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03; p less then 0.001) and low volume hospitals (OR3.86; p less then 0.001) were associated with higher rates of open conversion. Last but not least, when the interaction between the number of patient risk factors (obesity and/or frailty and/or CCI≥2) and hospital volume was tested, a dose-response effect was observed. Specifically, the rates of open conversion ranged from 0.3% (patients with 0 risk factors treated at high volume hospitals) to 2.2% (patients with 2-3 risk factors treated at low volume hospitals). Conclusion Overall contemporary (2008-2015) rate of open conversion at MIRP was 0.6% and it was strongly associated with patient obesity, frailty, CCI≥2 and hospital surgical volume. In consequence, these parameters should be taken into account during preoperative patients counselling, as well as in clinical and administrative decision making.For nearly 200 years, the only natural source of the alcohol ambrein has been coproliths produced in about 1% of sperm whales and in related jetsam. However, the finding of ambrein in adipocere/faeces of human corpses, led us to hypothesise that ambrein might occur in the faeces of other mammals. Herein, we used a recently developed gas chromatography-mass spectrometry method, with suitable derivatisation of the hindered hydroxy group of ambrein, to screen a number of extracts of mammalian faeces. Minor proportions of ambrein were detected in digested human sewage sludge and in the dung of elephant, domestic cattle, giraffe and buffalo. Whether ambrein formation in the terrestrial species is associated with coprolith formation, is unknown, but solid deposits known as enteroliths and fecaliths occur in humans and some domestic animals.The purpose of this prospective non-randomized study was to study the effectiveness of semen washing followed by intrauterine insemination (IUI) in Human Immune Deficiency Virus (HIV)-discordant couples in which the male partner was infected, in preventing HIV transmission to uninfected partner and offspring. The study was performed in a private assisted reproductive center specialized in couples with infectious diseases and enrolled sixty-nine fertile couples in which male partner tested positive for HIV, seeking for reproductive treatment. Triple sperm washing followed by viral RNA purification and real-time polymerase chain reaction was performed prior to IUI intervention. HIV transmission to female partner and newborns, and clinical pregnancy rate were the main outcome measures. A total of 180 IUI treatment cycles were performed in 69 couples. There were 16 clinical pregnancies (clinical pregnancy rate/cycle 9.0%, clinical pregnancy rate/patient 23.2%), one of which resulted in miscarriage (6.3%). No seroconversion was detected in the 69 women treated with sperm washing followed by IUI or in any of the newborns (tested at birth and at 3 months of age). Sperm washing followed by IUI is a safe and effective treatment option for serodiscordant couples wishing to conceive and to prevent HIV virus transmission to the mothers and newborns.Over a third of new HIV infections occur in adolescents aged 10-19 globally. Pre-exposure prophylaxis (PrEP) could be a powerful tool for prevention. Understanding more about the drivers of PrEP interest could inform implementation strategies among this age group. read more Moreover, family dynamics may play a uniquely critical role for this younger age group, thus it is important to gauge whether caregivers would support their children's use of PrEP. We surveyed 2,089 adolescents (aged 10-16) and their caregivers in Malawi during 2017-2018. Data were collected on PrEP interest, factors that may facilitate PrEP use, and preferences for PrEP modality. We used multivariate logistic regression to estimate the association between the above characteristics and PrEP interest. We find that young adolescents are engaging in behaviors that would put them at substantial risk of acquiring HIV, would likely benefit from PrEP, are largely (82%) interested in using such, would prefer to get an injection over taking a daily pill, and are considerably discouraged by the prospect of side effects. Endorsement by caregivers was even greater (87%). Our findings demonstrate initial support for adolescent PrEP, and suggest parents may be a surprising advocate.Introduction and Objectives Budgetary constraints and novel minimally invasive surgical approaches have resulted in surgical care being increasingly provided at ambulatory centers rather than traditional inpatient settings. Despite increasing use of ambulatory-based surgery for bladder outlet obstruction (BOO) procedures, little is known about the effect of care setting on perioperative outcomes and costs. We sought to compare 30-day readmissions rates as well as costs of BOO surgery performed in the ambulatory vs. inpatient setting. Methods Using Florida and New York all-payer data from the 2014 Healthcare Cost and Utilization Project State Databases, we identified patients that underwent transurethral resection, thermotherapy, or laser/photovaporization for BOO. Patient demographics, regional data, 30-day readmissions rates, and costs (from converted charges) associated with the index surgery and revisits were analyzed. Predictors of 30-day revisits were also identified by fitting a multivariate logistic reIn the context of value-based healthcare initiatives, our findings have important implications for policymakers seeking to reduce variation in non-clinical sources of perioperative costs and outcomes.BACKGROUND Chronic incomplete proximal hamstring avulsion injuries are debilitating injuries associated with prolonged periods of convalescence and poor return to preinjury level of function. This study explores the efficacy of operative intervention for these injuries on patient satisfaction, muscle strength, range of motion, functional performance, return to preinjury level of sporting activity, and injury recurrence. HYPOTHESIS Surgical intervention of chronic incomplete proximal hamstring avulsion injuries enables return to preinjury level of sporting function with low risk of clinical recurrence. STUDY DESIGN Case series Level of evidence, 4. METHODS This prospective single-surgeon study included 41 patients with incomplete proximal hamstring avulsion injuries refractory to 6 months of nonoperative treatment. All study patients underwent primary operative repair of the avulsed proximal hamstring tendon and received standardized postoperative rehabilitation. Predefined outcomes were recorded at regular inres were maintained at 1- and 2-year follow-up. CONCLUSION Operative repair of chronic incomplete proximal hamstring avulsion injuries enabled return to preoperative level of sporting function with no episodes of clinical recurrence at short-term follow-up. Surgical intervention was associated with high patient satisfaction and improved isometric hamstring muscle strength, range of motion, and functional outcome scores as compared with preoperative values. High patient satisfaction and improved functional outcomes were sustained at 2-year follow-up.Background The Cardiovascular OutcoMes for People using Anticoagulation StrategieS (COMPASS) trial demonstrated dual pathway inhibition (DPI) with rivaroxaban 2.5 mg twice-daily plus aspirin 100 mg once-daily versus aspirin 100 mg once-daily reduced the primary major adverse cardiovascular event (MACE) outcome of cardiovascular death, myocardial infarction (MI), or stroke as well as mortality in patients with chronic coronary syndromes or peripheral arterial disease. Whether this remains true in patients with a history of percutaneous coronary intervention (PCI) is unknown. Methods In a pre-specified sub-group analysis from COMPASS, we examined the outcomes of chronic coronary syndrome patients with or without a prior PCI treated with DPI versus aspirin alone. Among patients with a prior PCI, we studied the effects of treatment according to the timing of prior PCI. Results Of the 27,395 patients in COMPASS, 16,560 chronic coronary syndrome patients were randomized to DPI or aspirin and of these, 9862 (59·6%) ality but with increased major bleeding with or without prior PCI. Among those with prior PCI one- year and beyond, effects on MACE and mortality were consistent irrespective of time since last PCI. Clinical Trial Registration URL www.ClinicalTrials.gov Unique Identifier NCT01776424.1. The potential of lecithin and lysolecithin to improve lipid digestion and growth performance was investigated in three experiments 1. an in vitro model that mimics the intestinal conditions of the chick, 2. a digestibility trial with chicks (5-7 days of age), and 3. a performance trial until 21 days of age.2. In experiment 1, palm oil (PO), palm oil with lecithin (PO+L), and palm oil with lysolecithin (PO+LY) were subjected to in vitro hydrolysis and applied to Caco-2 monolayers to assess lipid absorption.3. The in vitro hydrolysis rate of triglycerides was higher in PO+LY (k = 11.76 × 103/min) than in either PO (k = 9.73 × 103/min) or PO+L (k = 8.41 × 103/min), and the absorption of monoglycerides and free fatty acids was highest (P  less then  0.01) for PO+LY. In experiment 2, 90 broilers were assigned to three dietary treatments a basal diet with 4% palm oil, and the basal diet supplemented with either 250 ppm lecithin or lysolecithin.4. ATTD of crude fat was higher in broilers supplemented with lysolecithin, but was lower in broilers supplemented with lecithin. DM digestibility and AMEn in birds supplemented with lysolecithin were significantly higher (3.03% and 0.47 MJ/kg, respectively).5. In experiment 3, 480 broilers were randomly allocated to four dietary treatments basal diet with soybean oil (2%), basal diet with lecithin (2%), soybean oil diet with 250 ppm lysolecithin, or lecithin oil diet with 250 ppm lysolecithin.6. Lecithin diets significantly reduced weight at day 10 and 21 compared with soybean oil. However, the addition of lysolecithin to lecithin-containing diets significantly improved bird performance.7. The results of these studies showed that, in contrast to lecithin, lysolecithin was able to significantly improve the digestibility and energy values of feed in young broilers.PURPOSE The purpose of this study was to analyze the biological content and activity of freeze-dried plasma rich in growth factors eye drops after their storage at 4°C and at room temperature for 3 months with respect to fresh samples (time 0). METHODS Plasma rich in growth factors was obtained after blood centrifugation from three healthy donors. After platelet activation, the obtained plasma rich in growth factors eye drops were lyophilized alone or in combination with lyoprotectant (trehalose), then they were stored for 3 months at room temperature or at 4°C. Several growth factors were analyzed at each storage time and condition. Furthermore, the proliferative and migratory potential of freeze-dried plasma rich in growth factors eye drops kept for 3 months at different temperature conditions was evaluated on primary human keratocytes. RESULTS The different growth factors analyzed maintained their levels at each time and storage condition. Freeze-dried plasma rich in growth factors eye drops stored at room temperature or 4°C for 3 months showed no significant differences on the proliferative activity of keratocytes in comparison with fresh samples.