Elder mistreatment : a case report

Elder mistreatment may become increasingly apparent as the elderly population continues to grow. Due to their knowledge and skills, physicians have a unique role in the multidisciplinary teams that care for such patients. This case report examines the suspected elder mistreatment in an aphasic, septic patient under the care of family members, one of which was also his medical decision maker. The healthcare team utilized medical and community resources in the care and intervention, which exemplified characteristics of best practice. Physicians and other providers have a responsibility to better identify and intervene in suspected cases of elder mistreatment and further education must be sought in order to adequately serve the elderly community.Emil Thyssen (1), Julia Halsey (2); 1. University of Missouri School of Medicine ; 2. Division of Hospital Medicine, Department of Medicine, University of Missouri, Columbia, MissouriIncludes bibliographical reference

A multicenter study investigating factors that influence initiation of return to sport functional testing following ACL reconstruction

Despite advances in surgical technique and rehabilitation following anterior cruciate ligament (ACL) reconstruction, re-injury rates after return to play (RTP) are high. There remains controversy over the most effective criteria utilized to initiate RTP functional testing following ACL reconstruction. The purpose of this study is to investigate factors that influence provider decision to initiate RTP functional testing

Functionalizing Arrays of Transferred Monolayer Graphene on Insulating Surfaces by Bipolar Electrochemistry

Development of versatile methods for graphene functionalization is necessary before use in applications such as composites or as catalyst support. In this study, bipolar electrochemistry is used as a wireless functionalization method to graft 4-bromobenzenediazonium on large (10 × 10 mm²) monolayer graphene sheets supported on SiO₂. Using this technique, transferred graphene can be electrochemically functionalized without the need of a metal support or the deposition of physical contacts. X-ray photoelectron spectroscopy and Raman spectroscopy are used to map the chemical changes and modifications of graphene across the individual sheets. Interestingly, the defect density is similar between samples, independent of driving potential, whereas the grafting density is increased upon increasing the driving potential. It is observed that the 2D nature of the electrode influences the electrochemistry and stability of the electrode compared to conventional electrografting using a three-electrode setup. On one side, the graphene will be blocked by the attached organic film, but the conductivity is also altered upon functionalization, which makes the graphene electrode different from a normal metal electrode. Furthermore, it is shown that it is possible to simultaneously modify an array of many small graphene electrodes (1 × 1 mm²) on SiO₂

Association between sustained virological response and clinical outcomes in patients with hepatitis C infection and hepatocellular carcinoma

BACKGROUND: Sustained viral response (SVR) improves survival for patients with hepatitis C (HCV) and hepatocellular carcinoma (HCC) after curative treatment; however, the benefit of SVR in those with active HCC with a significant competing risk of mortality is unknown. This study aimed to evaluate the association between SVR and outcomes in patients with active HCC. METHODS: The authors performed a multicenter, retrospective cohort study including consecutive adults with HCV cirrhosis and treatment-naive HCC diagnosed between 2014 and 2018. Patients were stratified into two groups: active viremia (n = 431) and SVR before HCC diagnosis (n = 135). All patients underwent nonsurgical therapy as their initial treatment and were followed until liver transplantation, last follow-up, or death. The primary outcome was incident or worsening hepatic decompensation within 6 months and the secondary outcome was overall survival. All analyses used inverse probability of treatment weights (IPTW) to account for differences between the nonrandomized cohorts. RESULTS: Post-SVR patients had significantly lower odds of hepatic decompensation compared to viremic patients (odds ratio [OR], 0.18; 95% confidence interval [CI], 0.06-0.59). Results were consistent among subgroups of patients with Child Pugh A cirrhosis (OR, 0.22; 95% CI, 0.04-0.77), Barcelona Clinic Liver Cancer stage B/C HCC (OR, 0.20; 95% CI, 0.04-0.65), and those receiving nonablative HCC therapies (OR, 0.21; 95% CI, 0.07-0.67). However, in IPTW multivariable Cox regression, SVR was not associated with improved survival (hazard ratio, 0.79; 95% CI, 0.56-1.12). CONCLUSIONS: Patients with HCV-related HCC and SVR are less likely to experience hepatic decompensation than viremic patients, suggesting patients with HCC who are undergoing nonsurgical therapies may benefit from DAA treatment