Holmium enucleation of the prostate (HoLEP) is becoming the gold standard for the treatment of benign prostatic hyperplasia (BPH). Our objective was to identify predictors of 30-day readmission and ...the impact of same-day discharge after HoLEP.
Using NSQIP data from 2011 to 2019, we identified men who underwent HoLEP for the treatment of BPH. We compared patients based on time of discharge and readmission status. We used multivariable logistic regression analysis (MLRA) to identify independent factors associated with 30-day readmission.
A total of 3,489 patients met inclusion criteria with 833 (23.88%) being discharged within 24 hours and 2,656 (76.12%) discharged after 24 hours. There were 158 (4.53%) 30-day readmissions, mostly due to hematuria and urinary tract infection. Patients being readmitted were older (72 vs. 70 years old, P = 0.001), were more likely to have preoperative anemia (36.7% vs. 23.1%; P < 0.001), chronic kidney disease (29.7% vs. 19.7%; P < 0.001), bleeding disorder (10.8% vs. 2.8%; P < 0.001), higher American Society of Anesthesiologists (ASA) scores (≥3: 70.3% vs. 46.7%; P < 0.001) and a higher frailty burden (5-item modified frailty index 5i-mFI ≥ 2: 36.1% vs. 19.1%; P < 0.001) compared to their counterparts. Factors independently associated with 30-day readmission were bleeding disorder (OR 2.89; 95% CI 1.63–5.11; P < 0.001), 5i-mFI ≥ 2 (OR 1.67; 95% CI 1.03–2.71; P = 0.038) and an ASA score ≥3 (OR 1.80; 95% CI 1.21–2.70; P = 0.004); however, same-day discharge was not found to be a significant predictor of 30-day readmissions.
The overall readmission rate after HoLEP is low. Patients discharged within 24 hours have similar rates of readmission compared to patients discharged after 24 hours. We found bleeding disorder, frailty burden, and ASA score to be independent predictors of 30-day readmission.
Generalized Helmholtz equation Riveros, Carlos; Corro, Armando
Selecciones matemáticas : revista científica del Departamento Académico de Matemáticas,
07/2019, Letnik:
6, Številka:
1
Journal Article
Recenzirano
Odprti dostop
En este artículo introducimos la ecuación de Helmholtz generalizada y presentamos soluciones explícitas para esta ecuación de Helmholtz generalizada, estas soluciones dependen de tres funciones ...holomorfas. Como aplicación presentamos soluciones explícitas para la ecuación de Helmholtz. Observamos que estas soluciones nonecesariamente estan limitadas a ciertos dominios del plano complejo C.
In this paper we introduce the generalized Helmholtz equation and present explicit solutions to this generalized Helmholtz equation, these solutions depend on three holomorphic functions. As an application we present explicit solutions to the Helmholtz equation. We note that these solutions are not necessarily limited to certain domains of the complex plane C.
Measures of lung function are heritable, and thus, we sought to utilise genetics to propose drug-repurposing candidates that could improve respiratory outcomes. Lung function measures were found to ...be genetically correlated with seven druggable biochemical traits, with further evidence of a causal relationship between increased fasting glucose and diminished lung function. Moreover, we developed polygenic scores for lung function specifically within pathways with known drug targets and investigated their relationship with pulmonary phenotypes and gene expression in independent cohorts to prioritise individuals who may benefit from particular drug-repurposing opportunities. A transcriptome-wide association study (TWAS) of lung function was then performed which identified several drug-gene interactions with predicted lung function increasing modes of action. Drugs that regulate blood glucose were uncovered through both polygenic scoring and TWAS methodologies. In summary, we provided genetic justification for a number of novel drug-repurposing opportunities that could improve lung function.
Group living leads to competition for food between group members. Two types of intragroup food competition may occur: scramble competition, in which all group members use the same resource, such that ...feeding opportunities are equal for everyone; and contest competition, in which some group members monopolize resources through aggression and dominance. In species in which females disperse from the natal group and immigrate into other groups, immigrant females increase group size and thus possibly food competition. Under these circumstances, other females may use aggression to discourage new females from joining the group. We assessed the distribution of aggression, embraces, and kisses among female spider monkeys (
Ateles geoffroyi
) in relation to group tenure. We recorded social interactions during 1688 10-min focal animal samples on 11 females in Santa Rosa, Costa Rica. We found that aggression was rare between long-term resident females and aggression rates were not higher during feeding than in other contexts, suggesting there was little contest competition. Long-term residents and less recently immigrant females showed higher aggression rates toward the most recent immigrants than toward other females, especially during the first months after a female immigrated, which coincided with the dry season. We did not find similar patterns for embrace and kiss. These results suggest that other females target aggression toward the most recent immigrants to reduce scramble competition. This finding suggests that group tenure should be included in socioecological models for species with female dispersal.
In this paper we study a large class of Weingarten surfaces M with prescribed hyperbolic Gauss map in the Hyperbolic 3-space, which are the analogous to the Laguerre minimal surfaces in Euclidean ...space, these surfaces will be called Generalized Weingarten surfaces of harmonic type (HGW-surfaces), this class includes the surfaces of mean curvature one and the linear Weingarten surfaces of Bryant type (BLW-surfaces). We obtain a Weierstrass type representation for this surfaces which depend of three holomorphic functions. As applications we classify the HGW-surfaces of rotation and we obtain a Weierstrass type representation for surfaces of mean curvature one with prescribed hyperbolic Gauss map which depend of two holomorphic functions. Moreover, we classify a class of complete mean curvature one surfaces parametrized by lines of curvature whose coordinates curves has the same geodesic curvature up to sign.
Bromodomains (BD) are epigenetic readers of histone acetylation involved in chromatin remodeling and transcriptional regulation of several genes including protooncogene cellular myelocytomatosis ...(c-Myc). c-Myc is difficult to target directly by agents due to its disordered alpha helical protein structure and predominant nuclear localization. The epigenetic targeting of c-Myc by BD inhibitors is an attractive therapeutic strategy for prostate cancer (PC) associated with increased c-Myc upregulation with advancing disease. MT-1 is a bivalent BD inhibitor that is 100-fold more potent than the first-in-class BD inhibitor JQ1. MT-1 decreased cell viability and causes cell cycle arrest in G0/G1 phase in castration-sensitive and resistant PC cell lines in a dose-dependent fashion. The inhibition of c-Myc function by MT-1 was molecularly corroborated by the de-repression of Protein Kinase D1 (PrKD) and increased phosphorylation of PrKD substrate proteins: threonine 120, serine 11, and serine 216 amino acid residues in β-Catenin, snail, and cell division cycle 25c (CDC25c) proteins, respectively. The treatment of 3D cell cultures derived from three unique clinically annotated heavily pretreated patient-derived PC xenografts (PDX) mice models with increasing doses of MT-1 demonstrated the lowest IC
in tumors with c-Myc amplification and clinically resistant to Docetaxel, Cabazitaxel, Abiraterone, and Enzalutamide. An intraperitoneal injection of either MT-1 or in combination with 3jc48-3, an inhibitor of obligate heterodimerization with MYC-associated protein X (MAX), in mice implanted with orthotopic PC PDX, decreased tumor growth. This is the first pre-clinical study demonstrating potential utility of MT-1 in the treatment of PC with c-Myc dysregulation.
While studies have demonstrated an association between preoperative hypoalbuminemia and adverse clinical outcomes, the optimal serum albumin threshold for risk-stratification in the broader surgical ...population remains poorly defined. We sought define the optimal threshold of preoperative serum albumin concentration for risk-stratification of adverse post-operative outcomes. Using the American College of Surgeons National Surgical Quality Improvement Program Database, we identified 842,672 patients that had undergone a common surgical procedure in one of eight surgical specialties. An optimal serum albumin concentration threshold for risk-stratification was determined using receiver-operating characteristic analysis. Multivariable logistic regression analysis was used to evaluate the odds of adverse surgical events; a priori defined subgroup analyses were performed. A serum albumin threshold of 3.4 g/dL optimally predicted adverse surgical outcomes in the broader cohort. After multivariable analysis, patients with hypoalbuminemia had increased odds of death within 30 days of surgery (odds ratio OR 2.01, 95% confidence interval CI 1.94–2.08). Hypoalbuminemia was associated with greater odds of primary adverse events among patients with disseminated cancer (OR 2.03, 95% CI 1.88–2.20) compared to patients without disseminated cancer (OR 1.47, 95% CI 1.44–1.51). The standard clinical threshold for hypoalbuminemia is the optimal threshold for preoperative risk assessment.
In-service prestressed concrete box girder bridges have received increasing attention in recent years due to a large number of bridges reaching decades in service. Therefore, the ageing of ...infrastructure demands the development of robust condition assessment methodologies based on affordable technology such as vehicle-induced vibration tests (VITs) in contrast with more expensive existing technologies such as tests using hammers or shakers. Ambient vibration tests (AVTs) have been widely used worldwide, taking advantage of freely available ambient excitation sources. However, the literature has commonly reported insufficient input energy to excite the structure to obtain satisfactory modal identification results, especially in long-span concrete bridges. On the other hand, the use of forced vibration tests (FVTs) requires more economic resources. This paper presents the results of field measurements at optimally selected locations in VITs consisting of a 32-ton truck and a springboard with a height of 50 mm. AVTs using optimal sensor placement (OSP) provide similar results to VITs without considering OSP locations. Additionally, the VIT/AVT cost ratio is reduced to 2 since a shorter data collection time is achieved within a one-day (8 h) test framework, which minimizes temperature effects, thus leading to improvements in AVT identification results, especially in vertical modes.
Graph-type biharmonic surfaces in R3 Corro, Armando M. V; P. de Araújo, Raquel; Carrión Riveros, Carlos
Selecciones matemáticas : revista científica del Departamento Académico de Matemáticas,
07/2020, Letnik:
7, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Neste artigo, estudamos superfícies bi-harmonicas que sao parametrizadas por funcoes coordenadas biharmonicas. Estudamos uma classe de superfícies bi-harmonicas, chamadas superficies bi-harmonicas de ...tipo gráfico. Tambem, definimos uma classe de superfícies associadas a duas funcoes harmonicas (FH2Asurfaces), essas superfícies satisfazem uma relacao entre a curvatura Gaussiana, a projecao da aplicacao de Gauss sobre um plano fixo e duas funcoes harmonicas. Mostramos que uma classe particular de superfícies bi-harmonicas de tipo gráfico sao FH2A-surfaces. Finalmente, classificamos as FH2A-surfaces de rotacao.
In this work, we study biharmonic surfaces that are parameterized by biharmonic coordinate functions. We study a class of biharmonic surfaces called graph-type biharmonic surfaces. Also, we define a class of surfaces associated to two harmonic functions (FH2A-surfaces), these surfaces satisfy a relation between the Gaussian curvature, the projection of the Gauss map on a fixed plane and two harmonic functions. We show that a particular class of graph-type biharmonic surfaces are FH2A-surfaces. Finally, we classify the FH2A-surfaces of rotation.
PDF
