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Recently, CdSe has become a prospective material for photocatalytic hydrogen evolution. However, the photocatalytic activity of pure CdSe is still dissatisfactory due to the electron-hole pair complex and lack of active sites. In this study, CdSe/NiS Schottky heterojunction photocatalysts was successfully prepared by the hydrothermal method. Of these, CdSe is daisy-like and NiS is hydrangea-like. The photocatalytic hydrogen evolution results indicated that the photocatalytic hydrogen production rate of 25NiS/CdSe was 9399 μmol g−1 h−1 under visible light irradiation in the presence of sacrificial agents, which was 120 times higher than that of pure CdSe (78 μmol g−1 h−1). Using X-ray photoelectron spectroscopy, the catalyst's elemental makeup was revealed. Photoluminescence spectroscopy and electrochemical characterizations demonstrated that the carrier separation efficiency of NiS/CdSe was significantly improved compared with CdSe and the overpotential was lowered. This improvement can be attributed to the formation of Schottky barriers. In addition, the metal-like nature of NiS promoted charge transfer and provided additional reactive active sites for the system. This study offers novel insights for the further design of low-cost, visible-light-driven photocatalysts with high photocatalytic activity. [Display omitted] • A new and efficient CdSe/NiS photocatalyst was successfully synthesized. • NiS provides active sites for hydrogen production. • The metal-like properties of NiS and Schottky heterojunctions work together to promote charge transfer. • The hydrogen production of the optimized heterojunction is 120 times that of pure CdSe. • The optimized heterojunction exhibits the hydrogen production rate of 9399 μmol g−1 h−1. [ABSTRACT FROM AUTHOR]

To investigate the association between race and route of hysterectomy among patients undergoing hysterectomy for abnormal uterine bleeding (AUB) in the absence of uterine myoma disease and excluding malignancy. A cross-sectional cohort study utilizing the Healthcare Cost and Utilization Project Nationwide Inpatient Sample and National Ambulatory Surgical databases to compare abdominal to minimally invasive routes of hysterectomy. Hospitals and hospital-affiliated ambulatory surgical centers participating in the Healthcare Cost and Utilization Project in 2019. A total of 75 838 patients who had undergone hysterectomy for AUB, excluding uterine myoma and malignancy. n/a Of the 75 838 hysterectomies performed for AUB in the absence of uterine myomas and malignancy, 10.1% were performed abdominally and 89.9% minimally invasively. After adjusting for confounders, Black patients were 38% more likely to undergo abdominal hysterectomy compared to White patients (OR 1.38, CI 1.12–1.70 p =.002). Black race, thus, is independently associated with open surgery. Despite excluding uterine myomas as a risk factor for an abdominal route of hysterectomy, Black race remained an independent predictor for abdominal versus minimally invasive hysterectomy, and Black patients were found to undergo a disproportionately higher rate of abdominal hysterectomy compared to White patients. [ABSTRACT FROM AUTHOR]

Samples of bryozoans collected from two localities in the Bay of Cádiz with different levels of anthropogenic impact are studied. A total of 25 species was identified, of which 8 are considered non-indigenous (NIS), 12 as native and 5 cryptogenic. A new species of Hippopodina, Hippopodina similis sp. nov., is here described, and corrections to the diagnosis of the genus are proposed. The species appears to be a recent immigrant in Cádiz, although it could also be present in the eastern Mediterranean. Aeverrilla setigera and the genus Hippopodina itself are recorded for the first time in the eastern Atlantic. Anguinella palmata is recorded for the first time in Spanish waters. Amathia vidovici was already recorded in the Iberian Peninsula, but previous records should be confirmed. Other species, such as Amathia verticillata, Biflustra tenuis, Watersipora subatra and Schizoporella errata, were already recorded in the Bay of Cádiz very recently. [ABSTRACT FROM AUTHOR]

Introduction: Total knee arthroplasty (TKA) is a common elective procedure aimed at improving patients' quality of life. Patients undergoing this procedure can have a wide variety of comorbidities, including chronic obstructive pulmonary disease (COPD). Several studies demonstrated a higher risk of postoperative complications for this patient population. In this study, we examined the mortality risk of this group of patients, as well as the length of stay (LOS) and general costs. Methods: This study is a retrospective, case–control study. Using the National Inpatients Sampling (NIS) database, we defined a cohort of adults who received their inpatient primary TKA between 1 January 2016 and 31 December 2020. Preoperative variables include age, sex, race, primary payer, hospital location, and hospital type. Outcomes examined in this study include overall patient mortality as a primary outcome. Secondary outcomes include total LOS (in days) and inpatient costs in the United States (in USD). Results: A total of 2,835,499 patients who underwent TKA procedure in the United States were included. A total of 173,230 (6.1%) COPD patients were included in the COPD group. The mortality rate in the COPD group (0.1%) was more than three times higher than the control group (0.03%, p-value < 0.001). Patients in the COPD group had a longer in-hospital length of stay (2.76) compared to the control group (2.31, p-value < 0.001) and a higher treatment cost (average value of treatment per patient) (USD 69,386) compared to the control group (USD 64,446, p-value < 0.001). We also found higher mortality risk for patients older than 60 and patients of white ethnicity. Conclusion: COPD patients undergoing TKA have a higher mortality rate and this issue should be addressed in order to improve patient care and outcomes. [ABSTRACT FROM AUTHOR]

U radu se prati razvoj civilnog apotekarstva na teritoriji Moravske banovine u periodu od 1929. do 1941. godine. Razvoj ove službe ogledao se u otvaranju apoteka po većim mestima, kao i u donošenju pravnih akata za regulisanje prometa lekova i sprečavanje neovlašćene trgovine. Rad je nastao na osnovu literature, kao i građe fonda Ministarstva socijalne politike i narodnog zdravlja, pohranjenog u Arhivu Jugoslavije.

Abstract The objective of this study was to evaluate the racial and ethnic disparities in delivery hospitalizations involving severe maternal morbidity (SMM) by location of residence and community income. We used the 2016 to 2019 Healthcare Cost and Utilization Project National Inpatient Sample. International Classification of Diseases, Tenth Revision, Clinical Modification codes were used to identify delivery hospitalizations with SMM. Using logistic regression models, we examined the association between race and ethnicity and delivery hospitalizations involving SMM. In adjusted analyses, the models were stratified by location of residence and community income and adjusted for patient and hospital characteristics. In rural areas, non-Hispanic Black women (AOR 1.50; 95% CI 1.25–1.79) and women of other races (AOR 1.32; 95% CI 1.03–1.69) had an increased odds of experiencing a delivery hospitalization involving SMM when compared to non-Hispanic White women. In micropolitan areas, non-Hispanic Black women (AOR 1.88; 95% CI 1.79–1.97), non-Hispanic Asian/Pacific Islander women (AOR 1.54; 95% CI 1.16–2.05), and women of other races (AOR 1.31; 95% CI 1.03–1.67) had an increased odds of experiencing a delivery hospitalization involving SMM when compared to non-Hispanic White women. Non-Hispanic Black women also had increased odds of experiencing a delivery hospitalization involving SMM in communities with the lowest income (quartile 1) (AOR 1.59; 95% CI 1.49–1.66), middle income (quartiles 2 and 3) (AOR 1.81; 95% CI 1.72–1.91), and highest income (AOR 2.09; 95% CI 1.90–2.29) when compared to non-Hispanic White women. We found that location of residence and community income are associated with racial and ethnic differences in SMM in the United States. These factors, outside of individual factors assessed in previous studies, provide a better understanding of some of the structural and systemic factors that may contribute to SMM.

Background: This study investigates the rising trend of total hip arthroplasty (THA) in patients under 55 years old, commonly referred to as "younger" THA patients. Traditionally a procedure for older adults with osteoarthritis, THA is increasingly performed on younger patients. Methods: Using data from the Nationwide Inpatient Sample (NIS) from 2016 to 2019, we analyze the factors driving this trend, including the causes of hip issues, patient characteristics, and coexisting medical conditions. The study examines in-hospital mortality, length of stay, post-surgical complications, and hospitalization costs for 231,630 THA patients aged 18–54.9, identified using ICD-10 codes. Results: Statistical analysis revealed that younger patients (aged 18–34.9) had higher rates of chronic anemia, inflammatory bowel disease, sickle cell disorders, connective tissue disorders, and coagulation defects compared to patients aged 35–44.9 and 45–54.9. They also experienced the longest hospital stays (2.08 days) and highest costs ($70,540). Significant odds ratios were found for sickle cell disorders (36.078), coagulation defects (1.566), inflammatory bowel disease (2.582), connective tissue disorders (11.727), hip dislocation (3.447), and blood transfusion (1.488) in younger patients compared to other THA patients. Conclusions: Comprehensive analysis of these unique needs is crucial for optimizing care, tailoring treatment, managing co-existing conditions, and personalizing recovery strategies to improve outcomes and quality of life for younger THA patients. [ABSTRACT FROM AUTHOR]

Due to their high energy density and cost‐effectiveness, lithium–sulfur batteries (LSBs) are considered highly promising for the next generation of energy storage technologies. However, the soluble lithium‐polysulfides (LiPSs) notorious for causing the shuttle effect and the sluggish redox kinetics have hindered their practical commercialization. To tackle these challenges, a heterostructural catalyst featuring NiS‐NiCo2O4 interfaces is developed, which serves as an interlayer for LSBs. These interfacial sites leverage the advantages of polar NiCo2O4 and conductive NiS, enabling smooth Li+ diffusion, rapid electron transport, and effective immobilization of LiPSs. This synergistic approach promotes the conversion of sulfur species, resulting in a high discharge capacity of 526 mAh g−1 at 3 C for cells with the NiS‐NiCo2O4 interlayer. Additionally, remarkable cycling stability is achievable with an areal sulfur loading of ≈5.0 mg cm−2. It is believed that this research paves the way for practical applications of LSBs. [ABSTRACT FROM AUTHOR]

Simple Summary: Leukemia history affects some radical prostatectomy (RP) patients. While its prevalence and impact as an adverse risk factor are well-known in cardiac surgery, the number of RP patients with a leukemia history and their rate of adverse in-hospital outcomes are unknown. We identified RP patients with a leukemia history in a large-scale database. Patients with a leukemia history had higher rates of acute kidney injury, more frequent dialysis, and extended hospital stays compared to those without a leukemia history. Introduction: Leukemia history affects some radical prostatectomy (RP) patients. Although its prevalence and effect as an adverse risk factor are well known in cardiac surgery, the number of RP patients with a leukemia history, as well as their rate of adverse in-hospital outcomes, are unknown. Methods: We identified RP patients (National Inpatient Sample 2000–2019), stratified according to the presence or absence of a leukemia history. Descriptive analyses, propensity score matching (PSM, ratio 1:10), and multivariable logistic regression models were used. Results: Of 259,939 RP patients, 416 (0.2%) had a leukemia history. Their proportion increased from 0.1 to 0.2% covering the study span (p < 0.01). Leukemia history patients were older (median age, 64 vs. 62 years, p < 0.001). After PSM for age, insurance status, ethnicity, pelvic lymph node dissection, and Charlson Comorbidity Index, leukemia history RP patients exhibited higher rates of acute kidney injury (<2.6 vs. 0.9%; Odds Ratio [OR] 2.0, p = 0.02), more frequently underwent dialysis (3.6 vs. 1.9%; OR 1.9, p = 0.03), and more frequently had a length of stay exceeding one week (4.8 vs. 2.5%; OR 2.0, p = 0.006). Conclusions: Although leukemia history RP patients are rare, their numbers have increased. Renal complications and extended hospital stays are more frequent in those individuals. [ABSTRACT FROM AUTHOR]

Background: In-hospital mortality and complication rates after partial and radical nephrectomy in patients with history of heart-valve replacement are unknown. Patients and Methods: Relying on the National Inpatient Sample (2000–2019), kidney cancer patients undergoing partial or radical nephrectomy were stratified according to presence or absence of heart-valve replacement. Multivariable logistic and Poisson regression models addressed adverse hospital outcomes. Results: Overall, 39,673 patients underwent partial nephrectomy versus 94,890 radical nephrectomy. Of those, 248 (0.6%) and 676 (0.7%) had a history of heart-valve replacement. Heart-valve replacement patients were older (median partial nephrectomy 69 versus 60 years; radical nephrectomy 71 versus 63 years), and more frequently exhibited Charlson comorbidity index ≥ 3 (partial nephrectomy 22 versus 12%; radical nephrectomy 32 versus 23%). In partial nephrectomy patients, history of heart-valve replacement increased the risk of cardiac complications [odds ratio (OR) 4.33; p < 0.001), blood transfusions (OR 2.00; p < 0.001), intraoperative complications (OR 1.53; p = 0.03), and longer hospital stay [rate ratio (RR) 1.25; p < 0.001], but not in-hospital mortality (p = 0.5). In radical nephrectomy patients, history of heart-valve replacement increased risk of postoperative bleeding (OR 4.13; p < 0.001), cardiac complications (OR 2.72; p < 0.001), intraoperative complications (OR 1.53; p < 0.001), blood transfusions (OR 1.27; p = 0.02), and longer hospital stay (RR 1.12; p < 0.001), but not in-hospital mortality (p = 0.5). Conclusions: History of heart-valve replacement independently predicted four of twelve adverse outcomes in partial nephrectomy and five of twelve adverse outcomes in radical nephrectomy patients including intraoperative and cardiac complications, blood transfusions, and longer hospital stay. Conversely, no statistically significant differences were observed in in-hospital mortality. [ABSTRACT FROM AUTHOR]

Nish joined the Ottoman administration in 1386. Ottoman rule continued in the region until 1878. In the 19th century, various rebellions against the Ottoman State took place in Nish and its neighbourhood. The 1841 Nish Rebellion is one of the most notable among them. For this reason, the related rebellion was determined as the subject of the study. In the study were investigated which the activities of Serbian prince Milos Obrenovic, main prince of the period Mihail and Miliyo (Miloje Jovanović) in the region during the Nish Rebellion, the tax issue that emerged after the Tanzimat, and the misconduct of some Ottoman officials. Especially Serbia’s encouraging and provocative attitudes towards the people of the region against the Ottoman State were analysed. Nish, Leskovac Sehirkoy, Kamaniche and Mutafcha villages, Vidin and Kula regions were identified as the spread areas of the rebellion. It was observed that Serbia carried out many activities against the Ottoman State before and during the Nish Revolt, and the Ottoman State tried to take certain measures. The aim of this study is to reveal the activities of Serbia in the face of the 1841 Nish Rebellion and the measures taken by the Ottoman State against this rebellion. In the research, archival documents, newspapers of the period, research and research works were utilised. [ABSTRACT FROM AUTHOR]

Anisotropy is a significant and prevalent characteristic of materials, conferring orientation-dependent properties, meaning that the creation of original symmetry enables key functionality that is not found in nature. Even with the advancements in atomic machining, synthesis of separated symmetry in different directions within a single structure remains an extraordinary challenge. Here, we successfully fabricate NiS ultrafine nanorods with separated symmetry along two directions. The atomic structure of the nanorod exhibits rotational symmetry in the radial direction, while its axial direction is characterized by divergent translational symmetry, surpassing the conventional crystalline structures known to date. It does not fit the traditional description of the space group and the point group in three dimensions, so we define it as a new structure in which translational symmetry and rotational symmetry are separated. Further corroborating the atomic symmetric separation in the electronic structure, we observed the combination of stripe and vortex magnetic domains in a single nanorod with different directions, in accordance with the atomic structure. The manipulation of nanostructure at the atomic level introduces a novel approach to regulate new properties finely, leading to the proposal of new nanotechnology mechanisms. [ABSTRACT FROM AUTHOR]

Habitat loss and change are often implicated as the primary causes of species extinction. Although any population can be instantly imperiled by catastrophe, most habitat loss occurs gradually, thus enabling affected individuals an adaptive advantage to occupy the best of their dwindling opportunities. I demonstrate how to infer the advantage between two habitats for any density and frequency‐dependent strategy of habitat selection. I explore the concept of an Adaptive Dispersal Strategy Landscape to reveal the Evolutionarily Stable Strategy separately for ideal‐free and ideal preemptive habitat selectors. Both solutions reveal an initially counterintuitive expectation that individuals living at high density gain insufficient adaptive advantage to disperse from a deteriorating habitat. Adaptive dispersal is constrained at high density because habitats of better quality are fully occupied. I test the theory with measures of movement and foraging in crossover experiments on a seminatural population of meadow voles. The experiment allowed the voles to choose among patches and between enclosures in which I differentially manipulated food and shelter. Although photographs from an infrared camera documented voles venturing from one habitat to the other, none became resident. Voles preferentially foraged in the richer of the two enclosures, even when I reversed treatments, and they foraged more in patches protected by mulched straw. The adaptive advantage of dispersal using a surrogate fitness proxy based on the voles' giving‐up densities mirrored that generated by theory. The convergence between theory and experiment yields much‐needed insight into our ability to test, predict, and hopefully resolve, the ecological, evolutionary, and conservation consequences of habitat loss. [ABSTRACT FROM AUTHOR]

Introduction: In this study, we investigate the evolution of lumbar fusion surgery with robotic assistance, specifically focusing on the impact of robotic technology on pedicle screw placement and fixation. Utilizing data from the Nationwide Inpatient Sample (NIS) covering 2016 to 2019, we conduct a comprehensive analysis of postoperative outcomes and costs for single-level lumbar fusion surgery. Traditionally, freehand techniques for pedicle screw placement posed risks, leading to the development of robotic-assisted techniques with advantages such as reduced misplacement, increased precision, smaller incisions, and decreased surgeon fatigue. However, conflicting study results regarding the efficacy of robotic assistance in comparison to conventional techniques have prompted the need for a thorough evaluation. With a dataset of 461,965 patients, our aim is to provide insights into the impact of robotic assistance on patient care and healthcare resource utilization. Our primary goal is to contribute to the ongoing discourse on the efficacy of robotic technology in lumbar fusion procedures, offering meaningful insights for optimizing patient-centered care and healthcare resource allocation. Methods: This study employed data from the Nationwide Inpatient Sample (NIS) spanning the years 2016 to 2019 from USA, 461,965 patients underwent one-level lumbar fusion surgery, with 5770 of them having the surgery with the assistance of robotic technology. The study focused primarily on one-level lumbar fusion surgery and excluded non-elective cases and those with prior surgeries. The analysis encompassed the identification of comorbidities, surgical etiologies, and complications using specific ICD-10 codes. Throughout the study, a constant comparison was made between robotic and non-robotic lumbar fusion procedures. Various statistical methods were applied, with a p value threshold of < 0.05, to determine statistical significance. Results: Robotic-assisted lumbar fusion surgeries demonstrated a significant increase from 2016 to 2019, comprising 1.25% of cases. Both groups exhibited similar patient demographics, with minor differences in payment methods, favoring Medicare in non-robotic surgery and more private payer usage in robotic surgery. A comparison of comorbid conditions revealed differences in the prevalence of hypertension, dyslipidemia, and sleep apnea diagnoses—In terms of hospitalization outcomes and costs, there was a slight shorter hospital stay of 3.06 days, compared to 3.13 days in non-robotic surgery, showcasing a statistically significant difference (p = 0.042). Robotic surgery has higher charges, with a mean charge of $154,673, whereas non-robotic surgery had a mean charge of $125,467 (p < 0.0001). Robotic surgery demonstrated lower rates of heart failure, acute coronary artery disease, pulmonary edema, venous thromboembolism, and traumatic spinal injury compared to non-robotic surgery, with statistically significant differences (p < 0.05). Conversely, robotic surgery demonstrated increased post-surgery anemia and blood transfusion requirements compared to non-robotic patients (p < 0.0001). Renal disease prevalence was similar before surgery, but acute kidney injury was slightly higher in the robotic group post-surgery (p = 0.038). Conclusion: This is the first big data study on this matter, our study showed that Robotic-assisted lumbar fusion surgery has fewer post-operative complications such as heart failure, acute coronary artery disease, pulmonary edema, venous thromboembolism, and traumatic spinal injury in comparison to conventional methods. Conversely, robotic surgery demonstrated increased post-surgery anemia, blood transfusion and acute kidney injury. Robotic surgery has higher charges compared to non-robotic surgery. [ABSTRACT FROM AUTHOR]

When reading texts mentioning past currencies, especially those that were in use in Ottoman and British Palestine and the first decade of the State of Israel, historians often remain puzzled as to the relative value of former legal tenders in particular historical periods (i.e. what a specific sum of money could buy), and more so how to interpret the value of specific currencies between these and later periods. Such an interpretation is not only the interest of historians, because there is a practical need to verify sums in obsolete currencies, such as in agreements and laws, in today's money. Few experts are able to make even an inexact linkage from the Mandate period to present day Israel, while linkage from the Ottoman period remains too vague. The main aim of this article is to improve this situation by using applied history, to propose some rules of thumb for understanding the magnitude of such currencies, according to market values and/or laws, and to provide a provisional tool for linkage of former legal tenders – Ottoman Liras, Egyptian Pounds, British Pounds, Palestinian Pounds, Israeli Liras and old Shekels – to present monetary values. [ABSTRACT FROM AUTHOR]

Purpose: The most prevalent lacrimal apparatus dysfunctions associated with differentiated thyroid cancer(DTC) after I-131 therapy are dry eye and nasolacrimal duct obstruction(NLDO), leading to ocular discomfort and lower quality of life for patients. It is crucial to diagnose and manage lacrimal apparatus dysfunction associated with I-131 therapy for DTC. Therefore, this review aims to comprehensively summarize and analyze the advances in mechanisms and therapeutic options underlying lacrimal apparatus dysfunction induced by I-131 therapy for DTC. Methods: A comprehensive search of CNKI, PubMed, and Wed of Science was performed from the database to December of 2023. Key search terms were "Thyroid cancer", "I-131", "Complications", "Dry eye", "Epiphora", "Tear", "Nasolacrimal duct" and "NLDO". Results: The research indicates that I-131 therapy for DTC causes damage to the lacrimal glands and nasolacrimal duct system, resulting in symptoms such as dry eye, epiphora, and mucoid secretions. Moreover, recent research has focused on exploring relevant risk factors of the condition and experimental and clinical treatments. However, there is some controversy regarding the mechanisms involved, whether it is due to the passive flow of I-131 in tears, active uptake of I-131 by the sodium-iodide symporter (NIS) in the lacrimal sac and nasolacrimal duct, or secondary metabolic and hormonal disturbances caused by I-131. Conclusion: It is crucial for early detection and preventive measures by ophthalmologists and the need for further studies to elucidate the mechanisms underlying the disease. [ABSTRACT FROM AUTHOR]

In the present work, a novel composite of nickel sulfide (NiS) and potato peel‐derived carbon spheres (NiS/PPCS) with higher specific capacitance and cyclic performance was synthesized as electrode material for supercapacitor applications. The composite was deposited on a graphite rod to be use as an electrode. The electrochemical performance studies using CV, GCD, and EIS revealed that the prepared electrode showed an improved current response and higher specific capacitance than the pristine NiS electrode. The maximum specific capacitance for the NiS/PPCS electrode was found to be 2185 F/g at 0.2 A/g current density. More precisely, it was observed that the NiS/PPCS composite exhibited an excellent retention capacity of 95.04% after 20 000 continuous charge‐discharge cycles, showing its exceptional cyclic performance. The impedance studies revealed that the reaction between the NiS/PPCS electrode and electrolyte was rapid and highly reversible. Based on the findings of the electrochemical performances, NiS/PPCS electrode appears to be a potential candidate for highly efficient and economical asymmetric supercapacitors. [ABSTRACT FROM AUTHOR]

In recent decades, photocatalysis technology, a typical mild and environmentally friendly technique, can use sunlight to drive the oxidation/reduction reactions on the surface of catalysts. However, single semiconductor materials can hardly meet the requirements of photocatalytic application due to the low availability of visible light, quick e− − h+ recombination, and the insufficiency of active sites. Cocatalysts are often introduced to solve the above problems. Among the numerous cocatalysts, NiS cocatalysts exhibit excellent properties, such as superior chemical stability, suitable band structure, and larger specific surface area, which can improve the photocatalytic efficiency of various semiconductors. Herein, the research progress of NiS cocatalysts in photocatalysis is reviewed. First, the structure of NiS and several common preparation methods are briefly introduced. Second, the NiS cocatalytic principle about how to achieve the effective separation of photogenerated carriers is introduced. Third, the methods to optimize the catalytic activity of NiS are mainly summarized. At the same time, the review summarizes the research progress of composite photocatalysts based on NiS cocatalyst. Finally, the review discusses the existing challenges and obstacles of NiS‐based photocatalytic systems and proposes feasible improvements and ideas to meet the future requirements of practical applications. [ABSTRACT FROM AUTHOR]

Iodine and thyroid hormones (TH) transport in the placenta are essential for fetal growth and development, but there is little research focus on the human placenta. The research aimed to investigate iodine and TH transport mechanisms in the human placenta. The placenta was collected from sixty healthy pregnant women. Urinary iodine concentration (UIC), serum iodine concentration (SIC), placenta iodine storage (PIS) and the concentration of serum and placenta TH were examined. Five pregnant women were selected as insufficient intake (II), adequate intake (AI) and above requirements intake (ARI) groups. Localisation/expression of placental sodium/iodide symporter (NIS) and Pendrin were also studied. Results showed that PIS positively correlated with the UIC (R = 0·58, P < 0·001) and SIC (R = 0·55, P < 0·001), and PIS was higher in the ARI group than that in the AI group (P = 0·017). NIS in the ARI group was higher than that in the AI group on the maternal side of the placenta (P < 0·05). NIS in the II group was higher than that in the AI group on the fetal side (P < 0·05). In the II group, NIS on the fetal side was higher than on the maternal side (P < 0·05). Pendrin was higher in the II group than in the AI group on the maternal side (P < 0·05). Free triiodothyronine (r = 0·44, P = 0·0067) and thyroid-stimulating hormone (r = 0·75, P < 0·001) between maternal and fetal side is positively correlated. This study suggests that maternal iodine intake changes the expression of NIS and Pendrin, thereby affecting PIS. Serum TH levels were not correlated with placental TH levels. [ABSTRACT FROM AUTHOR]

In 2015, an unknown snapping shrimp of the genus Alpheus was collected in the San Pedro River inlet (Bay of Cadiz, SW Spain). Initially, its identification was not possible only based on DNA barcoding or morphology, considering the difficulties in the Alpheus taxonomy and the low percentage of DNA sequences of Alpheus spp. available in public databases. However, recent studies from Kuwait, Qatar and Iraq describing the morphology of Alpheus cf. lobidens allowed us to place the exotic Alpheus in this species complex. There are also recent sequences of 16S mtRNA and COI deposited in GenBank and BOLD that match >99% of similarity with the sequences of the specimens from the Bay of Cadiz. These sequences have the same origin in the Persian Gulf, but they have been attributed to different Alpheus species. Here we discuss these mismatches, and data about the distribution in the Gulf of Cadiz as well as the habitat of Alpheus cf. lobidens. Additionally, DNA barcodes, and a detailed morphological description and illustrations are provided. Some hypotheses about possible ways of introduction are discussed, and the most plausible route seems to be a natural expansion to the west after entering the Mediterranean Sea by the Suez Canal. [ABSTRACT FROM AUTHOR]

A better understanding of stroke pathogenesis through the identification of stroke risk and protective factors can lead to new strategies for stroke prevention. This study investigates the diet of stroke patients and whether there is a relationship between the diet pattern and their age, gender, recurrence of stroke, mortality, and duration of hospitalization. This is a cross-sectional prospective study that included all stroke patients referred to the emergency department between April 2022 and June 2022. The daily diet and demographic characteristics of patients were collected. 100 patients (65% men) were included. According to the statistical analysis, type of oil, and sugar consumption were correlated with the gender of patients (p values of .001 and.014, respectively). Also, correlations between age of patients and number of meals consumed in a day, grain serving, meat consumption and serving, and fruit serving were detected (p values of.030,.001,.0009,.003, and.043, respectively). Additionally, correlations between mortality and the number of meals in a day, meat consumption, and fruit serving were found (p values of .011, .033, and .033, respectively). Our study found that the number of meals consumed in a day, grain servings, meat consumption, and fruit servings in elderly patients is less than in young ones. Additionally, in patients, a higher number of meals consumed in a day, meat consumption, and fruit servings are detected. In stroke patients, women consume liquid oil, while men consume solid oil. Additionally, sugar consumption in male patients is higher than in female patients. [ABSTRACT FROM AUTHOR]

Background: Hypothyroidism is a common endocrine condition and chronic thyroid hormone deficiency is associated with adverse effects across multiple organ systems. In compensated hypothyroidism, however, patients remain clinically stable due to gradual physiological adaptation. In contrast, the clinical syndrome of decompensated hypothyroidism referred to as myxedema coma (MC) is an endocrine emergency with high risk of mortality. Because of its rarity, there are currently limited data regarding MC. This study analyzes the clinical features and hospital outcomes of MC compared with hypothyroid patients without MC (nonMChypo) in national United States hospital data. Methods: A retrospective analysis of the National Inpatient Sample, a public database of inpatient admissions to nonfederal hospitals in the United States, 2016–2018, including adult patients with primary diagnosis of MC (International Classification of Diseases 10th Revision [ICD-10]: E03.5) or nonMChypo (E03.0–E03.9, E89.0). Patient demographics, relevant clinical features, mortality, length of stay (LOS), and hospital costs were compared. Results: Of 18,635 patients hospitalized for hypothyroidism, 2495 (13.4%) had a diagnosis of MC. Sex distribution and race/ethnicity were similar between patients with MC and nonMChypo, whereas MC was associated with older patient age (p = 0.02), public insurance (p = 0.01), and unhoused status (p = 0.04). More admissions with MC occurred in winter compared with other seasons (p = 0.01). The overall mortality rate for MC was 6.8% versus 0.7% for nonMChypo (p < 0.001), and MC was independently associated with in-hospital mortality after adjusted regression analysis (adjusted odds ratio = 9.92 [CI 5.69–17.28], p < 0.001). Mean LOS ± standard error was 9.64 ± 0.73 days for MC versus 4.62 ± 0.12 days for nonMChypo (p < 0.001), and total hospital cost for MC was $21,768 ± $1759 versus $8941 ± $276 for nonMChypo (p = 0.07). In linear regression analyses, MC was an independent predictor of both increased LOS and total hospital cost. Conclusions: In summary, MC remains a clinically significant diagnosis in the modern era, independently associated with high mortality and health care costs. This continued burden demonstrates a need for further efforts to prevent, identify, and optimize treatment for patients with MC. [ABSTRACT FROM AUTHOR]

The solute carrier (SLC) family is a large group of membrane transport proteins. Their dysfunction plays an important role in the pathogenesis of thyroid cancer. The most well-known SLC is the sodium-iodide symporter (NIS), also known as sodium/iodide co-transporter or solute carrier family 5 member 5 (SLC5A5) in thyroid cancer. The dysregulation of NIS in thyroid cancer is well documented. The role of NIS in the uptake of iodide is critical in the treatment of thyroid cancer, radioactive iodide (RAI) therapy in particular. In addition to NIS, other SLC members may affect the autophagy, proliferation, and apoptosis of thyroid cancer cells, indicating that an alteration in SLC members may affect different cellular events in the evolution of thyroid cancer. The expression of the SLC members may impact the uptake of chemicals by the thyroid, suggesting that targeting SLC members may be a promising therapeutic strategy in thyroid cancer. [ABSTRACT FROM AUTHOR]

Background: Obesity is a complex and multifactorial medical condition that can have far reaching consequences on cancer patients, particularly those undergoing treatment such as chemotherapy. Our study focuses to comprehensively explore the various adverse outcomes in obese patients receiving chemotherapy during hospitalization. Methods: The National Inpatient Sample 2020 was used using the ICD-10 codes to identify patients hospitalized with a primary discharge diagnosis of neoplastic chemotherapy with or without a secondary diagnosis of obesity. Statistical analysis using Stata software was done, and primary and secondary outcomes were obtained after adjusting for confounders using multivariate regression analysis. Results: Mortality was similar in both obese and non-obese patients. Length of stay and total hospitalization charges were increased in obese patients. Obese patients had higher odds of developing acute respiratory failure and were more likely to require non-invasive and invasive mechanical ventilation. Conclusion: Our study concluded that obesity could be considered an independent predictor of worse outcomes in patients admitted for neoplastic chemotherapy. Notably, addressing obesity could help to improve the efficacy of treatment for cancer patients while simultaneously reducing any negative consequences associated with being obese. [ABSTRACT FROM AUTHOR]

A novel p-n heterojunction photocatalyst of CoMoO 4 /NiS-3 was constructed by electrostatic adsorption (In CoMoO 4 /NiS-3, the content of CoMoO 4 accounts for 30%). Through SEM and crystal structure, it can be seen that the composite catalyst has a starry flower morphology and is successfully synthesized. The fluorescence emission spectra show that CoMoO 4 /NiS-3 can accelerate the separation rate of photogenerated carriers. The electron transfer mechanism can be determined by ultraviolet characterization and electrochemical methods. Hydrogen evolution experiments can be observed that the amount of hydrogen evolution by the composite catalyst CoMoO 4 /NiS-3 is 225.1 μmol, which is 2.74 and 4.89 times higher than that of the CoMoO 4 and NiS catalysts, respectively. Through the control of the starry flower morphology and the contact interface of p-n heterojunction, the internal electric field is effectively constructed to inhibit the recombination rate of photogenerated carriers, which provides a powerful theoretical model for high performance hydrogen evolution reaction. The formation of p-n heterojunction effectively improves the transmission path of photogenerated carriers and greatly improves the performance of photocatalytic hydrogen evolution. [Display omitted] • The p-n heterojunction between NiS and CoMoO 4 has good stability. • Dispersion of NiS on CoMoO 4 is important for the hydrogen evolution reaction activity. • The electron transport path and hydrogen evolution mechanism of CoMoO 4 /NiS composite catalyst are proposed. • High-efficiency hydrogen evolution is realized through CoMoO 4 /NiS heterojunction. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to explore the differences in iodine metabolism and expression of NIS and Pendrin in pregnant rats under different iodine nutritional status. Methods: Female Wistar rats were divided into four groups: low iodine (LI), normal iodine (NI), ten fold high iodine (10HI), and fifty fold high iodine (50HI). The intervention began after one week of adaptive feeding. Iodine metabolism experiments were performed beginning on the 15th day of pregnancy. 24-h iodine intake and excretion were calculated. The concentrations of iodine in urine, fecal, thyroid, and placenta were measured by ICP-MS. PCR and Western Blot were used to detect the mRNA levels and cell membrane protein of sodium/iodide symporter (NIS) and Pendrin in the small intestine, thyroid, kidney, and placenta. Results: Fecal iodine excretion (FIE) and urinary iodine excretion (UIE) in the 50HI group were significantly higher than those in the NI group (P < 0.05). The NIS protein and mRNA in the kidney and small intestine have an upward trend in iodine deficiency and a downward trend in iodine excess. Thyroid and placental iodine storage in the 50HI group were significantly higher than those in the NI group (P < 0.05). NIS, Pendrin protein, and mRNA in the thyroid and placenta tend to increase when iodine is deficient and decrease when there is excess. Conclusion: Iodine excretion and iodine stores in the placenta and thyroid gland are positively correlated with iodine intake. NIS and Pendrin are also regulated by iodine intake. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the impact of racial disparities on surgical outcomes for cervical spondylotic myelopathy (CSM). Adult patients undergoing anterior cervical discectomy and fusion (ACDF) or posterior cervical decompression and fusion (PCDF) for CSM were identified from the 2016 to 019 National Inpatient Sample Database using the International Classification of Diseases codes. Patients were categorized based on approach (ACDF or PCDF) and race/ethnicity (White, Black, Hispanic). Patient demographics, comorbidities, operative characteristics, adverse events, and health care resource utilization were assessed. Multivariate logistic regression analyses were used to identify independent predictors of extended length of stay (LOS), nonroutine discharge (NRD), and exorbitant costs. A total of 46,500 patients were identified, of which 36,015 (77.5%) were White, 7465 (16.0%) were Black, and 3020 (6.5%) were Hispanic. Black and Hispanic patients had a greater comorbidity burden compared to White patients (P = 0.001) and a greater incidence of any postoperative complication (P = 0.001). Healthcare resource utilization were greater in the PCDF cohort than the ACDF cohort and greater in Black and Hispanic patients compared to White patients (P < 0.001). Black and Hispanic patient race were significantly associated with extended hospital LOS ([Black] odds ratio [OR]: 2.24, P < 0.001; [Hispanic] OR: 1.64, P < 0.001) and NRD ([Black] OR: 2.33, P < 0.001; [Hispanic] OR: 1.49, P = 0.016). Among patients who underwent PCDF, Black race was independently associated with extended hospital LOS ([Black] OR: 1.77, P < 0.001; [Hispanic] OR: 1.47, P = 0.167) and NRD ([Black] OR: 1.82, P < 0.001; [Hispanic] OR: 1.38, P = 0.052). Our study suggests that patient race may influence patient outcomes and healthcare resource utilization following ACDF or PCDF for CSM. [ABSTRACT FROM AUTHOR]

Background: Osteosarcoma is the most common primary bone malignancy. It has classically been described as having a bimodal incidence by age. We sought to identify whether the bimodal incidence distribution still exists for osteosarcoma using the SEER and NIS databases. Methods: Incidence rates of primary osteosarcoma between 2000–2021 were analyzed by age at diagnosis, year of occurrence, sex, and tumor site from the SEER Research Data, 17 Registries, Nov 2023 Sub (2000–2021). The incidence of cases in 35–64 year-olds and 65 and above was compared statistically to determine if there is an increased incidence in the later ages. Incidence of tumors of the long bones of the lower limbs from the NIS discharge database 2012–2019 was also analyzed for comparison. Results: Overall, 5,129 cases of osteosarcoma were reported in the SEER database. Across the 22 calendar year span, a consistent first peak appeared in the second decade of life. There was no consistent second peak in the 35+ age group. There were 86,100 discharges with long bone tumors analyzed in the NIS data which exhibited nearly identical patterns. Conclusions: Our analysis shows that the incidence of osteosarcoma is no longer bimodally distributed but rather unimodally distributed.

Even though the Europeanization of Niš under the Obrenović dinasty (1878-1903) was a continuation of the Ottoman westernization, carried out in Niš during the late Tanzimat (1856-1878), it was not only a continued adoption of the advanced achievements of European culture and society. In Niš, under the Obrenovićs, the effort was also spent on removing everything that belonged to the culture and heritage of the Ottomans, and replacing it with Serbian, so that the city would catch up with other developed cities in the Principality of Serbia, in terms of appearance and the way of life of its inhabitants. This paper aims to show how deep the roots of the Ottoman influence were in Niš during the reign of the last Obrenovićs, through the most visible characteristics of its urban layout and the daily life of its inhabitants (habits, language, and clothing). Since the preserved archival materials written in the language of the administration mostly do not contain data on the mentioned aspects of everyday life, the research used the narrative records of authors who stayed in Niš during this period and left their observations about it.

The paper presents a reconstruction of the Albanian rebellion (1843-1844) with a focus on the analysis of its final phase which took place on the territory of the Eyalet of Niš. In order to better understand the Albanian movement chronologically and territorially, its key moments in other parts of Rumelia are presented and then their connection and reflection on the events in Eyalet of Niš. Having presented the problem in this way, the paper points to two important conclusions: that the Albanians in the Ottoman Empire during the first half of the 19th century did not reach the political maturity which was necessary for the realization of their political goals, and that, due to the complex political conditions and relations between the central and local authorities towards the Christians in the Eyalet of Niš, Albanians with their revolt actually accelerated the resolution of issues which were of key importance for the Christians in this Ottoman province.

Thyroid cancer is the most common malignant neoplasm within the endocrine system and the field of head and neck surgery. Although the majority of thyroid cancers, more than 90%, are well-differentiated thyroid carcinomas with a favourable prognosis, the escalating incidence of this disease has contributed to an increasing number of patients with a propensity for recurrent disease, rapid disease progression, and poor or no response to conventional treatments. These clinical challenges are commonly attributed to alterations in key thyroid oncogenes or signaling pathways, thereby initiating tumour cell dedifferentiation events, accompanied by reduced or virtually absent expression of the sodium/iodine symporter (NIS). As a result, the disease evolves into iodine-refractory differentiated thyroid cancer (RAIR-DTC), an entity that is insensitive to conventional radioiodine therapy. Despite being classified as a differentiated thyroid cancer, RAIR-DTC has an extremely poor clinical prognosis, with a 10-year survival rate of less than 10%. Therefore, it is of paramount importance to comprehensively elucidate the underlying pathogenesis of RAIR-DTC and provide specific targeted interventions. As the pathogenic mechanisms of RAIR-DTC remain elusive, here we aim to review recent advances in understanding the pathogenesis of RAIR-DTC and provide valuable insights for the development of future molecularly targeted therapeutic approaches. [ABSTRACT FROM AUTHOR]

We studied the temporal trends of hepatocellular carcinoma (HCC)-related hospitalizations and potential predictors of in-hospital mortality around the COVID-19 pandemic. Using the International Classification of Diseases code, we used the National Inpatient Sample 2019–2020 and defined HCC and its underlying etiology. To assess the impact of the COVID-19 pandemic on hospitalization and in-hospital mortality, the study period was divided into the pre-COVID-19 era (2019 Q1–2020 Q1) and the COVID-19 era (2020 Q2–2020 Q4). Quarterly trends in etiology-based hospitalizations with HCC and predictors of in-hospital mortality among hospitalizations with HCC were determined. Hospitalization rates for HCC, as well as viral hepatitis-related HCC hospitalization rates, remained stable, while hospitalizations with alcohol-related liver disease (ALD, quarterly percentage change [QPC]: 2.1%; 95% confidence interval [CI]: 0.1%-4.2%) increased steadily. Hospitalization related to nonalcoholic fatty liver disease (NAFLD)-related HCC increased significantly steeper in the COVID-19 era (QPC: 6.6%; 95% CI: 4.0%-9.3%) than in the pre-COVID-19 era (QPC: 0.7%; 95% CI: 0.2%-1.3%). COVID-19 infection was independently associated with in-hospital mortality among hospitalizations with HCC (odds ratio: 1.94, 95% CI: 1.30–2.88). Hospitalization rates for viral hepatitis-related HCC remained stable, while those for HCC due to ALD and NAFLD increased during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

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In this work, we prepared and studied the physical properties of nickel sulfide (NiS) nanostructure thin films, which were deposited on heated glasses substrates (T = 250°C) using the spray pyrolysis technique (SPT)using different Precursor concentrations of these two solution sources: nickel nitrates hyxahydrate {(Ni(NO3)2.6H2O)=X} and thiourea {(CS(NH2)2)=Y}: {30% [X].70%[Y]}, {33%[X].76% [Y]}&{36% [X]. 63 % [Y]} with fixing the other remaining experimental conditions, and this is to understand more the role of the Precursor concentrations of the solutions on the physical properties of nickel sulfide thin films. The results of X-ray diffraction (DRX) analysis showed that all nickel sulfide (NiS) thin films samples are polycrystalline in a hexagonal phase and have a preferred orientation of (010). The Crystallite size (D) was estimated by The Debye–Scherrer’s relation, ranging from 9.915 nm to 22.148 nm. The emergence of the Ni-S bond corresponding to the frequency 668.563 cm–1 was confirmed by FTIR analysis. On the other hand, the energy of the band gaps varies for samples from 0.87, 0.88 to 0.92 eV. Finally, the Sheet resistance (Rsh) was measured using the four-point method, which it used to determine the conductivity of the samples. [ABSTRACT FROM AUTHOR]

Introduction: Despite being the preferred modality for treatment of colorectal cancer and diverticular disease, minimally invasive surgery (MIS) has been adopted slowly for treatment of inflammatory bowel disease (IBD) due to its technical challenges. The present study aims to assess the disparities in use of MIS for patients with IBD. Methods: A retrospective analysis of the National Inpatient Sample (NIS) database from October 2015 to December 2019 was conducted. Patients < 65 years of age were stratified by either private insurance or Medicaid. The primary outcome was access to MIS and secondary outcomes were in-hospital mortality, complications, length of stay (LOS), and total admission cost. Univariate and multivariate regression was utilized to determine the association between insurance status and outcomes. Results: The NIS sample population included 7866 patients with private insurance and 1689 with Medicaid. Medicaid patients had lower odds of receiving MIS than private insurance patients (OR 0.85, 95% CI [0.74–0.97], p = 0.017), and experienced more postoperative genitourinary complications (OR 1.36, 95% CI [1.08–1.71], p = 0.009). In addition, LOS was longer by 1.76 days (p < 0.001) and the total cost was higher by $5043 USD (p < 0.001) in the Medicaid group. Independent predictors of receiving MIS were age < 40 years old, female sex, highest income quartile, diagnosis of ulcerative colitis, elective admission, and care at teaching hospitals. Conclusions: Patients with Medicaid are less likely to receive MIS, have longer lengths of stay, and incur higher costs for the surgical management of their IBD. Further investigations into disparities in inflammatory bowel disease care for Medicaid patients are warranted. [ABSTRACT FROM AUTHOR]

BackgroundClinical experience suggests an increased hospitalization rate for alcohol-related hepatitis (AH) in the winter months; however, seasonal variations in the prevalence of hospitalizations for AH have not been described previously. We hypothesized that AH hospitalizations would be higher in the winter months due to the holiday season and increased alcohol sales.MethodsPatients with primary or secondary discharge diagnosis of AH were included in the study (International Classification of Diseases, Clinical Modification-10th Revision codes K70.4 and K70.1) between January 2016 and December 2019. The primary outcome measure for this study was daily hospitalizations by each month of the year. Secondary outcome measures included the rate of in-hospital mortality associated with AH, for each month.ResultsThe highest number of AH-related admissions was reported in July (n = 56,800; 9%), followed by August (n = 55,700; 8.8%) and May (n = 54,865; 8.7%). February had the lowest number of admissions (n = 46,550; 7.37%). The adjusted mortality was highest in December (overall mortality: 9.6%; adjusted odds ratio: 1.29; 95% confidence interval: 1.142 - 1.461; P < 0.0001) and lowest in May (overall mortality rate: 7.7%). No difference was noted between length of stay and total hospitalization cost between months.ConclusionOur findings demonstrate that seasonal variations in hospitalizations related to AH do exist across the United States. Regional differences also exist and follow unique patterns. The increase in admissions for AH is in line with other studies suggesting that heavy drinking happens during the warm season. Hospital administrators and other stewards of healthcare resources can use seasonal patterns to guide allocation of resources.

New treatment strategies are urgently needed for glioblastoma (GBM)—a tumor resistant to standard-of-care treatment with a high risk of recurrence and extremely poor prognosis. Based on their intrinsic tumor tropism, adoptively applied mesenchymal stem cells (MSCs) can be harnessed to deliver the theranostic sodium/iodide symporter (NIS) deep into the tumor microenvironment. Interleukin-6 (IL-6) is a multifunctional, highly expressed cytokine in the GBM microenvironment including recruited MSCs. MSCs engineered to drive NIS expression in response to IL-6 promoter activation offer the possibility of a new tumor-targeted gene therapy approach of GBM. Therefore, MSCs were stably transfected with an NIS-expressing plasmid controlled by the human IL-6 promoter (IL-6-NIS-MSCs) and systemically applied in mice carrying orthotopic GBM. Enhanced radiotracer uptake by 18F-Tetrafluoroborate-PET/magnetic resonance imaging (MRI) was detected in tumors after IL-6-NIS-MSC application as compared with mice that received wild-type MSCs. Ex vivo analysis of tumors and non-target organs showed tumor-specific NIS protein expression. Subsequent 131I therapy after IL-6-NIS-MSC application resulted in significantly delayed tumor growth assessed by MRI and improved median survival up to 60% of GBM-bearing mice as compared with controls. In conclusion, the application of MSC-mediated NIS gene therapy focusing on IL-6 biology-induced NIS transgene expression represents a promising approach for GBM treatment.

Background: Successful radioiodine treatment of differentiated thyroid canc er requires iodine avidity: that is, the concentration and retention of iodine in cancer tissue. Several parameters have previously been linked with lower iodine avidity. However, a comprehensive analysis of which factors best predict iodine avidity status, and the magnitude of their impact, is lacking. Methods: Quantitative measurements of iodine avidity in surgical specimens (primary tumour and lymph node metastases) of 28 patients were compared to immunohistochemical expression of the thyroid-stimulating hormone receptor, thyroid peroxidase (TPO), pendrin, sodium–iodide symporter (NIS) and mutational status of BRAF and the TERT promoter. Regression analysis was used to identify independent predictors of poor iodine avidity. Results: Mutations in BRAF and the TERT promoter were significantly associated with lower iodine avidity for lymph node metastases (18-fold and 10-fold, respectively). Membranous NIS localisation was found only in two cases but was significantly associated with high iodine avidity. TPO expression was signific antly correlated with iodine avidity (r = 0.44). The multivariable modelling showed that tumour tissue localisation (primary tumour or lymph node metastasis), histological subtype, TPO and NIS expression and TERT promoter mutation were each independent predictors of iodine avidity that could explain 68% of the observed variation of iodine avidity. Conclusions: A model based on histological subtype, TPO and NIS expression and TERT promoter mutation, all evaluated on initial surgical material, can predict iodine avidity in thyroid cancer tissue ahead of treatment. This could inform early adaptation with respect to expected treatment effect.

Against the backdrop of interconnected devices, people, and processes in the Internet of Everything (IoE) an examination of the MDR (Regulation (EU) 2017/745 of the European Parliament and of the Council of 5 April 2017 on medical devices, amending Directive 2001/83/EC, Regulation (EC) No 178/2002 and Regulation (EC) No 1223/2009 and repealing Council Directives 90/385/EEC and 93/42/EE), data protection and cybersecurity rules are carried out with respect to medical devices' privacy and security. The legal analysis therefore investigates how and to what extent the MDR could cope with the copious challenges of cybersecurity and data protection in the IoE of medical devices. The article sheds light on how the MDR sets a minimal standard of requirements for medical device safety and security. In this respect, an unexpected and complicated regulatory interplay is discussed providing for a well-coordinated approach for digital health technologies. Finally, the article discusses several key points of the proposed EU AI Regulation considering digital health technologies. [ABSTRACT FROM AUTHOR]

Previous studies recommend a watch-and-wait approach to paraesophageal hernia (PEH) repair due to an increased risk for mortality. While contemporary studies suggest that elective surgery is safe and effective, many patients presenting with PEH are elderly. Therefore, we assessed the impact of frailty on in-hospital outcomes and healthcare utilization among patients receiving PEH repair. This retrospective population-based cohort study assessed patients from the National Inpatient Sample database who received PEH repair between October 2015 to December 2019. Demographic and perioperative data were gathered, and frailty was measured using the 11-item modified frailty index. The outcomes measured were in-hospital mortality, complications, discharge disposition, and healthcare utilization. Overall, 10,716 patients receiving PEH repair were identified, including 1442 frail patients. Frail patients were less often female and were more often in the lowest income quartile compared to robust patients. Frail patients were at greater odds for in-hospital mortality [odds ratio (OR) 2.83 (95% CI 1.65–4.83); P  < 0.001], postoperative ICU admissions [OR 2.07 (95% CI 1.55–2.78); P  < 0.001], any complications [OR 2.18 (95% CI 1.55–2.78); P  < 0.001], hospital length of stay [mean difference (MD) 1.75 days (95% CI 1.30–2.210; P  < 0.001], and total admission costs [MD $5631.65 (95% CI $3300.06–$7.963.24); P  < 0.001] relative to their robust patients. While PEH repair in elderly patients is safe and effective, frail patients have an increased rate of in-hospital mortality, postoperative ICU admissions, complications, and total admission costs. Clinicians should consider patient frailty when identifying the most appropriate surgical candidates for PEH repair. [ABSTRACT FROM AUTHOR]

Cardiovascular disease is the leading cause of death for patients with end-stage renal disease (ESRD). ESRD is known to affect a large portion of the American population. Previous data for patients undergoing percutaneous coronary intervention (PCI) in the setting of ESRD for Acute Coronary Syndrome (ACS) and non-ACS etiologies have shown to have an increase in in-hospital mortality, and prolonged hospitalization among other complications. The national inpatient sample (NIS) was used to identify patients who underwent PCI between the years 2016–2019. Patients were then grouped into those with ESRD on renal replacement therapy (RRT). Logistic regression models were employed to assess the primary outcome of in-hospital mortality, while linear regression models were utilized to evaluate secondary outcomes, including hospitalization cost and length of stay. A total of 21,366 unweighted observations were initially included, consisting of 50 % ESRD patients and 50 % randomly selected patients without ESRD who underwent PCI. These observations were weighted to represent a national estimate of 106,830 patients. The mean age of the study population was 65 years, and 63 % of the patients were male. The ESRD group had a greater representation of minority groups compared to the control group. The in-hospital mortality rate was significantly higher in the ESRD group compared to the control group, with an odds ratio of 1.803 (95 % CI: 1.502 to 2.164; p -value of 0.0002). Additionally, the ESRD group had significantly higher healthcare costs and longer length of stay, with a mean difference of $47,618 (95 % CI: $42,701 to $52,534, p -value <0.0001) and 2.933 days (95 % CI, 2.729 to 3.138 days, p-value <0.0001), respectively. In-hospital mortality, cost, and length of stay for patients undergoing PCI were found to be significantly greater in the ESRD group. • The study analyzed PCI outcomes in ESRD patients vs. non-ESRD using NIS database during hospitalization. • Cardiovascular disease is a leading cause of death for patients with ESRD, which affects a large portion of the American population. • ESRD population had a significantly higher in-hospital mortality rate, as well as higher costs and longer length of stay in the hospital. • Racial minorities and those of lower socioeconomic status were found to carry a greater burden of these complications. [ABSTRACT FROM AUTHOR]