Background and aim
Since individuals in the early stages of liver cirrhosis are typically asymptomatic, the prevalence of liver cirrhosis may be underestimated. Liver cirrhosis has a significant ...morbidity and mortality rate, with 1.03 million deaths worldwide each year. For end-stage liver disease, liver transplantation is a potential therapeutic option. The goal of our research was to examine the current trend in liver transplants using data from a national database.
Methods
Using the International Classification of Diseases (ICD)-9 codes, we identified individuals who had a liver transplant during the index hospital admission in the Nationwide Inpatient Sample from 2007 to 2011. This national sample of patients is from the United States. We looked at the yearly trend in liver transplants and related outcomes, such as duration of hospitalization (DOH), hospital expenses, and mortality in the hospital. In order to find determinants of mortality, we used a multivariate analysis.
Results
There were 25,331 patients hospitalized (weighted for national estimate). Between 2007 and 2011, the number of transplants grew by 1.2%. The majority of transplant recipients were Caucasian (57%), with an average age of 54 years, had a private healthcare plan (53%), and had average earnings in the upper quartile by zip code (26%). Patients with a higher Charlson Comorbidity Index (79% had a score of four) were more likely to be admitted to a southern hospital (33%), an academic hospital (>99%), and a large capacity hospital (90%). Seventy percent of liver transplant recipients received cadaver donors. Hepatitis C was the most prevalent reason for transplant (30%), followed by hepatocellular carcinoma (HCC) (29%) and alcoholic liver disease (25%). In 2011, compared to 2007, there was an upward rise in fatality (from 3.8% to 5.1%), average hospital expenditures (from $335,504 to $498,369), and DOH (from 17.4 to 22.7 days). The cost of hospitalization was two billion dollars per year. The independent variables related to an increased mortality on multivariate analysis were African American race (OR: 2.0, 95%, CI: 1.2-3.2; p=0.005) and large capacity hospitals (OR: 2.5, 95% CI: 1.6-4.1; p=0.0002). Predictors linked to lower mortality included private healthcare coverage (vs. Medicare: OR: 0.7, 95%, CI: 0.51-0.97; p=0.03), academic hospital (OR: 0.6, 95% CI: 0.4-0.8; p=0.005), cadaver donor (OR: 0.6, 95% CI: 0.5-0.8; p=0.002), HCC (OR: 0.6, 95% CI: 0.4-0.9; p=0.01), and non-alcoholic steatohepatitis (NASH) cirrhosis (OR: 0.4, 95% CI: 0.2-0.9; p=0.02).
Conclusion
Our study found an increasing trend in worse outcomes (increased mortality, average hospital costs, and average DOH) after a liver transplant. Patients of the African American race and large capacity hospitals were associated with a higher risk of death, whereas private healthcare plans, academic hospitals, cadaver donors, HCC, and NASH cirrhosis were associated with a lower risk.
Dentures with antimicrobial properties are desirable for preventing Candida albicans adhesion. This study was to assess the effectiveness of bioactive glass (BAG) on C. albicans adhesion, surface ...roughness, and hardness of denture base materials.
Heat-polymerized (HP) and autopolymerized (AP) acrylic resins were used to fabricate 240 disk specimens (120/material, 60/C. albicans, 60/surface roughness and hardness). Specimens were divided into five groups (n = 10) based on the BAG concentration: 0.5, 1.5, 3, 5, and 7.5 wt% of the acrylic powder, with a control group comprised of unmodified specimens. Direct culture method was used to assess C. albicans adhesion. A profilometer and Vickers hardness test were used to measure surface roughness and hardness respectively. Analysis of variance (ANOVA) and post hoc Tukey’s test were used for data analysis (α = 0.05).
BAG addition significantly decreased the C. albicans count when compared with the control group (P < 0.001) for both HP and AP. Regarding surface roughness, there was no change in the HP acrylic resins (P> 0.05), while the AP acrylic resins exhibited significantly higher surface roughness with BAG addition (P < 0.001). The hardness of the HP and AP acrylic resins were significantly higher with the addition of BAG (P < 0.001).
The addition of BAG to HP and AP acrylic resins effectively decreases C. albicans adhesion. The roughness of AP acrylic resins increases with the addition of BAG, while the hardness of both HP and AP acrylic resins increase with the addition of BAG.
We present a detailed investigation on the effects of water diffusion at the different interfaces of gold-graphene plasmonic sensors on the propagation of the supported surface plasmon polaritons ...(SPPs). The substrate/metal interfacial chemical reactions are investigated by monitoring the full width at half-maximum of the SPR reflectivity curve. Although protection by single-layer graphene (SLG) grown by chemical vapor deposition inhibits the chemical reactions happening at the metal-dielectric interfaces, SPR experimental results confirm that water diffusion paths through the borders of graphene domains are still present into the plasmonic sensors. Density functional theory calculations show that the doping level of SLG after the transfer on gold as well as interfacial charge transfer can be tuned in the presence of water molecules. On these bases, we propose a simplified effective medium approach for heterogeneous metal-carbon interfaces, where the interaction between the surface atomic layers of the gold thin film, water molecules, and the SLG induces the creation of an extended charge density difference region crossing the Au/H2O/SLG/H2O heterointerface. The latter is modeled as an ultrathin effective medium with a thickness and extraordinary optical susceptivity and conductivity that are different from those of the free-standing graphene. In this context, the extraordinary refractive index and thickness of the graphene-gold effective medium are measured in the near-infrared on the low-damping SPR platforms by applying the two-medium SPR method. The results are coherent with graphene n-doping in water environment, showing that the optically excited electrons along the extraordinary axis have a substantial bonding character and that the enhancement of the sensitivity of the gold-graphene plasmonic sensors is not related to a shift in the plasma frequency of the metal layer but to the changes in the extraordinary polarizability of graphene. The research highlights the importance of the SLG-substrate and SLG-environment interactions in graphene-protected plasmonics and optoelectronics.
We present a detailed investigation on the effects of water diffusion at the different interfaces of gold–graphene plasmonic sensors on the propagation of the supported surface plasmon polaritons ...(SPPs). The substrate/metal interfacial chemical reactions are investigated by monitoring the full width at half-maximum of the SPR reflectivity curve. Although protection by single-layer graphene (SLG) grown by chemical vapor deposition inhibits the chemical reactions happening at the metal–dielectric interfaces, SPR experimental results confirm that water diffusion paths through the borders of graphene domains are still present into the plasmonic sensors. Density functional theory calculations show that the doping level of SLG after the transfer on gold as well as interfacial charge transfer can be tuned in the presence of water molecules. On these bases, we propose a simplified effective medium approach for heterogeneous metal–carbon interfaces, where the interaction between the surface atomic layers of the gold thin film, water molecules, and the SLG induces the creation of an extended charge density difference region crossing the Au/H2O/SLG/H2O heterointerface. The latter is modeled as an ultrathin effective medium with a thickness and extraordinary optical susceptivity and conductivity that are different from those of the free-standing graphene. In this context, the extraordinary refractive index and thickness of the graphene–gold effective medium are measured in the near-infrared on the low-damping SPR platforms by applying the two-medium SPR method. The results are coherent with graphene n-doping in water environment, showing that the optically excited electrons along the extraordinary axis have a substantial bonding character and that the enhancement of the sensitivity of the gold–graphene plasmonic sensors is not related to a shift in the plasma frequency of the metal layer but to the changes in the extraordinary polarizability of graphene. The research highlights the importance of the SLG–substrate and SLG–environment interactions in graphene-protected plasmonics and optoelectronics.
Single Carrier Transmission (SCT) is a competing technique for Orthogonal Frequency Division Multiplexing (OFDM) in Broadband Wireless Systems (BWS). Recent developments in Frequency Domain ...Equalization (FDE) using Decision Feedback Equalization (DFE) have greatly improved the system based on the SC technique, this caused SC-DFE to be selected as a candidate technique for the forthcoming BWS. This paper concentrates the growth of DFE design from scratch till its present form used in SCT and thus restricts our survey to the development of DFE for SCT. A new SCT-DFE modified model is also presented and compared with OFDM, both simulated for WLAN system. This presented equalizer structure performs better than OFDM and improves its performance when the number of iterations is increased. SC-LE and SC-DFE both supersede the performance of OFDM.
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