Risk Factors for Frequent Readmissions and Barriers to Transplantation in Patients with Cirrhosis

Background: Hospital readmission rate is receiving increasing regulatory scrutiny. Patients with cirrhosis have high hospital readmissions rates but the relationship between frequent readmissions and barriers to transplantation remains unexplored. The goal of this study was to determine risk factors for frequent readmissions among patients with cirrhosis and identify barriers to transplantation in this population. Methods: We retrospectively reviewed medical records of 587 patients with a confirmed diagnosis of cirrhosis admitted to a large tertiary care center between May 1, 2008 and May 1, 2009. Demographics, clinical factors, and outcomes were recorded. Multivariate logistic regression was performed to identify risk factors for high readmission rates. Transplant-related factors were assessed for patients in the high readmission group. Results: The 587 patients included in the study had 1557 admissions during the study period. A subset of 87 (15%) patients with 5 or more admissions accounted for 672 (43%) admissions. The factors associated with frequent admissions were non-white race (OR = 2.45, p = 0.01), diabetes (OR = 2.04, p = 0.01), higher Model for End-Stage Liver Disease (MELD) score (OR = 35.10, p30) and younger age (OR = 0.98, p = 0.02). Among the 87 patients with ≥5 admissions, only 14 (16%) underwent liver transplantation during the study period. Substance abuse, medical co-morbidities, and low (<15) MELD scores were barriers to transplantation in this group. Conclusions: A small group of patients with cirrhosis account for a disproportionately high number of hospital admissions. Interventions targeting this high-risk group may decrease frequent hospital readmissions and increase access to transplantation. © 2013 Ganesh et al

Do Participatory Learning and Action Women’s Groups Alone or Combined with Cash or Food Transfers Expand Women’s Agency in Rural Nepal?

Participatory learning and action women’s groups (PLA) have proven effective in reducing neonatal mortality in rural, high-mortality settings, but their impacts on women’s agency in the household remain unknown. Cash transfer programmes have also long targeted female beneficiaries in the belief that this empowers women. Drawing on data from 1309 pregnant women in a four-arm cluster-randomised controlled trial in Nepal, we found little evidence for an impact of PLA alone or combined with unconditional food or cash transfers on women’s agency in the household. Caution is advised before assuming PLA women’s groups alone or with resource transfers necessarily empower women

Public Health Surveillance of Construction Site Injuries in Delhi, India Using the First Information Reports (FIRs) Registered by Delhi Police

Background: An injury surveillance system can inform strategies to reduce the incidence of injuries. Aim: To explore whether the First Information Reports (FIRs) of Indian police can form the basis of an unintentional injuries surveillance system. Methods: Initially, a systematic review of literature on “The use of police records for injury surveillance” was undertaken. Three different but related studies were then conducted. The Minimum Data Set (MDS) recommended for injury surveillance was identified in the first study; a tool for the extraction of data from FIRs was also developed, and its inter-rater reliability was assessed using Cohen’s Kappa; the percentage availability of each MDS data item in the FIRs was calculated. The total numbers of fatal and nonfatal construction site injuries in the Delhi population in 2017 were estimated by applying the two-sample capture-recapture method in the second study. The third study describes the epidemiology of construction site injuries in Delhi between 2016 and 2018. Results: The systematic review of literature showed that police records are a potentially useful source of information on unintentional injuries. The first study identified 12 MDS data items for injury surveillance; FIRs were found to contain complete information on 5 MDS data items but for 7 MDS data items, information was less complete. The second study estimated that FIRs ascertained 37%, 42.6% and 30.2% of the estimated total, fatal and non-fatal construction site injuries respectively. The third study found that 1,227 construction workers sustained injuries in 939 construction site incidents. Male workers (87%) and workers in the age group of 22 to 44 years (58.77%) accounted for most of those injured. The risk of a fatal injury was higher in migrant workers. The nonfatal injury rate per 100,000 workers per year was almost 3 times higher in female workers (98.55; 95% CI 82.52 to 116.8) than in male workers (34.36; 95%CI 31.92 to 36.94). Workers were at higher risk of injury in the rainy season and during 12:00 to 16:00 hours. Electricians and plumbers were the trade groups at higher risk of injury. Construction sites of government companies, and construction through a construction company, and works related to water supply, road construction, and power generation/distribution works were associated with higher odds of fatal injuries. The head (including face and eyes) was most prone to injury. Conclusion: Information on injuries can be reliably extracted from FIRs, however FIRs occasionally have incomplete information on some of the MDS data items. Furthermore, any epidemiological estimates made using these data must be adjusted to allow for the approximately two-thirds of injuries not reported to the police. Enforcement of existing legal provisions and the training of police personnel could help to reduce the ‘missingness’ of MDS data items and help to improve the ascertainment of injuries by FIRs. Imputation of missing data may help to improve the system further

Utility Of Salivary CA-125 And LDH As Tumor Markers In Oral Malignancy

Background: The mortality and morbidity associated with oral squamous cell carcinoma(OSCC)&nbsp; can be greatly reduced if tumor markers which can detect OSCC at an early stage are available. This study attempts to use saliva as the diagnostic medium to determine the correlation of salivary CA 125 and LDH in tobacco users with and without potentially malignant disorders. Changes in CA 125 and&nbsp; LDH level can be used as a marker in patients with and without premalignant disease and can be used as a deterrent in continuation of the habit. Aims: To assess the role of CA 125 &amp; LDH as a tumour marker in Oral cancer patients. Materials and methods: Cross sectional observational study .Time period: December 2015 to August 2017. Study area: OPD of tertiary care hospital in pune. Total participants: 150 persons. Under non-stimulatory conditions whole saliva sample was collected from each individual&nbsp; and was centrifuged. The resulting supernatant was used for estimation of CA 125 and LDH levels. Results: In present study, mean Salivary LDH level was found to be&nbsp; lowest among cases of healthy individuals&nbsp; while it was highest among individuals who were diagnosed and&nbsp; underwent treatment for malignancy. However there was insignificant difference seen between levels of diagnosed case of oral malignancy and the ones who underwent treatment for oral malignancy. Also mean Salivary CA-125 was lowest in healthy individuals and highest in individuals diagnosed with oral malignancy and the levels were seen to be reduced significantly in the one who underwent treatment for oral malignancies than those who didn't. Conclusion: Salivary CA 125 and LDH has a role in early detection of oral malignancies&nbsp; and&nbsp; can be used as a diagnostic marker. However LDH levels are persistently raised even after treatment for oral malignancy

Utility Of Salivary CA-125 And LDH As Tumor Markers In Oral Malignancy

Background: The mortality and morbidity associated with oral squamous cell carcinoma(OSCC)&nbsp; can be greatly reduced if tumor markers which can detect OSCC at an early stage are available. This study attempts to use saliva as the diagnostic medium to determine the correlation of salivary CA 125 and LDH in tobacco users with and without potentially malignant disorders. Changes in CA 125 and&nbsp; LDH level can be used as a marker in patients with and without premalignant disease and can be used as a deterrent in continuation of the habit. Aims: To assess the role of CA 125 &amp; LDH as a tumour marker in Oral cancer patients. Materials and methods: Cross sectional observational study .Time period: December 2015 to August 2017. Study area: OPD of tertiary care hospital in pune. Total participants: 150 persons. Under non-stimulatory conditions whole saliva sample was collected from each individual&nbsp; and was centrifuged. The resulting supernatant was used for estimation of CA 125 and LDH levels. Results: In present study, mean Salivary LDH level was found to be&nbsp; lowest among cases of healthy individuals&nbsp; while it was highest among individuals who were diagnosed and&nbsp; underwent treatment for malignancy. However there was insignificant difference seen between levels of diagnosed case of oral malignancy and the ones who underwent treatment for oral malignancy. Also mean Salivary CA-125 was lowest in healthy individuals and highest in individuals diagnosed with oral malignancy and the levels were seen to be reduced significantly in the one who underwent treatment for oral malignancies than those who didn\u27t. Conclusion: Salivary CA 125 and LDH has a role in early detection of oral malignancies&nbsp; and&nbsp; can be used as a diagnostic marker. However LDH levels are persistently raised even after treatment for oral malignancy

Effect of potassium application on yield and quality of green gram (Vigna radiata L.) on coarse textured soils of southern Haryana

59-63Crops need large quantity of potassium for enhancing their yield as well as quality. Pulses are important crops grown in India but their productivity is low. Among production inputs, recommendations for N and P fertilizers are made in most states with no K application resulting in imbalanced nutrient supply and lower crop yields.To quantify optimum dose for green gram ( Vigna radiata L.), a series of field experiments were conducted at Regional Research Station, CCS HAU, Bawal, Haryana, to assess the response of green gram to fertilizer potassium on coarse textured (Typic Haplustepts) soils of southern Haryana. After completion of research trials, crop was tested on farmer’s field through demonstrations and on farm trials (OFTs) to evaluate the response and adoptability of green gram as per the fertilizer potassium doses concluded in research experiment. Five levels of fertilizer potassium (0, 10, 20, 30 and 40 kg K2O ha-1) were evaluated for the response of green gram in randomized block design replicated thrice. The results of research trials revealed that the yield, protein content and growth parameters of green gram increased significantly with the application of fertilizer potassium @20 kg K2O ha-1. Significantly higher yield of green gram was recorded (5.87, 16.29, 19.23 and 22.36 %) due to application of 10, 20, 30 and 40 kg K2O ha-1, respectively over control. The total K uptake by green gram increased significantly with the incremental doses of potassium application which helped to prevent the depletion of available soil K and build-up its content in the soil. The mean K use efficiency varied from 38.30 to 54.15 and maximum (54.15 %) was recorded with the application of 20 kg K2O ha-1. The benefit cost ratio was also increased with the application of potassium and reflected in terms of additional returns per rupee (Rs. 10.94, 15.63, 12.17 and 10.72) invested on application of K @ 10, 20, 30 and 40 kg K2O ha-1, respectively. The farmer’s field trial results with 0 and 20 kg K2O ha-1 revealed that application of 20 kg K2O ha-1 increased the yield of green gram by 10.87% over control

CMB Telescopes and Optical Systems

The cosmic microwave background radiation (CMB) is now firmly established as a fundamental and essential probe of the geometry, constituents, and birth of the Universe. The CMB is a potent observable because it can be measured with precision and accuracy. Just as importantly, theoretical models of the Universe can predict the characteristics of the CMB to high accuracy, and those predictions can be directly compared to observations. There are multiple aspects associated with making a precise measurement. In this review, we focus on optical components for the instrumentation used to measure the CMB polarization and temperature anisotropy. We begin with an overview of general considerations for CMB observations and discuss common concepts used in the community. We next consider a variety of alternatives available for a designer of a CMB telescope. Our discussion is guided by the ground and balloon-based instruments that have been implemented over the years. In the same vein, we compare the arc-minute resolution Atacama Cosmology Telescope (ACT) and the South Pole Telescope (SPT). CMB interferometers are presented briefly. We conclude with a comparison of the four CMB satellites, Relikt, COBE, WMAP, and Planck, to demonstrate a remarkable evolution in design, sensitivity, resolution, and complexity over the past thirty years.Comment: To appear in: Planets, Stars and Stellar Systems (PSSS), Volume 1: Telescopes and Instrumentatio

Platinum-(IV)-derivative satraplatin induced G2/M cell cycle perturbation via p53-p21(waf1/cip1)-independent pathway in human colorectal cancer cells

Platinum-(IV)-derivative satraplatin represents a new generation of orally available anti-cancer drugs that are under development for the treatment of several cancers. Understanding the mechanisms of cell cycle modulation and apoptosis is necessary to define the mode of action of satraplatin. In this study, we investigate the ability of satraplatin to induce cell cycle perturbation, clonogenicity loss and apoptosis in colorectal cancer (CRC) cells.Platinum-(IV)-derivative satraplatin represents a new generation of orally available anti-cancer drugs that are under development for the treatment of several cancers. Understanding the mechanisms of cell cycle modulation and apoptosis is necessary to define the mode of action of satraplatin. In this study, we investigate the ability of satraplatin to induce cell cycle perturbation, clonogenicity loss and apoptosis in colorectal cancer (CRC) cells

Behavior and Impact of Zirconium in the Soil–Plant System: Plant Uptake and Phytotoxicity

Because of the large number of sites they pollute, toxic metals that contaminate terrestrial ecosystems are increasingly of environmental and sanitary concern (Uzu et al. 2010, 2011; Shahid et al. 2011a, b, 2012a). Among such metals is zirconium (Zr), which has the atomic number 40 and is a transition metal that resembles titanium in physical and chemical properties (Zaccone et al. 2008). Zr is widely used in many chemical industry processes and in nuclear reactors (Sandoval et al. 2011; Kamal et al. 2011), owing to its useful properties like hardness, corrosion-resistance and permeable to neutrons (Mushtaq 2012). Hence, the recent increased use of Zr by industry, and the occurrence of the Chernobyl and Fukashima catastrophe have enhanced environmental levels in soil and waters (Yirchenko and Agapkina 1993; Mosulishvili et al. 1994 ; Kruglov et al. 1996)