Zobrazení zdroje stránky Vellingmanning5108

Background There are very limited data available on 30-day readmissions for ethnic minority patients with cirrhosis. The aim of the study was to identify the risk factors for 30-day readmission in ethnic minority patients admitted for cirrhosis. Methods We did a retrospective review of 1,373 electronic medical records of patients with cirrhosis admitted from 2009 to 2011. Several parameters including alcohol use history, discharge location and cirrhosis severity scores - model for end-stage liver disease (MELD) score and Child-Pugh-Turcotte (CPT) at first admission were assessed. [https://www.selleckchem.com/products/bay-61-3606.html read more] Statistical analysis was done using Chi-square test and t-test for categorical and continuous variables, respectively. Results There were 79 patients in the readmission group (63% male, 54% Hispanics and 22% African Americans) and 104 in the no readmission group (62% male, 58% Hispanics and 24% African Americans). History of alcohol use within a month prior to admission (55% vs. 33%, P = 0.002), platelet count at discharge (89,000 vs. 124,000, P = 0.003), and discharge with more than seven medications per day (7.3 vs. 5.2, P = 0.005) were identified as risk factors for readmissions by multivariate analysis. Conclusion Platelet count, active alcohol use and more than seven medications at discharge are predictors of readmission. These parameters can guide future interventions to reduce readmission rate and health care costs related to cirrhosis readmissions. Copyright 2020, Patel et al.Colon cancer is a common preventable cancer. With the adoption of widespread colon cancer screening in the developed countries, the incidence and mortality of colon cancer have decreased in the targeted population. But unfortunately, the incidence and mortality of colorectal cancer (CRC) have been increasing over the last 25 years in the young adults below the age of 50. There is disparity in benefit, i.e. reduction in risk of death between right-sided and left-sided colon cancer by screening colonoscopy. The reason could be multifactorial and various measures have been taken to decrease this disparity. Although most of the screened populations are average risk individuals, a minority of the population have various risk factors for developing colon cancer and need to follow specific colon cancer screening guidelines. Gene mutations (adenomatous polyposis coli (APC), deleted in colon cancer (DCC), K-ras, p53, B-Raf proto-oncogene serine/threonine kinase (BRAF), mismatch repair genes) and microsatellite instabincologic and surgical) are available in advanced stages of this cancer. Adequate number of lymph node assessment during surgery is essential in accurate staging of CRC. Checkpoint inhibitors have been found to have dramatic response and durable clinical benefit in dMMR/MSI-H metastatic CRC. Different genetic and immune-oncologic research trials are ongoing for early detection and better management of CRC. Copyright 2020, Ahmed.Applications of neutron diffraction to microstructure evaluation of steel investigated by a project commissioned by the Innovative Structural Materials Association are summarized. The volume fraction of austenite (γ) for a 1.5Mn-1.5Si-0.2C steel was measured by various techniques including backscatter electron diffraction (EBSD) and X-ray diffraction. It is recommended to measure volume fraction and texture simultaneously using neutron diffraction. The γ reverse transformation was in situ monitored using dilatometry, EBSD, X-ray diffraction and neutron diffraction. The γ reversion kinetics showed excellent agreements between dilatometry and neutron diffraction, whereas the γ formation started at higher temperatures in EBSD and X-ray diffraction measurements. Such discrepancy is attributed to the change in chemical compositions at the specimen surface by heating; Mn and C concentrations were decreased with heating. Phase transformations from γ upon cooling were monitored, which enabled us to elucidate the changes in lattice parameters of ferrite (α) and γ affected by not only thermal contraction but also transformation strains, thermal misfit strains and carbon enrichment in γ in the above hypoeutectoid steel. Pearlitic transformation started after the carbon enrichment reached approximately 0.76 mass% and contributed to diffraction line broadening. Martensitic transformation with or without ausforming at 700°C was monitored for a medium carbon low alloyed steel. Dislocation density after ausforming was determined using the convolutional multiple whole profile fitting method for 10 s time-sliced data. The changes in γ and martensite lattice parameters upon quenching were tracked and new insights on internal stresses and the axial ratio of martensite were obtained. © 2020 The Author(s). Published by National Institute for Materials Science in partnership with Taylor &amp; Francis Group.Food abundance plays an important role in the reproduction of fish, especially multiple spawners. Multiple spawners can exhibit various biological strategies when under starvation stress. However, the reproductive strategy used in these fish species remains unknown. To explore whether rare minnows (Gobiocypris rarus) prioritize survival over current reproduction under starvation conditions, paired adult rare minnows were starved for 0, 5, 10, 15 d and their spawning activities were recorded. Anatomical and histological characteristics of unpaired adult rare minnows were examined during starvation and following re-feeding. It was found that only 30-70% of paired rare minnows spawned within 5 d after deprivation of food. Though spawning activity was suppressed by starvation, rare minnows starved for 0, 5, 10, and 15 d waited 3.89 ± 0.78 d, 5.57 ± 3.36 d, 5.83 ± 5.15 d and 6.57 ± 4.50 d, respectively, after re-feeding to resume spawning. The average inter-spawning interval and length until egg production of those starved for 15 d was 4.60 ± 2.37 d and 139.1 ± 67.9 d, respectively, when they spawned with rhythm, which were significantly different from those starved for 0 d (P less then 0.05). Anatomical and histological data further revealed that late maturing oocytes degraded after 8 d of starvation, but the gonadosomatic index recovered to initial levels after 8 d of re-feeding. Thus, reproduction of rare minnows was markedly affected by starvation, but rapidly returned to normal upon re-feeding. These observations demonstrated that paired rare minnows prioritize survival by channeling energy from the liver and absorbing late maturing oocytes instead of continuing to reproduce under food deprivation condition.