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Archer Bowers posted an update 6 months, 3 weeks ago
Understanding the risk factors that contribute to post-mastectomy complications can better inform preoperative discussions. Here, we assess the impact of the 5-Factor Frailty Index Score (mFI-5) in predicting 30-day postoperative complications in patients undergoing mastectomy. A retrospective review of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) data base was conducted for patients older than 65 undergoing mastectomy between 2010 and 2015. We assessed each patient’s Frailty Index Score using the mFI-5. Primary outcomes included wound complications and overall complications. Multivariate logistic and linear regression analyses were used to determine the ability of the mFI-5 to predict postoperative outcomes. A total of 13,783 patients were analyzed. The rate of wound complications was 3.0%, while the rate of overall complications was 6.0%. An mFI-5 score greater than 2 was an independent risk factor for wound complications and overall complications. Overall, patients undergoing mastectomy with an mFI-5 of 2 or greater experienced higher rates of postoperative complications. buy TP0427736 The mFI-5 is an accessible tool that can be used to risk-stratify patients undergoing mastectomy and can positively contribute to the informed consent and shared decision-making process.
The increase of peptide yield contributed to reducing the usage of antibiotics in solid-state fermented feed. Ultrasound technology is used in the field of liquid-state fermentation to improve yield of fermented products but has not been utilized in the field of solid-state fermentation (SSF). The main objective of this study was to investigate the feasibility of improving peptide yield in SSF products through ultrasound-treated bacterial strain.
The highest peptides content in soybean meal SSF products reached 153.28 mg g
, which increased by 15.05% compared with the control. This content value was acquired through treating the bacteria of Bacillus amyloliquefaciens by ultrasound before inoculating into soybean meal under the optimized mode and parameters (simultaneous dual-frequency ultrasound mode, frequency combination of 40/60 kHz, total power density of 40 W L
, time of 20 min, pulse-on and pulse-off times of 40 and 60 s, delayed inoculation time of 0 h). Fermenting with ultrasound-treated bacterial strain can effectively increase peptide yield, biomass and protease activity of soybean meal fermented products during the SSF prophase. After treating by ultrasound, the latent phase and logarithmic phase of the bacterial strain shortened by 1 and 3 h while the generation time reduced by 23.64%. In qualitative test of protease activity, diameter ratio (DR) value of ultrasound-treated bacterial cells enlarged by 12.0% compared with the control.
Peptide yield of soybean meal SSF products can be improved through ultrasound-treated bacterial inoculum, which attributed to the promoting effect of ultrasound treatment on growth activity and protease production capability of bacterial cells. © 2021 Society of Chemical Industry.
Peptide yield of soybean meal SSF products can be improved through ultrasound-treated bacterial inoculum, which attributed to the promoting effect of ultrasound treatment on growth activity and protease production capability of bacterial cells. © 2021 Society of Chemical Industry.
Stroke is affecting an increasing number of young and middle-aged adults. Given the substantial diversion from anticipated life trajectories that younger stroke survivors experience as a result of their stroke deficits, their health-related quality of life (HRQOL) is likely to be negatively impacted during the immediate post-acute recovery period. The aim of this study was to generate a comprehensive understanding of the influences on HRQOL and acute recovery during the first three months following stroke for younger adults using a socio-ecological perspective.
Longitudinal, convergent mixed methods design.
HRQOL survey data, assessed using the Patient Generated Index (N=31), and qualitative interview data about survivors’ recovery experiences (N=20) were collected. Simple linear regression and effect size results were integrated with themes and sub-themes identified from conventional content analysis using joint data displays.
Depression and fatigue negatively affected recovery at the individual leve affect the acute stroke recovery experience. Findings underscore the need for research and clinical approaches that consider environmental factors at multiple levels of influence when supporting stroke recovery for younger adults.
Circadian rhythm disruption is commonly reported in patients with bipolar disorder. Lithium has been suggested to have effects on the circadian clock, the biological basis of the circadian rhythm. The objective of the current review was to review systematically the existing studies on the effect of lithium on circadian rhythm in patients with bipolar disorder.
We systematically searched the scientific literature up to September 2020 for experimental or observational studies which measured circadian rhythm in bipolar patients taking lithium (in comparison with placebo or other active treatments) and carried out a meta-analysis. Circadian rest-activity was our primary outcome, but we also collected data about sleep quality and chronotype (Morningness-Eveningness). The protocol was registered in PROSPERO (CRD42018109790).
Four observational studies (n=668) and one experimental study (n=29) were included. Results from the meta-analysis suggest a potential association between lithium and shifts towards morninal study design, adopting actigraphy to monitor daily circadian rest-activity changes are needed.Since the outbreak of COVID-19, there have already been over 26 million people being infected and it is expected that the pandemic will not end in near future. Not only the daily activities and lifestyles of individuals have been affected, the medical practice has also been modified to cope with this emergency catastrophe. In particular, the cancer services have faced an unprecedented challenge. While the services may have been cut by the national authorities or hospitals due to shortage of manpower and resources, the medical need of cancer patients has increased. Cancer patients who are receiving active treatment may develop various kinds of complications especially immunosuppression from chemotherapy, and they and their carers will need additional protection against COVID-19. Besides, there is also evidence that cancer patients are more prone to deteriorate from COVID-19 if they contract the viral infection. Therefore, it is crucial to establish guidelines so that healthcare providers can triage their resources to take care of the most needed patients, reduce less important hospitalization and visit, and to avoid potential complications from treatment.