Background Two-year longevity is a crucial consideration in revascularization strategies for patients with symptomatic lower extremity arterial disease (LEAD). However, factors associated with 2-year longevity and risk stratification in octogenarians or nonagenarians have been underreported. Objective This paper aims to investigate the associated variables and stratify the 2-year prognosis in older patients with LEAD. Methods We performed logistic regression and association rule mining based on the Apriori algorithm to discover independent variables and validate their associations with 2-year longevity. Malnutrition, inflammation, and stroke factors were identified. C statistics and Kaplan-Meier analysis were used to assess the impact of different numbers of malnutrition, inflammation, and stroke factors on 2-year longevity. Results We recruited a total of 232 octogenarians or nonagenarians (mean age 85 years, SD 4.2 years) treated with endovascular therapy. During the study period, 81 patients died, and 27 of those (33%) died from a cardiac origin within 2 years. Association rules analysis showed the interrelationships between 2-year longevity and the neutrophil-lymphocyte ratio (NLR) and nutritional status as determined by the Controlling Nutritional Status (CONUT) score or Geriatric Nutritional Risk Index (GNRI). The cut-off values of NLR, GNRI, and CONUT were ≥3.89, ≤90.3, and >3, respectively. The C statistics for the predictive power for 2-year longevity were similar between the CONUT score and the GNRI-based models (0.773 vs 0.760; P=.57). The Kaplan-Meier analysis showed that 2-year longevity was worse as the number of malnutrition, inflammation, and stroke factors increased from 0 to 3 in both the GNRI-based model (92% vs 68% vs 46% vs 12%, respectively; P<.001) and the CONUT score model (87% vs 75% vs 49% vs 10%, respectively; P<.001). The hazard ratio between those with 3 factors and those without was 18.2 (95% CI 7.0-47.2; P<.001) in the GNRI and 13.6 (95% CI 5.9-31.5; P<.001) in the CONUT score model. Conclusions This study demonstrated the association and crucial role of malnutrition, inflammation, and stroke factors in assessing 2-year longevity in older patients with LEAD. Using this simple risk score might assist clinicians in selecting the appropriate treatment.

Background Obesity has become the main health issue in developed countries as it impacts life expectancy and increases mortality of cerebrovascular or cardiovascular diseases. The leptin is one of the adipokines which presents in the serum in proportion to the amount of adipose tissue and is translated from LEP gene. It involves in energy homeostasis, lipid and glucose metabolisms, modulation of immune systems, and thermogenesis. Many previous studies have revealed controversial results between LEP polymorphisms and leptin levels in different ages and ethnicities. Herein, we investigated the impacts of LEP polymorphism against leptin levels in Taiwanese subjects. Methods In 599 Taiwanese subjects, excluding clinically overt systemic disease, age below 18 years old, and C‐reactive protein (CRP) level of above 10 mg/L, few of LEP polymorphisms were genotyped with TaqMan SNP genotyping assays, were further analyzed for association with leptin level in univariate and multivariate linear regression analyses with Bonferroni correction for multiple tests in stratified groups. The univariate and stepwise multivariate linear regression analyses were performed to determine the coefficient of determinant of LEP polymorphisms over leptin level. Results Significant associations were found between LEP polymorphisms and leptin levels in obese women. Circulating leptin level was positively correlated with inflammatory, insulin resistance markers, and visceral obesity markers in all subjects. Furthermore, stratified and interaction analyses revealed that LEP polymorphisms, rs7799039 and rs2167270, were significantly associated with leptin levels in obese women—8%–10% of which could be explained by LEP polymorphisms. Conclusion The LEP polymorphisms are independently associated with leptin levels in Taiwanese obese women. Further, the genetic determinants for leptin levels may be different between obese and nonobese, and in different sex individuals. The obesity status and female sex may exert modification effect on transcription of LEP, particularly in obese women.

Since service failure is inevitable in the service industry, how to remedy the failure and maintain customer satisfaction has become an important management issue for enterprises in marketing. This study took gender and physical attractiveness as moderators, hoping to find a mechanism that is more conducive to improving the effectiveness of failure recovery from the perspective of these two variables. In this study, experimental design was used to design a total of 16 experimental scenarios for model verification. The experiment was conducted on a network platform, and a total of 800 valid experimental samples were completed. The study found that for tangible compensation, female service personnel and physical attractiveness are helpful to improve post-recovery satisfaction. In addition, the opposite sex combination of customers and service personnel will produce better remedial effect than the heterosexual combination. Finally, it is also verified that physical attractiveness is an important moderator. The physical attractiveness of the service personnel enables the recovery type and gender combination to have more positive influence on post-recovery satisfaction, thus it plays an important role in failure recovery strategy. Managerial implications for marketing manager of the service industry as well as directions for future research are also discussed.

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BACKGROUND Two-year longevity (2YL) is a crucial consideration in revascularization strategies for patients with symptomatic lower-extremity artery disease (LEAD). However, factors associated with 2YL and risk stratification in octogenarians or nonagenarians have been underreported OBJECTIVE We aimed to investigate the association variables and stratify the 2-year prognosis in elderly patients with LEAD METHODS We performed logistic regression and association rules mining based on the Apriori algorithm to discover the independent variables and validate their associations with 2YL. The malnutrition, inflammation, and stroke (MIS) factors were identified. C-statistics and Kaplan-Meier analysis were used to assess the impact on 2YL of different numbers of MIS factors. RESULTS We recruited a total of 232 octogenarians or nonagenarians (mean age 85±4.2 years) treated with endovascular therapy. During the study period, 81 patients died (33% with a cardiac origin) within 2 years. Association rules analysis showed the interrelationships of neutrophil-lymphocyte ratio (NLR) and nutritional status, determined by the Controlling Nutritional Status (CONUT) score or Geriatric Nutritional Risk Index (GNRI), with 2YL. The cutoff value of NLR, GNRI, and CONUT was ≥3.89, ≤90.3, and >3, respectively. The C-statistics for the predictive power for 2YL were similar between the CONUT score and GNRI-based models (0.773 vs. 0.760, P=0.572). The 2YL was much worse in patients with all three MIS factors than in those without (hazard ratio 18.2 and 13.6 [P<0.001] in the GNRI and CONUT score models, respectively). CONCLUSIONS This study demonstrated the association and crucial role of MIS factors in assessing 2YL in elderly patients with LEAD. Using this simple risk score might assist clinicians in selecting the appropriate treatment. CLINICALTRIAL not applicable