Levineshah4678

There are no prior studies assessing the risk factors and outcomes for kidney delayed graft function (K-DGF) in simultaneous heart and kidney (SHK) transplant recipients. Using the OPTN/UNOS database, we sought to identify risk factors associated with the development of K-DGF in this unique population, as well as outcomes associated with K-DGF. A total of 1161 SHK transplanted between 1998 and 2018 were included in the analysis, of which 311 (27%) were in the K-DGF (+) group and 850 in the K-DGF (-) group. In the multivariable analysis, history of pretransplant dialysis (OR 3.95; 95% CI 2.94 to 5.29; p less then .001) was significantly associated with the development of K-DGF, as was donor death from cerebrovascular accident and longer cold ischemia time of either organ. SHK recipients with K-DGF had increased mortality (HR 1.99; 95% CI 1.52 to 2.60; p less then .001) and death censored kidney graft failure (HR 3.51; 95% CI 2.29 to 5.36; p less then .001) in the multivariable analysis. Similar outcomes were obtained when limiting our study to 2008-2018. Similar to kidney-only recipients, K-DGF in SHK recipients is associated with worse outcomes. Careful matching of recipients and donors, as well as peri-operative management, may help reduce the risk of K-DGF and the associated detrimental effects.The relationship between metapopulation stability and connectivity has long been investigated in ecology, however, most of these studies are focused on theoretical species and habitat networks, having limited ability to capture the complexity of real-world metapopulations. Network analysis became more important in modeling connectivity, but it is still uncertain which network metrics are reliable predictors of persistence. Here we quantify the impact of connectivity and larval life history on marine metapopulation persistence across the complex seascape of southeast Australia. Our work coupled network-based approaches and eigenanalysis to efficiently estimate metapopulation-wide persistence and the subpopulation contributions. Larval dispersal models were used to quantify species-specific metapopulation connectivity for five important fisheries species, each summarized as a migration matrix. Eigenanalysis helped to reveal metapopulation persistence and determine the importance of node-level network properties. Across metapopulations, the number of local outgoing connections was found to have the largest impact on metapopulation persistence, implying these hub subpopulations may be the most influential in real-world metapopulations. Results also suggest the length of the pre-competency period may be the most influential parameter on metapopulation persistence. Finally, we identified two major hot spots of local connectivity in southeast Australia, each contributing strongly to multispecies persistence. Managers and ecologists would benefit by employing similar approaches in making more efficient and more ecologically informed decisions and focusing more on local connectivity patterns and larval competency characteristics to better understand and protect real-world metapopulation persistence. Practically this could mean developing more marine protected areas at shorter distances and supporting collaborative research into the early life histories of the species of interest.Risk analysis offers a useful framework for evaluating and managing environmental health risks across different settings. In this Perspective, we question whether the principles and practice of risk analysis could be beneficial in the context of land-based pollution in low- and middle-income countries (LMICs) to better support risk-based decision making. Specifically, potential health and economic impacts from land-based pollution in LMICs has become an increasing issue of concern due to widespread environmental contamination from active and legacy operations, particularly informal activities that are becoming increasingly dispersed throughout communities, such as used lead acid battery recycling, artisanal and small-scale gold mining, and small-scale tanneries. However, the overall magnitude and scale of the public health problem arising from these sources remains highly uncertain and poorly characterized and cannot be compared to land-based pollution in high-income countries due to unique factors. This lackents will need to work together to develop improved study designs and risk mitigation strategies.

Joint infections cause premature implant failure. The avoidance of bacterial colonization of implant materials by modification of the material surface is therefore the focus of current research. In this in vitro study the complex interaction of periodic structures on PET and titanium surfaces on the adhesion of Staphylococcus aureus is analysed.

Using direct laser interference patterning as well as roll-to-roll hot embossing methods, structured periodic textures of different spatial distance were produced on surfaces and S. aureus were cultured for 24h on these. The amount of adhering bacteria was quantified using fluorescence microscopy and the local adhesion behaviour was investigated using scanning electron microscopy. For PET structures, minimal bacterial adhesion was identified for an aspect ratio of about 0·02. On titanium structures, S. aureus adhesion was significantly decreased for profile heights of < 200nm. Our results show a significantly decreased bacterial adhesion for structures with an aspect ratio range of 0·02 to 0·05.

We show that structuring on surfaces can decrease the amount of S. aureus on titanium and PET as common implant materials.

The study highlights the immense potential of applying specific structures to implant materials to prevent implant colonization with pathogen bacteria.

The study highlights the immense potential of applying specific structures to implant materials to prevent implant colonization with pathogen bacteria.

Cervical cancer (CC) is the most common female cancer in many countries of sub-Saharan Africa (SSA). We assessed treatment guideline adherence and its association with overall survival (OS).

Our observational study covered nine population-based cancer registries in eight countries Benin, Ethiopia, Ivory Coast, Kenya, Mali, Mozambique, Uganda, and Zimbabwe. Random samples of 44-125 patients diagnosed from 2010 to 2016 were selected in each. Cancer-directed therapy (CDT) was evaluated for degree of adherence to National Comprehensive Cancer Network (U.S.) Guidelines.

Of 632 patients, 15.8% received CDT with curative potential 5.2% guideline-adherent, 2.4% with minor deviations, and 8.2% with major deviations. CDT was not documented or was without curative potential in 22%; 15.7% were diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage IV disease. Adherence was not assessed in 46.9% (no stage or follow-up documented, 11.9%, or records not traced, 35.1%). The largest share of g treatment guideline adherence, and survival in eight countries. Patients across sub-Saharan Africa present in late stages, and treatment guideline adherence is remarkably low. Both factors were associated with unfavorable survival. This report warns about the inability of most women with cervical cancer in sub-Saharan Africa to access timely and high-quality diagnostic and treatment services, serving as guidance to institutions and policy makers. With regard to clinical practice, there might be cancer-directed treatment options that, although not fully guideline adherent, have relevant survival benefit. Others should perhaps not be chosen even under resource-constrained circumstances.Researchers are trying to tackle water scarcity in numerous ways. One of those ways is the use of nanotechnology in water processing and purification. The current work involves the fabrication and optimization of activated carbon and graphene-based hybrid water purification system. Five different concentrations of methylene blue and deionized water (DI) dye solutions were used, and they were filtered in three different cycles. For the potential usage on the consumer side, a small-scale, low-cost water filter is developed using activated carbon, commercial filter paper, and graphene nanoplatelets. The filter paper is used to hold mixtures of the activated carbon and graphene nanoplatelets within the water filter. The conductivity, TDS, and pH are measured for the feed water and the processed water using an Oakton EcoTestr and Apera Instruments PH60 Premium Pocket pH meter, respectively. A UV-Vis spectrometer is used to measure the absorption of solutions. The distribution and adsorption of the dye particles were observed by scanning electron microscopy. PRACTITIONER POINTS These results show the effectiveness of the system in the removal of dye particles above a given particle size. The concentration of the dye solution decreased after every cycle. The GnPs filtration system more effectively dye particles as compared to the filtration system containing only Activated carbon. UV-Vis spectroscopy results showed that the methylene blue dye particles decreased after every cycle. This research can open a broad area of projects toward waste/wastewater practice for particles above a certain particle size.

This study explores online e-cigarette retailer marketing in the absence of regulations.

New Zealand-based online e-cigarette retailer websites were identified using a keyword search. Ten New Zealand-based retailer websites were selected based on top results from Google. The four leading tobacco companies operating in New Zealand were also included. A content analysis of the online marketplace was performed.

Price was variable, with disposable devices sold from as little as $9.99 (NZD). Online e-cigarette retailers frequently presented health (79%) and smoking cessation (71%) messages. Nicotine addiction warnings were explicit in less than half of retailer sites (43%) and only 29% of retailers stated that the use of devices may pose health risks. Marketing techniques with potential youth appeal included sweet flavours (80%) and cartoon characters on e-liquid products (20%). Only one retailer had an age verification procedure to purchase a product.

The findings suggest that online marketing is likely to appeal to young people despite industry assurances that e-cigarettes are only promoted to adult smokers who want to quit. SAR245409 Regulations for online retailers are urgently needed. SO WHAT? This study adds to the surveillance research on the online marketing of e-cigarette retailers. Study findings may help inform future decisions on the regulation of e-cigarette marketing in New Zealand.

The findings suggest that online marketing is likely to appeal to young people despite industry assurances that e-cigarettes are only promoted to adult smokers who want to quit. Regulations for online retailers are urgently needed. SO WHAT? This study adds to the surveillance research on the online marketing of e-cigarette retailers. Study findings may help inform future decisions on the regulation of e-cigarette marketing in New Zealand.

In the United States, some states and localities have added vaping restrictions to established smoke-free indoor air laws in order to reduce electronic cigarette use. Yet, if smokers use e-cigarettes to quit, such restrictions could have the unintended effect of attenuating the original smoke-free air policy's effects on smoking. This study estimated changes in current smoking, past-year smoking cessation, and recent vaping following the introduction of smoke- and vape-free air laws.

Observational study of nationally representative data from the 2014-2018 National Health Interview Survey.

United States.

87 334 participants, 18-54years of age.

Multivariable linear regressions estimated the association between increased exposure to smoke- and vape-free worksite and restaurant laws and self-reported current smoking and recent vaping among emerging adults (ages 18-25), as well as past-12-month smoking cessation among prime age adults (ages 26-54). All regressions adjusted for respondent sociodemographic and other tobacco control policies, along with state and year fixed effects.