16 research outputs found
Automatic speech recognition (ASR) based approach for speech therapy of aphasic patients: A review
No full textThe Netherlands as a global hydro-hub
No full textOn 1 November 2021, Prime Minister of the Netherlands Mark Rutte delivered a speech at COP-26 in Glasgow, Scotland. He stressed the history of the Netherlands in “battling the elements for centuries. From North Sea floods to Caribbean storms” (GoN, 2021). He further stated that “(climate) adaptation is in our DNA” and stressed that sustainability innovations carry economic opportunities. He finished the speech with a statement that the world “can count on the Kingdom of the Netherlands”, in other words, that the Netherlands is open for business.Organisation & Governanc
Advancing precision oncology in metastatic colorectal cancer: The food and drug administration approval of foundation one liquid CDx as a companion diagnostic a correspondence
No full textSuboptimal use of inpatient palliative care consultation in alcoholic hepatitis hospitalizations may lead to higher readmissions
No full textAims: Alcoholic hepatitis (AH), a clinical syndrome precipitated by chronic alcohol consumption, constitutes about 0.9 % of total admissions in the United States. It presents a wide severity spectrum, from mild disease to severe cases associated with high mortality. Palliative care (PC) is a specialized medical approach focused on enhancing the quality of life for patients with serious or life-threatening illnesses. This study aims to investigate the national trends of palliative care (PC) utilization in AH hospitalizations and its impact on resource utilization.
Methods: We identified adult AH hospitalizations from the Nationwide Readmission Database, further categorized based on PC utilization. Multivariate regression analysis was employed to evaluate the impact of PC on the 90-day readmission rate.
Results: Among the 68,062 AH patients, 3,784 (5.56 %) utilized PC services. PC utilization in AH hospitalizations was associated with a significantly lower 90-day readmission rate (adjusted hazard ratio (aHR) 0.45, P = 0.02). 90-day readmission benefits with PC were persistent on analysis of severe (North American Consortium for the Study of End-Stage Liver Disease-Acute-on-Chronic Liver Failure [NACSELD-ACLF] score ≥1) AH population as well (aHR 0.46, P \u3c 0.01). Trend analysis of PC utilization in AH hospitalizations revealed a non-significant change from 5.39 % in 2016 to 5.69 % in 2020 (P = 0.07).
Conclusion: This study shows that PC utilization in AH hospitalizations reduces readmissions and healthcare burden. We advocate integrating PC into the comprehensive management of AH. Further research is needed to determine the optimal timing and components of PC interventions for AH patients
Abdominal Compartment Syndrome in Decompensated Cirrhosis: Findings from a National Cohort
No full textIntroduction: Abdominal compartment syndrome (ACS), caused by increased intra-abdominal pressure resulting in compromised organ function, is a serious complication in critically ill patients and is associated with increased morbidity and mortality. This study aims to analyze the prevalence, outcomes and predictors of ACS in hospitalizations for decompensated cirrhosis. Methods: Using the National Readmission Database 2016-2020, we employed the International Classification of Diseases, 10th revision, Clinical Modifications (ICD-10-CM) codes to identify adult patients (age .18 years) admitted with decompensated cirrhosis (DC). We further stratified DC hospitalizations based on the presence of ACS. Utilizing a multivariate regression model, we compared the outcomes of DC in patients with ACS and determined predictors of ACS. STATA 14.2 was utilized for statistical analysis. Results: We included 618,696 DC patients, of whom 838 (0.14%) patients had ACS. After adjusting for confounding variables, we found significantly higher odds of mortality (adjusted odds ratio [aOR]:18.62, P\u3c0.001), septic shock (aOR: 9.28, P\u3c0.001), vasopressor requirement (aOR:10.03, P\u3c0.001), mechanical ventilation (aOR:14.20, P\u3c0.001) in cirrhotic patients with ACS (Table 1). Additionally, liver-specific complications such as upper gastrointestinal bleeding (aOR: 2.34, P\u3c0.001), hepatorenal syndrome (aOR: 5.16, P\u3c0.001), and spontaneous bacterial peritonitis (aOR: 2.58, P\u3c0.001) had elevated odds in the ACS group. Further, using multivariate logistic regression analysis, we determined predictors of ACS in DC patients. North American Consortium for the Study of End-Stage Liver Disease (NACSELD)-ACLF score ≥2 (aOR: 12.06), malignancy (aOR: 1.86), chronic kidney disease (aOR: 1.71), blood transfusion (aOR: 1.68), active infection (aOR: 1.56), hyponatremia (aOR: 1.51), and coagulopathy (aOR: 1.37) were predictive of ACS development in DC patients (Figure 1). Conclusion: ACS in cirrhotic patients is associated with significantly worse hospitalization outcomes as well as higher rates of liver-specific complications. Early identification and prompt management of this vulnerable patient cohort are imperative to enhance clinical outcomes. Further research is warranted to better understand the underlying mechanisms and refine clinical approaches for optimal care
S1735 Abdominal Compartment Syndrome in Decompensated Cirrhosis: Findings from a National Cohort
No full text“Veozah (Fezolinetant): A Promising Non‐Hormonal Treatment for Vasomotor Symptoms in Menopause”
No full textAbstract Vasomotor symptoms (VMS) are a common and distressing experience during menopause, affecting a significant portion of women. Hormone therapy (HT) has been the traditional treatment, but its limitations and potential risks have led to the search foar non‐hormonal alternatives. Recently, the FDA approved Veozah (Fezolinetant) as a promising nonhormonal solution for moderate to severe VMS in menopause. Veozah, an innovative neurokinin 3 (NK3) receptor antagonist, targets the disrupted thermoregulation underlying VMS. It modulates neural activity within the thermoregulatory center by crossing the blood‐brain barrier, offering relief from hot flashes and night sweats. Clinical trials, including SKYLIGHT 1TM, SKYLIGHT 2TM, and SKYLIGHT 4TM, have established Fezolinemtant's efficacy and safety profile. The recommended dosage of one 45 mg tablet per day demonstrates proportional pharmacokinetics, with generally mild side effects that require regular monitoring. Fezolinetant's oral availability makes it a convenient and accessible option for women seeking relief from VMS, potentially improving their overall well‐being
Study of Incident Drag Response of Hyperloop Pod Based on Change in Aerodynamic Brake Plate Orientation
No full textThe idea for the Hyperloop has received significant attention, with expectations of it becoming a revolutionary and potentially the fastest mode of land transportation on the planet. The low-pressure tube through which the pod travels at expected speeds close to Mach 1.0, presents a unique case among other transport models, and as such, braking of the pod is of critical importance if passenger safety protocols are to be maintained. The high-speed flow around the pod exerts high adverse pressure gradients on the pod surface, resulting in boundary layer separation, increasing drag and affecting the acceleration of the pod. Numerical simulations have shown that the placement of an aerodynamic brake plate on the pod surface at the point at which boundary layer separation occurs provides the necessary drag required for safe deceleration. This study was aimed to find the best angle for the aerodynamic brake positioned at a fixed point on the pod, allowing for the maximum generation of drag, using numerical simulations. After various trials, it was observed that angling the brake 15 backwards while increasing its length to keep incident brake profile constant, the drag value obtained was the highest.The presentation of the authors' names and (or) special characters in the title of the pdf file of the accepted manuscript may differ slightly from what is displayed on the item page. The information in the pdf file of the accepted manuscript reflects the original submission by the author
Evaluation of clinical efficacy and safety of natural micronized progesterone in prevention of preterm labor: a prospective study at tertiary care teaching hospital in India
No full textBackground: Uterine relaxants (UR) are used in management of in Preterm labour (PTL), which is responsible for considerable morbidity and mortality in mother as well as preterm infant. Author are yet to discover an ideal UR which is highly effective yet safe. Literature supports the use of natural micronized progesterone (NP) during threatened PTL. However, little data exists for Indian population. Therefore, present study becomes imperative.Methods: A comparative clinical study was carried out on 78 patients (aged 19 to 35 years with singleton pregnancy and gestational age between 28 and 37 weeks with cervix ≤4 cm dilated) who were diagnosed with threatened PTL were included. Those who refused treatment were allocated to control group (n= 29) and received only bed rest. NP was given orally 200 mg twice a day to 21 patients and 200 mg intra vaginal twice a day to 28 patients and was continued until delivery or 37 weeks of gestation whichever occurred first. The efficacy was proven if PTL was prevented and patient did not require an alternative UR for ≥48 hours.Results: The mean age of patients was 23±3.2 years, majority being multipara. Author observed that both oral and vaginal formulation of NP was found to be highly effective (p <0.05) as primary UR and maintenance therapy in preventing PTL as compared to the control group. However, difference between them was not statistically significant. None of the patients were lost to follow-up and no adverse events linked to the treatment were reported.Conclusions: Although, the data obtained from this study was limited and the sample size was small, findings of this study support the use of NP in prolonging threatened PTL
Trends in Alzheimer's disease and heart failure-related mortality among older American adults: Insights from the CDC WONDER database
No full textIntroduction: Alzheimer's disease is one of the leading causes of death among the elderly in the United States with heart failure sharing similar risk factors. This study investigated trends and disparities in Alzheimer's disease mortality among older adults with heart failure from 1999 to 2020 in the United States. Methods: Making use of ICD-10 codes death certificate data from the Centers for Disease Control and Prevention Wide-Ranging OnLine Data for Epidemiologic Research database was retrieved for patients aged ≥65 years between 1999 and 2020. Age-adjusted mortality rates (AAMRs), per 100,000 people, and Annual Percentage Change (APCs) with their respective 95 % Confidence Intervals (CI) were also calculated. Data was stratified by year, gender, race and geographical distribution. Results: Alzheimer's disease with coexisting heart failure was responsible for 192,459 deaths between 1999 and 2020. Overall the AAMR increased from 21.32 in 1999 to 24.56 in 2005 (APC: 1.9760*; 95 % CI: 0.6001 to 3.9507) after which a significant decrease to 16.52 by 2013 was observed (APC: −4.9301*; 95 % CI: −6.5209 to −4.0119). AAMRs decreased from this point forward reaching 22.21 in 2020 (APC: 4.1573*; 95 % CI: 3.0373 to 5.7232). Women had higher AAMRs than men (21.57 vs 18.41). Among racial groups, the Non-Hispanic (NH) White (21.62) population had the highest AAMRs followed by NH Black/African American (17.87), Hispanic/Latino (14.3) and NH Asian/Pacific Islander (8.96). Furthermore, AAMRs also varied by census region (West: 24.05; Midwest: 22.83; South: 21.1; Northeast: 13.38). Moreover, nonmetropolitan areas had higher AAMRs compared to metropolitan areas (27.23 vs 19.09). States in the top 90th percentile such as Kentucky, Oklahoma, Washington, North Dakota and Mississippi had AAMRs that were three times higher relative to states in the lower 10th percentile including Nevada, Florida, New York, District of Columbia and Hawaii. Conclusion: Alzheimer's disease mortality with associated heart failure has shown considerable variation in adults ≥65 years. AAMRs were highest in women, NH Whites, residents of the West and nonmetropolitan patient populations. Targeted interventions and a more holistic approach to patient management are essential in achieving favorable outcomes for vulnerable groups moving forward
