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Advanced HF therapy includes heart transplantation and Left Ventricular Assist Device implantation (LVAD). Readmission studies about malnutrition in patients receiving advanced HF therapy at the national level are limited. Our cross-sectional study used Nationwide Readmission Database (NRD) for 2016-2019. First, we extracted all cases older than 18 years that received advanced heart failure therapy during the index admission. Appropriate survey and domain analyses were applied using SAS 9.4. We identified 27,409 discharges who received advanced HF therapy. Malnutrition was present in 27% of the study cohort (or 7,443 cases). Patients with malnutrition were slightly older than those without malnutrition (mean age 56 years vs. 54 years, p<0.001) and had fewer women (22% vs. 24%, p<0.001). Patients with malnutrition had a higher prevalence of acute myocardial infarction (AMI), coagulopathy, peripheral vascular disease (PVD), and chronic (liver and renal) diseases (p<0.02). Malnourished patients also had significantly higher sudden cardiac arrest (11.9% vs. 8.8%, p<0.001), inpatient mortality during index admission (13.8% vs. 7.1%, p<0.001), length of stay (mean of 54 days vs. 32 days, p<0.001), and all-cause 30-day readmission rates (26% vs. 24%, p<0.003). Inpatient mortality on readmission was also higher in those with malnutrition (0.9% vs. 0.6%, p<0.1). Even after adjusting for age, gender, AMI, coronary artery disease, PVD, malignancy, depression, dementia, cerebrovascular disease on admission, acute encephalopathy, coagulopathy, and chronic (liver, renal, thyroid, and lung) diseases, the presence of malnutrition continued to be associated with higher inpatient mortality compared to those without malnutrition (OR 1.58[1.35-1.53]). In patients receiving advanced HF therapy, malnutrition is associated with worse outcomes during index and subsequent hospitalizations. [ABSTRACT FROM AUTHOR]

Frailty has been associated with inferior outcomes in patients with advanced heart failure (HF) therapy, which includes heart transplantation and Left Ventricular Assist Device implantation (LVAD). There is a lack of data to assess if hospital frailty risk score (HFS) is associated with worse outcomes in such populations. Our retrospective study used Nationwide Readmission Database (NRD). First, we extracted all cases older than 18 years that received advanced heart failure therapy during the index admission between Jan-Jun for 2016-2019 to allow for a 6-month follow-up. Appropriate survey and domain analyses were applied to obtain national estimates using SAS 9.4. We identified 14,837 discharges who received advanced HF therapy. HFS <5 was present in 25% (n=3,753) of the cohort. Patients with intermediate-high frailty risk score (HFS<=5) were slightly older than those with low frailty risk (HFS<5) with a mean age of 56 years vs. 54 years, and had fewer women (23% vs. 27%, p<0.001). Patients with HFS>5 had a higher prevalence of diabetes mellitus, cerebrovascular disease (CBVD), acute encephalopathy, anemia, coagulopathy, peripheral vascular disease (PVD), and chronic (liver and renal) diseases (p<0.001). Also, they had higher inpatient mortality during index admission (11% vs. 3%, p<0.001), and all-cause 6-month readmission rates (52% vs. 50%, p=0.05). Even after adjusting for age, gender, CBVD, acute encephalopathy, PVD, coagulopathy, malnutrition, and chronic (liver and renal) diseases, the HFS>5 continued to be associated with higher inpatient mortality compared to those with HFS<5 (OR 2.27[1.69-3], p<0.001). Length of stay had a linear trend with HFS (mean of 25 days for HFS<5 vs. 37 days for HFS 5-10 vs. 50 days for HFS 10-15 vs. 61 days for HFS>15, p<0.001). In patients receiving advanced HF therapy, hospital frailty risk score is associated with worse outcomes. [ABSTRACT FROM AUTHOR]

Malnutrition has been associated with inferior outcomes in patients with advanced heart failure (HF) therapy, which includes heart transplantation and Left Ventricular Assist Device implantation (LVAD). However, there is a lack of data to assess if the degree of malnutrition correlates with outcome severity. Our cross-sectional study used Nationwide Readmission Database (NRD) for 2016-2019. First, we extracted all cases older than 18 years that received advanced heart failure therapy during the index admission. Appropriate survey and domain analyses were applied to obtain national estimates using SAS 9.4. We identified 27,409 discharges who received advanced HF therapy. Malnutrition was present in 27% of the study cohort (n=7,443 cases). Most malnourished patients (81%, n=6,034) had moderate-severe malnutrition. Patients with malnutrition were slightly older than those without malnutrition (mean age 56 years vs. 54 years, p<0.001) and had fewer women (22% vs. 24%, p<0.001). Univariate analysis showed that moderate-severe malnutrition is associated with higher inpatient mortality compared to no malnutrition (OR 2.36[2.04-2.72], p<0.001). Mild malnutrition was not associated with higher inpatient mortality (OR 1.04[0.75-1.44]). After adjusting for age, gender, cerebrovascular disease, acute encephalopathy, acute myocardial infarction, peptic ulcer disease, coagulopathy, peripheral vascular disease, as well as chronic kidney and liver diseases, the presence of moderate-severe malnutrition continued to be associated with higher inpatient mortality compared to those without malnutrition (aOR 1.74[1.48-2.05], p<0.001). Either degree of malnutrition was associated with higher 30-day readmission (aOR 1.16[1.06-1.27], p<0.001) and length of stay (mean of 56 days in moderate-severe malnutrition vs. mean of 52 days in mild malnutrition vs. mean of 33 days with no malnutrition, p<0.001). In patients receiving advanced HF therapy, malnutrition severity correlates with worse outcomes. [ABSTRACT FROM AUTHOR]

Right ventricular endomyocardial biopsy (EMB) is uncommonly used for patients admitted with myocarditis. In this study, we assessed the utilization of EMB and outcomes in patients admitted with myocarditis. We used the Nationwide Readmissions Database (NRD) from 2016 to 2019 to include patients ≥ 18 years of age with a primary diagnosis of myocarditis. Appropriate domain and Propensity Score (PS) analyses were applied using SAS 9.4. The outcomes were compared among patients who underwent EMB vs. those who did not. We included 11,927 cases of myocarditis, out of which only 378 patients (3.1%) had EMB. Patients who underwent EMB were older (mean age 45 vs. 41 years, p <0.01), more females (47% vs. 35%, p<0.01) compared to those who did not undergo EMB, respectively. Also, patients who underwent a biopsy, had higher rates of atrial fibrillation (19% vs. 7%), diabetes mellitus (18% vs. 11%), hypertension (40 vs. 34%), End-stage renal disease (4% vs. 1.3%), autoimmune disease (7% vs. 3%) and malignancy (13% vs. 3%) [p<0.01]. Patients who had EMB had higher incidence of cardiogenic shock (40% vs. 5%), ventricular tachycardia (30% vs. 7%), and sudden cardiac arrest (3.4% vs. 1.5%) [p<0.05]. They had higher inpatient mortality during index admission (5% vs. 1.5%), 30-day readmission (14% vs. 7%), hospitalization length (mean of 15 vs. 4 days), and charges ($367,801 vs. $63,726) [p<0.01]. After applying PS analysis and adjusting for comorbidities, age and gender did not affect survival. Although EMB is invasive, it seemed safe (not associated with increased mortality). (Figure 1) EMB was considered in very few selected critically ill patients admitted with myocarditis. EMB use was safe, although not associated with improved outcomes, most likely due to its limited use in the sicker population. Further studies are needed to determine the role of EMB in myocarditis patients. [ABSTRACT FROM AUTHOR]

Abstract: This paper presents a methodology for the prediction of the performance of sea water reverse osmosis units acquired by salient mathematical correlations which involve the important aspects of membrane input and output variables. Feed water conditions pertinent to flow rate, TDS (total dissolved solids), pressure, pH and temperature are correlated with recovery ratio, permeate TDS and power consumption via regression analysis. Satisfactory results are obtained by comparing the resulting correlations against the software ROSA predictions. The mathematical correlations and regression assessment led to the derivation of simple polynomial expressions which were used for sensitivity analysis and may be useful for the design, monitoring and control of this important desalination process. [Copyright &y& Elsevier]

Thin films of lead sulphide (PbS) were grown on the Si (100) and glass substrates using the simple chemical bath deposition (CBD) method. The prepared films had the cubic structure at room temperature, and the thickness was 350 nm at a 120 min deposition time. In this work, the effect of low-dose rate gamma irradiation on the structural and optical characteristics of the prepared thin films was investigated. The PbS thin films were exposed at the National SSDL (Secondary Standard Dosimetry Laboratory) using gamma beam emitted from Co-60 source, the average energy of the photon beam was 1.25 MeV. Here, four different doses (1, 2, 3 and 4 kGy) were used and the dose rate was about 380 mGy/min. The changes on the optical and structural properties of the PbS films due to the gamma irradiation were evaluated. The results showed that the intensity of photoluminescence PL and the grain size decreased with increasing the radiation dose. This could be related to the changes in the crystalline structural during the experiment. In addition, the band gap obtained by the UV transmittance spectrum was confirmed with the results of XRD. These results could indicate the potential application for PbS film in microelectronic field. • Effect of low-dose rate gamma irradiation on PbS thin films, prepared using the simple chemical bath deposition (CBD) method, was studied. • The grain size of the studied film decreased about 3 nm with increasing the gamma irradiation dose from 0 to 4 kGy, and the intensity of the PL spectra (at 425 nm) decreased with increasing the irradiation dose. • The low dose rate gamma irradiation process did not improve the optical properties of prepared films. [ABSTRACT FROM AUTHOR]

The effect of low-dose rate gamma rays irradiation on ZnO thin films of different thicknesses has been studied. Preferentially oriented (002) ZnO thin films have been deposited on Si (100) and glass substrates using radio frequency magnetron sputtering. ZnO films with c-axis-oriented Würtzite structure were obtained at room temperature. ZnO films with thickness of 200 nm and 600 nm were prepared and studied. The prepared films were irradiated using1.25-MeV gamma beam emitted from Cobalt sources (Co-60) with two different doses (2and 4 kGy) and the effect of the gamma irradiation on the optical and structural properties of the ZnO films was examined. The photoluminescence PL intensity was found to increase with the increasing of the irradiation dose in both thin and thick films. This finding allows improving the scintillation output signal of the material while keeping grain size unchanged if low dose rate irradiation is used, as X-ray diffraction patterns showed. Raman spectrum correlates with XRD results. The band gap extracted by UV transmittance spectrum was also identified. • Effect of low-dose rate gamma rays irradiation on ZnO thin films was studied. • ZnO thin films with different thicknesses were used. • Photoluminescence intensity increased with the increase of the irradiation dose for all films. • Improving the scintillation output signal of the material while keeping grain size unchanged. • The band gap extracted by UV transmittance spectrum was also identified. [ABSTRACT FROM AUTHOR]