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

Observation of chi_c2 Production in B-meson Decay

We report the first observation of chi_c2 production in B-meson decays. We find an inclusive B -> chi_c2 X branching fraction of (1.80^{+0.23}_{-0.28}+/- 0.26) 10^-3. The data set, collected with the Belle detector at the KEKB e^+e^- collider, consists of 31.9 million B\bar B events. We also present branching fractions and momentum spectra for both chi_c1 and chi_c2 production.Comment: 5 pages with 2 figure

Observation of Mixing-induced CP Violation in the Neutral B Meson System

This report describes an observation of mixing-induced CP violation and a measurement of the CP violation parameter, sin(2phi_1), with the Belle detector at the KEKB asymmetric e+e- collider. Using a data sample of 29.1 fb-1 recorded on the Upsilon(4S) resonance that contains 31.3 million BBbar pairs, we reconstruct decays of neutral B mesons to the following CP eigenstates: J/psi K_S^0, psi(2S) K_S^0, chi_c1 K_S^0, eta_c K_S^0, J/psi K_L^0 and J/psi K^*0. The flavor of the accompanying B meson is identified by combining information from primary and secondary leptons, K+/- mesons, lambda baryons, slow and fast pions. The proper-time interval between the two B meson decays is determined from the distance between the two decay vertices measured with a silicon vertex detector. The result sin(2phi_1) = 0.99 +/- 0.14(stat) +/- 0.06(syst) is obtained by applying a maximum likelihood fit to the 1137 candidate events. We conclude that there is large CP violation in the neutral B meson system. A zero value for sin(2phi_1) is ruled out by more than six standard deviations.Comment: 25 pages, 16 figures, accepted for publication in Physical Review

Measurement of B0d - B0d-bar mixing rate from the time evolution of dilepton events at the Upsilon(4S)

We report a determination of the B0d - B0d-bar mixing parameter Delta-m_d based on the time evolution of dilepton yields in Upsilon(4S) decays. The measurement is based on a 5.9 /fb data sample collected by the Belle detector at KEKB. The proper-time difference distributions for same-sign and opposite-sign dilepton events are simultaneously fitted to an expression containing Delta-m_d as a free parameter. Using both muons and electrons, we obtain Delta-m_d = 0.463 +- 0.008(stat.) +- 0.016(sys.) ps^{-1} This is the first determination of Delta-m_d from time evolution measurements at the Upsilon(4S). We also place limits on possible CPT violations.Comment: 12 pages, 2 figure

Major and minor fisheries harbours of India. 8. Fisherries harbours along the coasts of North Andhra Pradesh, Orissa and West Bengal

The present account gives information about the three major and five minor fisheries harbours along the coasts of north Andhra Pradesh, Orissa and West Benga

Measurement of Inclusive Production of Neutral Pions from Upsilon(4S) Decays

Using the Belle detector operating at the KEKB e+e- storage ring, we have measured the mean multiplicity and the momentum spectrum of neutral pions from the decays of the Upsilon(4S) resonance. We measure a mean of 4.70 +/- 0.04 +/- 0.22 neutral pions per Upsilon(4S) decay.Comment: 15 pages, 4 figs. Submitted to Phys.Rev.

Precise Measurement of B Meson Lifetimes with Hadronic Decay Final States

The lifetimes of the B0bar and B- mesons are extracted from 29.1/fb of data collected with the Belle detector at the KEK B-factory. A fit to the decay length differences of neutral and charged B meson pairs, measured in events where one of the B mesons is fully reconstructed in several hadronic modes, yields tau_B0bar = 1.554 +/- 0.030(stat) +/- 0.019(syst) ps, tau_B- = 1.695 +/- 0.026(stat) +/- 0.015(syst) ps, and tau_B-/tau_B0bar = 1.091 +/- 0.023(stat) +/- 0.014(syst).Comment: 10 pages, 2 figures, and 1 table. (To be) published in Phys. Rev. Let

Search for Direct CP Violation in B -> K pi Decays

We search for direct CP violation in flavor specific B -> K pi decays by measuring the rate asymmetry between charge conjugate modes. The search is performed on a data sample of 11.1 million B B bar events recorded on the Upsilon(4S) resonance by the Belle experiment at KEKB. We measure 90% confidence intervals in the partial rate asymmetry A_CP of -0.25 < A_CP(K-/+ pi+/-) < 0.37, -0.40 < A_CP(K-/+ pi^0) < 0.36, and -0.53 < A_CP(K^0 pi-/+) < 0.82. By combining the K-/+ pi+/- and K-/+ pi^0 final states, we conclude that -0.22 < A_CP[K-/+(pi+/- + pi^0)] < 0.25 at the 90% confidence level.Comment: Submitted to PRD Rapid Communication