Comparison of gender roles in male and female in patients with borderline personality disorder (BPD) with control group and it’s correlation with severity of clinical symptoms

Introduction: The objective of this research was to comparethe gender masculine and the gender feminine rolesin patients with borderline personality disorder and controlgroup. This study was aimed to determine the correlationcoefficient of the gender masculine and the gender feminineroles with severity of borderline personality disorder.Methods: In this case-control study, 17 males and 25 femaleswith borderline personality disorder, and 22 malesand 18 females in control group were examined. To evaluatethe sex roles, the Bem sex role inventory (BSRI) andthe gender masculine (GF) and gender feminine (GF) rolesderived from the Minnesota Multi-Stage Personality Inventory(MMPI-2) were used. The borderline personalitydisorder and its severity were diagnosed using a semistructuredclinical interview based on DSM-IV for personalitydisorders (SCID-II). Pearson correlation coefficientand variance analysis were used to analyze the findings.Results: According to GM inventory, no significant differencewas found between the male patients and controlgroup subjects. No significant difference was foundbetween female patients and control group subjects andbetween male patients and two groups of women. Basedon the GF inventory, the femininity of male and femalepatients and control group of men was less than that ofcontrol group of women. Based on BSRI, gender masculinetraits score was significantly higher in men and womenwith borderline personality disorder than those in controlgroup of men and control group of women. In gender femininetrait score, control group of women obtained higherscores than both of control group of men and men withborderline personality disorder. There was no significantdifference between control group of women and womenwith borderline personality disorder. There was a significantcorrelation between the severity of borderline personalitydisorder in women and gender masculine trait score basedon the Bem sex roles index (BSRI) (r=0.410, p=0.042).Conclusion: Men with borderline personality disorder hadmore masculinity than control group of men, althoughthey showed no significant difference with control groupbased on sex role. Higher masculinity was associated withmore severe personality disorder in women

Metabolomic Characterization of Human Rectal Adenocarcinoma with Intact Tissue Magnetic Resonance Spectroscopy

PURPOSE: This study was designed to test whether metabolic characterization of intact, unaltered human rectal adenocarcinoma specimens is possible using the high-resolution magic angle spinning proton (1H) magnetic resonance spectroscopy technique. METHODS: The study included 23 specimens from five patients referred for ultrasonographic staging of suspected rectal cancer. Multiple biopsies of macroscopically malignant rectal tumors and benign rectal mucosa were obtained from each patient for a total of 14 malignant and 9 benign samples. Unaltered tissue samples were spectroscopically analyzed. Metabolic profiles were established from the spectroscopy data and correlated with histopathologic findings. RESULTS: Metabolomic profiles represented by principle components of metabolites measured from spectra differentiated between malignant and benign samples and correlated with the volume percent of cancer (P = 0.0065 and P = 0.02, respectively) and benign epithelium (P = 0.0051 and P = 0.0255, respectively), and with volume percent of stroma, and inflammation. CONCLUSIONS: Magnetic resonance spectroscopy of rectal biopsies has the ability to metabolically characterize samples and differentiate between pathological features of interest. Future studies should determine its utility in in vivo applications for non-invasive pathologic evaluations of suspicious rectal lesions

Utilization and Outcomes of Patients with Colorectal Cancer Liver Metastases in the Medicare Population

Aggressive treatment of colorectal liver metastases (CRLM) after colectomy is increasing in the last two decades with reports of improved survival. Multiple treatment options are available for CRLM but their use and utility remains unknown. Methods: Using SEER-Medicare linked database (1991-2005), we identified 7131 patients who had undergone colectomy with CRLM. Demographic, clinical and tumor factors were examined as determinants of therapy. Treatment options consisted of surgery (resection, ablation) or chemotherapy. Univariate and multivariate analyses were performed to determine predictors of overall survival after colectomy. Results:635 patients (8.9%) underwent liver directed surgery defined as either a liver resection (n=495), ablation (n=216) or both (n=76) for CRLM. 322 patients (51%) were female and 313 (49%) were male. 147 patients (23%) were SES 1, 230 patients (36%) were SES 2, and 258 (41%) were SES 3. There was a survival advantage to receiving liver surgery or chemotherapy in selected patients with CRLM (p Conclusion: In the Medicare population, patients with CRLM who receive potentially curative therapy such as resection, ablation or chemotherapy experience a substantial survival advantage; despite this only 8.9% of patients received directed therapy for their metastasis. Barriers to treatment and its underutilization must be identified to improve survival in patients diagnosed with CRLM after colectomy

On-chip supercontinuum generation in nanostructured Ge11.5As24Se64.5 chalcogenide waveguides using Panda-ring resonator

The on-chip scale microring circuit is proposed to numerically investigate the supercontinuum (SC) generation of light power. The device is formed by the chalcogenide Panda-ring resonator with the nanoscale planar waveguide using Ge11.5As24Se64.5chalcogenide glass channel waveguide, air-clad and MgF2glass for lower cladding. The waveguide is designed to exhibit normal dispersion along with a low-energy pumped at 1.55 μm using a short pulse, which has the duration of 50 fs and peak power ranging from 1 W to 100 W. The numerical result obtained has shown a good-quality SC generation of both the spectral bandwidth and high output peak power. All SC spectral extended to more than 13 μm by cumulative Kerr nonlinearities. The obtained results can be useful for developing new experimental work in the important area of SC generation on compact chip broadband sources, which can be used in both infrared and radio wave applications

Clinical and Financial Impact of Readmissions Following Colorectal Resection: An Analysis of Predictors, Outcomes, and Cost

Background: Following passage of the Affordable Care Act, 30day readmissions have come under greater scrutiny, with penalties levied for higher than expected readmission rates. We examined risk factors for 30day readmission following colorectal resection and evaluated the financial impact of readmissions on the healthcare system. Methods: The University HealthSystem Consortium Clinical Database was queried for adults undergoing colorectal surgery for cancer, diverticular disease, inflammatory bowel disease, or benign tumors from 2008-2012. Predictors of 30day readmission were assessed with multivariable logistic regression. Additional endpoints included time to readmission, readmission diagnosis, readmission length of stay (LOS), and readmission cost. Results: A total of 70,484 patients met study inclusion criteria, 13.7% (9,632) of which were readmitted within 30 days of discharge. The strongest independent predictors of readmission were: LOS ≥4 days (OR 1.44; 95% CI 1.32-1.57), stoma (OR 1.54; 95% CI 1.46-1.51), and non-home discharge (OR 1.68; 95% CI 1.57-1.81). Of those readmitted, half occurred within 7 days, 13% required ICU care, 6% had a reoperation, and 2% died during the readmission stay. The median combined total direct hospital cost was over two times higher ($26,917 v.$13,817; p\u3c0.001) than non-readmitted patients. Compared with late readmissions, those readmitted within 7 days were more likely to have a reoperation (8% v. 4%, p\u3c0.001), be admitted to the ICU (14% vs. 12%, p\u3c0.001), and had a longer median readmission LOS (5d vs. 4d, p\u3c0.001). CONCLUSIONS: 30-day readmissions following colorectal resection occur frequently and incur a significant financial burden on the healthcare system. Highest-risk patients include those with longer LOS, stoma, and non-home discharge. Future studies aimed at targeted interventions may reduce readmissions and curb escalating healthcare costs

A New Look at the Volume and Outcome Relationship in Surgery for Colorectal Cancer

Purpose: Surgeon and hospital factors have a significant impact on treatment outcomes for colorectal cancer (CRC). Limited research has been done to assess cost and quality of treatment by surgeon-volume. We aim to identify the surgeon factors impacting cost and quality of surgical care for CRC. Methods: The University HealthSystem Consortium database was queried for patients who underwent colon resection for cancer from 2008 to 2012. Patients were grouped by surgeon-volume. Outcomes of interest were postoperative complications, ICU admission, readmission rate, inpatient hospital length of stay (LOS) and direct hospital cost. Average surgeon-volume per year was categorized as high (\u3e6) or low (16) based on the distribution of surgeon-volume. Results: 29,972 patients over age 18 were identified for inclusion. 25,426 underwent resection by high-volume surgeons (HVS) and 4,547 by low-volume surgeons (LVS). LVS were more likely to admit patients to the ICU than HVS (21% v 33%, p Conclusions: Surgeons who perform greater than 6 colectomies per year for colon cancer are more likely to use laparoscopy, less likely to admit patients to the ICU, have lower complication and readmission rates, and shorter LOS. Hospital cost is significantly lower in patients operated on by high volume surgeons. As health care costs continue to escalate and health care reform efforts gain momentum, factors leading to high-quality, cost-effective care need to be identified

AN INTEGRATED APPROACH FOR SIMULATION AND PREDICTION OF LAND USE AND LAND COVER CHANGES AND URBAN GROWTH (CASE STUDY: SANANDAJ CITY IN IRAN)

One of the growing areas in the west of Iran is Sanandaj city, the center of Kordestan province, which requires the investigation of the city's growth and the estimation of land degradation. Today, the combination of remote sensing data and spatial models is a useful tool for monitoring and modeling land use and land cover (LULC) changes. In this study, LULC changes and the impact of Sanandaj city growth on land degradation in geographical directions during the period 1989 to 2019 were investigated. Also, the accuracy of three models, artificial neural network-cellular automata (ANN-CA), logistic regression-cellular automata (LR-CA), and the weight of evidence-cellular automata (WOE-CA) for modeling LULC changes was evaluated, and the results of these models were compared with the CA-Markov model. According to the results of the study, ANN-CA, LR-CA, and WOE-CA models, with an accuracy of more than 80%, are efficient and effective for modeling LULC changes and growth of urban areas

Improving stamina and mobility with preop walking in surgical patients with frailty traits -OASIS IV: randomized clinical trial study protocol

BACKGROUND: Frail older surgical patients face more than a two-fold increase in postoperative complications, including myocardial infarction, deep vein thrombosis, pulmonary embolism, pneumonia, ileus, and others. Many of these complications occur because of postoperative loss of stamina and poor mobility. Preoperative exercise may better prepare these vulnerable patients for surgery. We present the protocol for our ongoing randomized trial to assess the impact of a preoperative walking intervention with remote coaching and pedometer on outcomes of stamina (six-minute walk distance- 6MWD) and mobility (postoperative steps) in older adults with frailty traits. METHODS: We will be conducting a randomized clinical trial with a total of 120 patients permitting up to a 33% rate of attrition, to reach a final sample size of 80 (with 40 patients for each study arm). We will include patients who are age 60 or higher, score 4 or greater on the Edmonton Frailty Scale assessment, and will be undergoing a surgical operation that requires a 2 or more night hospital stay to be eligible for our trial. Using block randomization stratified on baseline 6MWD, we will assign patients to wear a pedometer. At the end of three baseline days, an athletic trainer (AT) will provide a daily step count goal reflecting a 10-20% increase from baseline. Subsequently, the AT will call weekly to further titrate the goal or calls more frequently if the patient is not meeting the prescribed goal. Controls will receive general walking advice. Our main outcome is change in 6MWD on postoperative day (POD) 2/3 vs. baseline. We will also collect 6MWD approximately 4 weeks after surgery and daily in-hospital steps. CONCLUSION: If changes in a 6MWD and step counts are significantly higher for the intervention group, we believe this will confirm our hypothesis that the intervention leads to decreased loss of stamina and mobility. Once confirmed, we anticipate expanding to multiple centers to assess the interventional impact on clinical endpoints. TRIAL REGISTRATION: The randomized clinical trial was registered on clinicaltrials.gov under the identifier NCT03892187 on March 27, 2019