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Customer views associated with faster entry to medications: a qualitative review.
Background Cholecystectomy is a frequently performed surgical procedure for symptomatic cholelithiasis, which is reported to be more common in patients with non-alcoholic steatohepatitis (NASH), given the common risk factors. However, the data remains unclear on the association of cholecystectomy with NASH. We performed a retrospective study to examine the association of cholecystectomy and NASH. Methods Medical charts of patients with steatohepatitis related liver disease at a tertiary care center from 2004 to 2011 were stratified by cholecystectomy and defined by its history and/or absence of gallbladder on ultrasonography. Logistic regression model was built for predictors of cholecystectomy. Patients with NASH were stratified based on timing of cholecystectomy. The diagnosis of NASH and timing of cholecystectomy were compared based on baseline characteristics and outcomes (liver disease complications and survival) on follow up. Kaplan-Meier curves were generated for the two group comparisons. Chi-square aon timing of cholecystectomy. On a median follow up of 5 years, timing of cholecystectomy did not impact on development of cirrhosis (74% vs. 67%, P=0.45), ascites (31% vs. 38%, P=0.76), variceal bleeding (11% vs. 16%, P=0.44), hepatic encephalopathy (22% vs. 29%, P=0.74), hepatocellular carcinoma (HCC) (15% vs. 9%, P=0.59), and patient survival (95% vs. 98%, P=0.3). Conclusions Cholecystectomy is associated with NAFLD diagnosis. We did not find cause and effect of cholecystectomy in the development of severity of NAFLD. Prospective studies are suggested to examine the role of cholecystectomy and bile acids in the pathogenesis of NAFLD. 2020 Translational Gastroenterology and Hepatology. All rights reserved.Newborn screening (NBS) for inborn metabolic disorders is a highly successful public health program that by design is accompanied by false-positive results. Here we trained a Random Forest machine learning classifier on screening data to improve prediction of true and false positives. Data included 39 metabolic analytes detected by tandem mass spectrometry and clinical variables such as gestational age and birth weight. Analytical performance was evaluated for a cohort of 2777 screen positives reported by the California NBS program, which consisted of 235 confirmed cases and 2542 false positives for one of four disorders glutaric acidemia type 1 (GA-1), methylmalonic acidemia (MMA), ornithine transcarbamylase deficiency (OTCD), and very long-chain acyl-CoA dehydrogenase deficiency (VLCADD). Without changing the sensitivity to detect these disorders in screening, Random Forest-based analysis of all metabolites reduced the number of false positives for GA-1 by 89%, for MMA by 45%, for OTCD by 98%, and for VLCADD by 2%. All primary disease markers and previously reported analytes such as methionine for MMA and OTCD were among the top-ranked analytes. Random Forest's ability to classify GA-1 false positives was found similar to results obtained using Clinical Laboratory Integrated Reports (CLIR). We developed an online Random Forest tool for interpretive analysis of increasingly complex data from newborn screening.The study was carried out to assess the effect of variety on polyphenols in cassava leaves and their stability in antioxidant activity before and after in vitro gastrointestinal digestion. The results showed that individual and total polyphenols content (TPC) and antioxidant activity of bound, free and bioaccessible polyphenols were significantly (p less then 0.05) influenced by variety at harvesting maturity. The bound polyphenols had lower TPC (5.00-19.16 mg GAE/g) than free (39.16-89.61 mg GAE/g) throughout harvesting maturity. The polyphenols were strongly affected after in vitro digestion, however, salicylic, syringic and benzoic acids are the most bioaccessible. The free polyphenols of variety IRAD4115 had the highest value of FRAP (35.17 μg TE/g) at 12 months after planting (MAP), while, bound polyphenols showed the lowest DPPH (6.59 μg TE/g, variety EN at 12MAP). The antioxidant activity value evaluated by DPPH method was decreased significantly after in vitro gastrointestinal digestion. However, there was no significant difference between antioxidant activity of bioaccessible polyphenols (77.71 μg TE/g) and methanolic polyphenols (79.17 μg TE/g) assessed by FRAP method. These findings showed the stability of antioxidant potential of polyphenols in cassava leaves harvested at different periods after in vitro digestion. Thus cassava leaves harvested at appropriate maturity can be used as ingredient of functional food for nutraceutical benefits. © 2020 The Author(s).Gastrointestinal (GI) cancers are known to have a high incidence worldwide and require an early diagnosis to successfully treat them, providing higher survival rates and better quality of life for the patients. Rapamycin MicroRNA-27a is a well-known oncogene that plays a significant role in various GI cancers. It is known to upregulate the expression of numerous oncogenes leading to cancer progression. The miR-27a harbors two polymorphisms rs895819 and rs11671784 which alter the disease susceptibility by interfering with the maturation and expression of miR-27a. In the current study, we aimed to investigate the role played by these polymorphisms in cancers of the GI tract. We conducted a case-control study with 210 GI cancer cases and 210 cancer-free controls to analyze the effect of these polymorphisms. The rs895819 polymorphism was genotyped using PCR-RFLP, and rs11671784 was genotyped on a MassARRAY platform. The association analysis failed to bring out any significant association of the polymorphisms with GI cancer risk. However, genotype-phenotype interaction analysis revealed that the rs895819 was found to increase the risk GI cancers along with the presence of risk factors such as socioeconomic status, diabetes mellitus, hypertension, alcohol consumption, and tobacco chewing. © 2020 Published by Elsevier Ltd.Polyvinyl chloride (PVC) is the most widely produced synthetic plastic polymer in the world it has a variety of applications due to its low cost, elasticity, light weight, good mechanical characteristics and corrosion resistance. In order to protect living beings from harmful radiation such as gamma rays, novel low-cost chalcocite and hematite-based PVCs were fabricated for shielding purposes. The mass attenuation coefficient μm for various fabricated hematite and chalcocite-based PVCs was calculated using MCNP-5 code. The results were compared with the values calculated theoretically using XCOM software between 0.015 and 15 MeV. Moreover, the simulated μm parameter for chalcocite/PVC and hematite/PVC was used to calculate other shielding factors, such as the half value layer (HVL), the mean free path (MFP) effective atomic number Zeff, the geometric-progress (G-P) fitting parameters and the exposure buildup factor (EBF). The simulated data of μm for all composites is comparable to that obtained from a theoretical calculation.
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