A holistic perspective to predict yoga tourists' revisit intention: An integration of the TPB and ECM model.

Introduction: The purpose of this study is to empirically investigate the pattern of visitors' revisiting behavioral intention via the innovational approach of Theory of Planned Behavior (TPB) and the Expectation Confirmation Theory (ECT). Methods: This research was conducted by data collection with structured questionnaires as its instrument, which was distributed among 420 yoga tourism visitors in two destinations, Mysore and Rishikesh in India. Collected data had been processed by confirmatory factor analysis and structural equation modeling. Results: The data analysis results showed that the behavioral attitude of yoga tourism visitors can mediate the influence of behavioral intention through the satisfaction. The findings of this study include the following points: (1) the components of attitude, subjective norm and destination image apply a direct effect on the cultural and spiritual experiences of yoga tourism visitors; (2) cultural and spiritual experiences have a direct effect on the expectation confirmation and the satisfaction of yoga tourism visitors; (3) Expectation confirmation has a direct effect on the satisfaction and the behavior intention of yoga tourism visitors; and (4) Satisfaction has a direct effect on the behavior intention of yoga tourism visitors. Discussion: This study contributed by examining the satisfaction and revisit intentions of yoga tourism visitors through an integrated study of planning behavior and expectation confirmation models, which might be refilling the scarcity of research in the tourism literature. The result of this study might offer important implications for scholars, marketers, and tourism industry to better serve this emerging niche market.

What predicts the unsuccess of bariatric surgery? An observational retrospective study.

PURPOSE: Bariatric surgery (BS) has been recognized as an effective treatment for most patients with morbid obesity, but a variable range of patients failed to achieve a successful weight-loss. Controversial data are available about predictors of unsuccess. We aimed to retrospectively assess whether clinical baseline characteristics of patients submitted to sleeve gastrectomy (SL) or gastric bypass (GBP) were associated with unsuccessful weight-loss after 12 and 24-month follow-up. METHODS: Three hundred patients who underwent BS from the 1st January 2016, with at least 24-months follow-up, were enrolled. Patients were divided according to their percentage of excess weight-loss (%EWL) either < 50% or ≥ 50% after 12 and 24-month follow-up. RESULTS: None of the patients was lost at follow-up; 56 (18.7%) patients showed a %EWL < 50% at 24 months. Age, neck circumference, obstructive sleep apnea (OSA) were significantly higher, while total cholesterol and %EWL 6-months lower in those with %EWL < 50% at 12-months. Age, neck circumference, male and OSA rates were increased, while %EWL at 6-months lower in patients with %EWL < 50% at 24-months. In a multiple regression model, age (OR = 1.076; 95% CI 1.029-1.125; p = 0.001; OR = 1.066; 1.027-1.107; p < 0.001) and %EWL at 6-months (OR = 0.876; 0.840-0.913; p < 0.001; OR = 0.950; 0.928-0.972; p < 0.001) were associated with %EWL < 50% both at 12- and 24-months, respectively, and neck circumference (OR = 1.142; 1.011-1.289; p = 0.032) with %EWL < 50% at 24-months. CONCLUSION: Older age, larger neck circumference, and %EWL at 6-months were significantly associated with BS unsuccess, showing almost 90% of those patients an unsuccessful weight-loss early after surgery. Further larger studies with longer follow-up are needed to confirm these results.

A Survival Analysis of Living Donor Kidney Transplant.

BACKGROUND: Superior patient and graft survival rates have been attributed to living donor kidney transplant (LDKT) when compared to deceased donor transplantation. The aim of this study was to assess graft survival in a population of LDKT in the last 14 years and the potential impact of some clinical features. METHODS: A retrospective observational study was conducted, reviewing the records of all patients undergoing LDKT in one center from January 1, 2004, to December 31, 2017. Survival data were evaluated by Kaplan-Meier, log rank test, and Cox regression. RESULTS: Two hundred seventy-seven LDKT were performed. The median follow-up time was 4 (0-13) years. Graft loss was observed in 9% of patients; 4 patients died. The overall survival was 97% at year 1, 94% at year 5, and 83% at years 10 and 13. We found a significantly worse graft survival in patients with early vascular complications that required surgical intervention (P = .00) ≥3 HLA MM (P = .01), ≥1 HLA-DR MM (P = .04) and female recipients (P = .01). The negative impact of ≥1 HLA-B MM on survival was borderline (P = .05). After excluding early graft losses secondary to vascular events, ≥1 HLA-A MM and rejection have also implicated a negative impact on survival (P = .04 and .01, respectively). In the multivariate analysis, these variables were still related to inferior survival. CONCLUSIONS: We observed a good overall graft survival (>80% after 13 years). Possible factors related to poor outcomes suggested by this study were early vascular complications; HLA mismatches; rejection; and, with less certainty, female recipients.

Outcome of cataract surgery at one year in Kenya, the Philippines and Bangladesh.

AIMS: To assess the change in vision following cataract surgery in Kenya, Bangladesh and the Philippines and to identify causes and predictors of poor outcome. METHODS: Cases were identified through surveys, outreach and clinics. They underwent preoperative visual acuity measurement and ophthalmic examination. Cases were re-examined 8-15 months after cataract surgery. Information on age, gender, poverty and literacy was collected at baseline. RESULTS: 452 eyes of 346 people underwent surgery. 124 (27%) eyes had an adverse outcome. In Kenya and the Philippines, the main cause of adverse outcome was refractive error (37% and 49% respectively of all adverse outcomes) then comorbid ocular disease (26% and 27%). In Bangladesh, this was comorbid disease (58%) then surgical complications (21%). There was no significant association between adverse outcome and gender, age, literacy, poverty or preoperative visual acuity. CONCLUSIONS: Adverse outcomes following cataract surgery were frequent in the three countries. Main causes were refractive error and preoperative comorbidities. Many patients are not attaining the outcomes available with modern surgery. Focus should be on correcting refractive error, through operative techniques or postoperative refraction, and on a system for assessing comorbidities and communicating risk to patients. These are only achievable with a commitment to ongoing surgical audit.

Rapid one-step capillary isoelectric focusing method to monitor charged glycoforms of recombinant human tissue-type plasminogen activator.

A rapid (< 10 min) one-step capillary isoelectric focusing (cIEF) method was developed to monitor charged glycoforms of recombinant human tissue-type plasminogen activator (rt-PA). Focusing takes place between the detector and the anode and the electro-osmotic flow (EOF) sweeps the separated glycoforms past the detector, towards the cathode. The separation uses a neutral coated capillary and hydroxypropylmethylcellulose (HPMC) to reduce the EOF to a constant and reproducible value. The method uses an ampholyte mix with a 50:50 ratio of pH 5-8 and pH 3-10 ampholytes in 4 M urea and 0.1% HPMC to produce maximal resolution whilst maintaining protein solubility during focusing. The electropherograms were compared to isoelectric focusing (IEF) slab gels of samples of intact rt-PA. In both cases approximately ten charged species could be detected. Data analysis indicated that the intra-assay precision was < 5% for peak migration times and < 10% for normalized peak areas. The number of charged species detected by each of the two methods was consistent for samples of intact rt-PA, rt-PA types I and II and for neuraminidase-digested rt-PA. Overall the data indicate that the automated cIEF method can be an adjunct to slab-gel IEF in the characterization and routine analysis of recombinant glycoproteins.