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Malnutrition is related to an increased rate of complications and prolonged hospital stays. selleck inhibitor Malnutrition risk screening is recommended for all hospital inpatients, but its applicability as part of routine care is not well known.

The prevalence of malnutrition risk, measured by the Screening Tool for Risk of Impaired Nutritional Status and Growth (STRONGkids), and acute malnutrition were studied 1 day per year in all pediatric inpatient and day wards in 2015 and 2016 and in inpatients and outpatients in 2017 at a university hospital. Nurses carried out the STRONGkids screening and measured the weight and height of each child, recording the information in the hospital database, where it was subsequently extracted along with data on the child's diagnoses, procedures, and the length and costs of hospital stay.

In all, 696/1217 patients (57.2%) were screened. Of inpatients and outpatients, 37/398 (9.3%) and 3/298 (1.0%), respectively, were classified as being at high risk of malnutrition. The corresponding figures for those who were acutely malnourished were 18/260 (6.9%) and 11/264 (4.2%). High risk of malnutrition increased the costs and length of hospital stay (P < .05). Dietetic input was involved during hospital stay in 12/37 (32.4%), 32/173 (18.5%), and 13/188 (6.9%) of inpatients at high, moderate, and low risk, respectively (P < .001). Nutrition risk screening did not detect all patients classified as acutely malnourished.

Hospitals need to ensure proper application of nutrition screening, develop a protocol for the care of children at nutrition risk, and monitor the use of this protocol.

Hospitals need to ensure proper application of nutrition screening, develop a protocol for the care of children at nutrition risk, and monitor the use of this protocol.Liquids are traditionally handled and stored in solid vessels. Solid walls are not functional, adaptive, or self-repairing, and are difficult to remove and re-form. Liquid walls can overcome these limitations, but cannot form free-standing 3D walls. Herein, a liquid analogue of a well, termed a "liquid well" is introduced. link2 Water tethered to a surface with hydrophobic-hydrophilic core-shell patterns forms stable liquid walls capable of containing another immiscible fluid, similar to fluid confinement by solid walls. Liquid wells with different liquids, volumes, and shapes are prepared and investigated by confocal and Raman microscopy. The confinement of various low-surface-tension liquids (LSTLs) on surfaces by liquid wells can compete with or be complementary to existing confinement strategies using perfluorinated surfaces, for example, in terms of the shape and height of the confined LSTLs. Liquid wells show unique properties arising from their liquid aggregate state they are self-healing, dynamic, and functional, that is, not restricted to a passive confining role. Water walls can be easily removed and re-formed, making them interesting as sacrificial templates. This is demonstrated in a process termed water-templated polymerization (WTP). Numerical phase-field model simulations are performed to scrutinize the conditions required for the formation of stable liquid wells.

Healthcare systems require effective and efficient blood donation supply chains to provide an adequate amount of whole blood and blood components to hospitals and transfusion centres. However, some crucial steps of the chain, for example blood collection, are not adequately studied in the literature. This work analyses the operations in a blood collection centre with the twofold aim of analysing different configurations and evaluating the effectiveness and feasibility of schedules defined at higher planning levels.

The analyses are performed through a discrete event simulation (DES) model that describes a customizable collection centre. Moreover, a feedback loop from the DES to the higher planning level allows to adjust scheduling decisions if they determine criticalities or infeasibilities at the operational level.

Numerical tests have been conducted considering a real Italian provider. An experimental plan has been designed to compare different configurations for the blood collection centre and evaluate the best ones in terms of cost and service quality for the three main actors involved (donors, workers and managers). The best configurations have been also used to test the feedback loop.

Results confirm the appropriateness of the proposed DES model, which can be considered a useful decision support tool for dimensioning and managing a blood collection centre, either as a standalone tool or in conjunction with a scheduler.

Results confirm the appropriateness of the proposed DES model, which can be considered a useful decision support tool for dimensioning and managing a blood collection centre, either as a standalone tool or in conjunction with a scheduler.The actual contribution of silver in silver diamine fluoride (SDF) towards the anti-demineralizing effect is unclear. This study compared the effects of single applications of three concentrations of fluoride (4.1%, 1.025%, 0.26% F- ) in the form of SDF and potassium fluoride (KF) on demineralized dentin in a 15-day non-microbial pH-cycling model. Calcium loss and uptake in de- and remineralization buffers were analyzed daily. Fluoride release in both buffers was analyzed on days 1, 2, 3, and 8. The net calcium results of de- and remineralization cycles revealed dose-response protection without significant differences between equal fluoride concentrations of SDF and KF. In the demineralization cycles, all fluoride treatments, except KF 0.26% F- , significantly inhibited demineralization, with KF 4.1% F- being the most effective. In the remineralization cycles, remineralization was enhanced in all fluoride concentration groups in a dose-response manner with no difference between similar fluoride concentrations of SDF and KF. Daily fluoride effects were constant throughout the experiment. Fluoride analysis revealed statistically significant differences in fluoride release between the treatments on day 1 that diminished on days 2 and 3. The non-microbial model showed no differences between SDF and KF in inhibiting demineralization and enhancing remineralization of dentin lesions.

Massive transfusions are associated with a high mortality rate, but there is little evidence indicating when such efforts are futile. The purpose of this study was to identify clinical variables that could be used as futility indicators in massively transfused patients.

We retrospectively analyzed 138 adult surgical patients at our institution receiving a massive transfusion (2016-2019). Peak lactate and nadir pH within 24 h of massive transfusion initiation, along with other clinical variables, were assessed as predictors of the primary outcome, in-hospital mortality.

The overall rate of in-hospital mortality among our patient population was 52.9% (n=73). Increasing lactate and decreasing pH were associated with greater mortality among massively transfused patients. Mortality rates were ~2-fold higher for patients in the highest lactate category (≥10.0 mmol/L 25 of 37; 67.6%) compared to the lowest category (0.0-4.9 mmol/L 17 of 48; 35.4%) (p= .005), and ~2.5-fold higher for patients in the lowest pH category (<7.00 8 of 9; 88.9%) compared to the highest category (≥7.40 8 of 23; 34.7%) (p= .016). Increasing age was also associated with higher mortality (≥65 years 24 of 33; 72.7%) when compared to younger patients (18-64 years 49 of 105; 46.7%) (p= .010).

Peak lactate ≥10.0 mmol/L, nadir pH <7.00, and age ≥65 years were significantly associated with higher rates of in-hospital mortality among massively transfused patients. Incorporating these clinical parameters into a futility index for massive transfusions will be useful in situations where blood products are scarce and/or mortality may be unavoidable.

Peak lactate ≥10.0 mmol/L, nadir pH less then 7.00, and age ≥65 years were significantly associated with higher rates of in-hospital mortality among massively transfused patients. Incorporating these clinical parameters into a futility index for massive transfusions will be useful in situations where blood products are scarce and/or mortality may be unavoidable.

Hedgehog (Hh) signaling promotes castration-resistant prostate cancer by supporting androgen-independent prostate cancer cell development and growth; however, its role in neuroendocrine prostate cancer (NEPC) has not yet been explored. In this study, we assessed the expression of key genes involved in Hh signaling in prostate cancer and investigated the potential role of smoothened (SMO) in the pathogenesis of NEPC.

Six public datasets, each containing cases of prostate adenocarcinoma (AdPC) and NEPC, were analyzed to compare the differential messenger RNA (mRNA) expression of six classic Hh signaling genes. The SMO, synaptophysin, chromogranin A (CHGA) and androgen receptor (AR) proteins were evaluated in human tissues from 5 cases of NEPC, 2 cases of AdPC mixed with NEPC, 2 cases of AdPC with neuroendocrine differentiation and 22 cases of high-grade AdPC as determined by an immunohistochemistry assay. Gene set enrichment analysis (GSEA) was performed to identify relevant genetic signatures associated wi on AR signaling activity and AR expression in LNCaP and C4-2B cells.

These results demonstrate that SMO loss is a characteristic of NEPC and that detecting SMO by IHC could aid pathologists in NEPC diagnosis. SMO loss may promote NEPC pathogenesis by modulating AR signaling.

These results demonstrate that SMO loss is a characteristic of NEPC and that detecting SMO by IHC could aid pathologists in NEPC diagnosis. link3 SMO loss may promote NEPC pathogenesis by modulating AR signaling.This study aims to increase insights into the potential role of the media in the amplification and attenuation of modern risks in society, by studying the dynamics and contents of the newspaper coverage about the potential health risk posed by rubber granulate in the Netherlands. We thematically analysed 153 national newspaper articles about the risks posed by rubber granulate between September 2016 and February 2017. Our results suggest that newspaper coverage might have contributed to heightened public risk perceptions by presenting the negligible health risk as uncertain, focusing on controversy between authorities and experts, describing responses such as concerns, commotion, and adopted risk mitigation measures by members of the public, and by providing insufficient contextualization on whether hazardous substances in rubber granulate pose a threat to health. The risks posed by rubber granulate is one of the many modern risks that has become subject to heated and mediated public discussions. Our results provide in-depth insights into important content elements in media coverage during such discussions and the impact of these elements on public perceptions. Public health institutes and other authorities might be able to mitigate the amplification of risks through media coverage by means of appropriate preparedness and response.The continuous development and application of technology for genetic improvement is a key element for advancing sheep production in the United States. The US sheep industry has contracted over time but appears to be at a juncture where a greater utilization of technology can facilitate industry expansion to new markets and address inefficiencies in traditional production practices. Significant transformations include the increased value of lamb in relation to wool, and a downtrend in large-scale operations but a simultaneous rise in small flocks. Additionally, popularity of hair breeds not requiring shearing has surged, particularly in semi-arid and subtropical US environments. A variety of domestically developed composite breeds and newly established technological approaches are now widely available for the sheep industry to use as it navigates these ongoing transformations. These genetic resources can also address long-targeted areas of improvement such as growth, reproduction and parasite resistance. Moderate progress in production efficiency has been achieved by producers who have employed estimated breeding values, but widespread adoption of this technology has been limited.