Rybergfoster8509

Conclusions This national analysis demonstrates that CDI is a significant complication following abdominal surgery and is associated with increased LOS and mortality. Furthermore, laparoscopic colorectal surgery appears to have the greatest risk of CDI. Future research is needed to determine the exact cause in order to decrease the incidence of CDI by reconsidering the protocol of antibiotic use within the high-risk population.Formation of desired three-dimensional (3D) shapes from flat thin sheets with programmed non-uniform deformation profiles is an effective strategy to create functional 3D structures. Liquid crystal elastomers (LCEs) are of particular use in programmable shape morphing due to their ability to undergo large, reversible, and anisotropic deformation in response to a stimulus. Here we consider a rectangular monodomain LCE thin sheet divided into one high- and one low-temperature strip, which we dub a 'bistrip'. Upon activation, a discontinuously patterned, anisotropic in-plane stretch profile is generated, and induces buckling of the bistrip into a rolled shape with a transitional bottle neck. Based on the non-Euclidean plate theory, we derive an analytical model to quantitatively capture the formation of the rolled shapes from a flat bistrip with finite thickness by minimizing the total elastic energy involving both stretching and bending energies. Using this analytical model, we identify the critical thickness at which the transition from the unbuckled to buckled configuration occurs. We further study the influence of the anisotropy of the stretch profile on the rolled shapes by first converting prescribed metric tensors with different anisotropy to a unified metric tensor embedded in a bistrip of modified geometry, and then investigating the effect of each parameter in this unified metric tensor on the rolled shapes. Our analysis sheds light on designing shape morphing of LCE thin sheets, and provides quantitative predictions on the 3D shapes that programmed LCE sheets can form upon activation for various applications.

The present study was carried out to design a phosphate solubilizing bacterial (PSB)-based biofertilizer using locally produced fruit waste.

Two PSB strains Pseudomonas aeruginosa CMG4 and AAC1 were inoculated into compost. Six compost piles were prepared with carbonnitrogen (CN) ratio 301. Four piles were inoculated with PSB and two piles served as a control. After 125 days, composts were considered mature at 29-31°C in the pH range of 7.1-7.3 and 32%-35% moisture content (MC). Accessible calcium (Ca) content increased up to 50 g kg

. Microbial analysis showed the survival of P. aeruginosa species in the maturing compost even at higher temperature (~53°C). Native bacterial load was retrieved in the range of 10

-10

 CFUg

. Heavy metal concentrations including copper (Cu), lead (Pb), chromium (Cr) and cadmium (Cd) were found to occur below critical thresholds. Seed germination index for compost toxicity was found to be >80%, significantly higher than animal manure and chemical fertilizer, that is, 78% and 31%, respectively, suggesting non-toxicity.

The evaluation of prepared compost by physicochemical parameters revealed that inoculation of P. aeruginosa does not affect the temperature, MC, carbon to nitrogen ratio, organic matter and Mg content but significantly increased the accessible Ca content, suggesting the solubilization of inorganic Ca bound phosphate. find more Compost was safe in terms of heavy metal concentration and seed germination.

This study encourages that the PSB-rich tailored compost can be utilized as a phosphatic biofertilizer to fulfil the demand for phosphorus which would improve and sustain soil fertility.

This study encourages that the PSB-rich tailored compost can be utilized as a phosphatic biofertilizer to fulfil the demand for phosphorus which would improve and sustain soil fertility.Background Peripheral arterial disease (PAD), coronary artery disease (CAD) and carotid stenosis (CS) are robust predictors of mortality. The value of individual vascular beds in polyvascular disease (PVD) to predict mortality in patients with atherosclerotic burden is not clear. Therefore, we have examined the predictive value of PAD, CAD and CS in patients at intermediate to high risk of cardiovascular (CV) disease. Patients and methods In our retrospective observational study we analyzed baseline data from the Ludwigshafen Risk and Cardiovascular Health (LURIC) study, a monocentric cohort study of 3316 patients referred to coronary angiography. Results As the number of atherosclerotic vascular beds increased, the hazard ratios (HRs) for both all-cause mortality and CV mortality significantly increased in a multivariate analysis after adjusting for age, sex, body mass index, diabetes mellitus and estimated glomerular filtration rate, with HRs of 1.36 (95%CI 1.11-1.68), 2.56 (95%CI 2.01-3.26), 2.84 (95%CI 1.93-4.17) and 1.56 (95%CI 1.19-2.06), 2.70 (95%CI 1.97-3.72), 3.50 (95%CI 2.19-5.62), respectively. The combination of PAD with either CAD or CS was associated with higher HRs for all-cause (HR 2.81 and 7.53, respectively) and CV (HRs 2.80 and 6.03, respectively) mortality compared with the combination of CAD and CS (HRs 1.94 and 2.43, respectively). The presence of PVD was associated with higher age, systolic blood pressure, pulse pressure (PP; a marker of vascular stiffness), former smoking and inversely with lower eGFR. Conclusions We show that as the number of atherosclerotic vascular beds increases, all-cause and CV mortality rates increase in parallel. Simultaneous prevalence of PAD is associated with significantly higher all-cause and CV mortality rates compared with CS coexistence. Furthermore, increasing atherosclerotic load may contribute to vascular stiffness and impaired renal function.

Lifestyle intervention and metformin have been shown to prevent diabetes; however, their efficacy in preventing cardiovascular disease associated with the development of diabetes is unclear. We examined whether these interventions reduced the incidence of major cardiovascular events over a 21-year median follow-up of participants in the DPP trial (Diabetes Prevention Program) and DPPOS (Diabetes Prevention Program Outcomes Study).

During DPP, 3234 participants with impaired glucose tolerance were randomly assigned to metformin 850 mg twice daily, intensive lifestyle or placebo, and followed for 3 years. During the next 18-year average follow-up in DPPOS, all participants were offered a less intensive group lifestyle intervention, and unmasked metformin was continued in the metformin group. The primary outcome was the first occurrence of nonfatal myocardial infarction, stroke, or cardiovascular death adjudicated by standard criteria. An extended cardiovascular outcome included the primary outcome or hospit Unique identifiers DPP (NCT00004992) and DPPOS (NCT00038727).

gov; Unique identifiers DPP (NCT00004992) and DPPOS (NCT00038727).Use of ambulatory blood pressure monitoring in children and adolescents has markedly increased since publication of the last American Heart Association scientific statement on pediatric ambulatory blood pressure monitoring in 2014. In addition, there has also been significant expansion of the evidence base for use of ambulatory blood pressure monitoring in the pediatric population, including new data linking ambulatory blood pressure levels with the development of blood pressure-related target organ damage. Last, additional data have recently been published that enable simplification of the classification of pediatric ambulatory monitoring studies. This scientific statement presents a succinct review of this new evidence, guidance on optimal application of ambulatory blood pressure monitoring in the clinical setting, and an updated classification scheme for the interpretation of ambulatory blood pressure monitoring in children and adolescents. We also highlight areas of uncertainty where additional research is needed.

Evidence suggests a link between depressive symptoms and risk of subsequent stroke. However, most studies assess depressive symptoms at only one timepoint, with few examining this relationship using repeatedly measured depressive symptoms. This study aimed to examine the relationship between depressive symptom trajectories and risk of incident stroke.

This prospective cohort included 12 520 US individuals aged ≥50 years enrolled in the Health and Retirement Study, free of stroke at study baseline (1998). We used the 8-item Center for Epidemiologic Studies Depression scale to assess depressive symptoms (high defined as ≥3 symptoms; low <3 symptoms) at 4 consecutive, biennial timepoints from 1998 to 2004. We assigned individuals to 5 predefined trajectories based on their scores at each timepoint (consistently low, decreasing, fluctuating, increasing, and consistently high). Using self-reported doctors' diagnoses, we assessed incident stroke over a subsequent 10-year period from 2006 to 2016. Cox regressrelationship between depressive symptoms and stroke risk over time through repeated assessments.

Depressive symptom trajectories characterized by high symptoms at multiple timepoints were associated with increased stroke risk. However, a trajectory with depressive symptoms that started high but decreased over time was not associated with higher stroke risk. Given the remitting-relapsing nature of depressive symptoms, it is important to understand the relationship between depressive symptoms and stroke risk over time through repeated assessments.The AcT trial (Alteplase Compared to Tenecteplase) compares alteplase or tenecteplase for patients with acute ischemic stroke. All eligible patients are enrolled by deferral of consent. Although the use of deferral of consent in the AcT trial meets the requirements of Canadian policy, we sought to provide a more explicit and rigorous approach to the justification of deferral of consent organized around 3 questions. Ultimately, the approach we outline here could become the foundation for a general justification for deferral of consent.

Sodium-glucose cotransporter-2 inhibitors are foundational therapy in patients with heart failure with reduced ejection fraction (HFrEF), but underlying mechanisms of benefit are not well defined. We sought to investigate the relationships between sodium-glucose cotransporter-2 inhibitor treatment, changes in metabolic pathways, and outcomes using targeted metabolomics.

DEFINE-HF (Dapagliflozin Effects on Biomarkers, Symptoms and Functional Status in Patients With HF With Reduced Ejection Fraction) was a placebo-controlled trial of dapagliflozin in HFrEF. We performed targeted mass spectrometry profiling of 63 metabolites (45 acylcarnitines [markers of fatty acid oxidation], 15 amino acids, and 3 conventional metabolites) in plasma samples at randomization and 12 weeks. Using mixed models, we identified principal components analysis-defined metabolite clusters that changed differentially with treatment and examined the relationship between change in metabolite clusters and change in Kansas City Cardiomyopth decreases in Kansas City Cardiomyopathy Questionnaire scores (ie, worse quality of life) and increases in NT-proBNP levels, without interaction by treatment group.

In this study of targeted metabolomics in a placebo-controlled trial of sodium-glucose cotransporter-2 inhibitors in HFrEF, we observed effects of dapagliflozin on key metabolic pathways, supporting a role for altered ketone and fatty acid biology with sodium-glucose cotransporter-2 inhibitors in patients with HFrEF. Only physiologic levels of ketosis were observed. In addition, we identified several metabolic biomarkers associated with adverse HFrEF outcomes.

URL https//www.

gov; Unique identifier NCT02653482.

gov; Unique identifier NCT02653482.