Lack of patient involvement in care decisions and not receiving written discharge instructions are associated with unplanned readmissions up to one year

This retrospective, cross-sectional study examined the relationship between aspects of inpatient communication and discharge instructions and unplanned, all-cause readmissions using individual-level data up to one-year post-discharge. Patients completed the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) telephone survey within 6 weeks of hospital discharge in Alberta, Canada. Survey data were linked to corresponding inpatient records. Independent variables included selected demographic characteristics, clinical variables, and five survey questions: a) patient involvement in care decisions, b) receiving written information at discharge, c) understanding the purpose of taking medications, d) understanding responsibility for one’s health, and e) discussing help needed when returning home. From April 2011 to March 2014, 24,869 patients with a mean age of 52.8±19.8 years (range=18-100) were included. 18.6% of patients (n=4,821) experienced an unplanned hospital readmission within 43 to 365 days post-discharge. In adjusted, logistic regression models, patients who felt they were not involved in care decisions were more likely to be readmitted (OR=1.34; 95%CI: 1.17-1.53), as were patients who reported not receiving written information about signs and symptoms to watch out for post-discharge (OR=1.24; 95%CI: 1.15-1.35). Odds of readmission did not differ according to understanding of medications, understanding responsibility for one’s health, or discussion of help needed when returning home. This study provides objective data, showing that specific hospital actions are associated with unplanned readmissions. It is an example of how patient-reported measures may be linked to administrative data to drive quality improvement initiatives

Synthesis and electrochemical study of new 3-(hydroxyphenyl)benzo[f]coumarins

New hydroxyl substituted 3-arylbenzo[f]coumarins (compounds 6–10) have been designed and synthesized. Their electrochemical redox mechanisms, and the influence of one or two hydroxyl groups, in different positions on the coumarin scaffold, was investigated by cyclic, differential pulse and square wave voltammetry, at a glassy carbon electrode, at different pHs, and a comparative study was performed. The structural information obtained enabled a better understanding of the structure/electrochemical relationship of hydroxyl substituted 3-arylbenzo[f]coumarins, compounds with important antioxidant properties

Sheets of branched poly(lactic acid) obtained by one step reactive extrusion calendering process: Melt rheology analysis

One-step reactive extrusion-calendering process (REX-Calendering) was used in order to obtain sheets of 1mm from two PD,L-LA extrusion grades modified with a styrene-acrylic multifunctional oligomeric agent. In a preliminary internal mixer study, torque versus time was monitored in order to determine chain extender ratios and reaction time. Once all parameters were optimized, reactive extrusion experiments were performed. Independently of the processing method employed, under the same processing conditions, PD,L-LA with the lower D enantiomer molar content revealed a higher reactivity towards the reactive agent, induced by its higher thermal sensitivity. REXCalendering process seemed to minimize the degradations reactions during processing, although a competition between degradation and chain extension/branching reactions took place in both processes. Finally, the rheological characterization revealed a higher degree of modification in the melt rheological behaviour for REX-Calendered samples

The component of Carica papaya seed toxic to A-aegypti and the identification of tegupain, the enzyme that generates it

As Aedes aegypti transmits the etiologic agents of both yellow and dengue fever; vector control is considered essential to minimise their incidence. the aim of this work was to identify the component of Carica papaya seed toxic to A. aegypti, and the identification of tegupain, the enzyme that generates it. Aqueous extracts (1%, w/v) of the seed tegument and cotyledon of C. papaya are not larvicidal isolately. However, a mixture of 17 mu g mL(-1) tegument extract and 27 mu g mL(-1) cotyledon extract caused 100% larval mortality in a bioassay. the mixture was no longer larvicidal after the tegument extract was pre-treated at 100 degrees C for 10 min. the enzyme tegupain efficiently hydrolysed the substrate Z-Phe-Arg-pNan (K-m 58.8 mu M, K-cat 28020 s(-1), K-cat/K-m 5 x 10(8) M-1 s(-1)), and its activity increased with 2 mM dithiothreitol (DTT), at 37 degrees C, pH 5.0. the chelating agent EDTA did not modify the enzyme activity. Inhibition of tegupain by cystatin (K-iapp 2.43 nM), E64 (3.64 nM, 83% inhibition), and the propeptide N-terminal sequence indicate that the toxic activity is due to a novel cysteine proteinase-like enzyme, rendered active upon the hydrolysis of a cotyledon component of C. papaya seeds. (c) 2013 Elsevier B.V. All rights reserved.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Universidade Federal de São Paulo, Dept Bioquim, BR-04044020 São Paulo, BrazilUniv Estadual Norte Fluminense, Biotechnol Lab, Campos Dos Goytacazes, RJ, BrazilUniversidade Federal de São Paulo, Dept Bioquim, BR-04044020 São Paulo, BrazilFAPESP: 2009/17058-6FAPESP: 2009/53766-5Web of Scienc

Genomic differentiation among varieties of Iberian pig

[EN] Aim of study: The objective of this study was to identify the autosomal genomic regions associated with genetic differentiation between three commercial strains of Iberian pig. Area of study: Extremadura (Spain). Material and methods: We used the Porcine v2 BeadChip to genotype 349 individuals from three varieties of Iberian pig (EE, Entrepelado; RR, Retinto; and TT, Torbiscal) and their crosses. After standard filtering of the Single Nucleotide Polymorphism (SNP) markers, 47, 67, and 123 haplotypic phases from EE, RR, and TT origins were identified. The allelic frequencies of 31,180 SNP markers were used to calculate the fixation index (FST) that were averaged in sliding windows of 2Mb. Main results: The results confirmed the greater genetic closeness of the EE and RR varieties, and we were able to identify several genomic regions with a divergence greater than expected. The genes present in those genomic regions were used to perform an Overrepresentation Enrichment Analysis (ORA) for the Gene Ontology (GO) terms for biological process. The ORA indicated that several groups of biological processes were overrepresented: a large group involving morphogenesis and development, and others associated with neurogenesis, cellular responses, or metabolic processes. These results were reinforced by the presence of some genes within the genomic regions that had the highest genomic differentiation. Research highlights: The genomic differentiation among varieties of the Iberian pig is heterogeneous along the genome. The genomic regions with the highest differentiation contain an overrepresentation of genes related with morphogenesis and development, neurogenesis, cellular responses and metabolic processes.Instituto Nacional de Investigacion y Tecnologia Agraria y Alimentaria (INIA), Spain RTA2012-00054-C02-01 Ministry of Science, Innovation and Universities, Spain CGL2016-80155-R; IDI-20170304 (CDTI)Alonso, I.; Ibáñez-Escriche, N.; Noguera, JL.; Casellas, J.; Martin De Hijas-Villalba, M.; Gracia-Santana, MJ.; Varona, L. (2020). Genomic differentiation among varieties of Iberian pig. Spanish Journal of Agricultural Research (Online). 18(1):1-20. https://doi.org/10.5424/sjar/2020181-15411120181Alexander DH, Novembre J, Lange K, 2009. Fast model-based estimation of ancestry in unrelated individuals. Genome Res 19: 1655-1664.Audetat KA, Galbraith MD, Odell AT, Lee T, Pandey A, Espinosa JM, Dowell RD, Taatjes D J, 2017. A kinase-independent role for cyclin-dependent kinase 19 in p53 response. 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Thermal and structural analysis of 4,5,6-trimethoxyisatin

4,5,6-Trimethoxyisatin was crystallized from water to give dark red needles that were characterized by NMR and IR spectroscopy, differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), single-crystal X-ray diffraction (XRD) and hot-stage microscopy.Fundação para a Ciência e a Tecnologia (FCT) - POCTISFA-3-686Fundo Europeu de Desenvolvimento Regional (FEDER

IP3R-driven increases in mitochondrial Ca2+ promote neuronal death in NPC disease

Ca2+ is the most ubiquitous second messenger in neurons whose spatial and temporal elevations are tightly controlled to initiate and orchestrate diverse intracellular signaling cascades. Numerous neuropathologies result from mutations or alterations in Ca2+ handling proteins; thus, elucidating molecular pathways that shape Ca2+ signaling is imperative. Here, we report that loss-of-function, knockout, or neurodegenerative disease-causing mutations in the lysosomal cholesterol transporter, Niemann-Pick Type C1 (NPC1), initiate a damaging signaling cascade that alters the expression and nanoscale distribution of IP3R type 1 (IP3R1) in endoplasmic reticulum membranes. These alterations detrimentally increase Gq-protein coupled receptor-stimulated Ca2+ release and spontaneous IP3R1 Ca2+ activity, leading to mitochondrial Ca2+ cytotoxicity. Mechanistically, we find that SREBP-dependent increases in Presenilin 1 (PS1) underlie functional and expressional changes in IP3R1. Accordingly, expression of PS1 mutants recapitulate, while PS1 knockout abrogates Ca2+ phenotypes. These data present a signaling axis that links the NPC1 lysosomal cholesterol transporter to the damaging redistribution and activity of IP3R1 that precipitates cell death in NPC1 disease and suggests that NPC1 is a nanostructural disease

Health related quality of life during dialysis modality transitions: a qualitative study

Abstract Background Modality transitions represent a period of significant change that can impact health related quality of life (HRQoL). We explored the HRQoL of adults transitioning to new or different dialysis modalities. Methods We recruited eligible adults (≥ 18) transitioning to dialysis from pre-dialysis or undertaking a dialysis modality change between July and September 2017. Nineteen participants (9 incident and 10 prevalent dialysis patients) completed the KDQOL-36 survey at time of transition and three months later. Fifteen participants undertook a semi-structured interview at three months. Qualitative data were thematically analyzed. Results Four themes and five sub-themes were identified: adapting to new circumstances (tackling change, accepting change), adjusting together, trading off, and challenges of chronicity (the impact of dialysis, living with a complex disease, planning with uncertainty). From the first day of dialysis treatment to the third month on a new dialysis therapy, all five HRQoL domains from the KDQOL-36 (symptoms, effects, burden, overall PCS, and overall MCS) improved in our sample (i.e., those who remained on the modality). Conclusions Dialysis transitions negatively impact the HRQoL of people with kidney disease in various ways. Future work should focus on how to best support people during this time