摘要： INTRODUCTION: Adenoma detection rate (ADR) is highly variable across practices, and national or population-based estimates are not available. Our aim was to study the ADR, variability of rates over time, and factors associated with detection rates of ADR in a national sample of patients undergoing colonoscopy. METHODS: We used colonoscopies submitted to the GI Quality Improvement Consortium, Ltd. registry from 2014 to 2018 on adults aged 50-89 years. We used hierarchical logistic models to study factors associated with ADR. RESULTS: A total of 2,646,833 colonoscopies were performed by 1,169 endoscopists during the study period. The average ADR for screening colonoscopies per endoscopist was 36.80% (SD 10.21), 44.08 (SD 10.98) in men and 31.20 (SD 9.65) in women. Adjusted to the US population, the ADR was 39.08%. There was a significant increase in ADR from screening colonoscopies over the study period from 33.93% in 2014 to 38.12% in 2018. DISCUSSION: The average ADR from a large national US sample standardized to the US population is 39.05% and has increased over time.

摘要： Supplemental Digital Content is Available in the Text.

摘要： [...]a tsunami of anti-LGBTQI+ legislation is flooding state legislatures with bills allowing denial of health care based on religious or moral objections in addition to those jeopardizing the health care of our transgender patients, specifically youth (4). [...]many LGBTQI+ patients do not reveal their sexual orientation or gender identity to their providers, despite the importance of such information in their medical care (5). From a gastroenterology and hepatology lens, lesbians and bisexual women are more likely to be obese, rates of anal cancer are increased among gay and bisexual men, and there is decreased utilization of preventative cancer screenings including colorectal, anal, and breast (6). [...]training all hospital and clinic staff is necessary.

关键词： mealworm meal   narrow‐   clawed crayfish   nutrition   Pontastacus    leptodactylus  

摘要： An eighty-day feeding study was performed to investigate the effects of mealworm meal (Tenebrio molitor) on the growth, survival and moulting frequency of juvenile Narrow-clawed crayfish (Pontastacus leptodactylus). Three dietary treatment groups with triplicate were fed with a fish meal-based without MW (control diet: MW0), two diets with 50% (MW50) and 100% (Mw100) of fish meal substitution with MW respectively. P. leptodactylus juveniles (11.0 +/- 0.05 mm, mean +/- SE and 0.011 +/- 0.002 g, mean +/- SE) were randomly stocked into nine flow-through tanks with a density of 30 crayfish per tank and reared for 80 days. Crayfish fed with MW50 mealworm meal showed positive effects on weight gain (WG), specific growth rate (SGR), protein efficiency ratio (PER), apparent net protein utilization (ANPU), moulting frequency (MF) and feed conservation ratio (FCR), but lower survival rate (SR) as compared to the other diet groups. Protein and lipid contents of the whole body of the crayfish fed with replacement diet (MW50) were found to be higher than those of the other two diet groups (p<0.05). However, the MW100 diet slightly increased the moisture and ash contents of the crayfish. Our observation indicated that the addition of a 50% mealworm meal in the diet of P. leptodactylus juveniles improved the growth performance of the crayfish without causing any adverse effects. Therefore, T. molitor meal can be considered as an alternative animal source of protein for the narrow-clawed crayfish juveniles.

关键词： mouth mucosa   oral health   urethra   urethral stricture  

摘要： Purpose: Previous studies have elucidated the unique macroscopic and histological properties of buccal mucosa that make it a viable and durable graft for urethral augmentation. However, no prior literature has directly investigated the impact of preoperative oral health on these *** and Methods: We analyzed all consenting patients who underwent buccal mucosal graft (BMG) urethroplasty at our institution from 2018 to 2020. Validated oral health surveys, the Oral Health Impact Profile (OHIP-14) and the Kayser-Jones Brief Oral Health Status Examination (BOHSE) were completed preoperatively. A staff pathologist analyzed BMG histology and quantified oral mucositis using a modified Oral Mucosa Rating ***: We analyzed 51 patients with a median age of 40 years (IQR 31-58). Mean BOHSE score was 1.1 and OHIP-14 score was 1.4. Median epithelial thickness was 530 [mu]m and lamina propria thickness was 150 [mu]m. On age-adjusted analysis, increasing BOHSE and OHIP-14 were associated with decreasing epithelial thickness (p values <0.05). Higher BOHSE scores also correlated with thinner lamina proprias (p=0.05) and increased graft stretch (p=0.03). The 2 patients with postoperative urine leaks and available graft histology had lamina propria thicknesses well below the cohort median, at 50 [mu]m and 60 [mu]***: This is the first study to demonstrate that oral health conditions impact graft histology and stretch. Although much remains to be learned, our findings shed light on the potential importance of optimizing oral health prior to BMG urethroplasty, and raise the question of if preoperative mucosal biopsy could help inform surgical decision making and discussions regarding surgical success.(C) 2021 by the American Urological Association, Inc.

关键词： Surgery   Abdominal Surgery   Cardiac Surgery   General Surgery   Thoracic Surgery   Vascular Surgery  

关键词： Health professionals   RT-LAMP   RT-PCR   SARS-CoV-2   Oxidative stress   Inflammation  

摘要： In early December 2019, an outbreak of coronavirus disease 2019 caused by a new strain of coronavirus (SARSCoV-2), occurred in the city of Wuhan, Hubei Province, China. On January 30, 2020, the World Health Organization (WHO) declared the outbreak a public health emergency of international concern. Since then, frontline healthcare professionals have been experiencing extremely stressful situations and damage to their physical and mental health. These adverse conditions cause stress and biochemical, hematological, and inflammatory changes, as well as oxidative damage, and could be potentially detrimental to the health of the individual. The study population consisted of frontline health professionals working in BHU in a city in southern Brazil. Among the 45 participants, two were infected with the SARS-CoV-2 virus and were diagnosed using immunochromatographic tests such as salivary RT-LAMP and qRT-PCR. We also evaluated biochemical, hematological, inflammatory, and oxidative stress markers in the participants. The infected professionals (CoV-2-Prof) showed a significant increase in the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), cholesterol, lactic dehydrogenase, lymphocytes, and monocytes. In this group, the levels of uric acid, triglycerides, leukocytes, neutrophils, hemoglobin, hematocrit, and platelets decreased. In the group of uninfected professionals (NoCoV-2-Prof), significant increase in HDL levels and the percentages of eosinophils and monocytes, was observed. Further, in this group, uric acid, LDH, triglyceride, and cholesterol levels, and the hematocrit count and mean corpuscular volume were significantly reduced. Both groups showed significant inflammatory activity with changes in the levels of C-reactive protein and mucoprotein. The NoCoV-2-Prof group showed significantly elevated plasma cortisol levels. To our kowledge, this study is the first to report the use of the RT-LAMP method with the saliva samples of health pro

关键词： elite controllers   HIV infections   immune response  

摘要： Purpose of review HIV-1 elite controllers encompass small populations of people infected with HIV-1 who can spontaneously control plasma viral loads below the limit of detection, in the absence of antiretroviral treatment. Antiviral immune responses are likely to contribute to such an impressive HIV-1 disease outcome. In this review, we discuss recent novel findings regarding antiviral innate and adaptive immune responses in elite controllers. Recent findings Elite controllers maintain a pool of infected cells in which intact HIV-1 proviruses are more frequently integrated into noncoding regions of the host genome, likely conferring a state of deep latency. This atypical viral reservoir configuration is best explained by potent antiviral immune responses that can successfully eliminate virally infected cells in which proviruses are integrated into permissive chromatin. However, identifying the specific type and nature of this immune selection pressure represents a formidable challenge. Recent studies continue to support the role of HIV-1-specific CD8(+) T cells as the main driver of elite immune control of HIV-1, however, increasing evidence suggests that their role is complemented by a fine-tuned interplay with innate immune cell subsets. Therefore, the combination of different immune effector mechanisms may shape antiviral immunity in elite controllers. Understanding the complex immune mechanisms responsible for natural, drug-free HIV-1 control represents a premier avenue to find and develop interventions for a cure of HIV-1 infection. Future single-cell assays designed to uncover the full genetic, epigenetic, transcriptional and functional complexity of antiviral immune responses in elite controllers may allow us to define correlates of antiviral immune protection in greater detail.