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To evaluate whether same-day discharge increased the incidence of 30-day readmission (30dR) after conventional transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) at a single institution.In this retrospective study, 253 patients with HCC underwent 521 transarterial chemoembolization procedures between 2013 and 2020. TACE was performed with 50-mg doxorubicin/10-mg mitomycin C/5-10-mL ethiodized oil/particles. Patients not requiring intravenous pain medications were discharged after a 3-hour observation, and 30dR was tracked. The primary objective was to determine the incidence of 30dR in same-day discharge patients versus patients admitted for observation using the chi-square test. Secondary objectives assessed factors associated with overnight admission and factors predictive of 30dR using generalized estimated equation calculations and logistic regression.In the cohort, 24 readmissions occurred within 30 days (4.6%). Same-day discharge was completed after 331 TACE procedures with sixteen 30dRs (4.8%). Patients admitted overnight were readmitted 8 times after 190 TACE procedures (4.2%). This difference was not statistically significant (P = .4). Factors predicting overnight admission included female sex (58/190 [30.5%] vs 58/331 [17.5%], P.001) and tumor size of ≥3.8 cm (104/190 [55%] vs 85/190 [45%]). Factors predicting 30dR included female sex (10/116 [8.6%] vs 14/405 [0.2%]) and younger age (median [interquartile range], 63 years [55-65 years] vs 65 years [59-71 years]). At regression, factors predictive of 30dR were Child-Pugh Class B/C (odds ratio [OR], 2.1; P = .04) and female sex (OR, 2.9; P = .004).Same-day discharge after conventional TACE is a safe and effective strategy with 30dR rate of5%, similar to overnight observation.

Associations between parasite loads and sexual signal expression have long been the focus of research. However, our understanding of how sexual selection operates in the context of multiple parasite infections within the same host is still quite limited. We examined the expression of plumage coloration, which is sexually selected in North American barn swallows, Hirundo rustica erythrogaster, and tail streamer length, which is sexually selected in other barn swallow subspecies, in the context of eight different parasite infections. We found that two parasites, nest mites and Plasmodium, were associated with colour expression, but in opposite directions. Attractive males were less likely to have mites in their nests, but more likely to be infected with Plasmodium. We found that different underlying mechanisms were generating the links between these different parasites and the same colour signal. Males that invested more in colour expression were less likely to survive when infected with Plasmodium, suggesting a physiological mechanism linking colour to Plasmodium infections. However, we found no clear cost to males when examining nest mites, which primarily infect offspring. Instead, using experimental mite manipulations, we provide evidence for a behavioural mechanism, where territorial behaviour and male–male competition likely drive the association between colour expression and nest mite infections. We did not find associations between parasites and streamer length in this subspecies, suggesting that the links between divergent sexual signals and parasites may be quite flexible. These results suggest that the evolution of a single sexual signal can be shaped by several, even opposing, links with different parasite infections.

In static surface filtration processes with filter media which pores are bigger than the particle size, the formation of bridges from particles over the pores is of crucial importance for the creation of the first particle layer and interference resistance of the filter. To achieve a better understanding of the bridging mechanisms, a numerical study of the particle deposition with a three-dimensional columnar pore model of a filter was performed using a coupled CFD-DEM approach. The time for bridge formation with spherical particles over the filter pores was obtained for different concentrations and inlet flow velocities. Furthermore, the simulation results were analyzed to investigate the total filter resistance, which results from interferences between filter medium, particles and fluid. The simulated characteristic filtration curves at a constant flow rate are in good agreement with the filtration model. Moreover, the bridging dynamics predicted by simulations agrees with the previously obtained experimental results.

Objective: To describe different domains of participation such as productive, leisure and social activities and describe sociodemographic and spinal cord injury (SCI)-related characteristics that are associated with participation in these domains in a large sample of community-dwelling individuals with SCI in Switzerland.Design: Cross-sectional population-based survey within the Swiss Spinal Cord Injury Cohort Study. Participation in major life domains was measured by the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation). Univariable unconditional analysis and unbiased recursive partitioning were used to identify the predominant associations of sociodemographic and SCI-related characteristics with multiple dimensions of participation.Setting: Community.Participants: Swiss residents aged 16 years or older and living with traumatic or nontraumatic SCI (N=1549).Interventions: Not applicable.Main Outcome Measure: The USER-Participation, a 32-item self-report questionnaire with 3 scales (Frequency, Restrictions, and Satisfaction) to assess key domains of participation (productive, leisure, social).Results: Frequency (median 34.5 out of 100) in productive, outdoor leisure, and social activities was reduced with distinctive perceived restrictions in work and education, sports, and partner relationships. Domestic leisure activities (65.4%) and maintaining social relationships (76.1%) were those activities most often performed and with least perceived restrictions. Participants were generally satisfied with their current daily life activities. Lower scores across all participation scales were associated with more severe SCI, higher age, being female, not having a partner, and lower level of education.Conclusions: This study provides a thorough analysis of participation in major life domains of individuals with SCI in Switzerland. Different risk groups for reduced levels in participation in productive, leisure, and social activities were identified. This population-based evidence is instrumental to the better targeting of rehabilitation and policy interventions that aim to improve community participation. (C) 2019 by the American Congress of Rehabilitation Medicine

This study deals with the time-dependent nonlinear response of catchments to the variations in rainfall. Both the rainfall and runoff discharge fields are treated to be nonstationary in time. A functional series representation, a generalization of the linear convolution integral, is employed to quantify the nonlinear relation between the input and output. The Fourier-Stieltjes representation approach is used to evaluate the variance of runoff discharge in the spectral frequency domain. The analysis based on the spectral solution for the runoff discharge variance clearly demonstrates that larger values of rainfall characteristic time scale or catchment size parameter lead to larger variability of the runoff discharge, while a larger catchment scale parameter leads to smaller variability of the runoff discharge.

We propose an application of network analysis to determine which traits and behaviors predict fertilizations within and between populations. This approach quantifies how reproductive behavior between individuals shapes patterns of selection and gene flow, filling an important gap in our understanding of the connection between evolutionary processes and emergent patterns.

Spectrins are cytoskeletal proteins essential for membrane biogenesis and regulation and serve critical roles in protein targeting and cellular signaling. αII spectrin (SPTAN1) is one of two α spectrin genes and αII spectrin dysfunction is linked to alterations in axon initial segment formation, cortical lamination, and neuronal excitability. Furthermore, human αII spectrin loss-of-function variants cause neurological disease. As global αII spectrin knockout mice are embryonic lethal, the in vivo roles of αII spectrin in adult heart are unknown and untested. Here, based on pronounced alterations in αII spectrin regulation in human heart failure we tested the in vivo roles of αII spectrin in the vertebrate heart. We created a mouse model of cardiomyocyte-selective αII spectrin-deficiency (cKO) and used this model to define the roles of αII spectrin in cardiac function. αII spectrin cKO mice displayed significant structural, cellular, and electrical phenotypes that resulted in accelerated structural remodeling, fibrosis, arrhythmia, and mortality in response to stress. At the molecular level, we demonstrate that αII spectrin plays a nodal role for global cardiac spectrin regulation, as αII spectrin cKO hearts exhibited remodeling of αI spectrin and altered β-spectrin expression and localization. At the cellular level, αII spectrin deficiency resulted in altered expression, targeting, and regulation of cardiac ion channels Na(V)1.5 and K(V)4.3. In summary, our findings define critical and unexpected roles for the multifunctional αII spectrin protein in the heart. Furthermore, our work provides a new in vivo animal model to study the roles of αII spectrin in the cardiomyocyte.

Research question: What concentration of anti-Mullerian hormone (AMH) corresponds to an antral follicle count (AFC) >15 for determination of ovarian reserve? Design: A prospective study conducted at 13 US fertility clinics in women aged 21–44 years who presented for AFC evaluation by transvaginal ultrasound. Serum samples were collected at the time of AFC evaluation (menstrual cycle day 2–4). AMH concentrations were measured by the Elecsys® AMH immunoassay; oestradiol and follicle-stimulating hormone (FSH) concentrations were also measured. The serum AMH cut-off able to detect AFC >15 with high sensitivity was determined (derivation cohort). Clinical performance of the AMH assay at the derived cut-off was evaluated (validation cohort). Receiver operating characteristic (ROC) analyses were also performed. Results: In the derivation cohort (n = 306), an optimal serum AMH cut-off value of 1.77 ng/ml was determined to correspond to AFC >15 with 89.63% sensitivity and 69.01% specificity, using the Elecsys AMH assay. In the validation cohort (n = 856), this 1.77 ng/ml cut-off could identify women with an AFC >15 with a sensitivity of 88.34% and a specificity of 68.29%; corresponding positive predictive and negative predictive values were 75.19% and 84.34%, respectively. ROC analyses demonstrated that AMH performed better than oestradiol or FSH in predicting AFC, with area under the curves of 85.7%, 57.1% and 69.7%, respectively, in the validation cohort. Conclusion: The Elecsys AMH immunoassay provides a robust and fully automated method to measure serum AMH levels. Women with AMH values below the cut-off of 1.77 ng/ml are unlikely to have AFC >15.

An eco-friendly post-drawing process without any chemical solvents for splitting orange (segmented) pie bicomponent multifilaments (OP bico fibers) from biodegradable poly(lactic acid) (PLA) und polypropylene (PP) is developed. Emphasis of the study is given on understanding thermal behavior of the PLA and PP during heating and cooling processes. Due to the differences in their thermal behavior, particular crystallization behavior, PLA and PP in OP bico fibers split from each other during drawing under heat treatment only and become ultrafine fibers special cross-sections and very large surface area. Furthermore, these post-drawn fibers possess very high tensile strength at 51.0 cN/Tex, which is 1.7 times higher than pure PLA fibers and three times as high as that of melt spun bico fibers.