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58, 95% CI = 0.32-1.04). Acupuncture therapy also improved mini-mental state examination (MMSE) scores on the first (mean difference (MD) = 3.28, 95% CI = 2.79-3.77) and third (MD = 2.52, 95% CI = 2.18-2.87) post-operative days, with no effect on the seventh (MD = 0.14, 95% CI = -0.24 to 0.51). Visual analogue scale (VAS) scores on the first post-operative day were not impacted by acupuncture but were likely associated with post-operative nausea and vomiting on the seventh post-operative day. With respect to methodological quality, most RCTs were found to have an unclear risk of bias.

Acupuncture may successfully treat/prevent POCD. However, the current evidence is limited and further research is needed.

Acupuncture may successfully treat/prevent POCD. However, the current evidence is limited and further research is needed.

Health inequities or disparities challenge governments and public health systems, impacting health service delivery worldwide. Inherent disadvantage linked to the social determinants of health is intrinsic to the health outcomes among society's marginalised and most vulnerable members. It is acknowledged that marginalised individuals present with higher levels of chronic disease, multi-morbidities and adverse health behaviours than their non-disadvantaged peers. Marginalised individuals and communities present with complex health problems and often receive poor quality or inadequate health care that is unable to meet their needs, leading to stigmatisation and perpetuating the cycle of disadvantage.

Emerging research indicates that there may be a role for acupuncture in managing the health needs of marginalised populations and that when historical barriers to accessing acupuncture treatment (such as awareness, availability and affordability of this therapy) are removed, certain marginalised populations areractice for acupuncture is timely and may contribute to tackling health inequity.

Both obesity and end stage liver disease (ESLD) are increasing. Obesity's impact on hospice and palliative care in patients with ESLD is unknown.

We retrospectively evaluated patients admitted to an academic, Midwestern, tertiary center between January 2016 and May 2019 with a diagnosis of ESLD. Body Mass Index and MELD Na were calculated for each patient's first admission during the study period. Patients with MELD Na scores ≥ 21 or 18-20 with additional criteria were considered potentially eligible for hospice and palliative care referrals.

Of 3863 patients admitted with ESLD, 1556 (40%) were potentially eligible for hospice and palliative care referrals. Of these, 703 (45%) were obese. Comorbidity burden was higher in obese patients (15.6% of obese patients had a Charlson Comorbidity Index ≥ 5, while 5% of non-obese patients had a comorbidity index of ≥ 5 (p < 0.001). Referral rates to hospice and palliative services in obese patients were 10.1% and 16.4% respectively. Hospice and palliative referral rates among non-obese patients were similar (10.1% and 15.5%). Among patients who died within 6 months of the first hospitalization, the mean time to referral to hospice or palliative care from index admission was longer in obese patients.

Obesity is common in patients hospitalized with ESLD who may be approaching the end of life. Referral rates to hospice and palliative care services are low and similar regardless of BMI and despite higher co-morbidity burdens in obese patients. Obesity may delay referrals to hospice and palliative care.

Obesity is common in patients hospitalized with ESLD who may be approaching the end of life. Referral rates to hospice and palliative care services are low and similar regardless of BMI and despite higher co-morbidity burdens in obese patients. Obesity may delay referrals to hospice and palliative care.

Medical management is the cornerstone of therapy for ulcerative colitis (UC). In the setting of fulminant disease, hospitalized patients may undergo medical rescue therapy (MRT) or urgent surgery. We hypothesized that delayed attempts at MRT result in increased morbidity and mortality following urgent surgery for UC.

The aim is to assess the outcomes for patients requiring urgent, inpatient surgery for UC in a prompt or delayed fashion.

The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) general and colectomy-specific databases from 2013 to 2016 were queried. Urgent surgery was defined as nonelective, nonemergency surgery. Patients were divided into prompt and delayed groups based on time from admission to surgery of <48hours or >48hours. Baseline characteristics and 30-day outcomes were compared using univariate and multivariate analyses.

The ACS NSQIP database from 2013 to 2016 was evaluated.

Adult patients undergoing nonelective, nonemergency colectomy for UC.

30-day morbidity and mortality.

921 patients underwent urgent inpatient surgery for UC. In univariate analysis, there was no significant difference between prompt and delayed surgery for wound infection, sepsis, return to operating room, or readmission.

Retrospective study of a quality improvement database. Patients who underwent successful MRT did not receive surgery, so are not included in the database.

Delaying surgery to further attempt MRT does not alter short-term outcomes and may allow conversion to elective future surgery. Contrarily, medical optimization does not improve short-term outcomes.

Delaying surgery to further attempt MRT does not alter short-term outcomes and may allow conversion to elective future surgery. Contrarily, medical optimization does not improve short-term outcomes.

Breast compression in mammography is important but is a source of discomfort and has been linked to screening non-attendance. Reducing compression has little effect on breast thickness, and likely little effect on image quality, due to force being absorbed in the stiff juxta thoracic area instead of in the central breast.

To investigate whether a flexible compression plate can redistribute force to the central breast and whether this affects perceived pain.

Twenty-eight women recalled from mammography screening were compressed with flexible and rigid plates while retaining force and positioning, 15 in the craniocaudal (CC) view and 13 in the mediolateral oblique (MLO) view. Pressure distribution was continuously measured using pressure sensors.

The flexible plate showed greater mean breast pressure in both views 2.8 versus 2.3 kPa for CC (confidence interval [CI] = 0.2-0.8) and 1.0 versus 0.5 kPa for MLO (CI = 0.2-0.6). Emricasan datasheet The percentage of applied force distributed to the breast was significantly higher with the flexible plate, both on CC (36% vs.