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Background: While single organ metastases generally present a more optimistic prognosis compared to multiple metastases, the influence of the specific organ site for single organ metastases on prognosis remains undetermined. This retrospective study aimed to investigate the prognostic differences in late-stage gastric cancer with single organ metastasis., Methods: Data for patients diagnosed with gastric cancer were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database for survival analysis, covering years spanning from 2010 to 2016. Furthermore, Kaplan-Meier survival curves and Cox regression were utilized to analyze overall survival (OS) and disease-specific survival (DSS). Additionally, given the impact of confounders and bias on the results, prognosis was further analyzed using propensity score matching (PSM) and floating absolute risk methods., Results: A cohort comprising 4,297 patients diagnosed with gastric cancer and exhibiting single organ metastasis was hereby enrolled. Liver metastasis was the most common (71% of the total), while brain metastasis accounted for the least (1.7% of the total). Compared to other metastases, patients with bone metastasis presented the worst OS [hazard ratio (HR), 1.319; 95% confidence interval (CI): 1.207-1.442; P<0.001], and this remained consistent even upon the application of floating absolute risk (HR, 1.10; 95% CI: 1.01-1.20) and PSM methods (HR, 1.187; 95% CI: 1.053-1.339; P=0.005). In addition, subgroup analysis and interaction tests of OS revealed an interaction between age (P=0.02), histological type (P=0.002), and bone metastasis., Conclusions: In patients with single organ metastasis of gastric cancer, the prognosis varies by the metastatic site, with bone metastasis presenting the poorest outcome. Overall, this study forges a foundation for further research on the mechanisms and patterns of different metastatic sites in gastric cancer and informs treatment strategies., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tgh.amegroups.com/article/view/10.21037/tgh-24-11/coif). H.N.G. reports funding supports from the Guangxi Natural Science Foundation, and the Research Capability Improvement Project for Young and Middle-aged Teachers in Guangxi Universities. The other authors have no conflicts of interest to declare., (2024 AME Publishing Company. All rights reserved.)

Most patients with VC have no symptoms, so they are often discovered due to male infertility. Early identification of them is a matter of concern for clinicians. A retrospective analysis of clinical data from patients between January 1, 2021, and February 1, 2024, was conducted. Patients were divided into VC and non-VC groups. Propensity score matching (PSM) was performed at a ratio of 1:1, and two cohorts with homogeneous baseline status were selected. Multivariate binary logistic regression and receiver operating characteristic (ROC) curve were used to analyze independent risk factors and protective factors and to evaluate their diagnostic value individually and in combination. A p-value <0.05 was considered statistically significant. A total of 256 patients with similar clinical characteristics were further analyzed after PSM in a 1:1 ratio of the 423 patients included in the study. The two groups had statistically significant differences in systemic immune-inflammation index (SII), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and body mass index (BMI) (p<0.05). Multivariate binary logistic regression analysis showed that SII and NLR were independent risk factors for VC, while high BMI could reduce the prevalence of VC. The PLR differences were not significant. The ROC analysis showed that BMI, SII, and NLR could predict VC, with areas under the curve of 68.3% (cut-off value 22.32), 83.4% (cut-off value 357.57), and 83.2% (cut-off value 1.8), respectively. The combination of BMI and inflammatory factors was more accurate for predicting VC than BMI alone (87.5% vs. 68.3%, p=0.0001), SII (87.5% vs. 83.4%, p=0.0106), and NLR (87.5% vs 83.2%, p=0.0058). Both SII and NLR are independent risk factors for VC while BMI is an independent protective factor. The BMI, SII, and NLR values have the potential to predict VC. The BMI combined with these inflammatory factors can improve the accuracy of prediction., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Ethics Committee of The First Affiliated Hospital of Nanchang University issued approval IIT/2024/192. This research is retrospective and involves the collection of existing data and records. The Ethics Committee of The First Affiliated Hospital of Nanchang University approved the study procedures and the exemption of informed consent. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Miao et al.)

Background: The necessity and therapeutic value of lymph node dissection (LND) in early stage T1 MTC patients remain controversial., Methods: Patients with T1MTC were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Poisson regression analysis was utilized to investigate promotive factors for lymph node metastasis in T1MTC patients. Fisher's exact test was employed to calculate baseline differences between non-LND and LND groups. Propensity score match (PSM) was used to control baseline bias. Survival outcomes were calculated by Kaplan-Meier method and log-rank test. Multivariable Cox regression assessed the prognostic impact of LND across subgroups., Results: Of 3298 MTC cases, 50.4% were T1MTC. The lymph node metastasis rate increased along with the T stage (from 22.2% to 90.5%). Among 1231 T1MTC patients included after exclusion criteria, 72.0% underwent LND and 22.0% had lymph node metastasis. Patients aged younger than 44 years (RR=1.700, p<0.001), male (RR=1.832, p<0.001), and with tumor larger than 10mm (RR=2.361, p<0.001) were more likely to have lymph node metastasis, while elderly patients (p<0.001) and those with microcarcinoma (p<0.001) were more likely to undergo non-LND procedures. LND provided no OS or DSS benefit over non-LND before and after propensity score match (matched 10-year OS/DSS: LND 83.8/96.2% vs non-LND 81.9/99.3%, p>0.05). Subgroup analyses revealed no prognostic gain with LND in any subgroup (p>0.05)., Conclusion: Nearly half of MTC patients were diagnosed at T1 stage and had low lymph node risk. Different from ATA guidelines, avoiding routine LND conferred similar prognosis to standard procedures while potentially improving quality of life. Large-scale prospective multi-center studies should be conducted to further validate these findings., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Tao, Deng, Ding, Guo and Fan.)

Background: The 8 th edition of the American Joint Committee on Cancer (AJCC) manual divides T1 stage testicular cancer into T1a and T1b, but it is only applicable to seminoma. The purpose of this observational study is to discuss further the possibility of extending this classification system to any T1 testicular cancer., Methods: Testicular cancer patients from 2000 to 2018 in the Surveillance, Epidemiology, and End Results (SEER) database were included in this analysis. After patient selection, univariate and multivariate Cox regression were used to evaluate the impact of tumor size on survival in patients with T1 testicular cancer. A time-dependent receiver operation curve (ROC) was used to determine the best tumor size cut-off value for further T1 subgroup classification. Restricted cubic splines (RCS) analysis was used to compare different tumor sizes with the best tumor size cut-off value. Propensity score matching (PSM) analysis was conducted to generate baseline balanced data to validate findings., Results: A total of 6,630 patients were included in this study. In the Cox regression model, we found that T1b staged tumor (>34 mm) was an independent risk factor of overall survival [OS, adjusted hazard ratio (HR): 1.57, 95% confidence interval (CI): 1.12-2.21] and cancer-specific survival (CSS, adjusted HR: 5.027, 95% CI: 1.95-12.93). Further PSM analysis consolidated our results., Conclusions: For any T1 testicular cancer, a tumor size of 34 mm could be used as the demarcation point to assess the prognosis. Adopting personalized treatments and follow-up plans may help improve the OS and CSS rate for testicular cancer patients., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tau.amegroups.com/article/view/10.21037/tau-23-544/coif). The authors have no conflicts of interest to declare., (2024 Translational Andrology and Urology. All rights reserved.)

Background: Mediastinal station 8 lymph node dissection (8LND) is recommended by guidelines but not routinely performed in real world clinical practice. This study aimed to investigate the effect of 8LND on the prognosis of pT ≤3 cm N0M0 lung adenocarcinoma., Methods: Patients undergoing lobectomy were retrospectively enrolled from West China Hospital from 2011 to 2019. Kaplan-Meier method and log-rank test were used to investigate the effects of 8LND on the progression-free survival (PFS), overall survival (OS), and cancer-specific survival (CSS). Propensity score matching (PSM) was used to reduce the confounding effects. Multivariable analysis was conducted to evaluate the effect of 8LND in the matched patients. Subgroup analyses were conducted to further identify patients who might benefit from 8LND., Results: A total of 1,209 patients were enrolled and 261 (21.59%) patients underwent 8LND. Before PSM, for patients who received 8LND (8LND + patients) and who did not (8LND - patients), the 5-year PFS was 91.34%, 88.03% (P=0.03) respectively, the 5-year OS was 97.10%, 92.78% (P=0.03) respectively, and the 5-year CSS was 97.67%, 93.59% (P=0.05) respectively. After PSM, 8LND + patients still had better PFS (P=0.006), OS (P=0.01), and CSS (P=0.03) as compared to 8LND - patients. Multivariable analyses showed that 8LND was associated with lower risk of disease progression [hazard ratio (HR): 0.46; 95% confidence interval (CI): 0.26-0.80; P=0.007], and lower risk of death (HR: 0.33; 95% CI: 0.13-0.85; P=0.02). The survival benefit of 8LND was still found in subgroup analyses in male patients, smokers, patients with a pT2 tumor (≤3 cm), and patients with a poorly differentiated tumor., Conclusions: 8LND could improve the survival of T ≤3 cm N0M0 lung adenocarcinoma patients. Routine 8LND is recommended, especially in male, smokers, patients with a pT2 tumor (≤3 cm), and patients with a poorly differentiated tumor., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (Available at https://tlcr.amegroups.com/article/view/10.21037/tlcr-24-184/coif). L.L. reports that this work was supported by the 1·3·5 Project for Disciplines of Excellence, West China Hospital, Sichuan University (No. ZYJC21002). The other authors have no conflicts of interest to declare., (2024 Translational Lung Cancer Research. All rights reserved.)

Mesangial IgM deposition is found in patients with immunoglobulin A nephropathy (IgAN). This study aims to investigate the relationships between mesangial IgM deposition and disease progression in IgAN patients. A total of 1239 patients with biopsy-proven primary IgAN were enrolled in this multicenter, observational study between January 2013 and August 2017. According to the degree of IgM deposition, 1239 patients were divided into three groups: Grade 0 (no or trace; n = 713, 57.55%), Grade 1 (mild; n = 414, 33.41%), Grades 2 + 3 (moderate and marked; n = 112, 9.04%). Using a 1:1 propensity score matching (PSM) method identifying age, gender and treatment modality to minimize confounding factors, 1042 matched patients (out of 1239) with different degrees of IgM deposition were enrolled to evaluate the severity of baseline clinicopathological features and renal outcome: Grade 0 (n = 521, 50.00%), Grade 1 (n = 409, 39.25%), Grades 2 + 3 (n = 112, 10.75%). Kaplan–Meier and Cox proportional hazards analyses were performed to determine whether different degrees of mesangial IgM deposition are associated with varying renal outcomes in IgAN. During a mean follow-up of 48.90 ± 23.86 and 49.01 ± 23.73 months, before and after adjusting for propensity scores, respectively, the rate of complete remission (CR) was progressively lower with increased IgM deposition in both unmatched (63.39%, 46.14%, 45.54%) and matched cohort (61.80%, 46.45%, 45.54%), whereas the proportion of patients progressing to end-stage renal disease (ESRD) showed reverse correlation (P < 0.001). Kaplan–Meier analysis indicated negative correlation between the intensity of mesangial IgM deposits and cumulative renal survival (all P < 0.05). Moreover, Cox regression analysis revealed that the degree of mesangial IgM deposition predicted renal outcome independent of MESTC score and clinical variables in the unmatched (Grade 1, HR, 1.59; 95% CI, 1.11–2.29; P = 0.01; Grades 2 + 3, HR, 1.69; 95% CI, 1.02–2.08; P = 0.04) and matched cohort (Grade 1, HR, 1.84; 95% CI, 1.19–2.85; P = 0.01; Grades 2 + 3, HR, 1.91; 95% CI, 1.01–3.24; P = 0.04). Mesangial IgM deposition is associated with histological activity, clinical severity and renal outcome and is an independent risk factor for poor renal prognosis in IgAN. Trial registration: TCTR, TCTR20140515001. Registered May 15, 2014, http://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=1074. [ABSTRACT FROM AUTHOR]

The present study aimed to assess whether women with polycystic ovarian syndrome (PCOS) ≥35 years age undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles experienced a higher cumulative live birth rate (CLBR) over a two-year period compared with age- and body mass index (BMI)-matched patients with tubal factor infertility. Through propensity score matching (PSM) approach, the authors retrospectively analyzed the IVF/ICSI outcomes of 263 PCOS patients (35-46 years of age [mean, 37 years]) and 526 age- and BMI-matched tubal factor controls two years after oocyte retrieval. Multivariate regression analysis was performed to explore factors influencing cumulative live birth. Women with PCOS exhibited better ovarian reserve and response, and higher CLBR in two years compared with age- and BMI-matched controls (CLBR: 55.51% in PCOS vs. 38.02% in control, p

The present study aimed to assess whether women with polycystic ovarian syndrome (PCOS) ≥35 years age undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles experienced a higher cumulative live birth rate (CLBR) over a two-year period compared with age- and body mass index (BMI)-matched patients with tubal factor infertility. Through propensity score matching (PSM) approach, the authors retrospectively analyzed the IVF/ICSI outcomes of 263 PCOS patients (35-46 years of age [mean, 37 years]) and 526 age- and BMI-matched tubal factor controls two years after oocyte retrieval. Multivariate regression analysis was performed to explore factors influencing cumulative live birth. Women with PCOS exhibited better ovarian reserve and response, and higher CLBR in two years compared with age- and BMI-matched controls (CLBR: 55.51% in PCOS vs. 38.02% in control, p<0.001). Multivariate logistic regression analysis revealed that the number of transferable embryos and antral follicle counts were both significant independent factors predicting cumulative live birth after adjusting for female age, female body mass index, percentage of transferred blastocysts, number of embryos transferred per embryo-transfer cycle, diagnosis of PCOS and freeze-all cycles (p<0.001, p=0.045). Women with PCOS ≥ 35 years of age demonstrated a higher CLBR over two years compared with age- and BMI-matched controls. This could be explained by favorable oocyte reserve and more available embryos compared with controls, which overcome the compromised oocyte quality in aged PCOS patients. [ABSTRACT FROM AUTHOR]

Delirium is a common complication in intensive care unit (ICU) patients, and it can significantly increase the length of hospital stay and cost. Dexamethasone is widely used in various inflammatory diseases and must be used with caution in critically ill patients. Previous studies have shown that the effect of corticosteroid use on the development of delirium in critically ill patients is still controversial, and there is inconclusive conclusion about the effect of dexamethasone on delirium in such patients. Therefore, this study aimed to confirm the effect of dexamethasone use and the dose on the incidence of delirium and patient prognosis in critically ill patients through a large cohort study. A retrospective cohort study was conducted using data extracted from the Medical Information Mart for Intensive Care III database, which is a large and freely available database of all 46,476 patients who visited Beth Israel Deaconess Medical Center in Boston, Massachusetts, USA and were admitted to the ICU between 2001 and 2012. The primary outcome was the development of delirium, using multivariate logistic regression analysis to reveal the relationship between dexamethasone and delirium. Secondary endpoints were in-hospital mortality, ICU mortality, total length of stay, and length of ICU stay, and the relationship between dexamethasone and prognosis was assessed with Cox proportional hazards models. Propensity score matching with 1:1 grouping was used to eliminate the effect of confounders on both cohorts. The locally weighted scatter plot smoothing technique was used to investigate the dose correlation between dexamethasone and outcomes, subgroup analysis was used to account for heterogeneity, and different correction models and propensity matching analysis were used to eliminate potential confounders. Finally, 38,509 patients were included, and 2204 (5.7%) used dexamethasone. No significant statistical difference was observed in basic demographic information after propensity score matching between the two study groups. A significantly higher incidence of delirium (5.0% versus 3.4%, P < 0.001), increased in-hospital mortality (14.9% versus 10.3%, P < 0.001), ICU mortality (9.0% versus 7.5%, P = 0.008), and longer length of stay and ICU stay were observed in patients taking dexamethasone compared with those not taking dexamethasone. Multivariate logistic and Cox regression analyses confirmed that dexamethasone was significantly associated with delirium (adjusted odds ratio = 1.48, 95% confidence interval [CI] = 1.09-2.00, P = 0.012), in-hospital mortality (adjusted hazard ratio = 1.19, 95% CI = 1.02-1.40, P = 0.032), and ICU mortality (adjusted hazard ratio = 1.62, 95% CI = 1.22-2.15, P = 0.001). Compared with critically ill patients using high-dose dexamethasone, the risk of delirium was lower in the dose less than the 10 mg group, and patients using 10-14 mg may be associated with a lower risk of in-hospital death and the least ICU mortality, length of hospital stay, and ICU stay. This study demonstrated that the use of dexamethasone in critically ill patients exacerbated the occurrence of delirium while increasing the risk of in-hospital death, ICU death, and length of hospital stay, with a lower risk of delirium and a shorter total length of hospital stay with low-dose dexamethasone than with larger doses. [ABSTRACT FROM AUTHOR]

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Linking the urban spatial structure with residential mobility is a vital yet challenging mission. With a unique dataset tracking changes in individual residential locations in Shanghai from 2014 to 2015, this paper portrays the directional trajectories of Shanghai's spatial structure and rigorously examines the motivations of residents for different spatial preferences with the approach of propensity score matching. By classifying the spatial structure into four typologies, polycentricity, sprawl, dispersed-monocentricity and compact-monocentricity, we find that relocated residents push Shanghai's spatial structure in greater favor of sprawl or compact-monocentricity. Furthermore, the movers towards sprawl, decentralized-monocentricity and compact-monocentricity mainly benefit from housing, jobs, and neighborhood amenities, respectively; and the movers towards the polycentric spatial structure can take the advantage of favorable house prices. These results shed light on the process of shaping the urban spatial structure and offer valuable insights into residents' spatial preferences. • It contributes by linking the urban spatial structure with residential mobility. • Relocated residents push Shanghai's spatial structure in greater favor of sprawl or compact-monocentricity. • The movers that contribute to the shaping of different urban spatial structures can take advantage of various advantages. [ABSTRACT FROM AUTHOR]

Objective: In this study, a new aspect of the relationship between ownership (The endogenous and exogenous) and dividend policy has been investigated. Method: For this purpose, data of 2080 firm-year were gathered in the period 2002 to 2016. The effect of ownership variable on dividend policy was firstly estimated as exogenous and endogenous as second. For the statistical analysis, the results were analyzed via R Software by using ordinary panel data, PSM and GMM. In both methods (OLS and PSM), the pooled logistic regression and panel logistic model model was fitted and Akaike's information criterion (AIC) were used for comparing the methods. Results: It was observed that the p-value of institutional investors (INS) and corporate investors (CORP) is less than 0.05, so these two variables have a significant effect on the variable dividend policy in the ordinary panel data and PSM. But in the GMM, there was a significant relationship between institutional ownership and dividend policy while no significant relationship between corporate ownership and dividend policy was observed. Finally, using PSM and matching of data in comparison with the other estimators can have a significant role in improving the fitted regression and its results are more significant and will lead to more accurate estimates.

BackgroundAs an important endocrine hormone regulating glucose metabolism, fibroblast growth factor 21 (FGF21) is increased in individuals with gestational diabetes mellitus (GDM) after 24 gestational weeks. However, it is unknown whether the increase in FGF21 precedes the diagnosis of GDM.MethodsIn this nested case-control study, 133 pregnant women with GDM and 133 pregnant women with normal glucose tolerance (NGT) were identified through propensity score matching, and serum FGF21 levels were measured at 14 to 21 gestational weeks, before GDM is routinely identified. The differences in FGF21 levels were compared. The association between FGF21 and the occurrence of GDM was evaluated using logistic regression models with adjustment for confounders.ResultsThe serum FGF21 levels of the GDM group at 14 to 21 gestational weeks were significantly higher than those of the NGT group overall (P < 0.001), with similar results observed between the corresponding BMI subgroups (P < 0.05). The 2nd (OR 1.224, 95% CI 0.603–2.485), 3rd (OR 2.478, 1.229–5.000), and 4th (OR 3.419, 95% CI 1.626–7.188) FGF21 quartiles were associated with greater odds of GDM occurrence than the 1st quartile after multivariable adjustments.ConclusionsThe serum FGF21 levels in GDM groups increased in the early second trimester, regardless of whether participants were stratified according to BMI. After adjusting for confounding factors, the FGF21 levels in the highest quartile were associated with more than three times higher probability of the diagnosis of GDM in the pregnancy as compared to levels in the first quartile.

Background: As an important endocrine hormone regulating glucose metabolism, fibroblast growth factor 21 (FGF21) is increased in individuals with gestational diabetes mellitus (GDM) after 24 gestational weeks. However, it is unknown whether the increase in FGF21 precedes the diagnosis of GDM. Methods: In this nested case-control study, 133 pregnant women with GDM and 133 pregnant women with normal glucose tolerance (NGT) were identified through propensity score matching, and serum FGF21 levels were measured at 14 to 21 gestational weeks, before GDM is routinely identified. The differences in FGF21 levels were compared. The association between FGF21 and the occurrence of GDM was evaluated using logistic regression models with adjustment for confounders. Results: The serum FGF21 levels of the GDM group at 14 to 21 gestational weeks were significantly higher than those of the NGT group overall (P < 0.001), with similar results observed between the corresponding BMI subgroups (P < 0.05). The 2nd (OR 1.224, 95% CI 0.603–2.485), 3rd (OR 2.478, 1.229–5.000), and 4th (OR 3.419, 95% CI 1.626–7.188) FGF21 quartiles were associated with greater odds of GDM occurrence than the 1st quartile after multivariable adjustments. Conclusions: The serum FGF21 levels in GDM groups increased in the early second trimester, regardless of whether participants were stratified according to BMI. After adjusting for confounding factors, the FGF21 levels in the highest quartile were associated with more than three times higher probability of the diagnosis of GDM in the pregnancy as compared to levels in the first quartile. [ABSTRACT FROM AUTHOR]

Background and aimsThis study aimed to determine the relationship between Ki67 expression and the efficacy of postoperative adjuvant transcatheter arterial chemoembolization (PA-TACE) in patients with hepatocellular carcinoma.MethodsThe Kaplan-Meier method was used to analyze the recurrence-free survival (RFS) and overall survival (OS) rates between the sub-groups in the ki67 low expression group and the ki67 high expression group and analyze the relationship between the expression of Ki67 and the efficacy of TACE.ResultsAfter PSM, there was no significant difference in the RFS and OS between the surgery + TACE and surgery subgroups after 1, 2, or 3 years (RFS: 63.9%, 55.6%, and 42.9% vs. 83.3%, 63.9%, and 55.6%, respectively, P = 0.279; OS: 91.7%, 83.3%, and 74.3% vs. 91.7%, 88.9%, and 71.4%, respectively, P = 0.890) in the Ki67 low-expression group. The RFS and OS were higher in the surgery + TACE subgroup than the surgery subgroup after 1, 2, and 3 years (RFS: 80.0%, 77.5%, and 69.2% vs. 53.5%, 39.5%, and 32.6%, respectively, P

Livestock has a considerable role in the well-being of poor rural households in many developing countries. On the other hand, its productivity is adversely affected by climatic changes mainly due to the absence or non-adoption of effective and modern mitigation and adaptation strategies. The geographical locations and socio-economic conditions of developing countries make livestock herders, especially the smaller ones, more vulnerable while their capabilities to mitigate the adverse effects with limited resources will exacerbate the situation in the future. Most of the efforts to face climatic changes are directed at crop sector while only a few studies document such actions to safeguard livestock sector with similar focus notwithstanding the huge impact of these stimuli on this sub-sector of agriculture. This study uses propensity score matching (PSM) to assess the causal impact of climate change adaptation strategies on livestock losses and poverty by using the primary data set of 405 small livestock herders of Punjab, Pakistan. The PSM analysis points towards a massive potential for reducing these losses. The livestock losses and poverty index are shown to decline respectively by 30–48% and 4–22% for the farmers adopting a mix of mitigation strategies. Such outcome is believed to sustain environment and livestock herders’ well-being. Results indicate that livestock herders easily adopt those strategies that have greater linkages with accessibility and resource availability. Study reveals the significance of improving infrastructure for speedy access to information, resources and uninterrupted flow of veterinary services. The vet personnel also need to be equipped with precise statistics of disease existence, impacts, dispersal, and costs for control by restructuring and advancing data collection efforts that would entail coherent policy formulation amidst evidence-based outcomes. The results do imply allocation of huge investment in the information delivery system; competitive institutional services and particular safeguarding of the resource-poor farmers to sustain livelihoods, food security and rural development.

Livelihood insecurity remains a prime concern for low household income countries. To provide secured livelihood to rural poor, the government of India has introduced a self-employment type poverty alleviation programme namely National Rural Livelihood Mission (NRLM). This paper empirically examines the effect of participation in NRLM on the livelihood security of rural poor. Data were collected from 220 respondents (including both beneficiaries and non-beneficiaries) through a structured questionnaire from Sonepur district of Odisha (India). A livelihood security index (LSI) was constructed to capture the livelihood security of the respondents taking habitat security, health security, food security, and economic security into account. Further, the impact of the programme has been estimated using propensity score matching (PSM) method. The study finds a positive and significant effect of participation in the programme on livelihood security. Therefore, poor should be encouraged to participate in the programme to strengthen their livelihood security.

Background and aims: This study aimed to determine the relationship between Ki67 expression and the efficacy of postoperative adjuvant transcatheter arterial chemoembolization (PA-TACE) in patients with hepatocellular carcinoma. Methods: The Kaplan-Meier method was used to analyze the recurrence-free survival (RFS) and overall survival (OS) rates between the sub-groups in the ki67 low expression group and the ki67 high expression group and analyze the relationship between the expression of Ki67 and the efficacy of TACE. Results: After PSM, there was no significant difference in the RFS and OS between the surgery + TACE and surgery subgroups after 1, 2, or 3 years (RFS: 63.9%, 55.6%, and 42.9% vs. 83.3%, 63.9%, and 55.6%, respectively, P = 0.279; OS: 91.7%, 83.3%, and 74.3% vs. 91.7%, 88.9%, and 71.4%, respectively, P = 0.890) in the Ki67 low-expression group. The RFS and OS were higher in the surgery + TACE subgroup than the surgery subgroup after 1, 2, and 3 years (RFS: 80.0%, 77.5%, and 69.2% vs. 53.5%, 39.5%, and 32.6%, respectively, P<0.001; OS: 97.5%, 85.0%, and 79.5% vs. 79.1%, 48.8%, and 42.9%, respectively, P = 0.001) in the Ki67 high expression group. The RFS was higher in the Ki67 high-expression subgroup than the low-expression subgroup after 1, 2, and 3 years, and OS had no significant difference (RFS: 80.0%, 79.5%, and 69.2% vs. 67.4%, 56.5%, and 46.7%, respectively, P = 0.035; OS: 97.5%, 85.0%, and 79.5% vs. 93.5%, 82.6%, and 75.6%, respectively, P = 0.665) in the surgery + TACE group. Conclusions: For patients with hepatocellular carcinoma and high expression of Ki67 (Ki67≥20%), adjuvant hepatic artery chemoembolization after radical liver tumor resection effectively reduced the probability of tumor recurrence after surgery and prolonged the OS of patients. High Ki67 expression during the post-operative follow-up evaluation of hepatocellular carcinoma patients is an indicator for adjuvant TACE therapy. [ABSTRACT FROM AUTHOR]

Livelihood insecurity remains a prime concern for low household income countries. To provide secured livelihood to rural poor, the government of India has introduced a self-employment type poverty alleviation programme namely National Rural Livelihood Mission (NRLM). This paper empirically examines the effect of participation in NRLM on the livelihood security of rural poor. Data were collected from 220 respondents (including both beneficiaries and non-beneficiaries) through a structured questionnaire from Sonepur district of Odisha (India). A livelihood security index (LSI) was constructed to capture the livelihood security of the respondents taking habitat security, health security, food security, and economic security into account. Further, the impact of the programme has been estimated using propensity score matching (PSM) method. The study finds a positive and significant effect of participation in the programme on livelihood security. Therefore, poor should be encouraged to participate in the programme to strengthen their livelihood security. [ABSTRACT FROM AUTHOR]

Background: Studies on survival and prognostic factors in individuals with remnant gastric cancer (RGC) after gastric cancer (GC) are rare. It is debatable whether prognosis of RGC after GC is worse than that of only primary GC (OPGC). The objective of this study is to compare the survival outcomes between post-GC RGC and OPGC undergoing surgical resection and to identify the prognostic factors of disease-specific survival (DSS) for RGC., Methods: We retrospectively collected data from the Surveillance, Epidemiology, and End Results (SEER) database among patients who underwent GC surgery in 1988-2020. Propensity score matching (PSM) was conducted to balance baseline characteristics. Kaplan-Meier (KM) survival analysis was performed to compare their overall survival (OS) and DSS. Multivariable Cox analyses were performed to identify the independent prognostic factors of DSS for post-GC RGC by estimating hazard ratios (HRs) with 95% confidence intervals (CIs)., Results: There were 76 patients with RGC and 32,763 patients with OPGC included and analyzed. After balancing the baseline characteristics by PSM, no significant difference existed between OPGC and RGC groups in both OS (P=0.65) and DSS (P=0.28). Fixed-time analyses also showed no difference between the two groups for the 5-year (60.0%, RGC vs . 53.3%, OPGC, P=0.38) and 10-year DSS (56.7%, RGC vs . 48.3%, OPGC, P=0.34). Multivariable analysis revealed that area of lower income ($75,000+ vs . <$55,000, HR =0.21, 95% CI: 0.05-0.89, P=0.03), cardiac tumor [middle vs . cardia, HR =0.16, 95% CI: 0.03-0.77, P=0.02; distal vs . cardia, HR =0.10, 95% CI: 0.02-0.58, P=0.01; not otherwise specified (NOS) vs . cardia, HR =0.11, 95% CI: 0.03-0.51, P=0.004], deeper invasion (T3-4 vs . Tis-2, HR =5.19, 95% CI: 1.21-22.15, P=0.03), higher grade (G3 vs . G1-2, HR =7.35, 95% CI: 1.41-38.48, P=0.02) and not receiving chemotherapy (yes vs . no/unknown, HR =0.16, 95% CI: 0.04-0.60, P=0.007) were independent risk factors for postsurgical DSS in patients with post-GC RGC., Conclusions: The prognosis of post-GC RGC was comparable to that of OPGC following surgical resection. The independent prognostic factors for RGC are similar to those established for OPGC. Our findings suggest that RGC following first GC might be the same entity to OPGC and curative resection should be considered in selected patients., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jgo.amegroups.com/article/view/10.21037/jgo-24-58/coif). The authors have no conflicts of interest to declare., (2024 Journal of Gastrointestinal Oncology. All rights reserved.)

Background: Since the introduction of drug-eluting beads (DEB), the result comparing transarterial chemoembolization (TACE) using lipiodol, also called conventional transarterial chemoembolization (c-TACE), and DEB-TACE shows considerable controversy. The objective of this study was to compare the safety and efficacy of c-TACE and DEB-TACE to treat unresectable hepatocellular carcinoma (uHCC)., Methods: This retrospective study used propensity score matching (PSM) analysis to analyze clinical data from 113 cases of primary hepatocellular carcinoma (HCC) treated at our hospital from September 2016 to July 2021. The safety and efficacy of the two treatment modalities were analyzed after 1:1 matching. The primary endpoint was progression-free survival (PFS); the secondary endpoints included overall survival (OS), disease control rates (DCRs), and objective response rates (ORRs) at 1, 3, 6, and 12 months, and postoperative complications., Results: Twenty-nine patients underwent DEB-TACE and 84 received c-TACE; 28 pairs of patients were eventually matched. After matching, baseline characteristics between groups were comparable. The median PFS of the DEB-TACE group was 10 months compared to 6 months in the c-TACE group (P=0.002). The median OS was 23 months in the DEB-TACE group vs. 14 months in the c-TACE group, but the difference was not statistically significant (P=0.265). The ORR at 1, 3, 6, and 12 months in the DEB-TACE group (69%, 78%, 60%, and 52%) were significantly higher than those in the c-TACE group (39%, 39%, 26%, and 8%) (P<0.05). The DCR at postoperative 3 months was significantly higher in the DEB-TACE group (95%) (P<0.05). There was one case of postoperative liver abscess in the DEB-TACE group, and the patient recovered well after drainage. No serious complications occurred., Conclusions: Compared to c-TACE, DEB-TACE prolonged PFS and exhibited better short-term ORR with a similar level of safety. However, there was no significant advantage in terms of OS., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jgo.amegroups.com/article/view/10.21037/jgo-24-369/coif). The authors have no conflicts of interest to declare., (2024 Journal of Gastrointestinal Oncology. All rights reserved.)

Background: Some occupational and environmental exposures could increase the risk of chronic obstructive pulmonary disease (COPD) and hypertension in various work and living environments. However, the effect of exposure to multiple exogenous harmful substances on COPD and hypertension co-morbidities remains unclear., Methods: Participants were selected from eight hospitals in five provinces in China using a multistage cluster sampling procedure. Participants' demographic, exposure, and disease information were collected through questionnaires, spirometry, and blood pressure examinations. Demographic data were used as matching factors, and 1:1 matching between the exposed and non-exposed groups was performed by employing propensity score matching (PSM) to minimize the influence on the results. A one-way chi-squared analysis and multifactorial logistic regression were used to analyze the association between the exposure to exogenous harmful substances (metals and their compound dust, inorganic mineral dust, organic chemicals, and livestock by-products) and the co-morbidity of COPD and hypertension., Results: There were 6,610 eligible participants in the final analysis, of whom 2,045 (30.9%) were exposed to exogenous harmful substances. The prevalence of co-morbidities of COPD and hypertension (6.0%) in the exposure group was higher than their prevalence in the total population (4.6%). After PSM, exogenous harmful substance exposure was found to be a risk factor for the co-morbidity of COPD and hypertension [odds ratio (OR) = 1.347, 95% confidence interval (CI): 1.011-1.794], which was not statistically significant before PSM (OR = 1.094, 95% CI: 0.852-1.405). Meanwhile, the results of different outcomes showed that the association between hypertension and exogenous harmful substance exposure was not statistically significant (OR = 0.965, 95% CI: 0.846-1.101). Smoking (OR = 4.702, 95% CI: 3.321-6.656), history of a respiratory disease during childhood (OR = 2.830, 95% CI: 1.600-5.006), and history of respiratory symptoms (OR = 1.897, 95% CI: 1.331-2.704) were also identified as risk factors for the co-morbidity of COPD and hypertension., Conclusion: The distribution of exogenous harmful substance exposure varies in the population, and the prevalence of co-morbidities is generally higher in susceptible populations. Exposure to exogenous harmful substances was found to be a key risk factor after adjusting for demographic confounders., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Chen, Zhou, Tang, Sun, Ao, Zhao and Chang.)

Background: Open surgery is gradually replaced by minimally invasive surgery, but few studies have reported the feasibility of laparoscopic pancreaticoduodenectomy (LPD) combined with vascular resection and reconstruction. The present study compared the efficacy of LPD with open pancreaticoduodenectomy (OPD) combined with portal vein/superior mesenteric vein (PV/SMV) resection and reconstruction for pancreatic cancer., Methods: The clinical data of patients who underwent PD combined with PV/SMV resection and reconstruction from March 2016 to August 2022 at our institution were retrospectively analyzed. The perioperative outcomes and survival outcomes were compared after propensity score matching (PSM)., Results: The original cohort included 64 patients. Sixteen pairs of patients were obtained by 1:1 PSM. The intraoperative blood loss was greater in the OPD group than in the LPD group (550 vs . 200 mL, P=0.04), and the PV clamp time was longer in the LPD group than in the OPD group (29.4 vs . 18.8 min, P<0.001). There was no significant difference in the incidence of postoperative complications. The median overall survival and progression-free survival were comparable between the two groups (P>0.05)., Conclusions: LPD combined with PV/SMV resection and reconstruction is safe and feasible in selected patients and results in similar perioperative outcomes and prognosis as open surgery., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://gs.amegroups.com/article/view/10.21037/gs-23-538/coif). The authors have no conflicts of interest to declare., (2024 Gland Surgery. All rights reserved.)

Background: As one of the most common diseases in terms of cancer-related mortality worldwide, gastric adenocarcinoma (GA) frequently develops peritoneal metastases (PMs) in advanced stages. Systemic therapy or optimal supportive care are recommended for advanced GA; however, patients frequently develop drug resistance. Surgical resection is not recommended for stage IV patients, and there have been some controversies regarding the role of it in GA patients with PMs. The aim of the study was to preliminarily evaluate the possible effect of surgical treatments on patients with only PMs from GA., Methods: Data were collected from the Surveillance, Epidemiology and End Results (SEER) database (year 2000-2022). A propensity score matching (PSM) was performed to reduce the influence of selection bias and confounding variables on comparisons. Then Cox proportional hazard regression, Kaplan-Meier analysis, and log-rank test were performed to assess the efficacy of surgical treatment in patients with PMs from GA., Results: A total of 399 patients diagnosed with PMs from GA were enrolled for our analysis, of which, 180 (45.1%) patients did not receive surgery and 219 (54.9%) patients received surgery. Multivariate Cox regression analysis before PSM indicated higher rates of overall survival (OS) outcome for patients who had received surgery [hazard ratio (HR) =0.4342, 95% confidence interval (CI): 0.3283-0.5742, P<0.001]. After PSM, a total of 172 patients were enrolled, with 86 in each group. Multivariate Cox analysis showed that surgery was the independent factor reflecting patients' survival (HR =0.4382, 95% CI: 0.3037-0.6324, P<0.001). Subgroup survival analysis revealed that surgery may bring advantages to patients with grades I-IV, stages T1-T4, stage N0, and tumor size less than 71 mm (P<0.05). We also found that the OS of chemotherapy patients who had undergone surgery was better than that of chemotherapy patients who had not undergone surgery (P<0.01)., Conclusions: Based on the SEER database, surgery has better OS for patients only with PMs from GA. Patients without lymph node metastasis and those who received chemotherapy before may benefit from surgery. These specific groups of patients may have surgery as an option to improve the prognosis., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jgo.amegroups.com/article/view/10.21037/jgo-23-886/coif). All authors report that the study was funded by the National Natural Science Foundation of China (grant number 31971166). The authors have no other conflicts of interest to declare., (2024 Journal of Gastrointestinal Oncology. All rights reserved.)

Nucleus farmer-outgrower schemes are contractual arrangements where a large farmer (nucleus farmer) who is well-resourced takes charge of smaller farmers by providing them with the necessary training on agronomic practices and some farm inputs for production. The study assesses the effects of nucleus farmer-outgrower schemes on profitability among smallholder farmers in Northern Ghana. A total of 330 smallholder farmers made up of 150 outgrowers and 180 non-outgrowers were interviewed using structured questionnaires. A comparative analysis is made between outgrowers and non-outgrowers. The study employs the binary logit regression model to identify the factors influencing participation in nucleus farmer-outgrower schemes and the propensity score matching technique to estimate the effect of nucleus farmer-outgrower schemes on profitability of smallholder farmers. The study reveals that the factors that significantly influence smallholder farmers’ participation in nucleus farmer-outgrower schemes are gender, marital status, farm size, membership of an FBO and extension contact. Gender and marital status of a farmer have negative influence on participation whilst farm size, membership of an FBO and extension contact have positive influence on participation. It was also revealed that nucleus farmer-outgrower schemes have significant positive effect on smallholder farmer’s gross margins, net margins and returns on investment. The study recommends that, nucleus farmers and other stakeholders who are involved in developing outgrower schemes or similar initiatives should take into consideration the social and demographic characteristics of the target farmers to enhance participation.

Background: The National Comprehensive Cancer Network (NCCN) guidelines recommend examination of a minimum of 12 lymph nodes (LNs) for accurate staging of a single case of colorectal cancer. However, the guidelines do not support the examination of LNs in synchronous colorectal carcinoma (SCC). This study aimed to investigate the association between lymph node yield and the prognosis of SCC patients. Methods: Synchronous colorectal carcinoma patients were selected from the Surveillance, Epidemiology, and End Results (SEER) database over a 10-year interval (2004 to 2013). Systematic dichotomization for optimal cut-off point identification was performed using X-tile. The baseline for the two LNs groups generated was balanced using the propensity score matching (PSM) method. Results: A total of 4616 patients met the inclusion criteria. The cut-off number for lymph node retrieved from a single patient was 15 and 12 for the first- and second-time diagnosis of SCC, respectively. Age, T category, N category, tumor grade, tumor site, tumor size, and radiation sequence were not balanced in the two groups. After adjusting the baseline in the two groups, the same results were observed. Age, T category, N category, tumor site had a partial effect on lymph node yield. There might be some biological characteristics of the tumor that influence lymph node yield. Conclusions: Retrieval of fewer than 15 LNs at the first time of SCC diagnosis indicates worse SCC prognosis. Because factors such as manner of surgical examination influence SCC prognosis, specimens should be preserved for at least 6 months to enable reevaluation should there be a need. Irb: IRB approval is not required because the SEER data are freely accessible. [ABSTRACT FROM AUTHOR]

Mass incarceration has led to an increased reliance on private prisons. Yet, there is little evidence regarding the extent to which public safety and misconduct patterns differ across private versus public prisons. Combining data from prisoners in the State of Texas within a counterfactual research design, the current study examines differences in the likelihood of engaging in misconduct among comparable male inmates sentenced to a private over a public prison unit. Findings indicate there are no significant differences in the amount of misconduct committed by inmates in either public or private institutions—with the exception of physical violence. Inmates assigned to private facilities were 10% less likely to engage in institutional violence compared with similarly situated inmates assigned to public facilities. [ABSTRACT FROM AUTHOR]

With the rapid development of China's economy, more and more listed companies have to face frequent corporate litigation. As corporate lawsuits are on the rise, it is necessary to study the measures taken by the company when a corporate litigation occurs. Some scholars' research indicates that top executive turnover may be one of the countermeasures, but few scholars have discussed this issue in the Chinese market. Our research uses 13 435 samples of Chinese market, takes the company's reputation as an observing point, and studies the relationship between corporate litigation and tap executive turnover. In addition, due to the special political environment and the large differences in the legal environment between different provinces in China, we have further explored the moderating role of political conditions and legal conditions. It is worth mentioning that our empirical research method is the propensity score matching (PSM),and by this way we can easily avoid sample selectivity bias. Finally, a robust experimental conclusion is obtained: corporate litigation and top executive turnover are significantly positively correlated, and this correlation will be adjusted by political and legal conditions. Our research enriches the field of corporate litigation and also have certain guiding significance for the social construction of the rule of law in China. [ABSTRACT FROM AUTHOR]

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We show that the acquiring firm's idiosyncratic stock return volatility (sigma) is an important determinant of the selection and perceived valuation effects of earnouts in Mergers and Acquisitions (M&As). Earnout‐based M&As are more often announced by high‐sigma acquirers (nearly 40% of all earnout‐based M&As), yet the documented higher risk‐adjusted returns accrued to acquirers in earnout‐based M&As, relative to M&As settled in cash, stock or mixed payments (the earnout effect), appear in deals announced by low‐sigma acquirers (nearly 20% of all earnout‐based M&As). High‐sigma acquirers employing earnouts appear to break even, or even experience losses, relative to their counterparts employing single up‐front payments. These results are confirmed based on a quasi‐experimental design through which the earnout effect is measured in isolation. We argue that in M&As announced by high‐sigma acquirers, the earnout effect is potentially elusive due to the presence of an acquirer‐specific information revelation effect, resulting from the heightened extent of information asymmetry between (small) acquirers' managers and outside investors. On the contrary, the use of earnouts in M&As announced by low‐sigma (large) acquirers, whereby the acquirer‐specific information revelation effect is likely negligible, sends a strong signal for value creation that also prevents investors from inducing a size‐related discount. [ABSTRACT FROM AUTHOR]

Nucleus farmer-outgrower schemes are contractual arrangements where a large farmer (nucleus farmer) who is well-resourced takes charge of smaller farmers by providing them with the necessary training on agronomic practices and some farm inputs for production. The study assesses the effects of nucleus farmer-outgrower schemes on profitability among smallholder farmers in Northern Ghana. A total of 330 smallholder farmers made up of 150 outgrowers and 180 non-outgrowers were interviewed using structured questionnaires. A comparative analysis is made between outgrowers and non-outgrowers. The study employs the binary logit regression model to identify the factors influencing participation in nucleus farmer-outgrower schemes and the propensity score matching technique to estimate the effect of nucleus farmer-outgrower schemes on profitability of smallholder farmers. The study reveals that the factors that significantly influence smallholder farmers' participation in nucleus farmer-outgrower schemes are gender, marital status, farm size, membership of an FBO and extension contact. Gender and marital status of a farmer have negative influence on participation whilst farm size, membership of an FBO and extension contact have positive influence on participation. It was also revealed that nucleus farmer-outgrower schemes have significant positive effect on smallholder farmer's gross margins, net margins and returns on investment. The study recommends that, nucleus farmers and other stakeholders who are involved in developing outgrower schemes or similar initiatives should take into consideration the social and demographic characteristics of the target farmers to enhance participation. [ABSTRACT FROM AUTHOR]

Interventions on consumer food waste behaviours are an effective way to reduce food waste as well as negative environmental impacts. Informational interventions are currently popular. However, the effectiveness of informational interventions is controversial and has not been evaluated on a large scale in practice. This study tested an 11-week randomized controlled trial in the food service industry covering 11 types of food waste and consumption, using a propensity score matching method between experimental (N = 712) and control groups (N = 591) to assess the effectiveness of different types of information (instructive VS guilt-based VS coupled) interventions. It was found that there was a significant reduction of 10.69g (10%) in the total amount of food waste after the informational intervention. Instructive information had a significant impact on food waste reduction, reducing 20% of waste at the consumption stage, followed by guilt-based (4%) and coupled (3%) information. The instructive-type intervention was found to be the most effective for reducing waste in pork, roots and tubers, cereals, and legumes, while the guilt-type intervention was found to be the most effective for reducing waste in eggs. Differences in terms of consumers' gender, education, weight, and amount spent were confirmed. In addition, the informational intervention had a spillover effect on food consumption, with instructive information significantly increasing food consumption by 23.82g (37%). This study shows that informational interventions, especially instructive information, are effective and reveals differences between segments. It also emphasizes the significance of considering the type of information and food categories for both the food service industry and national interventions. • Confirmation that informational interventions are effective. • Instructive information is more effective than guilt-based information. • Instructive information significantly increased food consumption. • Informational intervention had the different effect on different consumers. [ABSTRACT FROM AUTHOR]

Mass vaccination against the COVID-19 pandemic is ongoing worldwide to achieve herd immunity among the general population. However, little is known about how the COVID-19 vaccination would affect mental health and preventive behaviors toward the COVID-19 pandemic. In this study, we conducted a cross-sectional survey to address this issue among 4244 individuals at several COVID-19 vaccination sites in Guangzhou, China. Using univariate analysis and multiple linear regression models, we found that major demographic characteristics, such as biological sex, age, education level, and family per capita income, are the dominant influencing factors associated with health beliefs, mental health, and preventive behaviors. After propensity score matching (PSM) treatment, we further assessed the changes in the scores of health belief, mental health, and preventive behaviors between the pre-vaccination group and the post-vaccination group. When compared to individuals in the pre-vaccination group, a moderate but statistically significant lower score was observed in the post-vaccination group (p = 0.010), implying possibly improved psychological conditions after COVID-19 vaccination. In addition, there was also a moderate but statistically higher score of preventive behaviors in the post-vaccination group than in the pre-vaccination group (p < 0.001), suggesting a higher probability to take preventive measures after COVID-19 vaccination. These findings have implications for implementing non-pharmaceutical interventions combined with mass vaccination to control the rebound of COVID-19 outbreaks.

Objects: The aim of our study was to investigate whether major depressive disorder (MDD) increased the risk of hypertension using propensity score matching (PSM) in patients with MDD in Taiwan.Methods: In this study, we recruited all samples from a random sample sub-dataset of one million insured individuals from 2005. A total of 743,114 outpatients were included in our study. We used PSM (nearest neighbor matching) stratified by age, hospital level, insurance amount, and Charlson Comorbidity Index score.Results: The hazard ratio (HR) of hypertension was significantly greater in the male MDD outpatients (HR = 1.116, P = 0.004) than in the female MDD outpatients (HR = 0.93, P = 0.02). Using PSM, we selected 27,988 outpatients with hypertension and 27,988 outpatients without hypertension for a nested case–control study. In this analysis, female outpatients with MDD (relative risk = 0.852) had lower risks of hypertension. Male outpatients without/with MDD (relative risk = 1.987/3.018) showed a synergistic interaction with gender in which male patients had a higher risk of hypertension in a multiplicative model. Furthermore, MDD appeared to have an interaction effect with gender (HR = 1.82, P < 0.001) in the proportional hazards model analysis. Antidepressant use also increased the risk of hypertension (HR = 1.16, P < 0.001).Conclusions: There was gender disparity in the risk of hypertension in subjects with MDD. MDD outpatients who used antidepressants had a higher risk of suffering from hypertension. A large-scale, population-based study is warranted to generalize these results in the future.

Background: The severity and prognosis of an array of inflammatory diseases have been predicted using systemic inflammatory indices, such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio (LMR), derived neutrophil-to-lymphocyte ratio (dNLR), and systemic immune inflammation index (SII). The purpose of this study was to examine the association between systemic inflammatory markers and postoperative arrhythmias (PA) in esophageal cancer patients., Methods: In the study, laboratory-related parameters were gathered and examined in 278 patients (non-PA = 221, PA = 57). Fit separate propensity score matching (PSM) within subgroup strata (surgery approaches); match within strata, and aggregate for main analysis. Finally, we established a 1:1(57:57) model. The ability of inflammatory makers on the first post-esophagectomy day to distinguish PA from postoperative non-arrhythmia (non-PA) by receiver operating characteristic (ROC) analysis., Results: On the first post-esophagectomy day, there was a greater difference between PA and non-PA in terms of white blood cell (WBC) and neutrophil (NE), Neutrophil percentage (NE%), NLR, dNLR, LMR, and SII. After PSM, the following variables were substantially different between non-PA and PA: NE%, NLR, dNLR, and SII. It was found that WBC, NE, NE%, NLR, dNLR, LMR, and SII had the area under the curve (AUC) that was higher than 0.500 in ROC analysis, with NLR and SII having the highest AUC (AUC = 0.661). The indicators were subjected to binary logistic regression analysis, which increased the indicators' predictive ability (AUC = 0.707, sensitivity = 0.877)., Conclusion: On the first post-esophagectomy day, systemic inflammatory indicators were significantly correlated with both PA and non-PA, and high SII and NLR are reliable markers of PA., (© 2024. The Author(s).)

Objective: This study aims to investigate the impact of social isolation on the utilization of primary health services among older adults in China., Methods: Data from the China Longitudinal Aging Social Survey (CLASS) conducted in 2018 were utilized. A binary logistic regression model was established, and propensity score matching (PSM) was employed for analysis., Results: The results of the binary logistic regression showed that family isolation within social isolation had a significant negative impact on the utilization of primary health services for older adults. In contrast, there was no significant association between friend isolation, community isolation, and the utilization of primary health services. Furthermore, the PSM results, using three matching methods (nearest neighbor matching, radius matching, and kernel matching), confirmed that family isolation significantly reduced older adults' utilization of primary health services, consistent with the baseline regression findings., Conclusion: Reducing the occurrence of family isolation among older adults may be a cost-effective intervention measure. Efforts should be directed toward improving family support for older adults, promoting the utilization of primary health services, and strengthening disease prevention., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Xie, Lyu, Li, Zhuang and Xu.)

Objectives: This study aimed to gather evidence for the survival benefit of cancer-directed surgery (CDS) in metastatic head and neck cancer (M1 HNC) and identify which patients will benefit most from CDS., Methods: Patients with M1 HNC were identified within the SEER database. According to whether received CDS, patients were divided into the CDS and non-CDS groups. The bias between the two groups was minimized using Propensity Score Matching (PSM), and the prognostic role of CDS was investigated using Kaplan-Meier analysis, log-rank test, and Cox proportional hazard models. The primary endpoint was overall survival (OS), and the secondary endpoint was cancer-specific survival (CSS)., Results: A total of 3215 patients with M1 HNC were extracted, including 566 patients who received CDS that were 1:1 propensity score-matched with patients who did not receive CDS. In the matched dataset, the median OS and CSS in CDS groups were significantly higher than in non-CDS groups (OS: 19.0 vs. 9.0 months, p < 0.001; CSS: 21.0 vs. 9.0 months, p < 0.001). Meanwhile, multivariable Cox regression analysis also revealed that CDS was a favorable prognostic factor for both OS and CSS. Furthermore, subgroups of patients with M1 HNC (younger age, being married, grade I-II, oropharynx site, earlier T/N stage, radiotherapy) were inclined to benefit from CDS, while those patients who received chemotherapy failed to benefit from CDS., Conclusions: This study indicated that CDS was associated with improved survival in M1 HNC, especially for those subpopulations that benefit more from CDS treatment., Level of Evidence: 3 Laryngoscope, 134:1288-1298, 2024., (© 2023 The American Laryngological, Rhinological and Otological Society, Inc.)

Copper is an essential trace element for the human body. The epidemiological evidence for the association of dietary intake of copper with the risk of Parkinson's disease (PD) is limited. We conducted an evaluation of the cross-sectional data gathered from the National Health and Nutrition Examination Surveys spanning from 2007 to 2018, which comprised a total of 17,948 participants. To discern the distinct characteristics of the participants, we performed a univariate analysis and utilized a 1:2 ratio propensity score matching method to minimize the effects of selection bias. We employed weighted univariate as well as three multivariate logistic regression models both prior to and following matching, with the aim of examining the association between dietary copper intake and PD risk. Finally, we used the restricted cubic spline (RCS) methodology in order to investigate possible non-linear relationships. Furthermore, subgroup analysis was undertaken to elicit further understanding concerning the association between copper intake and PD. A negative correlation resulted between dietary copper intake and PD risk in both univariate and multivariate logistic regression models, prior to and following matching. Our findings demonstrate that there is a nonlinear, dose-dependent relationship between copper intake and PD, according to our RCS analysis. In subgroup analysis, copper intake was identified as an important protective factor for individuals who were non-Hispanic White, unmarried, and had completed higher education. Dietary copper intake was associated with the risk of PD. Supplementation of dietary copper may have potentially beneficial effects., (© 2023. The Author(s).)

Background: There is a paucity of Chinese studies evaluating the quality of life (QoL) in young acute type A aortic dissection (AAAD) patients with Marfan syndrome., Methods: Young adult AAAD patients (younger than 45 years old) underwent surgical treatment at our institution from January 2017 to December 2020 were consecutive enrolled. The hospital survivors completed 1 year of follow up. Patients were divided into two groups according to the presence or absence of Marfan syndrome (MFS). A 1:1 propensity score matching (PSM) with a caliper 0.2 was conducted to balance potential bias in baseline. The follow-up data were analyzed primarily for change in quality of life and anxiety status., Results: After PSM, 32 comparable pairs were matched. The baseline data were comparable and postoperative complications were similar between groups. In terms of SF-36 scale, the role physical, bodily pain, role emotional and mental health subscales were no significantly improved in MFS patients over time. At 1 year after discharged, the subscale of mental health and bodily pain were significantly lower in the MFS group than in the non-MFS group. In terms of HADS assessments, the level of anxiety in MFS patients was significantly higher than in non-MFS patients at 1 year after discharged., Conclusions: The QoL in young AAAD patients with MFS is lower than those without MFS after surgery. This may be associated with the uncontrollable persistent chronic pain and the uncertainty and concerns for the disease's progression., (© 2024. The Author(s).)

Background: Preoperative nutritional support studies for patients undergoing gastrointestinal (GI) surgery mostly focused on enteral nutrition (EN) or long-term (≥7 days) parenteral nutrition (PN). Some studies also found that preoperative short-term PN could improve the postoperative short-term nutritional status of tumor patients. But whether short-term PN support (1-6 days) before surgery can improve the prognosis of patients undergoing surgery for gastric cancer (GC) remains unclear. Therefore, we focused on assessing the effect of preoperative short-term PN on the outcomes of patients undergoing radical surgery for GC., Methods: A retrospective analysis of 1,155 patients who underwent radical gastrectomy for GC between July 2014 and February 2019 was conducted. According to whether patients received short-term (1-6 days) PN support before surgery, patients were divided into non-PN group and PN group. After 1:1 propensity score matching (PSM), two groups of patients with similar baseline clinical characteristics were obtained. The incidence of various complications and overall survival (OS) rate were compared between the two groups, and logistic regression analysis for complications, Cox regression analysis for OS, and subgroup analysis were performed., Results: Each group had 478 patients after PSM, and the clinical characteristics were balanced. There were no significant differences in overall postoperative complications (pre-PSM: P=0.495; post-PSM: P>0.99), postoperative length of stay (LOS; pre-PSM: P=0.092; post-PSM: P=0.460), or readmission rate within 30 days (pre-PSM: P=0.496; post-PSM: P=0.793) between the two groups before and after PSM. The OS of PN group before matching was lower than that of non-PN group (P=0.023), but this difference was not significant after matching (P=0.950), but the PN group's hospitalization expenses were substantially greater than those of the control group (post-PSM: P<0.001). Preoperative short-term PN support was not an independent factor in the incidence of postoperative complications (P>0.99) and OS (P=0.949). Subgroup analyses failed to identify those patients who might benefit from preoperative short-term PN support., Conclusions: Preoperative short-term PN support may have no significant benefit on short-term postoperative complications or the long-term OS of patients with GC but increase hospitalization costs. It thus should not be the first choice of treatment for these patients., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jgo.amegroups.com/article/view/10.21037/jgo-23-1000/coif). The authors have no conflicts of interest to declare., (2024 Journal of Gastrointestinal Oncology. All rights reserved.)

Background: Patients with Triple-negative breast cancer (TNBC) face a poor prognosis and limited therapeutic options. Current data on eribulin usage to treat TNBC is scarce. Therefore, we sought to compare the feasibility and tolerability of eribulin-based regimens with other chemotherapy regimens in patients with TNBC. Method: This retrospective study was conducted at Fujian Medical University Cancer Hospital and included 159 patients with TNBC enrolled between October 2011 and January 2023. Patients underwent treatment with eribulin-based and other chemotherapy regimens. The study's primary endpoints were progression-free survival (PFS) and overall survival (OS), while its secondary endpoint was objective response rate (ORR), disease control rate (DCR), and safety. Tumour response was assessed using RECIST V.1.1 criteria. Results: Of the 159 participants in the study, 42 individuals (26.4%) received treatment with eribulin, whereas 117 participants (73.6%) were administered alternative chemotherapy regimens, which included nab-paclitaxel-based therapy (n = 45) and platinum-based therapy (n = 51). The follow-up period for all patients ended on 31 December 2022, and the median follow-up time was 18.3 months (range:0.7-27.5). Following propensity score matching (PSM), eribulin-based treatment resulted in longer median progression-free survival compared to platinum-based (hazard ratio (HR) = 0.41, p = 0.006), nab-paclitaxel-based (hazard ratio = 0.36, p = 0.001) and other chemotherapy (HR = 0.39, p < 0.001). Also, eribulin induced a remarkable prolongation of the median overall survival duration in all three comparative groups. The group receiving eribulin treatment showed significantly reduced incidences of any grade of anaemia, peripheral neuropathy, nausea and vomiting, and hair loss compared to other chemotherapy groups. Conclusion: For the salvage treatment of advanced TNBC, treatment with eribulin produced longer median PFS and OS than other chemotherapy regimens, with a well-tolerated safety profile. Therefore, further investigation of eribulin-based treatment in larger randomized trials for patients with advanced TNBC is warranted., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Huang, Wang, Wang, Shen, Chen, Huang, Liu, Lin, Wu, Chen, Li, Hong, Chen, Li and Huang.)

Background: Increasing attention has been raised on the surgical option for lung cancer patients aged ≥75 years, however, few studies have focused on whether uniportal video-assisted thoracoscopic surgery (VATS) is safe and feasible for these patients. This study aimed to evaluate short-term results of uniportal versus three-port VATS for the treatment of lung cancer patients aged ≥75 years., Methods: We retrospectively evaluated 582 lung cancer patients (≥75 years) who underwent uniportal or three-port VATS from August 2007 to August 2021 based on the Western China Lung Cancer Database. The baseline and perioperative outcomes between uniportal and three-port VATS were compared in the whole cohort (WC) and the patients undergoing lobectomy (lobectomy cohort, LC) respectively. Propensity score matching (PSM) was used to minimize confounding bias between the uniportal and three-port cohorts in WC and LC., Results: Intraoperative blood loss was significantly less in the uniportal than three-port LC (50 mL vs. 83 mL, P = 0.007) before PSM and relatively less in the uniportal than three-port LC (50 mL vs. 83 mL, P = 0.05) after PSM. Significantly more lymph nodes harvested (13 vs. 9, P = 0.007) were found in the uniportal than three-port LC after PSM. In addition, in WC and LC, there were no significant differences between uniportal and three-port cohorts in terms of operation time, the rate of conversion to thoracotomy during surgery, nodal treatments (dissection or sampling or not), the overall number of lymph node stations dissected, postoperative complications, volume and duration of postoperative thoracic drainage, hospital stay after operation and hospitalization expenses before and after PSM (P > 0.05)., Conclusions: There were no significant differences in short-term outcomes between uniportal and three-port VATS for lung cancer patients (≥75 years), except relatively less intraoperative blood loss (P < 0.05 before PSM and P = 0.05 after PSM) and significantly more lymph nodes harvested (P < 0.05 after PSM) were found in uniportal LC. It is reasonable to indicate that uniportal VATS is a safe, feasible and effective operation procedure for lung cancer patients aged ≥75 years., (© 2024. The Author(s).)

Objective: Current evidence on the association between dietary vitamin E intake and the risk of Parkinson's disease (PD) is limited. The aim of the study was to explore the association of dietary vitamin E intake with PD in the United States among adults over 40 years., Methods: We conducted a cross-sectional study with data collected from National Health and Nutrition Examination Survey (NHANES) from 2009 to 2018. A total of the sample of 13,340 participants were included. To identify the different characteristics of the participants, we utilized propensity score matching (PSM) to reduce the effects of selection bias and confounding variables. Weighted univariate and multivariable logistic regression were used to examine the association between dietary vitamin E intake and PD before and after matching. Then, restricted cubic spline (RCS) was used to visually describe the possible non-linear relationships. Finally, we employed the subgroup analysis to further investigate the relationship between dietary vitamin E intake and PD., Results: According to the weighted univariate and multivariable logistic regression analysis, vitamin E intake was inversely associated with the risk of PD before and after matching. The results of RCS analysis revealed no non-linear inverse relationship between vitamin E intake and PD before and after matching. The subgroup analysis showed that age may influence the negative association between vitamin E and PD ( P < 0.05 for interaction)., Conclusion: Among participants over 40 years of age, vitamin E intake was negatively associated with the risk of PD. Our data may support the supplementation of vitamin E to be used as an intervention strategy for the occurrence of PD., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Hao, Li, Li, Gao, Wang, Wu, Wang and Zhu.)

Objective: There is no scientific consensus about the treatment of perforated gastric cancer (PGC). Therefore, the aim of this study was to investigate which is the better treatment option for PGC between the single-stage and two-stage strategies., Methods: All 81 PGC patients from 13 medical institutions were retrospectively enrolled in this study. The PGC patients who underwent R0 gastrectomy were divided into one-stage surgery and two-stage surgery groups. The clinicopathological characteristics of the two groups were compared, and 415 regular gastric cancer patients without perforation were randomly selected as a control. The propensity score matching (PSM) method was used to find matched regular GC patients with similar clinicopathological parameters. The OS (overall survival) and the number harvested lymph nodes from PGC patients and regular GC patients were compared., Results: Compared with PGC patients who underwent one-stage surgery, those who underwent two-stage surgery harvested significantly more lymph nodes [31(27, 38) vs 17 (12, 24), P < 0.001], required less blood transfusion [0 (0, 100) vs 200 (0, 800), P = 0.034], had a shorter ICU stay [0 (0, 1.5) vs 3 (0, 3), P = 0.009], and had a significantly better OS (Median OS: 45 months vs 11 months, P = 0.007). Compared with propensity score-matched regular GC patients without perforation, PGC patients who underwent one-stage gastrectomy had a poorer quality of lymphadenectomy [17 (12, 24) vs 29 (21, 37), P < 0.001] and suffered a worse OS (Median OS: 18 months vs 30 months, P = 0.024). Conversely, two-stage gastrectomy can achieve a comparable quality of lymphadenectomy (P = 0.506) and a similar OS (P = 0.096) compared to propensity score-matched regular GC patients., Conclusions: For PGC patients in poor condition, two-stage treatment is a better option when D2 radical gastrectomy cannot be achieved in emergency surgery, based on our findings that two-stage gastrectomy could provide PGC patients with a better quality of lymphadenectomy and a better OS., (© 2024. The Author(s).)