Search

Postoperative morbidity following hepatectomy for hepatocellular carcinoma (HCC) is common and its impact on long-term oncological outcome remains unclear. This study aimed to investigate if postoperative morbidity impacts long-term survival and recurrence following hepatectomy for HCC. The data from a multicenter Chinese database of curative-intent hepatectomy for HCC were analyzed, and independent risks of postoperative 30-day morbidity were identified. After excluding patients with postoperative early deaths (≤90 days), early (≤2 years) and late (>2 years) recurrence rates, overall survival (OS), and time-to-recurrence (TTR) were compared between patients with and without postoperative morbidity. Among 2,161 patients eligible for the study, 758 (35.1%) had postoperative 30-day morbidity. Multivariable logistic regression analysis showed that diabetes mellitus, obesity, Child-Pugh grade B, cirrhosis, and intraoperative blood transfusion were independent risks of postoperative morbidity. The rates of early and late recurrence among patients with postoperative morbidity were higher than those without (50.7% vs. 38.8%, P < 0.001; and 41.7% vs. 34.1%, P = 0.017). Postoperative morbidity was associated with decreased OS (median: 48.1 vs. 91.6 months, P < 0.001) and TTR (median: 19.8 vs. 46.1 months; P < 0.001). After adjustment of confounding factors, multivariable Cox-regression analyses revealed that postoperative morbidity was associated with a 27.8% and 18.7% greater likelihood of mortality (hazard ratio 1.278; 95% confidence interval: 1.126–1.451; P < 0.001) and recurrence (1.187; 1.058–1.331; P = 0.004). This large multicenter study provides strong evidence that postoperative morbidity adversely impacts long-term oncologic prognosis after hepatectomy for HCC. The prevention and management of postoperative morbidity may be oncologically important. [ABSTRACT FROM AUTHOR]

Background/objectives Few data exist about the relationship between rosuvastatin use and acute pancreatitis. We tested a plausible hypothesis that rosuvastatin use might be associated with acute pancreatitis in Taiwan. Methods We designed a case-control study using a randomly sampled database of the Taiwan National Health Insurance Program. We identified 5728 subjects with the first episode of acute pancreatitis in 1998-2011 as the case group and we randomly selected 22,912 sex- and age-matched subjects without acute pancreatitis as the control group. Subjects who never received a rosuvastatin prescription were defined as never use of rosuvastatin. Subjects who at least received 1 prescription for rosuvastatin within 7 days before the date of diagnosing acute pancreatitis were defined as active use of rosuvastatin. Subjects who did not receive a prescription within 7 days but at least received 1 prescription for rosuvastatin ≥ 8 days before the date of diagnosing acute pancreatitis were defined as non-active use of rosuvastatin. Those at least receiving 1 prescription for other statins or non-statin lipid-lowering drugs were excluded from this study. We estimated the odds ratio with 95% confidence interval for acute pancreatitis associated with rosuvastatin use by using the multivariable unconditional logistic regression model. Results The multivariable analysis disclosed that the adjusted odds ratio for acute pancreatitis in subjects with active use of rosuvastatin was 3.21 (95% confidence interval 1.70, 6.06). The adjusted odds ratio was 0.90 in subjects with non-active use of rosuvastatin (95% confidence interval 0.67, 1.19), without statistical significance. Conclusions We observed active use of rosuvastatin to be associated with increased risk for acute pancreatitis. [ABSTRACT FROM AUTHOR]

• It is one of the first empirical studies on the relationship between psychological cues and fake reviews. • It examines the influence of time distance and reviewer location on fake reviews. • It identifies whether there is a statistical difference between authentic and fake reviews when photos are added. • It helps practitioners better identify fake reviews using psychological cues, time distance, and reviewer location. • It contributes to the literature on deviant online behavior (DOB) and interpersonal deception theory (IDT). Although fake online reviews have been gaining more attention from both academics and practitioners, little effort has been made to explore the linguistic characteristics of the psychological processes related to fake reviews. This research proposes four linguistic cues (i.e. , affective, cognitive, social, and perceptual) related to a reviewer's psychological processes and explores their relationships with fake reviews while examining the influence of time distance and reviewer location on these reviews. The results of logistic regression analysis of 43,496 reviews from Yelp.com suggest that affective, social, and perceptual cues are significantly related to fake reviews with the presence of the significant effects of time distance and reviewer location. Further, the results of post-hoc analysis confirm that the effect of photos on fake reviews is limited. This study contributes to the body of knowledge on online reviews and interpersonal deception theory, providing valuable implications for practitioners in the hospitality and tourism industry. [ABSTRACT FROM AUTHOR]

Introduction: Studies have proven that the crash possibility and crash type are not the same among different expressway segment types. However, few studies have conducted real-time safety analysis considering different segment types. This study aimed to explore the crash mechanism's heterogeneity for different segment types (i.e., merge, diverge, weaving, and basic segments). Method: To enable in-depth exploration, this study used detailed traffic data, which were 0–10 min before crash, at 1-min intervals, and from five detectors of both the upstream and downstream to the target segment. This study analyzed the crash mechanism's heterogeneity from the following aspects: crash characteristics, significant crash contributing variables, and variables' importance. Based on this, a variables selection method was proposed to solve the huge dimension scale in modeling. Then, a nested logit model was built, which could consider the crash mechanism's heterogeneity, to quantitatively analyze the impact of crash contributing factors on the crash risk. Results: The results revealed that there are statistically significant differences in crash characteristics between each segment type. Additionally, the sources of most crash contributing factors were found to be significantly different in the spatial–temporal dimension between each segment type. Moreover, this study found that the weather parameter, indicating pavement's wet condition, had a similar effect on crash risk between different segment types. However, the geometry and traffic parameters had significantly different impacts between different segment types. Moreover, when the number of target segments' upstream ramps increases or when the distance between ramps and the target segment decreases, the crash risk would increase. Practical Applications: This study can be applied in the intelligent transportation system to improve traffic safety performance, especially in active traffic management systems. [ABSTRACT FROM AUTHOR]

Background Context: Anterior controllable antedisplacement and fusion (ACAF) is a novel surgical technique for the treatment of ossification of the posterior longitudinal ligament (OPLL). Its prognostic factors for decompression have not been well studied. Additionally, no detailed radiological standard has been set for hoisting the vertebrae-OPLL complex (VOC) in ACAF.Purpose: To identify the possible prognostic factors for decompression outcomes after ACAF for cervical OPLL, to determine the critical value of radiological parameters for predicting good outcomes, and to establish a radiological standard for hoisting the VOC in ACAF.Study Design: This was a retrospective multicenter study.Patient Sample: A total of 121 consecutive patients with OPLL who underwent ACAF at a point between January 2017 and June 2018 at any one of seven facilities and were monitored for at least 1 year afterward were enrolled in a multicenter study.Outcome Measures: Japanese Orthopedic Association (JOA) scores, recovery rate (RR) of neurologic function, and surgical complications were used to determine the effectiveness of ACAF.Methods: Patients were divided into two groups according to their RR for neurologic function. Patients with an RR of ≥50% and an RR of <50% were designated as having good and poor decompression outcomes, respectively. The relationship between various possible prognostic factors and decompression outcomes was assessed by univariate and multivariate analysis. The receiver operating characteristic curve was used to determine the optimal cutoff value of the radiological parameters for prediction of good decompression outcomes. Next, the patients were redivided into three groups according to the cutoff value of the selected radiological parameter (postoperative anteroposterior canal diameter [APD] ratio). Patients with postoperative APD ratios of ≤80.7%, 80.7%-100%, and ≥100% were defined as members of the incomplete, optimal, and excessive antedisplacement groups, respectively. Differences in decompression outcomes among the three groups were compared to verify the reliability of the postoperative APD ratio and assess the necessity of excessive antedisplacement.Results: Multivariate logistic regression analysis showed that patients' age at surgery (odds ratio [OR]=1.18; 95% confidence interval [CI]=1.08-1.29; p<.01) and postoperative APD ratio (OR=0.83; 95% CI=0.77-0.90; p<.01) were independently associated with decompression outcomes. The optimal cutoff point of the postoperative APD ratio was calculated at 80.7%, with 86.2% sensitivity and 73.5% specificity. There were no significant differences in the postoperative JOA scores and RRs between the excessive antedisplacement group and optimal antedisplacement group (p>.05). However, a lower incidence of cerebrospinal fluid leakage and screw slippage was observed in the optimal antedisplacement group (p<.05).Conclusions: Patients' age at surgery and their postoperative APD ratio are the two prognostic factors of decompression outcomes after ACAF. The postoperative APD ratio is also the most accurate radiological parameter for predicting good outcomes. Our findings suggest that it is essential for neurologic recovery to restore the spinal canal to more than 80.7% of its original size (postoperative APD ratio >80.7%), and restoration to less than its original size (postoperative APD ratio <100%) will help reduce the incidence of surgical complications. This may serve as a valuable reference for establishment of a radiological standard for hoisting the VOC in ACAF. [ABSTRACT FROM AUTHOR]

Background: Major depressive disorder (MDD) is common among older adults. The epidemiology of MDD is greatly influenced by sociocultural and economic factors. This study examined the 1-month and lifetime prevalence of MDD and its socio-demographic correlates in older adults living in Hebei province, an agricultural area of China.Methods: Multistage, stratified, random sampling was administered between April and August 2016. The diagnosis of MDD was established with the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV) Axis I Disorders.Results: A total of 3911 participants were enrolled. The 1-month and lifetime prevalence of MDD in older adults was 2.0% (95%CI: 1.6-2.4%) and 3.4% (95%CI: 2.8-4.0%), respectively. Multivariable logistic regression analyses revealed that female gender [P < 0.001, adjusted odds ratio (aOR) = 2.6, 95%CI: 1.53-4.53], presence of comorbid major medical conditions (P < 0.001, aOR = 4.8, 95%CI: 2.17-10.39) and family history of psychiatric disorders (P = 0.013, aOR = 3.4, 95%CI: 1.30-8.96) were independently and significantly associated with higher odds of MDD.Conclusion: The prevalence of MDD in older adults in Hebei province, China, was lower than most findings in China and other countries. Nevertheless, continued surveillance of elderly depression in China along with the development of primary, secondary and tertiary preventative interventions for the elderly with MDD is indicated. [ABSTRACT FROM AUTHOR]

The role of circular RNAs (circRNAs) in coronary artery disease (CAD) remains elusive. The aim of the present study was to profile circRNAs expression in CAD patients and assess diagnostics biomarkers for CAD. The circRNA profiles of 24 CAD patients and 7 controls were assessed by microarray. The expression levels of candidate circRNAs were further verified by qRT-PCR in large cohorts. Logistic regression analysis and receiver operating characteristic were conducted to assess the diagnostic value. Gain-of-function approach was used to determine the functional significance of validated circRNA in THP-1-derived macrophages. A total of 624 circRNAs and 171 circRNAs were significantly upregulated and downregulated, respectively, in CAD patients relative to controls. Hsa_circ_0001879 and hsa_circ_0004104 were validated to be significantly upregulated in large cohorts. The receiver operating characteristics analysis of hsa_circ_0001879 and hsa_circ_0004104 in CAD patients and controls showed that the area under curve was 0.703 (95% confidence interval: 0.656–0.750; p < 0.001) and 0.700 (95% confidence interval: 0.646–0.755; p < 0.001), respectively. The combination of hsa_circ_0001879 and hsa_circ_0004104, together with CAD risk factors, had the better performance to discriminate CAD patients from healthy controls. Overexpression of hsa_circ_0004104 resulted in dysregulation of atherosclerosis-related genes in THP-1-derived macrophages. We offered a transcriptome-wide overview of aberrantly expressed circRNAs in CAD patients and identified two novel circRNA biomarkers to diagnose CAD. Upregulation of hsa_circ_0004104 might contribute to the pathogenesis of CAD. Image 1 • We offered a transcriptome-wide overview of aberrantly expressed circRNAs in CAD patients. • hsa_circ_0001879 and hsa_circ_0004104 were identified as novel circRNA biomarkers for diagnosing CAD. • Hsa_circ_0004104 might contribute to the pathogenesis of atherosclerosis and CAD by regulating atherosclerosis related genes expression. [ABSTRACT FROM AUTHOR]

Background: Major depressive disorder (MDD) is a common psychiatric disorder which is associated with significant disability and psychosocial factors. There are only few epidemiological studies of MDD in economically underdeveloped regions of China. This study examined the 1-month and lifetime prevalence of MDD and their sociodemographic correlates in Hebei province, China.Methods: Using multistage, stratified and random sampling, the study was conducted between April and August 2016. The diagnosis of MDD was established using the Structured Clinical Interview for DSM-IV Axis I Disorders-Patient Edition.Results: The weighted 1-month and lifetime prevalence of MDD were 0.9% (95%CI: 0.8-1.1%) and 1.6% (95%CI: 1.4-1.8%), respectively in the sample of 14,654 adult participants. Multiple logistic regression analysis revealed that the age group of 45-59 years (P < 0.001, OR=3.206, 95%CI:1.693-6.072), female gender (P < 0.001, OR=2.171, 95%CI: 1.522-3.097), married marital status (P < 0.001, OR=0.328, 95%CI: 0.198-0.545), college educational level or higher (P = 0.006, OR=0.145, 95%CI: 0.037-0.573), employment (P = 0.010, OR=2.305, 95%CI: 1.220-4.353), major medical conditions (P < 0.001, OR=3.758, 95%CI: 2.607-5.418) and family history of psychiatric disorders (P < 0.001, OR=3.947, 95%CI: 2.203-7.071) were significantly associated with MDD.Conclusion: The prevalence of MDD in Hebei province was found to be lower than in most areas of China and other countries. Further studies are warranted to confirm the low prevalence of MDD in other economically underdeveloped regions of China. [ABSTRACT FROM AUTHOR]

This study investigated whether sleep duration and quality were related to life satisfaction (LS) among older Chinese adults and whether depression mediated those relationships. Cross-sectional data from the aging arm of the Rugao Longevity and Aging Study were used. Sleep duration, sleep quality, depression, LS and covariates were analyzed using logistic regressions. To assess the potential mediation of depression on the association between sleep duration and quality and LS, Aroian tests were used. Of 1756 older Chinese adults aged 70–84 years, 90.7% of the men and 83.3% of the women reported being satisfied with their lives. After adjusting for covariates, older adults who slept ≤6 h per night were more likely to suffer from life dissatisfaction compared with those who slept 7–8 h (OR = 2.67, 95% CI 1.86–3.79), and individuals who slept poorly were almost 2 times (OR = 2.91, 95% CI 2.16–3.91) more likely to have life dissatisfaction. The Aroian tests confirmed that these relationships were partially mediated by depression (p < 0.001). Between short sleep and LS, the mediating effect of depression accounted for 13.9% of the total effects. Moreover, the mediating effect of depression on the association between sleep quality and LS was 13.3%. Short sleep duration and poor sleep quality were inversely associated with LS, and the relationships were partially mediated by depression. Our study suggests that both sleep and depression status are important factors for LS among the elderly. [ABSTRACT FROM AUTHOR]