Causes and predictors of 30‐day readmission in patients with syncope/collapse: a nationwide cohort study

Background Syncope accounts for 0.6% to 1.5% of hospitalizations in the United States. We sought to determine the causes and predictors of 30‐day readmission in patients with syncope. Methods and Results We identified 323 250 encounters with a primary diagnosis of syncope/collapse in the 2013-2014 Nationwide Readmissions Database. We excluded patients younger than 18 years, those discharged in December, those who died during hospitalization, hospital transfers, and those whose length of stay was missing. We used multivariable logistic regression analysis to evaluate the association between baseline characteristics and 30‐day readmission. A total of 282 311 syncope admissions were included. The median age was 72 years (interquartile range, 58-83), 53.9% were women, and 9.3% had 30‐day readmission. The most common cause of 30‐day readmissions was syncope/collapse, followed by cardiac, neurological, and infectious causes. Characteristics associated with 30‐day readmissions were age 65 years and older (odds ratio [OR], 0.7; 95% confidence interval [CI], 0.6-0.7), female sex (OR, 0.9; 95% CI, 0.8-0.9), congestive heart failure (OR, 1.5; 95% CI, 1.2-1.9), atrial fibrillation/flutter (OR, 1.3; 95% CI, 1.3-1.4), diabetes mellitus (OR, 1.2; 95% CI, 1.2-1.3), coronary artery disease (OR, 1.2; 95% CI, 1.2-1.3), anemia (OR, 1.4; 95% CI, 1.4-1.5), chronic obstructive pulmonary disease (OR, 1.4; 95% CI, 1.3-1.4), home with home healthcare disposition (OR, 1.5; 95% CI, 1.5-1.6), leaving against medical advice (OR, 1.7; 95% CI, 1.6-1.9), length of stay of 3 to 5 days (OR, 1.5; 95% CI, 1.4-1.6) or >5 days (OR, 2; 95% CI, 1.8-2), and having private insurance (OR, 0.6; 95% CI, 0.6-0.7). Conclusions The 30‐day readmission rate after syncope/collapse was 9.3%. We identified causes and risk factors associated with readmission. Future prospective studies are needed to derive risk‐stratification models to reduce the high burden of readmissions.Revisión por pare

Stability-Indicating Reverse Phase HPLC Method for the Determination of Cefazolin

Purpose: The aim of the present study was to establish the inherent stability of cefazolin through stress studies under a variety of ICH recommended test conditions and, also to develop a stability indicatingassay. Methods: A stability-indicating HPLC assay method was developed and validated for cefazolin using an isocratic RP-HPLC method which employed an SS Wakosil II- C18 column (250 mm × 4.6 mm i.d., 5 μm) with a mobile phase consisting of phosphate buffer (pH 6.8) and methanol (5:2 v/v), and UV detection at 254 nm at a flow rate of 1 ml/min. The stress testing of cefazolin was carried out under acidic, alkaline, neutral, oxidation and thermal conditions. Results: The drug peak was well resolved from the peaks of the degradation products. The proposed method was validated for sensitivity, selectivity, linearity, accuracy, precision and solution stability. From the degradation studies it was found that the drug was thermally stable but unstable in acidic, alkaline, neutral and oxidative conditions. The response of drug was linear in the concentration Range of 1 - 50 μg/ml with the number of theoretical plates, and tailing factor being 1341 and 1, respectively. Limit of detection and limit of quantification were 0.1 and 0.2, μg/ml respectively while recovery ranged from 95 - 100%. Method precision and precision of the system were within the limits of acceptance criteria. Conclusion: This study presents a simple and validated stability-indicating HPLC method for the estimation of cefazolin in the presence of degradation products. The developed method is specific, accurate, precise and robust. All the degradation products formed during forced degradation studies were well separated from the analyte peak.Keywords: Cefazolin; Stability-indicating assay; Reversed-phase HPL

Species-Specific Effects of Woody Litter on Seedling Emergence and Growth of Herbaceous Plants

The effect of litter on seedling establishment can influence species richness in plant communities. The effect of litter depends on amount, and also on litter type, but relatively little is known about the species-specific effects of litter. We conducted a factorial greenhouse experiment to examine the effect of litter type, using two woody species that commonly co-occur in boreonemoral forest—evergreen spruce (Picea abies), deciduous hazel (Corylus avellana), and a mixture of the two species—and litter amount—shallow (4 mm), deep (12 mm) and leachate—on seedling emergence and biomass of three understorey species. The effect of litter amount on seedling emergence was highly dependent on litter type; while spruce needle litter had a significant negative effect that increased with depth, seedling emergence in the presence of hazel broadleaf litter did not differ from control pots containing no litter. Mixed litter of both species also had a negative effect on seedling emergence that was intermediate compared to the single-species treatments. Spruce litter had a marginally positive (shallow) or neutral effect (deep) on seedling biomass, while hazel and mixed litter treatments had significant positive effects on biomass that increased with depth. We found non-additive effects of litter mixtures on seedling biomass indicating that high quality hazel litter can reduce the negative effects of spruce. Hazel litter does not inhibit seedling emergence; it increases seedling growth, and creates better conditions for seedling growth in mixtures by reducing the suppressive effect of spruce litter, having a positive effect on understorey species richness

Neural Network Learning Algorithms for High-Precision Position Control and Drift Attenuation in Robotic Manipulators

In this paper, different learning methods based on Artificial Neural Networks (ANNs) are examined to replace the default speed controller for high-precision position control and drift attenuation in robotic manipulators. ANN learning methods including Levenberg–Marquardt and Bayesian Regression are implemented and compared using a UR5 robot with six degrees of freedom to improve trajectory tracking and minimize position error. Extensive simulation and experimental tests on the identification and control of the robot by means of the neural network controllers yield comparable results with respect to the classical controller, showing the feasibility of the proposed approach

Attitude and Myths Towards Rape among Medical Students in Rajkot, India

Background: Violence against women takes many forms – physical, sexual, psychological and economic. Violence against women harms families and communities across generations and reinforces other violence prevalent in society. Rape myths encompass a set of (false) beliefs about rape that places the blame on the victim and not the perpetrator. Objective: to assess the prevailing attitudes on rape myths among the medical students. Methods: The study was conducted after taking informed consent among 346 undergraduate medical students of P D U Government Medical College, Rajkot, India from January to June, 2013 by using previously validated questionnaire using updated Illinois Rape Myth Acceptance Scale. Results: The age range of 346 medical students was 17 to 23 years with 172 male and 174 female students. Total 24.4% male and 23% female students had very good positive attitude. One fourth of male and one fifth of female students had a more negative attitude. No relation was observed for rape myth acceptance among medical students for residential or socio-economic status. Conclusion: The present study provides insight to the prevalence of attitude and rape myths towards rape among medical students. Introduction of education on gender violence with introduction of courses on ‘sexual violence’ in medical curriculum may help to decrease rape incidence and for better management of victims

Effet de l’arbre Acacia senegal sur la fertilité des sols de gommeraies au Niger

Six gommeraies des trois bassins gommiers du Niger ont été étudiées : Kiki et Kokoiyé dans le bassin gommier occidental, Bader Goula et Azzaî dans le bassin gommier central et Malam Mainari et N’Guel Kolo dans le bassin gommier oriental. L’objectif de l’étude est d’évaluer l’effet d’Acacia senegal sur la fertilité des sols sous et hors houppiers dans ces gommeraies. Les résultats obtenus à travers les paramètres retenus (le pH, le carbone organique (C), l’azote (N), la capacité d’échange cationique (CEC), le phosphore assimilable (P) et la somme des bases échangeables (S) pour appréhender cet effet d’A. senegal sur le sol montrent une amélioration de la teneur en ces éléments dans le sol sous houppier comparativement aux témoins dans la plupart des cas.Mots clés : Acacia senegal, fertilité, sol, gommeraie, Nige

Defining the 5 and 3 landscape of the Drosophila transcriptome with Exo-seq and RNaseH-seq

Cells regulate biological responses in part through changes in transcription start sites (TSS) or cleavage and polyadenylation sites (PAS). To fully understand gene regulatory networks, it is therefore critical to accurately annotate cell type-specific TSS and PAS. Here we present a simple and straightforward approach for genome-wide annotation of 5- and 3-RNA ends. Our approach reliably discerns bona fide PAS from false PAS that arise due to internal poly(A) tracts, a common problem with current PAS annotation methods. We applied our methodology to study the impact of temperature on the Drosophila melanogaster head transcriptome. We found hundreds of previously unidentified TSS and PAS which revealed two interesting phenomena: first, genes with multiple PASs tend to harbor a motif near the most proximal PAS, which likely represents a new cleavage and polyadenylation signal. Second, motif analysis of promoters of genes affected by temperature suggested that boundary element association factor of 32 kDa (BEAF-32) and DREF mediates a transcriptional program at warm temperatures, a result we validated in a fly line where beaf-32 is downregulated. These results demonstrate the utility of a high-throughput platform for complete experimental and computational analysis of mRNA-ends to improve gene annotation

Bronchiectasis-associated infections and outcomes in a large, geographically diverse electronic health record cohort in the United States

BACKGROUND: Bronchiectasis is a pulmonary disease characterized by irreversible dilation of the bronchi and recurring respiratory infections. Few studies have described the microbiology and prevalence of infections in large patient populations outside of specialized tertiary care centers.METHODS: We used the Cerner HealthFacts Electronic Health Record database to characterize the nature, burden, and frequency of pulmonary infections among persons with bronchiectasis. Chronic infections were defined based on organism-specific guidelines.RESULTS: We identified 7,749 patients who met our incident bronchiectasis case definition. In this study population, the organisms with the highest rates of isolate prevalence were Pseudomonas aeruginosa with 937 (12%) individuals, Staphylococcus aureus with 502 (6%), Mycobacterium avium complex (MAC) with 336 (4%), and Aspergillus sp. with 288 (4%). Among persons with at least one isolate of each respective pathogen, 219 (23%) met criteria for chronic P. aeruginosa colonization, 74 (15%) met criteria for S. aureus chronic colonization, 101 (30%) met criteria for MAC chronic infection, and 50 (17%) met criteria for Aspergillus sp. chronic infection. Of 5,795 persons with at least two years of observation, 1,860 (32%) had a bronchiectasis exacerbation and 3,462 (60%) were hospitalized within two years of bronchiectasis diagnoses. Among patients with chronic respiratory infections, the two-year occurrence of exacerbations was 53% and for hospitalizations was 82%.CONCLUSIONS: Patients with bronchiectasis experiencing chronic respiratory infections have high rates of hospitalization.</p

Padronização das técnicas de processamento e extração de RNA viral de amostras de sêmen caprino.

O sêmen se mostrou uma amostra adequada para a detecção de RNA genômico do vírus da artrite-encefalite caprina; As sucessivas lavagens com PBS estéril foram eficientes para a retirada do fluido seminal do restante dos componentes celulares; A incubação do sêmen fresco a 60°C por 30 minutos, após a homogenização em solução denaturante, foi eficiente para a dissolução protéica e inibição de Rnases, sendo adequada para iniciar o protocolo de extração de RNA viral de amostras de sêmen

A Time-Varied Probabilistic ON/OFF Switching Algorithm for Cellular Networks

In this letter, we develop a time-varied probabilistic on/off switching planning method for cellular networks to reduce their energy consumption. It consists in a risk-aware optimization approach that takes into consideration the randomness of the user profile associated with each base station (BS). The proposed approach jointly determines 1) the instants of time at which the current active BS configuration must be updated due to an increase or decrease of the network traffic load and 2) the set of minimum BSs to be activated to serve the networks’ subscribers. Probabilistic metrics modeling the traffic profile variation are developed to trigger this dynamic on/off switching operation. Selected simulation results are then performed to validate the proposed algorithm for different system parameters