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

Immunomodulatory Function of Interleukin 28B During Primary Infection With Cytomegalovirus

Background. Feedback mechanisms between interferons α and λ (IFNs) may be affected by single nucleotide polymorphisms (SNP) in interleukin 28B (IL-28B; IFN-λ3) promoter region and may influence cytomegalovirus (CMV) replication. Methods. We associated IL-28B SNPs with the risk of CMV replication after transplantation. Next, we examined the effect of IL-28B genotypes on IL-28B, and IFN-stimulated gene (ISG) expression, and CMV replication in human foreskin fibroblast (HFF) and peripheral blood mononuclear cells (PBMCs). Results. Transplant recipients with an IL-28B SNP (rs8099917) had significantly less CMV replication (P = .036). Both HFF-cells and PBMCs with a SNP showed lower IL-28B expression during infection with CMV, but higher "antiviral” ISG expression (eg, OAS1). Fibroblasts with a SNP had a 3-log reduction of CMV replication at day 4 (P = .004). IL-28B pretreatment induced ISG expression in noninfected fibroblasts, but a relative decrease of ISG expression could be observed in CMV-infected fibroblasts. The inhibitory effects of IL-28B could be abolished by siRNA or antagonistic peptides against the IL-28 receptor. In fibroblasts, inhibition of IL-28 signaling resulted in an increase of ISG expression and 3-log reduction of CMV-replication (P = .01). Conclusions. We postulate that IL-28B may act as a key regulator of ISG expression during primary CMV infection. IL-28B SNPs may be associated with higher antiviral ISG expression, which results in better replication contro

Defect structures in nematic liquid crystals around charged particles

We numerically study the orientation deformations in nematic liquid crystals around charged particles. We set up a Ginzburg-Landau theory with inhomogeneous electric field. If the dielectric anisotropy varepsilon_1 is positive, Saturn ring defects are formed around the particles. For varepsilon_1<0, novel "ansa" defects appear, which are disclination lines with their ends on the particle surface. We find unique defect structures around two charged particles. To lower the free energy, oppositely charged particle pairs tend to be aligned in the parallel direction for varepsilon_1>0 and in the perpendicular plane for varepsilon_1<0 with respect to the background director . For identically charged pairs the preferred directions for varepsilon_1>0 and varepsilon_1<0 are exchanged. We also examie competition between the charge-induced anchoring and the short-range anchoring. If the short-range anchoring is sufficiently strong, it can be effective in the vicinity of the surface, while the director orientation is governed by the long-range electrostatic interaction far from the surface.Comment: 10 papes, 12 figures, to appear in European Physical Journal

The level of satisfaction of the secondary customers of Central Philippine University in school year 2006-2007 and the possibility of sending return customers to the university

Abstract onlyThis survey-correlational study using a sample survey attempted to analyze the level of satisfaction of the secondary customers of Central Philippine University and the possibility of sending secondary customers to the university. This study likewise determined percentages, differences, predictive significance of the variables, and the direction and significance of the relationship between variables. Data for this investigation were gathered from the 383 parents of students enrolled in the different colleges and departments of the University for school-year 2006-2007, using an eleven section researcher-made data gathering instrument. The instrument was face validated, pilot tested and revised using factor analysis via Statistical Package for Social Sciences (SPSS) 10.00. Data gathered were presented using percentages, means and standard deviations, and analyzed using, stepwise multiple regression analysis and Pearson’s product moment correlation coefficient, and chi - square -test for independent samples. The alpha level for inferential statistics was set at .05. Results of the investigation revealed that the respondents are well informed about the admission and enrollment procedure and consider the procedure easy. Their level of knowledge about tuition fees is high and consider the tuition and fees high. They are knowledgeable about billing practices and consider these practices advantageous to parents. Generally, they are moderately familiar with the instructional effectiveness and perceive academic instruction to be effective. They are familiar with and view the University’s grading system to be efficient. They are familiar with the educational climate of the University and believe it is conducive to learning. They are aware that their children’s are safe and secure in the University. They are moderately familiar of the University’s support services and consider these services adequate. They are satisfied with the University’s services and are certain to send return customers to the University. Age was found to be significantly related to billing practices, safety and security and support services. Number of children was found significantly related to instructional effectiveness, and educational climate. Number of children at CPU was found significantly related to tuition and fees. Aside from Admission and enrollment Procedure and Tuition and Fees, being CPU graduate or not was found significantly related to Instructional Effectiveness, Educational Climate, Safety and Security and Support Services. There are six predictors for customer satisfaction and three for return customers. The two dependent variables Customer Satisfaction and Return Customers are significantly related.Includes bibliographical reference

Factors influencing the failure of the students who took the placement exam in Math and English to enroll at Central Philippine University

Journal articleThis survey-correlational study attempted to analyze the factors influencing the failure of the students who took the placement exam in Math and English to enroll at Central Philippine University for school year 2004-2005. This study likewise determined differences, significance of the differences, and predictive significance of the independent variables on the dependent variable. Data for this investigation were obtained from 200 purposively selected high school graduates who took the placement exam in Math and English in this university but enrolled in other colleges/universities. Results of the investigation showed that high tuition and fees was the number one reason why these students did not enroll in this university. The student respondents generally come from rich families, regarded tuition and fees as just about right, considered the placement exam in Math and English easy, and viewed the educational standard of the university to be high. The students differed significantly in their family’s economic condition when classified according to high school last attended, family’s monthly income and colleges/universities enrolled, and in their perception of the university’s tuition and fees when classified according to gender and family’s monthly income. No significant difference was found in the students’ view of the educational standard of the university. The significant predictors of colleges/universities where the students enrolled are family’s economic condition and educational standard of the university

Light at the end of the tunnel: Case studies of thirty work students of Central Philippine University

Abstract onlyThis descriptive investigation attempted to study in-depth thirty work students of the University in terms of their personal and family backgrounds, economic condition, relationship with people, problems encountered and what they hope to accomplish after graduation from college. Data for this investigation were gathered from work students assigned in four work areas: Janitorial, Clerical, Library, and Service and Laboratory from June 6, 2008 to October 20, 2008 using a nine section interview schedule and an eight section interview guide. The instruments were face and content validated. Quantitative data gathered were analyzed using means and percentages and presented in frequency distribution tables which serve as introduction to the thirty case studies. Qualitative data gathered were structurally analyzed and presented as case studies. Result of the investigation showed that the respondents are 20.2 years old on the average, enrolled in different courses in six colleges of the University. Most are females, come from rural areas, belonging to families with 7.23 members on the average, and assigned in the Service and Laboratory section of the University. Most respondents live in their own house with water sealed toilets, and standing on housing lot which their family used for free. The family’s average monthly income of Php. 4,050.00 is not enough to meet their financial needs which is why family members work to augment the income of the family. Most of respondents’ parents still live under one roof, are very liberal with their children, where sibling to sibling and sibling to parent relationship is very close. Incidents which threaten to split the family make the respondents cry or angry while personal accomplishment and those which maintain peace and harmony within the family make them laugh. Of respondents who stay in boarding houses, one half stay for free while the rest pay their bedspace when needed. Respondents are very friendly to their boardmates, very close to their work supervisor and the opposite sex, and do not have any lovelife as of the moment. There are respondents who go to school on an empty stomach without any money in their pocket. Many respondents still work outside the University for them to have a place to stay and fill their stomach while working and studying at the University. The respondents have many aspirations for their family, themselves and their community after they graduate from college and find employmentIncludes bibliographical reference

The level of satisfaction of the secondary customers of Central Philippine University in school year 2005-2006 and the possibility of sending return customers to the university

Abstract onlyThis survey-correlational study attempted to analyze the factors influencing the satisfaction of the secondary customers of Central Philippine University and the possibility of sending secondary customers to the university. This study likewise determined percentages, differences, predictive significance of the variables, and the direction and significance of the relationship between variables. Data for this investigation were gathered from the 400 parents of students enrolled in the different colleges and departments of the University for school year 2005-2006, using an eleven section researcher-made data gathering instrument. The instrument was face validated, pilot tested and revised using factor analysis via Statistical Package for Social Sciences (SPSS) 10.00. Data gathered were presented using percentages, means and standard deviations, and analyzed using, stepwise multiple regression analysis and pearson’s product moment correlation coefficient. The alpha level for inferential statistic was set at .05. Results of the investigation revealed that the participants are well informed about the admission and enrollment procedure and consider the procedure easy. Their level of knowledge about tuition fees was high but considered the tuition and fees high. They are knowledgeable about billing practices and consider these practices advantageous to parents. Generally, they are moderately familiar with the instructional effectiveness and perceive academic instruction to be effective. They are familiar with and view the University’s grading system to be efficient. They are familiar with the educational climate of the University and believe it is conducive to learning. They are aware that their children’s are safe and secure in the University. They are moderately familiar of he University’s support services and consider these services adequate. They are satisfied with the University’s services and are certain to send return customers to the University. Age was found to be significantly related to grading system and safety and security and number of children enrolled at CPU was found significantly related to tuition and fees. There are five predictors for customer satisfaction and two for return customers. The two dependent variables are significantly related.Includes bibliographical reference

An analysis of the factors influencing the decision of the students who took the placement exam in Math and English at Central Philippine University to enroll in other schools for school year 2005-2006

Abstract onlyThis survey-correlational study attempted to analyze the factors influencing the decision of the students who took the placement exam in Math and English to enroll at Central Philippine University for school-year 2005-2006 to enroll in other schools. This study likewise determined differences, significance of the differences, and predictive significance of the independent variables on the dependent variable. Data for this investigation were obtained from 242 purposively selected high school graduates who took the placement exam in Math and English in this university but enrolled in other colleges/universities. Data were gathered using a researcher made data-gathering instrument divided into five sections. The instrument was face validated, pilot tested, and revised. It was administered and retrieved by three sections of Sociology 1b students. Gathered data were analyzed using percentages, means and standard deviations, t-test for independent samples and Stepwise Multiple Regression Analysis. Analysis of the data was done using the Statistical Package for Social Sciences (SPSS) 10.00. The Alpha level for all inferential tests was set at .05. Results of the investigation showed that high tuition and fees was the number one reason why the students did not enroll in this university. The student respondents come from rich families, regarded tuition and fees as just about right, considered the placement exam in Math and English easy, and viewed the educational standard of the university to be high. The students differed significantly in their family’s economic condition when classified according to high school last attended and family’s monthly income, and in their perception of the university’s tuition and fees when classified according to high school last attended, family’s monthly income, and colleges and universities enrolled in. Significant difference was found in the students’ view of the placement examination of the university when grouped according to colleges and universities enrolled in. The four independent variables of the investigation were all found to be significant predictors of colleges/universities where the students enrolled.Includes bibliographical reference

Children in conflict with the law: An in-depth investigation

Abstract only Full text availableThis descriptive-qualitative investigation attempted to study in-depth twelve cases of minors who committed various crimes in violation of the law. Results of the investigation showed that minors committed the crime of rape followed by theft, robbery, murder, and illegal possession of dangerous drugs. The Children in Conflict with the Law (CICL) are mostly 16 and 17 years old with the youngest being only 11 years old, come from big families whose members are mostly inadequately educated, mostly unemployed and poor. Of the four rape cases, two have been dismissed by the Court. One is under detention at Dalayunan Home for Boys, and one has been released on recognizance to the custody of his mother. Of the three minors who were accused of Theft, one was released on recognizance to the custody of his father, the other one to the custody of his mother, the reamining one is still under detention at Dalayunan Home for Boys. On the robbery case, one is out on bail while the other one is under detention at the Regional Rehabilitation of the Youth. The minor accused of Murder is under detention at Dalayunan Home for Boys while the minor accused of Attempted Homicide has been released on recognizance to the custody of his mother. The minor accused of Illegal Possession of Dangerous Drugs has been released on recognizance to the custody of his mother. Some CICL are undergoing a court approved diversion program as part of their rehabilitation before final community integration.Central Philippine UniversityIncludes bibliographical reference

Relationship between possibility of enrolling at the university, personal characteristics, economic background, academic achievement and actual enrollment of students taking the placement exam at Central Philippine University

Abstract onlyThis descriptive-relational study attempted to determine the relationship between the possibility of enrolling at the University, personal characteristics, economic background, academic achievement, and actual enrollment of students taking the placement exam at Central Philippine University. This study determined the percentages and significance of relationships between some independent and dependent variables. Data for this investigation were gathered from 400 randomly chosen and clustered high school graduates who took the placement exam from April 21 to June 15, 2007, using a researcher-made data gathering instrument divided into five (5) sections. The instrument was face and content validated and revised. Data gathered were analyzed using frequency distribution and Chi-Square with an alpha level of .05. The result showed that the majority of the respondents are 16 years and younger, female, have graduated from public urban high schools located mostly in the province of Iloilo. The respondents’ parents are engaged in various occupations and are responsible for paying their tuition and fees The higher proportion of the respondents belong to families with income of more than Php 20,000.00 per month, owned their dwelling unit with flush toilets, constructed in their own housing lots with many families using piped-in and purified/mineral water for drinking. Many respondents received academic honors and special awards, are members of different student organizations in high school, and are certain to enroll in the University in school-year 2007-2008. For many respondents who took the placement exam in other schools, West Visayas State University (WVSU) is the most popular. A little over one-half of the respondents who took the placement exam at the University actually enrolled in school-year 2007-2008. Age, sex, family’s monthly income, type of school, academic awards received, and special awards received were not significantly related to the possibility of the respondents’ enrolling at the University in school year 2007-2008. Location of residence, location of the school, and high school average grade were found significantly related to the possibility of enrolling at the University. The possibility of enrolling at the University and the location of the school were significantly related to actual enrollment.Includes bibliographical reference