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01) alignments. Only the Hospital for Special Surgery (HSS) (p less then 0.001) score at final follow-up was significantly better in rTKA than cTKA. rTKA also had a lower mean blood loss (p less then 0.001) despite a longer mean operation time (p = 0.006). There were no statistically significant difference in terms of other clinical outcome measures, range of motion and complications. Conclusion Both rTKA and cTKA are reliable and safe to perform. However, rTKA is capable of achieving superior alignment in several axes, lower mean blood loss and this may lead to marginally better clinical outcomes than cTKA. Evidence level Level II, Meta-analysis of non-homogeneous studies.The main aim of this study was to evaluate gamma radiation level in the mineral hot springs of Ardabil province in Iran. In addition, the cancer risk of gamma radiation was assessed for swimmers. Natural gamma radiation was measured using Ion Chamber Survey Meter 451B in 22 springs throughout the province. Gamma was measured at 20 cm and 100 cm above the ground level in 15 locations of each spring. Excess lifetime cancer risk was calculated to investigate the risk of exposure to gamma radiation. The highest and lowest annual absorbed dose rate of gamma were found to be 1.17(10-3) and 1.99(10-3) Sv/y at the height of 20 cm above the ground level and 5.26(10-4) and 1.52(10-3) Sv/y at the height of 100 cm above the ground level, respectively. Excess lifetime cancer risk ranged from 4.57(10-4) to 7.76(10-4) at the height of 20 cm and from 2.06(10-4) to 5.94(10-4) at the height of 100 cm which are lower than global average of 1.45(10-3) declared by the United Nations. Although the risk level in this study is lower than the global average, protective and preventive measures should be considered by individuals and authorities in these areas to reduce the effects of gamma radiation on the health of the swimmers.Purpose An institutional workflow developed by clinical pharmacists for initiation of directing-acting antiviral (DAA) therapy for patients who receive solid organ transplants from hepatitis C (HCV)-positive donors is described; programmatic challenges in providing pharmaceutical care to these patients are reviewed. Summary In recent years the introduction of new oral DAAs, coupled with faster screening of donor organs for HCV infection through use of a nucleic acid test (NAT), has facilitated transplants of organs from HCV-seropositive donors to HCV-seronegative recipients. The solid organ transplant program of a North Carolina health system began performing such transplants in December 2017. In the pharmacist-developed workflow, patients are initiated on DAA therapy in the outpatient clinic setting, and clinic pharmacists are consulted regarding drug selection. Prescriptions for DAA therapy are sent to an on-site specialty pharmacy, where pharmacists and pharmacy technicians work to obtain prior authorizatisplanted HCV NAT-positive organs.Identifying those patients who were at high risk of stroke associated infection (SAI) for preventive antibiotic therapy was imperative for patients' benefits, thus improving prediction of SAI was critical for all acute ischemic stroke (AIS) patients. Circular RNA FUNDC1 (circFUNDC1) has been reported to be the diagnosis and prognosis biomarker of AIS. Therefore, the present study aimed to figure out whether circFUNDC1 could be the potential predictor of SAI that could help to guide preventive treatment. In total, 68 patients were included in the study, 26 of which had infection and 42 without. Copy number of circFUNDC1 in plasma were quantified by quantitative real-time polymerase chain reaction (qPCR). Platelet spike-in experiment and correlation analysis were conducted to explore possible origins of circFUNDC1 in plasma. A significantly elevated level of circFUNDC1 was found in SAI patients compared with not infected AIS patients (P=0.0258). Receiver operating characteristic (ROC) curves demonstrated the prediction significance of circFUNDC1, with the area under the curve (AUC) at 0.6612 and sensitivity, specificity at 69.23%, 61.90% respectively in predicting SAI. Then, when adding circFUNDC1 in the risk model, the AUC increased from 0.7971 in model A to 0.8038 in model B. Additionally, positive correlation was observed between circFUNDC1 level and neutrophils counts. WBC and neutrophil ratios were significantly elevated in SAI patients compared with non-SAI patients. Therefore, circFUNDC1 could be used to construct a risk model for the prediction of SAI that is beneficial for AIS patients' preventive treatment.Purpose The primary objective of the study described here was to compare rates of patient adherence to anticancer medications filled at an internal health system specialty pharmacy (HSSP) vs external specialty pharmacies. The primary outcome was the medication possession ratio (MPR), and the secondary outcomes included proportion of days covered (PDC), and time to treatment (TTT). Methods A retrospective chart review was conducted to compare the MPR, PDC, and TTT for patients who received oral anticancer therapy using prescriptions claim data. A t test or Wilcoxon test was used to explore the effect of demographic and other factors on adherence and TTT. [https://www.selleckchem.com/products/rk-701.html RK-701 GLP inhibitor] A multiple regression model with backward elimination was used to analyze significant factors to identify covariates significantly associated with the outcomes. Results Of the 300 patients screened for study inclusion, 204 patients whose records had complete MPR and PDC data and 164 whose records had TTT data were included in the analysis. There were significant between-group differences in mean MPR and mean PDC with patient use of the HSSP vs external pharmacies (1.00 vs 0.75 [P less then 0.001] and 0.95 vs 0.7 [P less then 0.001], respectively). Pharmacy type (P = 0.024) and tumor type (P = 0.048) were significantly associated with TTT. Conclusion The multiple regression analysis indicated that oncology patients who filled their anticancer medication precriptions at an internal HSSP at an academic medical center had significantly higher adherence, as measured by MPR and PDC, and quicker TTT than those who filled their prescriptions at an external specialty pharmacy.