Decreasing Mortality and Hospitalizations with Rising Costs Related to Gastric Cancer in the USA: An Epidemiological Perspective

BACKGROUND: There is no convincing data on the trends of hospitalizations, mortality, cost, and demographic variations associated with inpatient admissions for gastric cancer in the USA. The aim of this study was to use a national database of US hospitals to evaluate the trends associated with gastric cancer. METHODS: We analyzed the National Inpatient Sample (NIS) database for all patients in whom gastric cancer (ICD-9 code: 151.0, 151.1, 151.2, 151.3, 151.4, 151.5, 151.6, 151.8, 151.9) was the principal discharge diagnosis during the period, 2003-2014. The NIS is the largest publicly available all-payer inpatient care database in the US. It contains data from approximately eight million hospital stays each year. The statistical significance of the difference in the number of hospital discharges, length of stay, and hospital costs over the study period was determined by regression analysis. RESULTS: In 2003, there were 23,921 admissions with a principal discharge diagnosis of gastric cancer as compared to 21,540 in 2014 (P \u3c 0.01). The mean length of stay for gastric cancer decreased by 17% between 2003 and 2014 from 10.9 days to 8.95 days (P \u3c 0.01). However, during this period, the mean hospital charges increased significantly by 21% from $75,341 per patient in 2003 to$ 91,385 per patient in 2014 (P \u3c 0.001). There was a more significant reduction in mortality over a period of 11 years from 2428 (10.15%) in 2003 to 1345 (6.24%) in 2014 (P \u3c 0.01). The aggregate charges (i.e., national bill ) for gastric cancer increased significantly from 1.79 bn $to 1. 96 bn$ (P \u3c 0.001), despite decrease in hospitalization (inflation adjusted). CONCLUSION: Although the number of inpatient admissions for gastric cancer have decreased over the past decade, the healthcare burden and cost related to it has increased significantly. Inpatient mortality is decreasing which is consistent with overall decrease in gastric cancer-related deaths. Cost increase associated with gastric cancer contributed significantly to the national healthcare bill

The Design and Synthesis of New Materials using Nucleophilic Aromatic Substitution Reactions

Abstract The overall objective of this research was to synthesize and study the structure-property relationships of novel polycyclic aromatic compounds capable of producing open crystalline networks based on π-stacking interactions in solid state. In this work, we describe a method of producing polycyclic aromatic compounds bearing electron-rich and electron-poor rings in order to promote cofacial π-stacking in the solid state. These compounds were synthesized from easily accessible molecules using nucleophilic aromatic substitution and copper-catalyzed aryl amination. The scope of phenoxazines bearing N-aryl substituents was explored for the synthesis of various polycyclic aromatic compounds. Interesting characteristics such as luminescence and predictable solid-state packing are displayed by electron-deficient phenoxazines. A focus was placed upon tuning the properties of the compounds by attaching phenoxazine units to different molecular architectures with the goal of producing open crystalline networks based on π-stacking interactions. The orange-colored solid compound 30 N-(4-bromophenyl) di-fluoro-di-cyano-phenoxazine was synthesized. Suzuki cross-coupling was used to attach an additional phenyl ring to compound 30 to produce compound 31. Similarly, compound 32 was synthesized by the reaction of 1, 4- benzenediboronic acid with two equivalents of compound 30. The crystal structure of compound 31revealed the presence of π-stacking interactions between the phenoxazine rings. The synthetic approach was extended to the preparation of heteropentacenes such as 52 and 58. Compound 52, which bears long alkyl chains, showed evidence of liquid crystallinity by polarized optical microscopy. However, the N-aryl heteropentacenes also showed limited stability

Decreasing mortality and hospitalizations with rising costs related to gastric cancer in the USA: an epidemiological perspective

Abstract Background There is no convincing data on the trends of hospitalizations, mortality, cost, and demographic variations associated with inpatient admissions for gastric cancer in the USA. The aim of this study was to use a national database of US hospitals to evaluate the trends associated with gastric cancer. Methods We analyzed the National Inpatient Sample (NIS) database for all patients in whom gastric cancer (ICD-9 code: 151.0, 151.1, 151.2, 151.3, 151.4, 151.5, 151.6, 151.8, 151.9) was the principal discharge diagnosis during the period, 2003–2014. The NIS is the largest publicly available all-payer inpatient care database in the US. It contains data from approximately eight million hospital stays each year. The statistical significance of the difference in the number of hospital discharges, length of stay, and hospital costs over the study period was determined by regression analysis. Results In 2003, there were 23,921 admissions with a principal discharge diagnosis of gastric cancer as compared to 21,540 in 2014 (P < 0.01). The mean length of stay for gastric cancer decreased by 17% between 2003 and 2014 from 10.9 days to 8.95 days (P < 0.01). However, during this period, the mean hospital charges increased significantly by 21% from $75,341 per patient in 2003 to$ 91,385 per patient in 2014 (P < 0.001). There was a more significant reduction in mortality over a period of 11 years from 2428 (10.15%) in 2003 to 1345 (6.24%) in 2014 (P < 0.01). The aggregate charges (i.e., “national bill”) for gastric cancer increased significantly from 1.79 bn $to 1. 96 bn$ (P < 0.001), despite decrease in hospitalization (inflation adjusted). Conclusion Although the number of inpatient admissions for gastric cancer have decreased over the past decade, the healthcare burden and cost related to it has increased significantly. Inpatient mortality is decreasing which is consistent with overall decrease in gastric cancer-related deaths. Cost increase associated with gastric cancer contributed significantly to the national healthcare bill