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Objectives: A meta-analysis has explored the effect of psychotherapy on the quality of life (QOL) but has not explored the effect on advanced cancer patients' survival, which is highly debated. Therefore, we consider the survival days and QOL as the primary outcomes in our analysis. Methods: Eligible studies were collected from four databases (PubMed, Embase, Cochrane Library, and Web of Science) until February 20, 2021. The pooled effect sizes were presented as weighted mean difference (WMD) or relative risk (RR) with 95% confidence intervals (CIs). Publication bias was evaluated by Egger's test, and I 2 statistics was used to assess the heterogeneity. Results: Thirty-three studies were finally included, containing 2,159 patients in the psychotherapy group and 2,170 patients in the control group. McGill Quality of Life Questionnaire (MQOL) and European Organization for Research and Treatment of Cancer Quality of Life-C15-Palliative (EORTC-QLQ-C15-Pal) supported that QOL of the psychotherapy group was significantly higher than that of the control group, and WMD value was 0.42 (95% CI: 0.12–0.71) and 17.26 (95% CI: 11.08–23.44), respectively. No significant difference was observed between the two groups regarding to the survival time (WMD: 17.85, 95% CI: −8.79, 44.49, P = 0.189). Moreover, the levels of anxiety, depression, confusion, pain, and suffering were lowered in psychotherapy group (all P < 0.05). Significance of results: Psychotherapy could improve the QOL of advanced cancer patients but not affect the survival time. [ABSTRACT FROM AUTHOR]

Abstract Background and Objective Among cancers, gastric cancer has the fifth highest incidence worldwide and is the third most common mortality factor, which may have been due to inadequate knowledge of its molecular pathogenesis. The retinoblastoma gene (RB1), a tumor suppressor gene, may have a role in gastric cancer. This research aims to assess Rb expression as a prognostic marker to obtain more insight regarding gastric cancer. Methods This retrospective analytical study was done on 61 patients (45 males and 16 females) with gastric adenocarcinoma admitted from 2010 to 2012 in Shahid Sadoughi and Mortaz hospitals, Yazd, Iran. Demographic data, including age, gender, clinical signs and symptoms, and pathology reports, were retrieved from patients' hospital folders. Then, the altered Retinoblastoma gene expression was evaluated by immunohistochemistry studies. Acquired data were analyzed by SPSS software v.16. p 0.05). There was only a meaningful relationship between the grade of tumors and survival rate (p = 0.039). Conclusion Altered pRB expression is not common in gastric cancer and does not impact the survival and grading of tumors. Poorly differentiated tumors had an ominous outcome with the lowest survival time.

Rhizoctonia solani AG-3 TB primarily causes tobacco target spot disease by producing a large number of sexual spores. However, inducing sexual spore formation under in vitro conditions has been challenging, impeding further research on its control. In this study, field experiments were conducted to assess the effects of different concentrations of chemical and biological fungicides on the production of sexual spores of R. solani AG-3 TB on tobacco plants. The results demonstrated that four chemical fungicides (propiconazole-morpholine guanidine, bordeaux mixture, thiophanate-methyl, and mancozeb) significantly induced sexual spore formation. Among them, increasing the concentrations of the first three fungicides resulted in an increase in the number of sexual spores, while increasing the concentration of mancozeb led to a decrease in spore count. The pathogenic fungus produced more sexual spores during the night than during the day. Temperature, humidity, and light conditions influenced spore production. Additionally, the infection rate of sexual spores was directly proportional to their concentration and inoculation time, but their survival time did not exceed 6 h in vitro. Importantly, Streptomyces rectiolaceus A8 significantly suppressed sexual spore formation, achieving an 83.63% control efficacy in the field and producing antimicrobial substances against R. solani AG-3 TB. In conclusion, appropriate concentrations of chemical fungicides can induce sexual spore formation, while A8 can inhibit their production, showing potential value for controlling tobacco target spot disease.

Objective: To explore the expression levels and survival prediction of plasmacytoma variant translocation 1 (PVT1) and MYC gene in pan-cancer. Methods: The clinic data and RNA-seq data from 31 types of cancer tissues totaling 10 016 cases were retrieved from The Cancer Genome Atlas (TCGA) database, among which 23 types of cancer with adjacent tissues as normal controls. Student t-tests were used to analyze the significant differences of PVT1 or MYC gene expression levels between cancer tissues and corresponding normal controls. Spearman correlation was used to analyze the expression correlation between PVT1 and MYC in 31 types of cancer. The relationship between PVT1 or MYC expression and overall survival of 31 types of cancer patients was depicted by the Kaplan-Meier curve and Cox proportional hazards model. Results: =PVT1 expression was highly expressed in 19 types of cancer(P0, P

Background. Since the first outbreak of COVID-19, most hospitals restricted patients’ family support accompaniment during medical treatment of infectious transmission. On the other hand, accompaniment has also been recognized as an essential part of the treatment. Therefore, this study aims to determine the effect of family presence accompanying COVID-19 patients during hospitalization on the recovery rate and survival time. Objective: this study was conducted in a private hospital designated as a referral hospital for COVID-19 cases in Surabaya, East Java province, Indonesia. Materials and Methods: There were 541 COVID-19 patients included in the study, consisting of 251 women and 290 men. The requirements set as a sample are patients treated between January 1st 2021 and March 31st 2021. This study used a survival analysis study design. The data used is secondary data and uses total sampling. Results: The result of this study is that patients who get support from their families can survive longer than patients who do not get family support. Among the 251 female samples, only 34 were accompanied by their families, with 29.411% fatalities recorded. Among 290 male patients, 25.71% fatalities were recorded in 35 accompanying family presence. Furthermore, female patients have a probability of better outcomes than males (P0.001). Conclusions: Based on these results, family presence has the benefit of improving outcomes and recovery. So, the authorities are expected to reconsider the restrictions on family presence by maintaining proper safety protocols of isolation and quarantine.

IntroductionChimeric antigen receptor (CAR) T cell therapy has achieved unprecedented efficacy recently. However, the factors related to responses and durable remission are elusive. This study was to investigate the impact of pre-lymphodepletion (pre-LD) absolute lymphocyte count (ALC) on CAR T cell therapy outcomes.MethodsWe conducted a retrospective study of 84 patients with relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL) who underwent CAR T cell treatment at the Affiliated Hospital of Xuzhou Medical University between March 1,2016 and December 31, 2021. The enrolled patients were divided into high group and low group according to the optimal cutoff value of pre-LD ALC. The Kaplan-Meier analyses was used to calculate survival curves. The Cox proportional hazards model was used for univariate and multivariate analysis to assess the prognostic factors.ResultsThe ROC showed that the optimal cutoff value of pre-LD ALC was 1.05 x 109/L. The overall response (defined as partial response or complete response) rate was significantly higher in patients with a high pre-LD ALC (75% versus 52.08%; P=0.032). Patients with a low pre-LD ALC had significantly inferior overall survival (OS) and progression-free survival (PFS) compared with those having a high pre-LD ALC (median OS, 9.6 months versus 45.17 months [P=0.008]; median PFS, 4.07 months versus 45.17 months [P= 0.030]). Meanwhile, low pre-LD ALC is an independent risk factor for PFS and OS.DiscussionThe data suggested that pre-LD ALC may serve as a helpful indicator to predict the outcomes of CAR T cell therapy in patients with R/R DLBCL.

Background: The purpose of our study is to investigate the expression level and prognostic value of serum α-hydroxybutyrate dehydrogenase (α-HBDH) in lung cancer (LC) patients. Method: LC patients treated in the Department of Oncology, Shaanxi Provincial Cancer Hospital from January 2014 to December 2016 were included in this study, all of whom underwent serological detection of α-HBDH prior to admission, and were enrolled in follow-up 5-year survival. Comparing the differences between high group and normal groups based on α-HBDH and LDH expression via clinicopathological parameters and laboratory data. Univariate and multivariate regression and overall survival (OS) were analyzed to explore whether elevated α-HBDH was an independent risk factor for LC, compared to LDH. Results: Multivariate regression analysis showed that age (P = 0.018), liver metastasis (P = 0.011), α-HBDH (P = 0.015), and neutrophil-to-lymphocyte ratio (NLR) (P = 0.031) were independent prognostic factors affecting OS in LC patients. The overall diagnostic efficacy of α-HBDH (AUC = 0.887) was higher than that of LDH (AUC = 0.709) in the ROC curve. The sensitivity was significantly higher of α-HBDH (sensitivity: 76.06%, specificity: 94.87%) compared with LDH (sensitivity: 49.30%, specificity: 94.87%). The median of OS was more significant in the high-α-HBDH group (6.4 months) than in the normal-α-HBDH group (12.7 months) (P = 0.023). The median of OS was significant in the high-LDH (> 245 U/L) group at 5.8 months and 12.0 months in the normal-LDH (≤ 245 U/L) group (P = 0.068). Conclusions: Elevated expression of α-HBDH may indicate a poor prognosis of LC patients. It has a higher sensitivity than LDH and can be used as a potential early biomarker and an independent risk factor predicting the prognosis of LC survival. [ABSTRACT FROM AUTHOR]

Pseudomonas syringae pv. actinidiae (Psa) is the causal agent of kiwifruit canker, a serious threat to commercial kiwifruit production worldwide. Studies of the movement path and the survival time of Psa in the host are crucial for integrated management programs. Hence, we used Psa with GFPuv gene (Psa-GFPuv) strain to investigate the movement path of Psa in leaves and branches, and the survival time of Psa in leaves under different environmental conditions. We found that the pathogen Psa spread longitudinally in the branches and leaves rather than transverse path. Additionally, the survival time of bacteria in fallen leaves under different environmental conditions were simulated by the way of Psa infecting the detached kiwifruit leaves. Psa survives the longest, up to 43 days in detached kiwifruit leaves with high humidity (above 80%) at 5 °C, and up to 32 days with low humidity (20%). At 15 °C, the Psa can survive in detached kiwifruit leaves for 20–30 days with increasing humidity. At 25 °C, it can only survive for 3 days with low humidity (20%) and 15 days with high humidity (above 80%). Furthermore, the population growth experiments showed that bacterial growth of Psa was more favorable in detached kiwifruit leaves with above 80% humidity at 5 °C. These results suggest that the survival condition of Psa in detached kiwifruit leaves is significantly affected by environmental conditions, and provide the basis for the control timing and technology of kiwifruit canker. [ABSTRACT FROM AUTHOR]

Background: Cervical cancer is the 4th most common cancer in women worldwide. as well as the 4th most common cause of cancer-related death. The main objective of this study was to identify factors that affect the survival time of outpatients with cervical cancer. Methods: A retrolective study including outpatients with cervical cancer was carried out in a hospital. To achieve the aim, 322 outpatients with cervical cancer were included in the study based on the data taken from the medical records of patients enrolled from May 15, 2018, to May 15, 2022, at the University of Gondar referral hospital, Gondar, Ethiopia. The Kaplan–Meier plots and log-rank test were used for the comparison of survival functions; the Cox-PH model and Bayesian parametric survival models were used to analyze the survival times of outpatients with cervical cancer. Integrated nested Laplace approximation methods have been applied. Results: Out of a total of 322 patients, 118 (36.6%) died as outpatients. The estimated median survival time for patients was 42 months. Using model selection criteria, the Bayesian log-normal accelerated failure time model was found to be appropriate. According to the results of this model, oral contraceptive use, HIV, stage, grade, co-morbid disease, history of abortion, weight, histology type, FIGO stage, radiation, chemotherapy, LVSI, metastatic number, regional nodes examined, and tumor size all have a significant impact on the survival time of outpatients with cervical cancer. The Bayesian log-normal accelerated failure time model accurately predicted the survival time of cervical cancer outpatients. Conclusions: The findings of this study suggested that reductions in weight, treatment, the presence of comorbid disease, the presence of HIV, squamous cell histology type, having a history of abortion, oral contraceptive use, a large tumor size, an increase in the International Federation of Gynecologists and Obstetricians stage, an increase in metastasis number, an increase in grade, positive regional nodes, lymphatic vascular space invasion, and late stages of cancer all shortened the survival time of cervical cancer outpatients. [ABSTRACT FROM AUTHOR]

Purpose: Non-small-cell lung cancer (NSCLC) comprises approximately 80% of all lung malignancies. The 5-year survival rate of patients with advanced lung cancer who lost their chances of surgery is approximately 15%. Suitable animal models are important in screening individualized treatment plans for patients with lung cancer, evaluating the pre-clinical efficacy of new drugs, and conducting basic research. Patients and Methods: In this study, we collected malignant pleural effusion (MPE) samples from 31 patients with NSCLC, successfully constructed 11 NSCLC patient-derived xenografts (PDXs), and analyzed the factors affecting their successful establishment. Primary PDX tumors were characterized using histological analysis, immunohistochemistry, short tandem repeat (STR) profiling, and cytogenetic analysis. Results: The PDXs preserved the histopathology and protein expression pattern of parental tumors. STR analysis revealed the PDX tissue and a tumor tissue of the same individual origin. Statistical analysis showed that the survival time of patients reflected the malignant degree of MPEs to a certain extent, thus affecting the establishment of PDXs. However, the age, gender, and clinical and biochemical indicators of the patients did not affect the establishment of PDX models. Conclusion: These data suggest that the established NSCLC PDXs preserved the molecular characteristics of primary lung cancer and can serve as a new tool to elucidate the pathogenesis of tumors, explore new treatment methods, and conduct the research and development of new drugs for tumors. [ABSTRACT FROM AUTHOR]

In this paper, we develop an inferential method based on conformal prediction, which can wrap around any survival prediction algorithm to produce calibrated, covariate-dependent lower predictive bounds on survival times. In the Type I right-censoring setting, when the censoring times are completely exogenous, the lower predictive bounds have guaranteed coverage in finite samples without any assumptions other than that of operating on independent and identically distributed data points. Under a more general conditionally independent censoring assumption, the bounds satisfy a doubly robust property which states the following: marginal coverage is approximately guaranteed if either the censoring mechanism or the conditional survival function is estimated well. The validity and efficiency of our procedure are demonstrated on synthetic data and real COVID-19 data from the UK Biobank. [ABSTRACT FROM AUTHOR]

Introduction: Creutzfeldt-Jakob disease (CJD) is a fatal and irreversible neurodegenerative disease. Identification of inexpensive and easy-to-implement biomarkers of CJD which could predict disease severity and patient survival is important for improving disease management. The aim of this study was to assess the predictive value of peripheral neutrophil to lymphocyte ratio (NLR), high-density lipoprotein (HDL), monocyte to HDL ratio (MHR) and neutrophil to HDL ratio (NHR) for CJD. Methods: Patients with definite or probable CJD admitted to the Neurology Department of Xuanwu Hospital from 2014 to 2021 were enrolled and followed up until April 2022. Clinical information including sex, age, Barth Index, survival time and results of auxiliary examination were collected, and NLR, HDL, NHR and MHR were measured for all enrolled patients. The associations between NLR, HDL, NHR and MHR, and disease severity (evaluated by Barth Index), survival time and auxiliary examinations were evaluated. Results: A total of 88 CJD patients were enrolled and all were deceased. NLR (r = -0.341, p = 0.001), NHR (r = -0.346, p = 0.001) and MHR (r = -0.327, p = 0.002) were significantly associated with disease severity. Higher NHR (HR = 2.344, 95% CI = 1.277–4.303 p = 0.006) and lower HDL (HR = 0.567, 95% CI = 0.346–0.930, p = 0.025) were associated with shorter survival time in the CJD patients. Conclusions: Peripheral inflammatory biomarkers, especially NHR, were associated with disease severity and survival duration. These findings provide new insights into the mechanisms and treatment strategies of CJD. [ABSTRACT FROM AUTHOR]

Although developing large-scale hydropower cascades in the upper Yangtze River effectively improves the hydropower resource utilization, it produces total dissolved gas (TDG) supersaturation. In the flood season, the high level of TDG supersaturation (TDGS) frequently occurs in the downstream of dams, causing migratory fish to suffer from gas bubble trauma (GBT) and reducing their survival and swimming ability. Currently, there is a deficiency in particular approaches to evaluate the ecological hazard posed by TDGS on migratory fish as they traverse different flow velocities within their migratory routes. This study assessed the vulnerability of juvenile Schizothorax prenanti (S. prenanti) to GBT from the static setting to 9.0 BL/s during exposure to nominal levels of 100%, 110%, 120% and 130% TDG. The mortality occurs when the flow velocity surpasses 6.0 and 7.5 BL/s in 100% and 110% TDG levels, respectively. For fish exposed to 120% and 130% TDG levels, the relationship between survival time and flow velocity is an approximately inverse bell-shaped curve with increasing velocity. The optimal velocity of maximal survival time of juvenile S. prenanti is 3.0 and 4.5 BL/s in 120% and 130% TDG-supersaturated water. Both TDG level and flow velocity significantly affect burst swimming speed (Uburst) and critical swimming speed (Ucrit). The cases involving GBT showed substantial declines in Uburst and Ucrit, exceeding 6.0 BL/s and TDG levels greater than 120%. The results may contribute to formulating a specific management strategy for hydropower operation during the migratory period and conserving vulnerable species in the Yangtze River. [ABSTRACT FROM AUTHOR]

This study aimed to identify clinical characteristics of cancer patients with incidental pulmonary embolism (IPE) and assess the variables associated with 30-day mortality in cancer patients with PE including symptomatic pulmonary embolism (SPE) and IPE. 6-Month mortality rate in cancer patients with SPE and IPE were also compared. We retrospectively analyzed electronic medical records of cancer patients with newly diagnosed PE between January 2016 and June 2021. We compared clinical and radiological characteristics in cancer patients with IPE and SPE and identified variables associated with the overall 30-day mortality on multivariate analysis. All patients were followed up for 6 months and survival analysis was performed by use of Kaplan-Meier. Five hundred and nine eligible cancer patients with pulmonary embolism were identified during the study period. IPE is associated with lower BMI, colorectal and pancreas cancers, stage III/IV of cancer, recent antiangiogenic therapy, central venous catheter (CVC) and chronic cardiac or respiratory disease compared to SPE. The factors associated with 30-day mortality included poor performance status, lung/pleura or upper gastrointestinal cancers, stage III/IV of cancer, previous VTE, oxygen saturation < 95%, lactic acid > 2 mmol/l and bilateral PE. The overall survival in patients with IPE at 6-month follow-up was similar to those diagnosed with SPE. The present study has allowed the identification of factors associated with 30-day mortality in cancer patients with IPE and SPE. We also found similar mortality rate in cancer patients with IPE compared with patients with SPE at 6-month follow-up. [ABSTRACT FROM AUTHOR]

Abstract Objective To investigate pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) safety and efficacy in preventing hematological toxicity during concurrent chemoradiotherapy (CCRT) for small-cell lung cancer (SCLC). Methods We retrospectively assessed 80 SCLC patients treated with CCRT from January 2013 to December 2018 who received PEG-rhG-CSF within 48 hours after the end of chemotherapy, defined as prophylactic use, as the experimental group. An additional 80 patients who were not treated with PEG-rhG-CSF were matched 1:1 by the propensity score matching method and served as the control group. The main observations were differences in hematological toxicity, neutrophil changes, febrile neutropenia (FN) incidence and adverse reactions. Progression-free survival (PFS) and overall survival (OS) were analyzed with regular assessment and follow-up. Results The leukocyte, neutrophil, erythrocyte, and platelet counts and hemoglobin level decreased after CCRT, but the experimental group had slightly higher leukocyte and neutrophil counts than the control group (P

Muhammed Siraj,1 Sisay Gedamu,2 Belachew Tegegne2 1Department of Nursing, Tropical College of Medicine, Dessie, Ethiopia; 2Department of Nursing, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, EthiopiaCorrespondence: Belachew Tegegne, Department of Nursing, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia, Email beletegegne@gmail.comBackground: Antiretroviral therapy (ART) enhances the survival of HIV-infected patients by reducing viral load and increasing CD4. As CD4 count increases, patients are more protected against opportunistic infections. In developing countries including Ethiopia, there were limited studies about the survival benefit of ART particularly no study in Kombolcha Town. Thus, this study was aimed to address the gap.Methods: A hospital-based retrospective cohort study was employed in Kombolcha town among 510 patients’ records from January 2015 to December 2019. A systematic random sampling technique was used to select patient records. The collected data were checked, coded, and entered into Epidata version 4.6 and exported to Statistical Package for Social Sciences version 26 for data cleaning and analysis. Kaplan–Meier was used to estimate the probability of category of each predictor and a log rank test was used to compare survival curves. Bivariate and multivariate Cox-regression were employed using a 95% CI and variables with p-value < 0.05 were declared as predictors of poor survival time.Results: In this cohort, out of 510 HIV-infected patients, 39 (7.65%) were died, and 471 (92.35%) were censored. Fair drug adherence (AHR=6.88, 95% CI: 4.31– 24.04), Poor drug adherence (AHR=9.58, 95% CI: 8.72– 30.97), CD4 count < 50 cell/μL (AHR=9.38, 95% CI: 1.48– 59.31), CD4 count 50– 99 cell/μL (AHR=9.67, 95% CI: 1.80– 51.73), bedridden (AHR=9.5, 95% CI: 4.49– 18.66), opportunistic infections (AHR=4.58, 95% CI: 1.20– 5.65), weight < 60kg (AHR=2.48, 95% CI:1.59, 10.38), WHO stage III (AHR=3.56, 95% CI: 1.71– 17.89), WHO stage IV (AHR=4.42, 95% CI:1.75– 25.93) were predictors of poor survival time.Conclusion: The Kaplan–Meier result showed that the estimated median survival time of patients after ART initiation in Kombolcha town was higher (32 months) as compared to other studies. Poor drug adherence, WHO stage III & IV, Lower baseline CD4 count, presence of opportunistic infections, weight < 60kg, and being bedridden were predictors of poor survival time. Thus, early initiation of ART ought to be encouraged among HIV-infected patients and good patient counseling on the level of adherence should be strengthened.Keywords: survival time, predictors, Kombolcha, HIV/AIDS

The SIS model is a classic model from epidemiology that formalizes a variety of diffusion processes on networks, such as biological infections and information dissemination. In this model, vertices are either infected or susceptible to an infection. Infected vertices infect their neighbors independently at a rate λ > 0 , and each infected vertex becomes susceptible at a rate of 1. Overall, these dynamics imply that each susceptible vertex with exactly m infected neighbors becomes infected at rate λ m , that is, linear in m. However, it has been observed that various processes exhibit a non-linear scaling of the infection rate with respect to m. For these kinds of processes, no fully rigorous guarantees exist so far. We address this shortcoming by considering a variant of the SIS model in which vertices get infected at a rate that scales polynomially in the number of their infected neighbors, weighted by the infection coefficient λ. We give the first fully rigorous results for thresholds of λ at which the expected survival time becomes super-polynomial. For cliques we show that when the infection rate scales sub-linearly, the threshold only shifts by a poly-logarithmic factor, compared to the standard SIS model. In contrast, super-linear scaling changes the process considerably and shifts the threshold by a polynomial term. For stars, sub-linear and super-linear scaling behave similar and both shift the threshold by a polynomial factor. Our bounds are almost tight, as they are only apart by at most a poly-logarithmic factor from the lower thresholds, at which the expected survival time is logarithmic. [ABSTRACT FROM AUTHOR]

• Explores pedestrian survival time and EMS response time across DACs and non-DACs. • Links 5-year fatal crashes with justice40 and analyzes using 2SRI treatment models. • EMS response time is higher, and survival time is lower in DACs vs. non-DACs. • Delayed EMS response time is linked to greater survival time reduction in DACs. • Enhanced infrastructure for better crash detection and EMS efficiency in DACs. The Vision Zero-Safe Systems Approach prioritizes fast access to Emergency Medical Services (EMS) to improve the survivability of road users in transportation crashes, especially concerning the recent increase in pedestrian-involved crashes. Pedestrian crashes resulting in immediate or early death are considerably more severe than those taking longer. The time gap between injury and fatality is known as survival time, and it heavily relies on EMS response time. The characteristics of the crash location may be associated with EMS response and survival time. A US Department of Transportation initiative identifies communities often facing challenges. Six disadvantaged community (DAC) indicators, including economy, environment, equity, health, resilience, and transportation access, enable an analysis of how survival and EMS response times vary across DACs and non-DACs. To this end, this study created a unique and comprehensive database by linking DACs data with 2017–2021 pedestrian-involved fatal crashes. This study utilizes two-stage residual inclusion models with segmentation for DACs and non-DACs accounting for the endogenous relationship between EMS response and pedestrian survival time. The results indicate that EMS response time is higher and pedestrian survival time is lower in DACs than in non-DACs. A delayed EMS response time is associated with a greater reduction in survival time in DACs compared to non-DACs. Factors, e.g., nighttime and interstate crashes, contribute to higher EMS response time, while pedestrian drugs, driver speeding, and hit-and-run behaviors are associated with a greater reduction in survival time in DACs than non-DACs. The implications of the findings are discussed in the paper. [ABSTRACT FROM AUTHOR]

• Primary hypothermia is caused by excessive exposure to low environmental temperature without any medical conditions prior to that. • Secondary hypothermia is caused by alteration in thermoregulation by disease, trauma, surgery, drugs or infections. • Notable differences were observed at baseline temperature, post-anesthesia induction temperature, and immediate post-submersion temperature. • There is a difference in survival time between primary and secondary hypothermia groups, depending on consumption and intoxication with alcohol or benzodiazepines. • The analysis of survival times following induced hypothermia showed a statistically significant difference among the groups. Hypothermia is defined as a body core temperature below 35 °C and can be caused by internal or external stress. Primary hypothermia is caused by excessive exposure to low environmental temperature without any medical conditions prior to that. Secondary hypothermia is caused by alteration in thermoregulation by disease, trauma, surgery, drugs, or infections. The aim of the research is to investigate core temperature values in rats subjected to specific water temperatures at five different time points. It focuses on distinguishing between primary and secondary hypothermia in these rats. The total 21 Wistar rats were divided into three experimental groups as: Control group rats exposed only to hypothermic condition (n = 7); Alcohol + hypothermia (n = 7); and Benzodiazepines + hypothermia (n = 7). The temperature spots analyzed in the study were: normal core temperature, core temperature during injection of 0,3 ketamine, temperature of immersion and the temperature at the onset of hypothermia and temperature at the time of death. In our study the comparative analysis of body temperatures at various time points following submersion in water revealed significant differences among the study groups treated with either alcohol or benzodiazepines and the control group. Notable differences were observed in baseline temperature, post-anesthesia induction temperature, and immediate post-submersion temperature. Specifically, significant differences were discovered among the alcohol and benzodiazepine groups (p < 0.001) and ranging from the alcohol and control groups (p < 0.001). The analysis of survival times following induced hypothermia revealed a statistically significant difference among the three experimental groups (p = 0.04), though subsequent post-hoc comparisons did not demonstrate significant differences in mean survival times. There is a difference in survival time between primary and secondary hypothermia groups, depending on consumption and intoxication with alcohol or benzodiazepines. The analysis of survival times following induced hypothermia showed a statistically significant difference among the groups. [ABSTRACT FROM AUTHOR]

Clinical prediction models are commonly utilized in clinical practice to screen high-risk patients. This enables healthcare professionals to initiate interventions aimed at delaying or preventing adverse medical events. Nevertheless, the majority of these models focus on calculating probabilities or risk scores for medical events. This information can pose challenges for patients to comprehend, potentially causing delays in their treatment decision-making process. Our paper presents a statistical methodology and protocol for the utilization of a Weibull accelerated failure time (AFT) model in predicting the time until a health-related event occurs. While this prediction technique is widely employed in engineering reliability studies, it is rarely applied to medical predictions, particularly in the context of predicting survival time. Furthermore, we offer a practical demonstration of the implementation of this prediction method using a publicly available dataset.

Abstract Background COVID19 patients may suffer from multiple cardiovascular complications. Recently, N-terminal of the prohormone brain natriuretic peptide (NT-proBNP) was a potentially independent risk factor for COVID-19 in-hospital death. The present study aimed to find new optimal cut points for NT-proBNP across censored survival failure time outcomes in hospitalized COVID-19 patients. Results This cohort study was conducted on 272 patients with COVID-19 whose initial records were recorded from March 2020 to July 2020. Demographic characteristics, clinical examinations, and laboratory measurements were collected at the beginning of the admission registered in the patient record system located in the hospital. We used the maximally selected rank statistics to determine the optimal cut points for NT-proBNP (the most significant split based on the standardized log-rank test). Survival time was defined as the days from hospital admission to discharge day. In this cohort study, two optimal cut points for NT-proBNP were 331 (pg/mL) and 11,126 (pg/mL) based on a survival model. The adjusted HR of NT-proBNP for in-hospital death was 3.41 (95% CI: 1.22–9.51, P = 0.02) for medium against low category, and 3.84 (95% CI: 1.30–11.57, P = 0.01) for high in comparison with low group. Conclusions We reported a dramatically increased concentration of NT-proBNP among COVID-19 patients without heart failure in both severe and non-severe cases. Moreover, our study showed that a high level of NT-proBNP was highly associated with the prolonged survival time of patients with COVID-19. NT-proBNP is a strong prognostic indicator of in-hospital death in the second week of admission.

Abstract Background Pieces of evidence strongly indicate that providing high-quality family planning services is accompanied by an increase in contraceptive uptake and a decrease in contraception discontinuation. Contraceptive, especially Implanon discontinuation is a global issue that could be linked to a summary outcome indicator of poor family planning service quality. Although Implanon is becoming more popular among Ethiopian contraceptive users, little is known regarding the survival and predictors of discontinuation. The study aimed at exploring the survival and predictors of Implanon discontinuation among women enrolled in family planning units of Public hospitals in southern Ethiopia, 2021. Methods A hospital-based retrospective cohort study was conducted among Implanon users who enrolled in family planning units of Public Hospitals. Five years of medical records, from January 1, 2016, to December 30, 2020, were reviewed. A total of 502 women were selected by using a random sampling technique. A standardized abstraction tool was used to collect data from medical records and registration books. The data were entered into Epidata Version 3.1 and then exported to STATA 14 for analysis. The median was calculated in the case of survival time. Across covariates, the Kaplan Meier survival curve was used to estimate time to Implanon discontinuation. To identify statistically significant predictors of Implanon discontinuation, a multivariable Cox proportional hazard model was fitted. Results The incidence rate of Implanon discontinuation was 1.87(95% CI = 1.63, 2.15) per 100 person-months of observation. The overall estimated survival probability at the end of 24 and 36 months was 67.4% (95%CI, 62.5, 71.8) and 25.9% (95%CI, 18.4, 34.1) months respectively. Residence [AHR = 1.50; 95%CI: 1.09, 2.08], parity [AHR = 2.02; 95%CI: 1.65, 3.67], pre-insertion counselling [AHR = 2.41; 95%CI: 1.72, 3.70], experiencing heavy vaginal bleeding [AHR = 3.91; 95%CI: 2.67, 5.32], post-insertion follow up [AHR = 3.15; 95%CI:2.11, 4.75] were identified as a significant predictors of Implanon discontinuation. Conclusion The risk Implanon of discontinuation was high, especially at 24 and 36 months. In family planning service delivery points, health care providers should pay special attention to clients who live in rural areas and do not have children. In addition, health care providers should provide pre-insertion counseling and post-insertion follow-up that focus on potential side effects. Finally, family planning units need to engage in early side effect management and reassurance to mitigate discontinuation.

Honglin Li,1,&ast; Chunzheng Ma,1,&ast; Sisi Chang,2 Yutan Xi,2 Shuai Shao,2 Mengli Chen,2 Juan Ren,2 Mingyue Sun,1 Liang Dong1 1Oncology Department, Henan Provincial Hospital of Traditional Chinese Medicine, Zhengzhou, Henan Province, People’s Republic of China; 2Oncology Department, Henan Provincial University of Traditional Chinese Medicine, Zhengzhou, Henan Province, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Honglin Li, Oncology Department, Henan Provincial Hospital of Traditional Chinese Medicine, No. 6 Dongfeng Road, Zhengzhou, 450002, People’s Republic of China, Email 46991701@qq.com Chunzheng Ma, Oncology Department, Henan Provincial Hospital of Traditional Chinese Medicine, No. 6 Dongfeng Road, Zhengzhou, 450002, People’s Republic of China, Email mchzh666@126.comObjective: Traditional Chinese medicine (TCM) is an ancient form of personalized medicine and may improve morbidity and mortality in patients with esophageal cancer. This retrospective study aimed to evaluate the utility of TCM in the treatment of stage IV esophageal squamous cell carcinoma (SCC).Methods: We collected the medical records of patients with stage IV SCC admitted to Henan Provincial Hospital of Traditional Chinese Medicine and Linzhou Hospital of Traditional Chinese Medicine between July 2017 and June 2020. We used univariate and multivariate analyses to determine if the use of TCM improved patient prognosis. Moreover, cluster analysis was used to classify the patients according to TCM syndrome type and identify the most frequently used combinations of remedies.Results: After that 402 patients were included in PSM, of which 196 (48.8%) were treated with traditional Chinese medicine. TCM prolonged the survival time of patients with stage IV esophageal SCC (P=0.084), and was an independently associated with prognosis as demonstrated by Cox multivariate regression analysis [risk ratio (RR) =0.543, 95% confidence interval (CI): 0.390– 0.755, P< 0.001]. Association analysis revealed 75 cases (38.26%) had obstruction of phlegm and qi syndrome, 53 cases (27.04%) had phlegm and blood stasis syndrome, 38 cases (19.39%) had yang-qi deficiency syndrome, and 30 cases (15.31%) had heat retention and fluid consumption syndrome.Conclusion: Treatment with TCM derived therapies may increase the survival time of patients with stage IV esophageal SCC. Since these patients were diagnosed with different TCM syndromes, individualized TCM therapy is essential for improving symptoms and survival.Keywords: esophageal cancer, survival time, traditional Chinese medicine syndrome type, syndrome differentiation, syndrome treatment

Abstract Aim To predict survival time of Korean hepatocellular carcinoma (HCC) patients using multi-center data as a foundation for the development of a predictive artificial intelligence model according to treatment methods based on machine learning. Methods Data of patients who underwent treatment for HCC from 2008 to 2015 was provided by Korean Liver Cancer Study Group and Korea Central Cancer Registry. A total of 10,742 patients with HCC were divided into two groups, with Group I (2920 patients) confirmed on biopsy and Group II (5562 patients) diagnosed as HCC according to HCC diagnostic criteria as outlined in Korean Liver Cancer Association guidelines. The data were modeled according to features of patient clinical characteristics. Features effective in predicting survival rate were analyzed retrospectively. Various machine learning methods were used. Results Target was overall survival time, which divided into approximately 60 months (= / 60 m). Target distribution in Group I (total 514 samples) was 28.8%: (148 samples) less than 60 months, 71.2% (366 samples) greater than 60 months, and in Group II (total 757 samples) was 66.6% (504 samples) less than 60 months, 33.4% (253 samples) greater than 60 months. Using NG Boost method, its accuracy was 83%, precision 84%, sensitivity 95%, and F1 score 89% for more than 60 months survival time in Group I with surgical resection. Moreover, its accuracy was 79%, precision 82%, sensitivity 87%, and F1 score 84% for less than 60 months survival time in Group II with TACE. The feature importance with gain criterion indicated that pathology, portal vein invasion, surgery, metastasis, and needle biopsy features could be explained as important factors for prediction in case of biopsy (Group I). Conclusion By developing a predictive model using machine learning algorithms to predict prognosis of HCC patients, it is possible to project optimized treatment by case according to liver function and tumor status.

Background: Poisoning has been one of the greatest medical emergencies from the dawn of human civilization, posing threat to mankind. Tripura being a seven sister state of Northeast India have a unique topography, diverse ethnic groups, cross-cultural food habits, agriculture, and a horticulture-based economy that draws some distinctive type of poisoning threats compared to the rest of the Indian subcontinent. The present study was carried out to find out the epidemiological factors, toxicological profiles, and clinical outcomes of patients after consumption of poison. Methods: A cross-sectional study on 212 patients with a complaint of poisoning was conducted in a teaching hospital in Tripura, India, for 2 years, and the data were analyzed by using SPSS-15 (Statistical Package for the Social Sciences) software. Results: Out of 212 participants, males from lower socioeconomic status, farmers by occupation, and belonging to the age group of 21–30 years predominated other categories. Organophosphorus compounds were majorly ingested (38.7%). Suicide was the most common manner of poisoning (62.73%). The majority of the patients (75%) died during treatment, 39.15% of patients died in the initial 24 hours and 43.87% of the patients had severe life-threatening symptoms [grade 3 of poison severity score (PSS)] during the first 72 hours of hospital admission. A Spearman rho value of −0.740 and a P value

Background: Hypoxia is an essential cause of fatigue and aging, and is associated with the occurrence and development of many diseases. Polygonatum kingianum (PK) is a deficiency-nourishing Chinese herbal medicine utilized as both medicine and food, and it has long been used to ameliorate human conditions associated with fatigue and aging over 2000 years in China. PK is an important genuine-medicinal-materials cultivated in Yunnan, China, and is used by the Bai, Wa, and Zhuang nationalities as a traditional medicine for enhancing immunity, anti-fatigue, and anti-aging, while the preventive effect of PK on hypoxia-induced injury and the underlying mechanism are indefinite. Aim of the study: The present study aimed to evaluate the anti-hypoxia efficacy and understand the corresponding mechanism of PK water extract. Materials and methods: The main active ingredients and targets of PK were predicted using network pharmacology, and the anti-hypoxia activities of Gracillin and Liquiritigenin were verified by in vitro experiments. The pharmacodynamic experiments were conducted to evaluate the major signal pathways of PK for detecting anti-hypoxia activity. Results: Fifty active ingredients and 371 potential targets were screened by network pharmacology, then, we confirmed that Gracillin and Liquiritigenin were the main active components of PK to exert anti-hypoxia effect in vitro. The pharmacodynamic experiments revealed that PK enhanced the extension rate of the survival time (ERST) and regulated the targets-related biochemical parameters of rats under hypoxia, showing significant anti-hypoxia effects on rats. Conclusion: The network pharmacology results suggested that PK exerts its anti-hypoxia effect through a multi-component and multi-target manner. Simultaneously, we also observed that Gracillin (saponins) and Liquiritigenin (flavonoids) are the main active components of PK to play a role in anti-hypoxia. The anti-hypoxia effect of PK could be associated with scavenging excess free radicals, maintaining the activities of antioxidant enzymes, and inhibiting oxidative stress due to lipid peroxidation. These findings provide insight into the Polygonatum kingianum as promising medicines or healthcare products for preventing and treating hypoxia.

This article discusses an instrumental variable approach for analyzing censored data that includes many instruments that are weakly associated with the endogenous variable. We study the effect of imprisonment on time to employment using an administrative data on all individuals sentenced for felony in Michigan in the years 2003–2006. Despite the large body of research on the effect of prison on employment, this is still a controversial topic, especially since some of the studies could have been affected by unmeasured confounding. We take advantage of a natural experiment based on the random assignment of judges to felony cases and construct a vector of instruments based on judges’ ID that can avoid the confounding bias. However, some of the constructed instruments are weakly associated with the sentence type, that is, the endogenous variable, which can potentially lead to misleading results. Using a dimension reduction technique, we propose a novel semiparametric estimation procedure in a survival context that is robust to the presence of many weak instruments. Specifically, we construct a test statistic based on the structural failure time model and provide inference by inverting the testing procedure. Under some assumptions, the optimal choice of the test statistic has also been derived. Analyses show a significant negative impact of imprisonment on time to employment which is consistent with some of the previous results. Our simulation studies highlight the importance of accounting for weak instruments in the analyses in terms of both bias and inflated type-I error rates.

Oral Cancer is one of the prevailing diseases worldwide. Taking previous studies into account, observations have shown that oral cancer has a poor prognosis due to the delay in the detection of the disease. The outcomes of cancer detection and prevention are ineffective unless the mutation of genetic factors is thoroughly understood. Nevertheless, understanding and identifying genetic mutation is a challenging issue for researchers. Determining the survival time is one of the essential outcomes in cancer detection. The existing survival time-based studies introduced models that use one type of genomic data or on clinical data, which do not consider the structural and biological relationships of genomic data in cancer. However, the current work is being carried out by integrating different types of genomic and clinical data to get a better understanding of cancer characterization. The key component to understand the complex molecular mechanisms of cancer is data integration. However, the integration of multi-genomic data poses significant challenges due to the existence of high dimensions and diverse approaches in it. The focus of this study is to create an integrative model for improved prediction accuracy of clinical outcomes in the survivability of oral cancer. The proposed model initially uses dimensionality reduction and feature selection techniques for the identification and elimination of features with insignificant and meaningless values from the Head and Neck Squamous Cell Carcinoma (HNSC) dataset taken from The Cancer Genome Atlas (TCGA). The integrative model's predictive performance is then compared to the performance of the model based on clinical features only. The proposed model performed well on the training and testing sets, achieving a c-index of 0.9439 and 0.916, respectively. It can be concluded from the results that the integrative model can effectively differentiate the interaction of genomic data types and it can be beneficial for the patients having oral cancer in terms of significant diagnostics and treatment plans. [ABSTRACT FROM AUTHOR]

Summary: The present study was carried out to estimate lamb survival (in days) from birth to weaning under survival analysis using data records from 2057 Harnali lambs born to 134 sires and 623 dams between the period from 2001 to 2020. The weaning age in resourced population was 90 days from birth. The hazard ratio in terms of risk of death up to weaning was determined using Cox proportional hazards model by subjecting some fixed factors such as year of birth, sex of lamb, birth weight (kg), dam's weight at lambing (kg) and dam's age at lambing (years). The overall survivability up to weaning among lambs was 91.59% and Kaplan–Meier estimates of mean survival time up to weaning was 85.77 days. Cox proportional hazard modelling revealed that the hazards of death up to weaning was higher in male lambs [1.66, 95% confidence interval (CI): 1.22–2.26] compared with female lambs [hazard ratio (HR) = 1.00]. It was also observed that the hazards of death (HR = 0.91, 95% CI: 0.88–0.94) had decreasing trends over years. For birth weight (kg), hazard rate was 0.34 (95% CI: 0.25–0.46), which indicated that the risk of pre-weaning mortality was lower as birth weight increases. The weight and age of dams at lambing did not influence the survival time of studied population. The present findings indicated that survival time increased in studied lambs over the years and it could be increased more by giving more emphasis on better litter weight and general health aspects at farm level. [ABSTRACT FROM AUTHOR]

Cox model is widely used for analysis of factor effects on censored survival time such as age at first marriage. In most practical situations, the fundamental assumption of the proportionality of hazard in Cox model, which implies that the covariates whose effects are to be investigated have a constant impact on the hazard ratio over the time is not always feasible. For example, the values of some of the covariates for individuals may be different over time and these may cause a break-down of proportionality assumption in the hazard model. Ignoring such violation may result in misleading effects of estimates. In this study therefore, Extended Cox models have been used to analyze data on age at first marriage among Nigerian women between 2013 and 2018 waves of Nigerian Demographic and Health Surveys (NDHS). The standard Cox model as well as Extended Cox models under four distinct time functions, namely, t, t2, log(t) and Heaviside were considered in the analysis and compared using Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC). The standard Cox model was found to perform worst among all the models considered and Extended model with log(t) time function was best fit for the data. [ABSTRACT FROM AUTHOR]

Objectives: To estimate median survival time until the appearance of anomalies indicating a potential implant failure associated with fluid ingress in implanted cochlear implant (CI) devices of the initial version of Advanced Bionics HiRes Ultra and HiRes Ultra 3D series. Study Design: Retrospective review. Methods: Cochlear implantation was performed in a standard fashion. Implant integrity was tested at follow-up visits by measuring impedance and electrically evoked compound action potential (ECAP). Additional tests such as electrical field imaging (EFI) were conducted by the manufacturer. Based on these tests, the presence or absence of an anomaly was classified. Results: Of the 349 devices implanted at this institution, 181 showed anomalies in accordance with the special failure mode and for this reason, 120 implants were already explanted. The median survival time without anomalies was 1062 days. So far, the suspicion of device failures has been confirmed in all cases in which a post-implantation analysis was already available. Conclusions: Regular tests at the follow-up visits are necessary to monitor the integrity of CIs. [ABSTRACT FROM AUTHOR]

Objective: A comprehensive study of the survival and causes of death of people with clinically diagnosed Dementia with Lewy bodies (DLB) were few. The aim of our study was to investigate the survival and causes of death of DLB.Methods: The patients diagnosed with probable DLB were consecutively enrolled from five memory clinics in China across a 5-year period (2017-2021) with mortality data updated to December 2021. The endpoint was all-cause death. Survival analysis including Cox regression by groups (time both from disease onset and the first visit to death) and causes of death were evaluated.Results: Of the 108 patients with DLB, 54 (50%) were men and the time from onset of disease to the first visit to the memory clinic (lag time) was 24 (12-48) months. During follow-up, 28.7% (n = 31) of the patients died. The median survival time both from disease onset and the first visit were 81 (95% cognitive impairment (CI) 69.09-92.91) and 45 (95% CI 34.78-55.22) months, respectively. The use of antipsychotic drugs (HR 0.15, 95% CI: 0.03-0.75), moderate to severe dementia (Clinical Dementia Rating [CDR]) at the first visit (HR 0.22, 95% CI 0.78 to 0.62) and the longer lag time (HR 0.943, 95% CI 0.92-0.97) predicted a shorter survival. Failure to thrive (stopped eating, drinking) or multiple organ dysfunction syndrome (MODS) maybe the most common cause of death (41.7%), followed by pneumonia or aspiration (29.2%).Conclusions: The factors associated with survival time were disease severity level, antipsychotic drug use and lag time to seek medical advice. Failure to thrive or MODS and pneumonia were probably the most common cause of death. The long-term outcomes of DLB patients may be helpful to guide clinicians counseling patients and caregivers. [ABSTRACT FROM AUTHOR]

Background: Random Forest (RF) is a technique that optimises predictive accuracy by fitting an ensemble of trees to stabilise model estimates. The RF techniques were adapted into survival analysis to model the survival of patients with liver disease in order to identify biomarkers that are highly influential in patient prognostics. Methods: The methodology of this study begins by applying the classical Cox proportional hazard (Cox-PH) model and three parametric survival models (exponential, Weibull and lognormal) to the published dataset. The study further applied the supervised learning methods of Tuning Random Survival Forest (TRSF) parameters and the conditional inference Forest (Cforest) to optimally predict patient survival probabilities. Results: The efficiency of these models was compared using the Akaike information criteria (AIC) and integrated Brier score (IBS). The results revealed that the Cox-PH model (AIC = 185.7233) outperforms the three classical models. We further analysed these data to observe the functional relationships that exist between the patient survival function and the covariates using TRSF. Conclusion: The IBS result of the TRFS demonstrated satisfactory performance over other methods. Ultimately, it was observed from the TRSF results that some of the covariates contributed positively and negatively to patient survival prognostics. [ABSTRACT FROM AUTHOR]

Background: Poisoning has been one of the greatest medical emergencies from the dawn of human civilization, posing threat to mankind. Tripura being a seven sister state of Northeast India have a unique topography, diverse ethnic groups, cross-cultural food habits, agriculture, and a horticulture-based economy that draws some distinctive type of poisoning threats compared to the rest of the Indian subcontinent. The present study was carried out to find out the epidemiological factors, toxicological profiles, and clinical outcomes of patients after consumption of poison. Methods: A cross-sectional study on 212 patients with a complaint of poisoning was conducted in a teaching hospital in Tripura, India, for 2 years, and the data were analyzed by using SPSS-15 (Statistical Package for the Social Sciences) software. Results: Out of 212 participants, males from lower socioeconomic status, farmers by occupation, and belonging to the age group of 21–30 years predominated other categories. Organophosphorus compounds were majorly ingested (38.7%). Suicide was the most common manner of poisoning (62.73%). The majority of the patients (75%) died during treatment, 39.15% of patients died in the initial 24 hours and 43.87% of the patients had severe life-threatening symptoms [grade 3 of poison severity score (PSS)] during the first 72 hours of hospital admission. A Spearman rho value of −0.740 and a P value <0.001 were found while establishing a relationship between survival time and PSS. Conclusion: Poisoning by any agents and means produces adverse effects on the human body which further influences the clinical outcome. Therefore, proper knowledge and attention regarding its clinico-toxico-epidemiological profile, accurate and timely diagnosis, and satisfactory management and prevention strategies are necessary. [ABSTRACT FROM AUTHOR]

Feline immunodeficiency virus (FIV) infection in experimentally infected domestic cats produces characteristic clinical manifestations including hematological changes, neurological disease, neoplasia (most notably lymphoma) and lymphopenia-mediated immunodeficiency predisposing cats to a range of secondary infections. Conflicting reports exist, however, with regard to disease associations and survival time in naturally FIV-infected cats. The purpose of this retrospective case–control study was to investigate the effect of natural FIV infection on hematological, blood biochemical and urinalysis parameters and survival time in three cohorts of pet cats in Australia. Cohorts 1 and 2 were recruited from a large veterinary hospital in Melbourne, Victoria (n = 525 and 282), while a third cohort consisted of cats recruited from around Australia as part of a FIV field vaccine efficacy trial (n = 425). FIV-infected cats in cohorts 1, 2 and 3 were found to have 15/37 (41%), 13/39 (33%) and 2/13 (15%) clinicopathological parameters significantly different to FIV-uninfected cats, respectively. Two changes in FIV-infected cats in cohort 1, hypochromia (low hemoglobin) and hyperglobulinemia, were outside the supplied reference intervals and should serve as diagnostic triggers for FIV testing. Kaplan–Meier survival analysis of cats in cohorts 1 and 2 combined did not find any difference between FIV-infected and FIV-uninfected cats, however a confounding factor was a large euthanasia rate within the first 12 months in both groups. Three significant (p < 0.05) spatial clusters of FIV infection were identified in Melbourne. A possible relationship between FIV infection status and socioeconomic disadvantage was discovered, based on three government indices of socioeconomic status (p < 0.001). Until longitudinal field studies are performed in Australia to further investigate the long-term effects of natural FIV infection, Australian veterinarians should consider FIV to be an important infection of pet cats, and recommend measures to prevent FIV infection. [ABSTRACT FROM AUTHOR]

Objective: To analyze the median survival time of and prognostic factors for metastatic epidural spinal cord compression (MESCC) secondary to preoperative unknown primary tumor (pre-op UPT) compared to MESCC secondary to preoperative known primary tumor (pre-op KPT). Materials and Methods: This retrospective cohort study reviewed all consecutive MESCC patients who underwent surgical decompression with or without stabilization within 72 hours of admission during 2010 to 2016. Survival was compared between the pre-op UPT and pre-op KPT groups, and preoperative and postoperative prognostic factors for survival were analyzed. Results: A total of 169 patients (pre-op UPT: 51, and pre-op KPT: 118) were enrolled. The survival rate at 3, 6, and 12 months was 84.3%, 58.8%, and 47.1% in the pre-op UPT group, and 72.0%, 48.3%, and 34.7% in the pre-op KPT group, respectively. The median survival time secondary to lung cancer was significantly longer in the pre-op UPT group (6.0±1.4 months) than in the pre-op KPT group (3.6±0.2 months) (p=0.031). Multivariate analysis revealed survival time to be influenced by preoperative known or unknown primary tumor status, revised Tokuhashi score, the adjuvant therapy, and postoperative complications, including myocardial infarction, gastrointestinal bleeding, and urinary tract infection. Conclusion: MESCC secondary to preoperative unknown primary tumor patients who had the clinical presentation with acute progressive neurological deficits who need urgency spine surgery has comparable survival to MESCC secondary to preoperative known primary tumors. [ABSTRACT FROM AUTHOR]

Background: A proinflammatory diet has been associated with a risk of individual chronic diseases, however, evidence on the association between inflammatory dietary patterns and the trajectory of chronic disease multimorbidity is sparse., Objectives: We aimed to investigate the associations of a low-inflammatory diet with the multimorbidity trajectory., Methods: Within the UK Biobank, 102,424 chronic disease-free participants (mean age 54.7 ± 7.9 y, 54.8% female) were followed up to detect multimorbidity trajectory (annual change in the number of 59 chronic diseases). Baseline inflammatory diet index (IDI) and empirical dietary inflammatory pattern (EDIP) were separately calculated from the weighted sum of 32 posteriori-derived (15 anti-inflammatory) and 18 prior-defined (9 anti-inflammatory) food groups, and tertiled as low-, moderate-, and high-inflammatory diet. Data were analyzed using linear mixed effects model, Cox model, and Laplace regression with adjustment for potential confounders., Results: During the follow-up (median 10.23 y), 15,672 and 35,801 participants developed 1 and 2+ chronic conditions, respectively. Adherence to a low-inflammatory diet was associated with decreased multimorbidity risk (hazard ratio [HR IDI ] = 0.84, 95% confidence interval [CI]: 0.81, 0.86; HR EDIP = 0.91, 95% CI: 0.89, 0.94) and a slower multimorbidity accumulation (β IDI = -0.033, 95% CI: -0.036, -0.029; β EDIP = -0.006, 95% CI: -0.010, -0.003) compared with a high-inflammatory diet, especially in participants aged > 60 y (β IDI = -0.051, 95% CI: -0.059, -0.042; β EDIP = -0.020, 95% CI: -0.029, -0.012; both P-interactions < 0.05). The 50th percentile difference (95% CI) of chronic disease-free survival time was prolonged by 0.81 (0.64, 0.97) and 0.49 (0.34, 0.64) y for participants with a low IDI and EDIP, respectively. Higher IDI and EDIP were associated with the development of 4 and 3 multimorbidity clusters (especially for cardiometabolic diseases), respectively., Conclusions: A low-inflammatory diet is associated with a lower risk and slower accumulation of multimorbidity (especially in participants aged > 60 y). A low-inflammatory diet may prolong chronic disease-free survival time., (Copyright © 2024 American Society for Nutrition. Published by Elsevier Inc. All rights reserved.)

Abstract Background Anti-retroviral therapy regimen discontinuations become a big challenge and cause diminishing the clinical and immunological benefit of treatment in Ethiopia. It reduces both the duration and the chance of viral control due to cross-resistance between different alternative drugs and overlapping toxicity between and within a class of antiretroviral drugs in Ethiopia. However, information’s on the time of initial regimen discontinuation and its predictors are not well studied. Objective This study aimed to assess the time to initial highly active antiretroviral therapy discontinuation and its predictors among HIV patients in Felege Hiwot comprehensive specialized hospital, North West Ethiopia. Method Institution-based retrospective cohort study was conducted among 418 HIV patients who started HAART from January 1, 2014, to December 31, 2019. Data were collected from the patient chart using a data extraction tool. The Kaplan–Meier curve was employed to compare survival rates. Multivariable Cox proportional hazard regression was applied to identify independent predictors of time to initial regimen discontinuation. Result A total of 418 patients on anti-retroviral therapy were followed. Incidence of initial HAART discontinuation was 16.7/100 person year. The median survival time was 3.5 years. Predictors showed association for time to initial HAART discontinuation were taking > 1 ART pills/day (AHR = 4.1, 95% CI 3.0–6.5), baseline CD4 count 1 ART pill/day were found predictors of initial HAART regimen discontinuation. Work on early detection of HIV before the disease is advanced and initiation of one ART regimen daily is vital for survival on the initial regimen.

Abstract Heart failure is a failure of the heart to pump blood with normal efficiency and a globally growing public health issue with a high death rate all over the world, including Ethiopia. The goal of this study was to identify factors affecting the survival time of heart failure patients. To achieve the aim, 409 heart failure patients were included in the study based on data taken from medical records of patients enrolled from January 2016 to January 2019 at Jimma University Medical Center, Jimma, Ethiopia. The Kaplan Meier plots and log-rank test were used for comparison of survival functions; the Cox-PH model and the Bayesian parametric survival models were used to analyze the survival time of heart failure patients using R-software. Integrated nested Laplace approximation methods have been applied. Out of the total heart failure patients in the study, 40.1% died, and 59.9% were censored. The estimated median survival time of patients was 31 months. Using model selection criteria, the Bayesian log-normal accelerated failure time model was found to be appropriate. The results of this model show that age, chronic kidney disease, diabetes mellitus, etiology of heart failure, hypertension, anemia, smoking cigarettes, and stages of heart failure all have a significant impact on the survival time of heart failure patients. The Bayesian log-normal accelerated failure time model described the survival time of heart failure patient's data-set well. The findings of this study suggested that the age group (49 to 65 years, and greater than or equal to 65 years); etiology of heart failure (rheumatic valvular heart disease, hypertensive heart disease, and other diseases); the presence of hypertension; the presence of anemia; the presence of chronic kidney disease; smokers; diabetes mellitus (type I, and type II); and stages of heart failure (II, III, and IV) shortened their survival time of heart failure patients.

Abstract Background The interaction between the left ventricle (LV) and systemic arterial systems, known as left ventricular‐arterial coupling (VAC), has been evaluated based on the effective arterial elastance (Ea) to LV end‐systolic elastance (Ees) ratio (Ea/Ees). The Ea reflects the total arterial load of LV, whereas Ees reflects the LV systolic function. A recent study found that inappropriate VAC based on increased Ea/Ees estimated by echocardiography is associated with advanced disease severity in dogs with myxomatous mitral valve disease (MMVD). Hypothesis Inappropriate VAC assessed by echocardiographic estimation of Ea/Ees is associated with a worse prognosis in dogs with MMVD. Animals Eighty‐nine dogs with MMVD. Methods Prospective cohort study. Dogs underwent echocardiographic examinations at enrollment. The Ea was estimated using the formula: mean blood pressure/(forward stroke volume/body weight). The Ees was estimated using the formula: mean blood pressure/(LV end‐systolic volume/body weight). The Ea/Ees was calculated. Results By end of study, 22 dogs died of cardiac‐related causes with 67 dogs censored. Dogs with increased Ea/Ees (Ea/Ees >0.34; median survival time, 527 days; 95% confidence interval [CI], 322 days‐not determinable) had a shorter survival time (P 1112 days; 95% CI, not determinable). Multivariate Cox proportional hazard analysis showed that Ea/Ees, body weight, peak systolic mitral annular velocity, and the peak early diastolic transmitral velocity‐to‐peak early diastolic mitral annular velocity ratio were independent predictors of cardiac‐related death among echocardiographic indices. Conclusions and Clinical Importance Inappropriate VAC assessed based on echocardiographically‐estimated Ea/Ees is associated with a worse prognosis in dogs with MMVD.

Despite improvements in the diagnosis and treatment of cancers, the incidence of pituitary metastasis has increased. Prostate cancer metastasis to the pituitary, however, is rare, and these tumors usually grow rapidly. They are also more likely to be located in the posterior pituitary, and the presenting symptoms are often nonspecific, which makes early diagnosis challenging. The management of this condition is usually multidisciplinary, and requires careful assessment and decision making. We present a case of a patient who developed prostate cancer metastasis to the pituitary. In this report, we show that patients with prostate cancer on corticosteroid therapy who develop withdrawal symptoms or other endocrine symptoms should be assessed for pituitary and other brain metastasis. This case report also discusses the impact of switching from prednisone and abiraterone to dexamethasone and abiraterone. Our report shows that patients on abiraterone and prednisone whose PSA has increased, but who have no radiologic progression, may have their PSA controlled and thereby improved survival time when they are switched to abiraterone and dexamethasone.

ObjectiveThe outbreak of COVID-19 in 2020 is reminiscent of the H7N9 outbreak in 2013, which poses a huge threat to human health. We aim to compare clinical features and survival factors in fatal cases of COVID-19 and H7N9.MethodsData on confirmed COVID-19 and H7N9 fatal cases identified in mainland China were analyzed to compare demographic characteristics and clinical severity. Survival curves were estimated by the Kaplan–Meier method and compared using log-rank tests and a restricted mean survival time model. A Cox regression model was used to identify survival factors in fatal cases of COVID-19 and H7N9.ResultsSimilar demographic characteristics were observed in fatal cases of COVID-19 and H7N9. The proportion of fatal cases of H7N9 receiving antibiotics, antiviral drugs, and oxygen treatment was higher than that of COVID-19. The potential protective factors for fatal COVID-19 cases were receiving antibiotics (HR: 0.37, 95% CI: 0.22–0.61), oxygen treatment (HR: 0.66, 95% CI: 0.44–0.99), and corticosteroids (HR: 0.46, 95% CI: 0.35–0.62). In contrast, antiviral drugs (HR: 0.21, 95% CI: 0.08–0.56) and corticosteroids (HR: 0.45, 95% CI: 0.29–0.69) were the protective factors for H7N9 fatal cases.ConclusionThe proportion of males, those having one or more underlying medical condition, and older age was high in COVID-19 and H7N9 fatal cases. Offering antibiotics, oxygen treatment, and corticosteroids to COVID-19 cases extended the survival time. Continued global surveillance remains an essential component of pandemic preparedness.

Objective: To analyze the median survival time of and prognostic factors for metastatic epidural spinal cord compression (MESCC) secondary to preoperative unknown primary tumor (pre-op UPT) compared to MESCC secondary to preoperative known primary tumor (pre-op KPT). Materials and Methods: This retrospective cohort study reviewed all consecutive MESCC patients who underwent surgical decompression with or without stabilization within 72 hours of admission during 2010 to 2016. Survival was compared between the pre-op UPT and pre-op KPT groups, and preoperative and postoperative prognostic factors for survival were analyzed. Results: A total of 169 patients (pre-op UPT: 51, and pre-op KPT: 118) were enrolled. The survival rate at 3, 6, and 12 months was 84.3%, 58.8%, and 47.1% in the pre-op UPT group, and 72.0%, 48.3%, and 34.7% in the pre-op KPT group, respectively. The median survival time secondary to lung cancer was significantly longer in the pre-op UPT group (6.0±1.4 months) than in the pre-op KPT group (3.6±0.2 months) (p=0.031). Multivariate analysis revealed survival time to be influenced by preoperative known or unknown primary tumor status, revised Tokuhashi score, the adjuvant therapy, and postoperative complications, including myocardial infarction, gastrointestinal bleeding, and urinary tract infection. Conclusion: MESCC secondary to preoperative unknown primary tumor patients who had the clinical presentation with acute progressive neurological deficits who need urgency spine surgery has comparable survival to MESCCsecondary to preoperative known primary tumors.

The article presents the discussion on associations and global aging increasingly showing the importance of dysphagia management. Topics include artificial nutrition supporting patients with dysphagia caused by various clinical conditions; and clarifying the effects of artificial nutritional support route on survival time of older terminal patients with dysphagia.

Introduction: It is essential to predict the survival status of patients based on their prognosis. This can assist physicians in evaluating treatment decisions. Random forest is an excellent machine learning algorithm even without any modification. We propose a new random forest weighting method and apply it to the gastric cancer patient data from the Surveillance, Epidemiology, and End Results (SEER) program. We evaluated the generalization ability of this weighted random forest algorithm on 10 public medical datasets. Furthermore, for the same weighting mode, the difference between using out-of-bag (OOB) data and all training sets as the weighting basis is explored.Material and methods: 110 697 cases of gastric cancer patients diagnosed between 1975 and 2016 obtained from the SEER database were included in the experiment. In addition, 10 public medical datasets were used for the generalization ability evaluation of this weighted random forest algorithm.Results: Through experimental verification, on the SEER gastric cancer patient data, the weighted random forest algorithm improves the accuracy by 0.79% compared with the original random forest. In AUC, macro-averaging increased by 2.32% and micro-averaging increased by 0.51% on average. Among the 10 public datasets, the random forest weighted in accuracy has the best performance on 6 datasets, with an average increase of 1.44% in accuracy and an average increase of 1.2% in AUC.Conclusions: Compared with the original random forest, the weighted random forest model shows a significant improvement in performance, and the effect of using all training data as the weighting basis is better than using OOB data. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to collect clinical information from owners of cats with hypersomatotropism (HS) distributed worldwide, assessing the impact of HS and its treatments on cats' quality of life (QoL) and survival time. Methods: A survey focused on clinical presentation, diagnostic procedures, treatments, cats' QoL and disease progression was distributed worldwide to owners of cats with HS. The owner's perception of the cats' QoL before and after or during treatment was defined using a score ranging from 1 (poor) to 5 (excellent). Improvement following treatment (IFT) was quantified using a score ranging from 1 (absent) to 5 (obvious). Different treatment groups, including at least five cases, were compared. Results: A total of 127 cats were included from at least 11 different countries. Among these, 120 (95%) were diabetic and 7 (5%) were not. Out of 120 diabetic cats, 55 (46%) were treated with insulin as a single treatment (INS). Other treatments were not mentioned to owners in 35/120 (29%) cases. The median QoL score at diagnosis was 2 (range 1–5) and improved after treatment in all groups. Cabergoline (4; range 1–5), radiotherapy (4; range 2–5) and hypophysectomy (5; range 4–5) showed better median IFT scores compared with INS (3; range 1–5) (P = 0.046, P <0.002 and P <0.0001, respectively). Hypophysectomy IFT proved superior to cabergoline (P = 0.047) and was equal to radiotherapy IFT (P = 0.32). No difference was found between cabergoline and radiotherapy IFT (P = 0.99). The median survival time (MST) was 24 months (range 0–75 months). Cats treated with INS showed shorter MST (22 months; range 0–69 months) compared with cats treated with causal treatments combined (36 months; range 3–75 months) (P = 0.04). Conclusions and relevance: Not all cats with HS will have diabetes mellitus. Causal treatments seem associated with the greatest improvements in perceived cats' QoL and survival; such treatments should therefore be discussed with owners. Cabergoline could be an effective alternative management option. [ABSTRACT FROM AUTHOR]

Simple Summary: Infiltrative brain tumours are common in dogs. Although different treatments have been used, such as surgery, radiotherapy, chemotherapy, or combinations, guidelines for the most effective management are lacking. In this study, we report the effect of combining surgery and chemotherapy on the survival of 14 dogs with infiltrative gliomas. Four dogs were operated on two or three times to remove the tumors, and only one of these dogs died shortly after the second surgery. All tolerated the surgery with minimal or no deterioration, and all were euthanized between 6 months to 2 years after diagnosis due to tumour progression. To conclude, surgery and chemotherapy, although not curative, can prolong survival in dogs with infiltrative brain tumours. This information may help future research into the most appropriate treatment for this debilitating condition. Intracranial gliomas are associated with a poor prognosis, and the most appropriate treatment is yet to be defined. The objectives of this retrospective study are to report the time to progression and survival times of a group of dogs with histologically confirmed intracranial gliomas treated with surgical debulking and adjuvant temozolomide chemotherapy. All cases treated in a single referral veterinary hospital from 2014 to 2021 were reviewed. Inclusion criteria comprised a histopathological diagnosis of intracranial glioma, adjunctive chemotherapy, and follow-up until death. Cases were excluded if the owner declined chemotherapy or there was insufficient follow-up information in the clinical records. Fourteen client-owned dogs were included with a median time to progression (MTP) of 156 days (95% CI 133–320 days) and median survival time (MST) of 240 days (95% CI 149–465 days). Temozolomide was the first-line adjuvant chemotherapy but changed to another chemotherapy agent (lomustine, toceranib phosphate, or melphalan) when tumour relapse was either suspected by clinical signs or confirmed by advanced imaging. Of the fourteen dogs, three underwent two surgical resections and one, three surgeries. Survival times (ST) were 241, 428, and 468 days for three dogs treated twice surgically and 780 days for the dog treated surgically three times. Survival times for dogs operated once was 181 days. One case was euthanized after developing aspiration pneumonia, and all other cases after progression of clinical signs due to suspected or confirmed tumour relapse. In conclusion, the results of this study suggest that debulking surgery and adjuvant chemotherapy are well-tolerated options in dogs with intracranial gliomas in which surgery is a possibility and should be considered a potential treatment option. Repeated surgery may be considered for selected cases. [ABSTRACT FROM AUTHOR]

Tongtong Zhou,1,2,&ast; Li Tan,1,&ast; Yang Gui,1 Jing Zhang,1 Xueqi Chen,1 Menghua Dai,3 Mengsu Xiao,1 Qing Zhang,1 Xiaoyan Chang,4 Qun Xu,5 Chunmei Bai,6 Yuejuan Cheng,6 Qiang Xu,3 Xue Wang,7 Hua Meng,1 Wanying Jia,1 Ke Lv,1 Yuxin Jiang1 1Department of Ultrasound, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; 2Department of Ultrasound, China-Japan Friendship Hospital, Beijing, People’s Republic of China; 3Department of General Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; 4Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; 5Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, People’s Republic of China; 6Department of Medical Oncology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China; 7Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Ke Lv; Yuxin JiangDepartment of Ultrasound, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People’s Republic of ChinaTel/Fax +86 10-69155493; +86 10-69155491Email lvke@163.com; yuxinjiangxh@163.comObjective: Investigate the CEUS enhancement patterns of PDAC and analyse correlations between the CEUS enhancement pattern and both the degree of tumour tissue differentiation and overall survival (OS).Methods: The study included 56 patients with locally advanced PDAC, performed conventional ultrasound and CEUS, and analysed characteristics of the CEUS enhancement patterns. In addition, clinical data, such as serum level of CA19-9, TNM stage were collected, and patients’ survival times were followed up. TICs of dynamic CEUS images were acquired using image processing software to obtain the peak, TP, sharpness, and AUC. Correlations of the CEUS enhancement patterns of PDAC with the degree of differentiation of tumour tissue and OS were quantitatively analysed, as were the correlations of the TIC parameters and CEUS enhancement patterns with OS.Results: Enhancement in the arterial phase included iso-enhancement (30.3%) and hypo-enhancement (69.6%), and was not significantly correlated with sex, age at disease onset, or lesion size. Also was not significantly correlated with tumour tissue differentiation. Clear survival times were obtained for 50 patients during follow-up, and the median survival time was significantly longer for the patients with iso-enhancement than hypo-enhancement. Among the TIC parameters, peaktumour, sharpnesstumour, AEsharpness, and REsharpness differed significantly between the group with iso-enhancement and hypo-enhancement (p < 0.05).Conclusion: The CEUS enhancement patterns of PDAC in the arterial phase include iso-enhancement and hypo-enhancement. Enhancement pattern was not significantly correlated with the degree of differentiation of tumour tissue, but patient survival time differed significantly between the two enhancement patterns, with longer survival for patients with iso-enhancement.Keywords: contrast-enhanced ultrasound, pancreatic ductal adenocarcinoma, survival time, enhancement pattern, time-intensity curve