusting for all confounders, women with HPV infection were less likely to have urinary incontinence (OR = 0.88, 95%CI 0.78-0.98). Low-risk HPV infection correlated with a lower incidence of incontinence (OR = 0.88, 95%CI 0.77-1.00). For women aged below 40years, low-risk HPV infection negatively correlated with stress incontinence (20-29ys: OR = 0.67, 95%CI 0.49-0.94; 30-39ys: OR = 0.71, 95%CI 0.54-0.93). However, low-risk HPV infection positively correlated with stress incontinence (OR = 1.40, 95%CI 1.01-1.95) for women 50-59years old. This study revealed a negative association between HPV infection and urinary incontinence in females. Low-risk HPV correlated with stress urinary incontinence, with the reverse trend for participants of different ages.

Dimensional Analysis of Double-Track Microstructures in a Lithium Niobate Crystal Induced by Ultrashort Laser Pulses

Double-track microstructures were induced in the bulk of a z-cut lithium niobate crystal by 1030 nm 240 fs ultrashort laser pulses with a repetition rate of 100 kHz at variable pulse energies exceeding the critical Kerr self-focusing power. The microstructure topography was characterized by atomic force microscopy in piezoelectric response mode. The spatial positions of laser-induced modification regions inside lithium niobate in the case of laser beam propagation along the crystal optical axis can be directly predicted by simple analytical expressions under the paraxial approximation. A dimensional analysis of the morphology of the double-track structures revealed that both their length and width exhibit a monotonous increase with the pulse energy. The presented results have important implications for direct laser writing technology in crystalline dielectric birefringent materials, paving the way to control the high spatial resolution by means of effective energy deposition in modified regions.

The impact of geopolitical risk, governance, technological innovations, energy use, and foreign direct investment on CO2 emissions in the BRICS region.

Geopolitical risk (GPR) and other social indicators have raised many somber environmental-related issues among government environmentalists, and policy analysts. To further elucidate whether or not these indicators influence the environmental quality, this study investigates the impact of GPR, corruption, and governance on environmental degradation proxies by carbon emissions (CO2) in BRICS(Brazil, Russia, India, China, and South Africa) countries, namely Brazil, Russia, India, China, and South Africa, using data over the period 1990 to 2018. The cross-sectional autoregressive distributed lag (CS-ARDL), fully modified ordinary least square (FMOLS), and dynamic ordinary least square (DOLS) methods are usedfor empirical analysis. First and second-generation panel unit root tests report a mixed order of integration. The empirical findings show that government effectiveness, regulatory quality, the rule of law, foreign direct investment (FDI), and innovation have a negative effect on CO2 emissions. In contrast, geopolitical risk, corruption, political stability, and energy consumption have a positive effect on CO2 emissions. Based on the empirical outcomes, the present research invites the concentration of central authorities and policymakers of these economies toward redesigning more sophisticated strategies regarding these potential variables to protect the environment.

The same parastomal hernia repairs rate in the different approaches to colostomy.

This study aimed to compare the parastomal hernia repairs rate in the different approaches to colostomy and investigate the risk factors for parastomal hernia formation in patients with permanent colostomies. Consecutive rectal cancer patients who underwent abdominoperineal resection from June 2014 to July 2020 in West China Hospital were divided into two groups according to their surgical approach for permanent colostomies. The impact of different approaches to colostomy on parastomal hernia repairs was determined by comparing a group of patients receiving an extraperitoneal route to colostomy with a group receiving transperitoneal. Potential variables were evaluated first with univariate and then multivariate analyses to identify the risk factors for the formation of parastomal hernia. Two hundred two subjects in the transperitoneal group and 103 in the extraperitoneal group attended the follow-up visit with a median follow-up period of 33 (25th-75th percentiles, 17-46) months. Clinically and radiologically detectable parastomal hernias were present in 76 of 202 (37.6%) and 14 of 103 (13.6%) subjects in the transperitoneal and extraperitoneal groups during the follow-up period (p＜0.01). Besides, 10 of 76 (13.1%) subjects in the transperitoneal group and 2 of 14 (14.3%) subjects in the extraperitoneal group underwent a parastomal hernia operation during the follow-up (p = 0.82). In addition, the transperitoneal approach of colostomy (p = 0.002), older age (p＜0.001), and higher body mass index (p = 0.013) were identified as independent risk factors for the occurrence of parastomal hernia. Extraperitoneal colostomy decreased the detectable parastomal hernias but did not reduce the surgical repair rate of parastomal hernias.