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05; 95% CI 0.01-0.16) and 69% more likely for those who sustain injury to the thorax. Individuals with an ISS score of 25 points or more were 18 times more likely to have sustained injury getting off their stair lift compared to any other method of falling from their stair lift. Mortality was associated with injuries to the thorax in those aged 70 years or below, injuries to the face, spine and limb for those aged 71-85 years and with head injury in those over 85 years. The overall mortality rate was 15.7%. CONCLUSION Falls from stairlifts commonly result in limb injuries and most severe injuries are sustained to the head. When patients fall getting off from astairlift, have injuries to their head or thorax they have a higher ISS. The overall mortality is 15.7%. Given the increasing use of stairlifts in our ageing population, strategies should be considered to make these safer. BACKGROUND Surgical hand rubbing (SHR) and surgical hand scrubbing (SHS) are two common methods used by surgeons to reduce surgical site infections. check details To date, the optimal method that can effectively reduce these infections remains unknown. In this study, we performed a comprehensive statistical analysis to compare the efficacy of these two methods in effectively controlling surgical site infections. METHODS A systemic review and meta-analysis was performed by mining literature from major databases, including Pubmed, Embase, Cochrane library, Ovid and Google Scholar, and recruiting studies published between 1980 and 1st April 2019. Analysis was performed using Revman, version 5.3, software, and focused on primary outcomes that included colony-forming unit (CFU) counts and logarithmic reduction of CFU after hand antisepsis and after surgery. RESULTS Seven clinical trials met our inclusion criteria, with a total of 764 healthcare workers analyzed. We found no statistically significant differences between the two methods with regards to CFU counts and logarithmic reduction of CFU after hand antisepsis and surgery, as well as antisepsis and surgery times. CONCLUSION From the literature, it was evident that SHR had similar efficacy to SHS, without necessarily increasing costs. Owing to advantages such as ease of application, exposure to less dermal irritation, and less time consumption, SHR is recommended as a cost-effective alternative for management of surgical site infections. INTRODUCTION AND OBJECTIVES N-acetyl-p-aminophenol (APAP)-induced liver injury is a major clinical challenge worldwide. The present study investigated the molecular role of microRNA (miR)-338-3p in the development of APAP-induced acute liver injury. MATERIALS AND METHODS B6 mice were treated with an miR-338-3p agomir, antagomir, and intraperitoneally injected with APAP 24h later to induce acute liver injury. Histological analysis was performed to evaluate the degree of liver injury. The gene expression of miR-338-3p and its downstream regulators was measured by reverse transcription-quantitative PCR and western blot. The miR target was validated using a luciferase reporter assay. RESULTS The results revealed that miR-338-3p was significantly upregulated following the intraperitoneal administration of APAP. Augmenting miR-338-3p alleviated acute liver injury caused by APAP overdose, while silencing of miR-338-3p exhibited a detrimental effect. Moreover, miR-338-3p inhibited the expression of pro-inflammatory cytokines by preventing the aberrant activation of inflammatory signaling pathways, including the nuclear factor kappa-B (NF-κB)/mitogen-activated protein kinase (MAPK) signaling pathway. Furthermore, calcium/calmodulin-dependent protein kinase IIα (CAMK IIα) was identified as a direct target of miR-338-3p. CONCLUSION The present study demonstrated that miR-338-3p inhibited inflammation in APAP-induced acute liver injury. The COVID-19 pandemic is causing global morbidity and mortality, straining health systems, and disrupting society, putting individuals with Alzheimer's disease and related dementias (ADRD) at risk of significant harm. In this Special Article, we examine the current and expected impact of the pandemic on individuals with ADRD. We discuss and propose mitigation strategies for the risk of COVID-19 infection and its associated morbidity and mortality for individuals with ADRD; the impact of COVID-19 on the diagnosis and clinical management of ADRD; consequences of societal responses to COVID-19 in different ADRD care settings; the effect of COVID-19 on caregivers and physicians of individuals with ADRD; mental hygiene, trauma, and stigma in the time of COVID-19; and the potential impact of COVID-19 on ADRD research. Amid considerable uncertainty, we may be able to prevent or reduce the harm of the COVID-19 pandemic and its consequences for individuals with ADRD and their caregivers. BACKGROUND The objectives of this study were to address the following questions regarding previous non-arthroplasty surgery prior to primary anatomic shoulder arthroplasty (either total shoulder arthroplasty [TSA] or ream-and-run arthroplasty) (1) To what degree is primary anatomic shoulder arthroplasty after prior non-arthroplasty surgery associated with inferior clinical outcomes and higher revision rates compared with arthroplasty without previous surgery? (2) Does type, approach, or timing of previous surgery affect outcomes after anatomic arthroplasty? METHODS A retrospective review of a primary shoulder arthroplasty database was performed and identified 640 patients undergoing anatomic shoulder arthroplasty (345 TSAs and 295 ream-and-run arthroplasties). Of these patients, 183 (29%) underwent previous non-arthroplasty surgery. Baseline and demographic information, 2-year postoperative outcome scores, and revision surgical procedures with associated culture results were collected. RESULTS In patients undd higher revision rates in patients undergoing index TSA but not in those undergoing the ream-and-run procedure. Patients with previous fracture surgery carry the highest risk of reoperation. STUDY OBJECTIVE Housing instability is prevalent among emergency department (ED) patients and is known to adversely affect health. We aim to determine the incidence and timing of homeless shelter entry after an ED visit among patients who are not currently homeless. METHODS We conducted a random-sample survey of ED patients at an urban public hospital from November 2016 to September 2017. Patients provided identifying information and gave informed consent for us to link their survey data with the New York City Department of Homeless Services shelter database. Shelter use was followed prospectively for 12 months after the baseline ED visit. We examined timing of shelter entry in the 12 months after the ED visit, excluding patients who were homeless at baseline. RESULTS Of 1,929 unique study participants who were not currently homeless, 96 (5.0%) entered a shelter within 12 months of their baseline ED visit. Much of the shelter entry occurred in the first month after the ED visit, with continued yet slower rates of entry in subsequent months.