scholarly journals Transitions from Cohabitation to Marriage or Separation among the Birth Cohort of 1970–1984 in Lithuania

2021 ◽  
Vol 46 (1) ◽  
pp. 48-68
Author(s):  
Irma Dirsytė

This paper aims to analyse the impact of demographic and social factors on first partnership in Lithuania – the duration of premarital cohabitation, the sustainability of such relationships, and the transition into marriage. The research is based on the 2019 Family and Inequality Survey of 1970–1984 birth cohorts. Data analysis shows that most young people began their first partnership as a cohabitation rather than marriage, and the average premarital time spent in a cohabitation increases within this cohort. Cohabitation eventually transitions into marriage, and five years after the start of cohabitation, almost all cohabitants marry, and only a small percentage of cohabitating unions dissolve. Based on Cox regression analysis, the level of education and finished studies, as well as pregnancy, are significant predictors of the transition from cohabitation to marriage. The results of the research show that three decades after the beginning of the spread of cohabitation in Lithuania, cohabitation competes with marriage, but it does not challenge the importance of marriage as an institution of childbearing and upbringing.

2021 ◽  
Author(s):  
Chenxi Yuan ◽  
Qingwei Wang ◽  
Xueting Dai ◽  
Yipeng Song ◽  
Jinming Yu

Abstract Background: Lung adenocarcinoma (LUAD) and skin cutaneous melanoma (SKCM) are common tumors around the world. However, the prognosis in advanced patients is poor. Because NLRP3 was not extensively studied in cancers, so that we aimed to identify the impact of NLRP3 on LUAD and SKCM through bioinformatics analyses. Methods: TCGA and TIMER database were utilized in this study. We compared the expression of NLRP3 in different cancers and evaluated its influence on survival of LUAD and SKCM patients. The correlations between clinical information and NLRP3 expression were analyzed using logistic regression. Clinicopathologic characteristics associated with overall survival in were analyzed by Cox regression. In addition, we explored the correlation between NLRP3 and immune infiltrates. GSEA and co-expressed gene with NLRP3 were also done in this study. Results: NLRP3 expressed disparately in tumor tissues and normal tissues. Cox regression analysis indicated that up-regulated NLRP3 was an independent prognostic factor for good prognosis in LUAD and SKCM. Logistic regression analysis showed increased NLRP3 expression was significantly correlated with favorable clinicopathologic parameters such as no lymph node invasion and no distant metastasis. Specifically, a positive correlation between increased NLRP3 expression and immune infiltrating level of various immune cells was observed. Conclusion: Together with all these findings, increased NLRP3 expression correlates with favorable prognosis and increased proportion of immune cells in LUAD and SKCM. These conclusions indicate that NLRP3 can serve as a potential biomarker for evaluating prognosis and immune infiltration level.


2020 ◽  
Vol 9 (4) ◽  
pp. 1236 ◽  
Author(s):  
Michael Bender ◽  
Kristin Haferkorn ◽  
Michaela Friedrich ◽  
Eberhard Uhl ◽  
Marco Stein

Objective: The impact of increased C-reactive protein (CRP)/albumin ratio on intra-hospital mortality has been investigated among patients admitted to general intensive care units (ICU). However, it was not investigated among patients with spontaneous intracerebral hemorrhage (ICH). This study aimed to investigate the impact of CRP/albumin ratio on intra-hospital mortality in patients with ICH. Patients and Methods: This retrospective study was conducted on 379 ICH patients admitted between 02/2008 and 12/2017. Blood samples were drawn upon admission and the patients’ demographic, medical, and radiological data were collected. The identification of the independent prognostic factors for intra-hospital mortality was calculated using binary logistic regression and COX regression analysis. Results: Multivariate regression analysis shows that higher CRP/albumin ratio (odds ratio (OR) = 1.66, 95% confidence interval (CI) = 1.193–2.317, p = 0.003) upon admission is an independent predictor of intra-hospital mortality. Multivariate Cox regression analysis indicated that an increase of 1 in the CRP/albumin ratio was associated with a 15.3% increase in the risk of intra-hospital mortality (hazard ratio = 1.153, 95% CI = 1.005–1.322, p = 0.42). Furthermore, a CRP/albumin ratio cut-off value greater than 1.22 was associated with increased intra-hospital mortality (Youden’s Index = 0.19, sensitivity = 28.8, specificity = 89.9, p = 0.007). Conclusions: A CRP/albumin ratio greater than 1.22 upon admission was significantly associated with intra-hospital mortality in the ICH patients.


2021 ◽  
Author(s):  
Takahiko Toyonaga ◽  
Kenza Araba ◽  
Meaghan Kennedy ◽  
Benjamin Keith ◽  
Elisabeth Wolber ◽  
...  

Abstract Background and Aims: The host receptor for SARS-CoV-2, angiotensin-converting enzyme 2 (ACE2), is highly expressed in small intestine. Our aim was to study colonic ACE2 expression in Crohn's disease (CD) and non-inflammatory bowel disease (non-IBD) controls. We hypothesized that the colonic expression levels of ACE2 impacts CD course. Methods: We examined the expression of colon ACE2 using RNA-seq and quantitative (q) RT-PCR from 69 adult CD and 14 NIBD control patients. In a subset of this cohort we validated ACE2 protein expression and localization in formalin-fixed, paraffin-embedded matched colon and ileal tissues using immunohistochemistry. The impact of increased ACE2 expression in CD for the risk of surgery was evaluated by a multivariate regression analysis and a Kaplan-Meier estimator. To provide critical support for the generality of our findings, we analyzed previously published RNA-seq data from two large independent cohorts of CD patients. Results: Colonic ACE2 expression was significantly higher in a subset of adult CD patients (ACE2-high CD). IHC in a sampling of ACE2-high CD patients confirmed high ACE2 protein expression in the colon and ileum compared to ACE2-low CD and NIBD patients. Notably, we found that ACE2-high CD patients are significantly more likely to undergo surgery within 5 years of diagnosis, with a Cox regression analysis finding that high ACE2 levels is an independent risk factor (OR 2.18; 95%CI, 1.05-4.55; p=0.037). Conclusion: Increased intestinal expression of ACE2 is associated with deteriorated clinical outcomes in CD patients. These data point to the need for molecular stratification that may impact CD disease-related outcomes.


2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 15594-15594
Author(s):  
A. Banu ◽  
E. Banu ◽  
D. Dionysopoulos ◽  
J. Medioni ◽  
F. Scotte ◽  
...  

15594 Background: Clinical studies suggested that the extent of neuro-endocrine differentiation in prostate cancer increases with tumor progression and the development of androgen refractory status. Chromogranine (CgA) and neuron-specific enolase (NSE) are currently explored as surrogate markers. Methods: Eligible chemonaive HRPC patients (pts) were required to have an ECOG performance status (PS) ≤ 2. Before chemotherapy initiation, we quantified NSE, CgA and PSA in the venous blood using commercial kits. We evaluated the impact of baseline NSE, CgA and PSA on overall survival (OS) using multivariate Cox regression analysis, stratified by chemotherapy regimen. Secondary, we studied the correlation between NSE, CgA, PSA and other important variables as age, Gleason score, hemoglobin, number of metastatic sites and ECOG PS. Results: Data of 39 consecutive HRPC pts treated between December 01–06 in a single French center were analyzed. Chemotherapy was docetaxel-based in 92% of pts. Median age was 71 years (range 51–86) and 79% of pts had bone metastases. Elevated NSE, CgA and PSA were observed in 6, 9 and 30% of pts and median levels were 10.8, 67 and 23.3 ng/mL, respectively. Gleason 8–10 was present in 49% of pts. Significant correlations were observed between NSE and the number of metastatic sites and between CgA and age, hemoglobin and ECOG PS. The baseline PSA was only correlated with Gleason score. Median OS for the entire cohort was 24.4 months (95% CI, 18.8–29.9). Two-year OS was 15% and only 19% of patients are dead. Univariate Cox regression analysis showed only a significant relationship between OS and baseline NSE: hazard ratio= 1.09 (95% CI, 1.03–1.16), P=0.006. No other known prognostic factors are related to outcome. A multivariate model including baseline NSE, CgA, ECOG PS and Gleason score showed a 15% rise of the risk of death related to NSE (borderline P value). Conclusions: NSE was the most powerful predictor of survival for HRPC pts. Our results emphasize the theory that cells secreting NSE are chemoresistant, with a negative impact on OS. No significant financial relationships to disclose.


2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 672-672
Author(s):  
Benjamin Garlipp ◽  
Patrick Stuebs ◽  
Hans Lippert ◽  
Karsten Ridwelski ◽  
Henry Ptok ◽  
...  

672 Background: Oxaliplatin (Ox) added to postoperative 5-fluorouracil (5FU) based adjuvant treatment has shown a survival benefit in colon cancer. For rectal cancer, the impact of Ox on survival has almost exclusively been tested in studies using 5FU +/- Ox both as a component of preoperative chemoradiotherapy (CRT) and as adjuvant treatment. Only one study (NCT00807911) investigated adjuvant 5FU +/- Ox in patients undergoing preop 5FU based CRT without Ox. Thus, the evidence for the benefit of adding Ox to adjuvant 5FU in patients treated with preop 5FU based CRT is limited. Methods: Data from the prospective German multicenter Quality Assurance in Rectal Cancer observational trial involving more than 300 hospitals of all levels of care throughout Germany were retrospectively analyzed. Patients undergoing R0 total mesorectal excision (TME) for rectal cancer following neoadjuvant 5FU based treatment without oxaliplatin between 01/01/2008 and 12/31/2010 were included. Disease-free survival (DFS) in patients receiving adjuvant treatment with or without Ox was compared using the Kaplan Meier method. The impact of adjuvant treatment with 5FU with or without Ox on DFS was investigated in a Cox regression analysis including open vs. laparoscopic approach, pT stage, pN stage, tumor grading, TME quality grade, and presence of anastomotic leakage as potential confounding factors. Results: The entire data set included 1,861 patients. Data for all variables investigated were available for 599 patients of whom 512 (85%) and 89 (15%) received 5FU based adjuvant treatment without and with Ox, respectively. Mean DFS was not different in patients receiving 5FU only vs. 5FU with Ox (p=0.103). Cox regression analysis revealed no significant impact of adding Ox to adjuvant 5FU on DFS. Of all factors analyzed, only pN2 (vs. pN0) status had an independent adverse effect on DFS (Hazard ratio 4.22, p<0.001). Conclusions: These data indicate that adjuvant Ox added to 5FU does not provide a DFS benefit in rectal cancer patients treated with preoperative 5FU based CRT under routine care conditions. Rectal cancer patients may be different from patients with colon cancer with respect to benefit from adjuvant Ox.


2017 ◽  
Vol 27 (6) ◽  
pp. 1171-1177 ◽  
Author(s):  
Andrew T. Wong ◽  
Yi-Chun Lee ◽  
David Schwartz ◽  
Anna Lee ◽  
Meng Shao ◽  
...  

ObjectiveClinical outcomes for patients with uterine carcinosarcoma are poor after surgical management alone. Adjuvant therapies including chemotherapy (CT) and/or radiation therapy (RT) have been previously investigated, but the optimal management of this disease remains controversial. The purposes of this study were to analyze the patterns of use of adjuvant CT and RT and to assess the impact on survival of each of these treatment regimens using the National Cancer Data Base.Methods/MaterialsThe National Cancer Data Base was queried for patients given a diagnosis of uterine carcinosarcoma confined to the pelvis who underwent total hysterectomy/bilateral salpingo-oophorectomy between 2004 and 2011. Patients were excluded if they survived less than 4 months after diagnosis. Data regarding CT and RT use were collected. Overall survival (OS) was analyzed using the Kaplan-Meier method. Multivariable Cox regression analysis was performed to evaluate the effect of covariates on OS.ResultsA total of 4906 patients were included in this study. Median age was 67 years (interquartile range, 60–75 years). Median follow-up was 28.9 months (interquartile range, 15.4–52.9 months). There were 1777 patients (36.2%) who received no adjuvant treatment, 971 (19.8%) who received CT alone, 1060 (21.6%) who received RT alone, and 1098 (22.4%) who received both RT and CT. The 5-year OS for patients receiving no adjuvant therapy, adjuvant RT alone, adjuvant CT alone, and combined CT and RT were 44.9%, 47.1%, 47.5%, and 62.9%, respectively. On pairwise analysis, combined CT and RT was associated with improved survival compared with all other subgroups (P < 0.001). On multivariable Cox regression analysis, combined CT and RT (hazard ratio, 0.50; 95% confidence interval, 0.44–0.57; P < 0.001) and CT alone (hazard ratio, 0.78; 95% confidence interval, 0.69–0.88; P < 0.001) were significantly associated with improved OS, whereas RT alone was not.ConclusionsCombination therapy with CT and RT was associated with significantly improved 5-year OS compared with no further therapy, RT alone, or CT alone.


Diseases ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 49
Author(s):  
Sen Matsumoto ◽  
Yasuharu Matsunaga-Lee ◽  
Masashi Ishimi ◽  
Mamoru Ohnishi ◽  
Nobutaka Masunaga ◽  
...  

The role of B-type natriuretic peptide (BNP) levels as a predictor of arrhythmia recurrence (AR) after atrial fibrillation (AF) ablation remains unclear. In this study, we investigated the association of BNP levels before and 3 months after ablation with the risk of AR. A total of 234 patients undergoing their first session of AF ablation were included (68% male, mean age of 69 years). The cut-off value for discriminating AR was determined based on the maximum value of the area under the receiver operating characteristic (ROC) curve. The impact of BNP levels on AR was evaluated using Cox regression analysis. ROC curve analysis showed that the area under the curve for BNP at 3 months after the procedure was larger (0.714) compared to BNP levels before ablation (0.593). Elevated levels of BNP 3 months after the procedure (>40.5 pg/mL, n = 96) was associated with a higher risk of AR compared to those without elevated levels (34.4% vs. 10.9%, p < 0.01). Multivariate Cox regression analysis revealed that elevated BNP levels were associated with an increased risk of AR (hazard ratio 2.43; p = 0.014). Elevated BNP levels 3 months after AF ablation were a significant prognostic factor in AR, while baseline BNP levels were not.


2019 ◽  
Vol 19 (1) ◽  
pp. 75-83
Author(s):  
Hairul Izwan Abdul Rahman ◽  
Nor Aida Sanusi ◽  
Muhammad Syafik Ikhwan Salleh ◽  
Ng Yoon Yeen ◽  
Ismail Ali Mohd Jobran ◽  
...  

In 2005, Ministry of Health introduced the Needle Syringe Exchange Program (NSEP) and Methadone Maintenance Therapy (MMT) program as a part of Harm Reduction program to combat HIV infection in Malaysia among people who inject drug (PWIDs). Expenditures were estimated approximately RM10 millions per year to establish and sustain the NSEP and MMT centres. This study examined the impact of MMT program on preventing HIV seroconversion among registered MMT clients that are people who inject drug (PWIDs), and to identify other predictors of HIV seroconversion among this group.  This was a retrospective cohort study done in the state of Perak involving a total of 212 randomly selected MMT clients registered between 2008-2017 in 6 clinics. This study looks at data collected from the last ten-year cohort from baseline to follow-up. A questionnaire was used to obtain socio-demographic data, sexual and drugs abuse history. Test results for HIV were obtained from medical records. Cox regression analysis was performed to examine factors associated with seroconversion and Kaplan-Meier analysis to estimate HIV survival time. This study displayed that both Methadone take home supply (HR 10.4, 95% CI: 1.6 – 68.8) and unprotected sexual practice (HR 5.9, 95%CI: 1.1 – 31.5) shown higher risks of HIV seroconversion compared to DOTS and condom practice among MMT clients respectively. Mean survival for HIV seroconversion among MMT clients was 104.44 (95%CI: 101.85 – 107.04) months.  This study provides reliable evidence that MMT program markedly reduces incidence of HIV infection among people who inject drug (PWIDs).


2020 ◽  
Vol 18 (5) ◽  
pp. 575-581
Author(s):  
Omar Abdel-Rahman ◽  
Hatim Karachiwala ◽  
Jacob C. Easaw

Background: This study assessed the patterns of opioid use among patients with advanced gastrointestinal cancers who were included in 8 clinical trials and evaluated the impact of opioid use on survival outcomes of included patients. Methods: Deidentified datasets from 8 clinical trials evaluating first-line systemic treatment of advanced gastrointestinal cancers were accessed from the Project Data Sphere platform (ClinicalTrial.gov identifiers: NCT01124786, NCT00844649, NCT00290966, NCT00678535, NCT00699374, NCT00272051, NCT00305188, and NCT00384176). These trials evaluated patients with pancreatic carcinoma, gastric carcinoma, hepatocellular carcinoma (HCC), and colorectal carcinoma. Multivariable logistic regression analysis was used to evaluate factors predicting the use of opioids. Kaplan-Meier survival estimates were used to compare survival outcomes in each disease entity among patients who did or did not receive opioid treatment. Multivariable Cox regression analysis was then used to further assess the impact of opioid use on survival outcomes in each disease entity. Results: A total of 3,441 participants were included in the current analysis. The following factors predicted a higher probability of opioid use within logistic regression analysis: younger age at diagnosis (odds ratio [OR], 0.990; 95% CI, 0.984–0.997; P=.004), nonwhite race (OR for white vs nonwhite, 0.749; 95% CI, 0.600–0.933; P=.010), higher ECOG score (OR for 1 vs 0, 1.751; 95% CI, 1.490–2.058; P<.001), and pancreatic primary site (OR for colorectal vs pancreatic, 0.241; 95% CI, 0.198–0.295; P<.001). Use of opioids was consistently associated with worse overall survival (OS) in Kaplan-Meier survival estimates of each disease entity (P=.008 for pancreatic cancer; P<.001 for gastric cancer, HCC, and colorectal cancer). In multivariable Cox regression analysis, opioid use was associated with worse OS among patients with pancreatic cancer (hazard ratio [HR], 1.245; 95% CI, 1.063–1.459; P=.007), gastric cancer (HR, 1.725; 95% CI, 1.403–2.122; P<.001), HCC (HR, 1.841; 95% CI, 1.480–2.290; P<.001), and colorectal cancer (HR, 1.651; 95% CI, 1.380–1.975; P<.001). Conclusions: Study findings suggest that opioid use is consistently associated with worse OS among patients with different gastrointestinal cancers. Further studies are needed to understand the underlying mechanisms of this observation and its potential implications.


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