Withdrawal Rate Research Articles

Clinical effects of combination therapy with continuous renal replacement therapy and continuous intravenous sodium infusion therapy.

This single-center retrospective study investigated the clinical effects of combination therapy involving continuous renal replacement therapy (CRRT) and continuous intravenous sodium infusion therapy (cIVNa) in critically ill patients with prerenal acute kidney injury (AKI) who were expected to experience insufficient plasma refilling. The clinical data of 92 patients were analyzed. Clinical data from the control (CRRT, n = 49) and intervention (CRRT + cIVNa, n = 43) groups were compared statistically. Combination therapy increased blood pressure and urine volume, while reducing hypotension events, indicating hemodynamic stabilization. Furthermore, it significantly improved the 90-day survival rate (61.9% vs. 38.8%, p < 0.05), 60-day and 90-day survival rates without RRT (59.5% vs. 28.6%, p < 0.01; 54.8% vs. 26.5%, p < 0.01, respectively), survival discharge rate from intensive care unit, CRRT withdrawal rate, and renal replacement therapy withdrawal rate. Combination therapy with continuous renal replacement therapy and continuous intravenous sodium infusion therapy may be a useful treatment option for critically ill patients with prerenal acute kidney injury who require continuous renal replacement therapy.

Anemia Is a Predictor of Withdrawal from Peritoneal Dialysis in Stable Peritoneal Dialysis Patients

Introduction: The association between anemia and peritoneal dialysis (PD) withdrawal in patients with stable PD remains poorly established. Herein, we investigated the relationship between anemia and PD withdrawal in patients with stable PD. Materials and Methods: We included 43 patients undergoing PD for at least 6 months between October 2011 and December 2022. Patients were categorized based on their hemoglobin (Hb) levels at the time of their first peritoneal equilibration test (PET) during the study period as follows: Hb ≥ 11 g/dL and Hb &lt; 11 g/dL. The PD withdrawal rates were compared between these groups. Patients were followed up until death or 31 July 2023. Results: During the follow-up, 36 patients discontinued treatment. Patients with Hb &lt; 11 g/dL had a significantly higher PD withdrawal rate than those with Hb ≥ 11 g/dL. Cox proportional hazards analysis identified Hb level as a risk factor for PD withdrawal. Furthermore, Hb levels negatively correlated with the annual decline in urine volume. Conclusions: Our findings suggest anemia as a predictor of PD withdrawal in patients with stable PD. The negative correlation between Hb levels and the annual decline in urine volume implies that anemia may contribute to PD withdrawal via the deterioration of residual renal function.

Risk-guided cardioprotection with carvedilol in patients with breast cancer (CCT guide): a phase 1 randomized clinical trial

PurposeBreast cancer treatment results in increased cardiotoxicity risk; a risk-guided approach to cardioprotection has not been fully tested.MethodsThis single-center, randomized Phase I trial enrolled patients with Stage I–III breast cancer who planned to receive anthracycline and/or trastuzumab therapy. An internally validated cardiotoxicity risk score classified participants as low or elevated risk. Elevated risk participants were randomized to receive open-label carvedilol or usual care for 12 months, beginning at cancer therapy initiation. Study visits occurred at baseline, 3, 6, 9, 12, and 24 months. Primary outcomes included feasibility, safety, and tolerability. Exploratory outcomes included echocardiography, biologic, and patient-reported measures.ResultsOf the 166 eligible patients approached, 68 (41%) agreed to participate and ultimately enrolled. Among these participants (median age 52, 35% Black), 49 were classified as low and 19 elevated risk. Within the elevated risk group, 13 were randomized to carvedilol and 6 usual care. For those randomized to carvedilol, the median maximum dose was 6.25 mg twice daily, with 93% adherence. Adverse events of interest (grade 3 + bradycardia, hypotension, or fatigue) occurred in 9% with carvedilol, 13% in usual care, and 4% in low risk groups. One (1.5%) low risk participant experienced cardiac dysfunction. There were no substantial differences in secondary outcomes across groups. The participant withdrawal rate was 7%.ConclusionsThis Phase 1 trial demonstrates that a risk-guided strategy can be applied to patients with active cancer. However, additional strategies are necessary to optimize the design and execution of non-treatment intervention trials in patients with active cancer.Trial registrationNCT04023110.

116 Does Insurance Status Affect Outcomes in Burn Admissions?

Abstract Introduction Burn injuries can require extended hospital stays, costly procedures, and intensive physical and occupational therapy after discharge. Lack of insurance or access to healthcare can frequently influence outcomes for these patients. Our objective was to compare outcomes for patients admitted to burn centers with and without insurance. Methods The American Burn Association (ABA) Noncommercial Burn Research Dataset was queried to search for admissions that included insurance status over ten years beginning in 2012. Demographic data and discharge disposition were recorded and analyzed with the chi-square test. Mortality was the primary outcome with ICU admission, respiratory failure, deep venous thrombosis (DVT), and hospital length of stay (LOS) were analyzed as secondary outcomes. Renal failure, unplanned intubation, cellulitis, systemic sepsis, and alcohol withdrawal were tertiary outcomes. Primary and secondary outcomes underwent covariate logistic regression analysis – adjusted for age, sex, TBSA%, and inhalation injury – to reduce the effects of these confounders. The Python language and PyCharm 3.1 software with Pandas, NumPy, and SciPy. Stats modules were used for all data analysis. Results 34,441 burn admissions were classified as uninsured compared to 74,886 with private insurance. Those uninsured had roughly three times higher odds of leaving against medical advice (AMA, OR = 2.97, p &amp;lt; 0.0001). Those who did not have insurance were significantly less likely to be white, more likely to be male, older (35.35±16.44 vs. 33.76±21.52), and have a flame injury (p &amp;lt; 0.0001 for all). Lack of insurance was associated with fewer unplanned intubations (p &amp;lt; 0.01), but an increase in alcohol withdrawal was seen in those without insurance (p &amp;lt; 0.0001). After removing the effects of covariates, uninsured status was linked to fewer ICU admissions (OR = 0.92), 1.06 days shorter hospital (LOS), higher rates of respiratory failure (OR = 1.61), and higher mortality rates (OR = 1.81, p &amp;lt; 0.0001 for all). Conclusions Patients lacking insurance are roughly three times as likely to leave AMA. Lack of insurance is also associated with significantly higher rates of alcohol withdrawal and mortality while also being correlated with significantly lower ICU admissions and shorter hospital stays. This nationwide database assessment is the most extensive analysis of insurance status on burn admissions. Applicability of Research to Practice These findings elucidate the disparity in outcomes for those with decreased access to healthcare. Burn centers and clinicians could potentially enhance case management services to those without insurance to reduce the likelihood of leaving AMA or have increased vigilance for these populations to avoid alcohol withdrawal. Funding for the Study N/A

900 Demographics, Outcomes, and Complications for the Homeless in Burn Unit Admissions: An Increasing Challenge?

Abstract Introduction Burn injuries are among the most severe in terms of morbidity and mortality with socioeconomic factors often complicating management and outcomes. Individuals experiencing homelessness are especially vulnerable, facing unique challenges that impact their admission, clinical course, and outcomes. This study investigates trends in burn injuries among the homeless, focusing on demographics, outcomes, and complications. Methods The American Burn Association Noncommercial Burn Research Dataset was queried for burn center admissions between 2012 and 2021. Individuals who identified as homeless were compared to those with confirmed housing. The primary outcome was the proportion of homeless admissions over time, and secondary outcomes included mortality, ICU admission, respiratory failure, pneumonia, DVT, and hospital length of stay (LOS). Minor complications examined were renal failure, unplanned intubation, arrhythmia, cellulitis, sepsis, alcohol withdrawal, and cardiac arrest. To reduce confounding, outcomes were adjusted for age, sex, TBSA, and inhalation injury. Odds ratios for complications were calculated using the chi-square test, and the change in the proportion of individuals experiencing homelessness relative to those with confirmed housing over time was analyzed using the Pearson correlation coefficient. Years with fewer than 100 cases were excluded. Data analysis was performed using PyCharm 3.1 software with Pandas, NumPy, and SciPy statistical modules. Results The dataset included 159,714 admissions with 4,669 (2.9%) identifying as homeless. From 2015 to 2021, the proportion of homeless admissions rose from 1.8% to 4.3% (r = 0.98). Homeless individuals were significantly older (45.18±13.34 vs. 35.56±24.01, p &amp;lt; 0.01), predominantly male (p &amp;lt; 0.01), and more likely to be white (p &amp;lt; 0.01). Homelessness was linked to lower rates of unplanned intubation (p &amp;lt; 0.01), cellulitis (p &amp;lt; 0.01), sepsis (p &amp;lt; 0.01), renal failure (p &amp;lt; 0.01), and cardiac arrest (p &amp;lt; 0.01), but higher rates of alcohol withdrawal (p &amp;lt; 0.01). After adjusting for covariates, homelessness was associated with lower rates of pneumonia (OR = 0.75, p &amp;lt; 0.01), higher rates of ICU admission (OR = 1.33, p &amp;lt; 0.01), and a longer LOS (4.88 days, p &amp;lt; 0.01). Conclusions This study is the largest retrospective analysis of burn admissions for the homeless population. There is a notable increase in homeless admissions compared to those with housing in recent years. Homeless burn patients exhibit lower rates of complications but higher ICU admissions and longer hospital stays. Applicability of Research to Practice This study highlights the need for healthcare providers to adapt their approaches for homeless burn patients, acknowledging their unique challenges. By focusing on their specific outcomes, care strategies can be improved to enhance recovery for this vulnerable group. Funding for the Study N/A

Comparing the feasibility, safety, and efficacy of Stretta radiofrequency and anti-reflux ablation therapy for treating patients with refractory gastroesophageal reflux disease: A retrospective, single-center cohort study.

Comparing the feasibility, safety, and efficacy of Stretta radiofrequency and anti-reflux ablation therapy for treating patients with refractory gastroesophageal reflux disease: A retrospective, single-center cohort study.

Consensus to Reduce Withdrawal and Improve Adherence with SGLT2i: Consensus TWO SGLT2i Adherence Group.

Sodium-glucose co-transporter-2 inhibitors (SGLT2i) are a class of medications that have shown significant efficacy in regulating blood glucose levels and providing additional benefits, such as cardiorenal protection. This study aims to analyze the factors leading to nonadherence and discontinuation of SGLT2i treatment and to identify strategies that can enhance patient compliance and reduce withdrawal rates. This consensus involved an expert committee comprising 14 leading opinion leaders, chosen for their profound expertise and experience in type 2 diabetes mellitus (T2D) and SGLT2i therapy. Prior to the meeting, a comprehensive document-developed through an extensive literature review on current challenges, best practices, and potential strategies for improving adherence and reducing withdrawal of SGLT2i-was distributed to the committee members. This allowed ample time for thorough review and preparation. The expert committee convened virtually multiple times to engage in in-depth discussions on various aspects of SGLT2i adherence and compliance. The finalized manuscript encapsulates the consensus achieved by the experts, presenting actionable recommendations aimed at enhancing adherence and reducing withdrawal rates in SGLT2i therapy. Based on the literature, several factors contribute to the nonadherence of SGLT2i, including being of Black race, older age (>65 years), high unemployment rate, lower income levels, extended duration of diabetes, a greater number of baseline comorbidities, genital infections, and limited access to healthcare facilities. To maintain good adherence, appropriate patient selection and education are essential. Healthcare practitioners should be well-informed about the drug's indications, interactions, and side effects. Regular monitoring, lifestyle adjustments, and open communication between healthcare practitioners and patients are crucial. Developing personalized care plans, educating patients, promptly addressing their concerns, and cultivating a collaborative healthcare relationship are critical in maintaining adherence.

Competitive growth behavior of converging bi-crystal of nickel-based superalloys under unsteady state conditions: effect of uniformly accelerated withdrawal rate

Competitive growth behavior of converging bi-crystal of nickel-based superalloys under unsteady state conditions: effect of uniformly accelerated withdrawal rate

Association of acamprosate versus gabapentinoids with hospitalization and total mortality in alcohol use disorder.

Alcohol use disorder (AUD) significantly increases hospitalizations and death. US Food and Drug Administration (FDA)-approved medications for AUD are underutilized. Gabapentinoids are not FDA-approved for AUD but are frequently prescribed by physicians. To examine the association of acamprosate and gabapentinoids on healthcare utilization and total mortality in patients with AUD. Two propensity score (PS)-matched retrospective cohort studies. Veterans diagnosed with AUD (years 2003-2021) initiating acamprosate or gabapentinoids in an AUD-related encounter and not on chronic opioid therapy (AUD-cohort). Another PS-cohort of veterans who were hospitalized for AUD diagnoses (AUD-admission cohort). Subgroup analysis included people with chronic obstructive lung diseases, opioid use, and age categories. Co-primary outcomes were admission for alcohol withdrawal (AW-admission) and annual rate of acute care events. Secondary outcome was total mortality. We matched 16,072 pairs of acamprosate and gabapentinoid users in AUD-cohort. AW-admission occurred in 35.4% of the acamprosate users and 30.0% of the gabapentinoid users (odds ratio [OR]: 1.28, 95% confidence interval [95% CI]: 1.22-1.34). Annual rate of acute care events in acamprosate and gabapentinoid users were 1.84 and 1.64, respectively (coefficient of regression [β]: 0.20, 95% CI: 0.12-0.28). There was no difference in total mortality (hazard ratio: 0.96, 95% CI: 0.91-1.005). In subgroup analysis, acamprosate use was associated with less total mortality in subgroups of people using opioids and older than 60 years. Gabapentinoids are associated with reduced AW-admission and lower annual rates of acute care events compared to acamprosate. Gabapentinoids may offer a viable alternative for AUD in carefully selected populations.

Formation of Lotus-Type Porous Iron by Zone Melting in a Nitrogen Atmosphere

Traditional lotus-type porous materials are typically fabricated under a hydrogen atmosphere, which poses safety risks. In contrast, using nitrogen enhances safety but often results in lower porosity and irregular pore shapes. This study investigates the fabrication of lotus-type porous iron using the zone melting technique under a nitrogen atmosphere, exploring the effects of nitrogen pressure and withdrawal rate on pore morphology. The results show that higher nitrogen pressure and a lower withdrawal rate lead to more regular and uniform pores. At 1.0 MPa nitrogen pressure and a 5 mm/min withdrawal rate, the most regular pore morphology was achieved, with porosity reaching 35%. Furthermore, as the nitrogen pressure increases, the nitrogen content and micro-Vickers hardness of the material increase significantly, exhibiting a pronounced solid solution strengthening effect. At 1.0 MPa, the nitrogen content reaches 0.077 wt.%, and the hardness increases from 136 HV for pure iron to 192 HV. Theoretical analysis suggests that stable pore growth is achieved when the product of nitrogen pressure and withdrawal rate is less than a constant. Increasing the nitrogen pressure promotes nitrogen dissolution in the molten zone, while a lower withdrawal rate facilitates adequate nitrogen diffusion, ensuring stable pore growth and higher porosity. This study provides a foundation for fabricating lotus-type porous materials using nitrogen as a safer alternative to hydrogen.

Evaluation of Implementation of Models of Academic Advising in Postgraduate Taught courses

The aim of this paper was to evaluate the effectiveness of the implementation of models of academic advising in PGT courses. Three main models of advising were created. Model 1 was an out of curriculum offer with at least three contact points per year. Model 2 was an embedded approach in which students are both taught by their academic adviser (AA) in a normal module, as well as receiving at least three contact points of dedicated academic advice. Model 3 was an extended advising offer in which student attend a series of one hour group academic advising sessions, each dedicated to developing the students academically, professionally and/or personally. A higher proportion of students experiencing Model 2 reported they had the opportunity and took up the opportunity to meet with their Academic Adviser compared with any other model. Additionally, these students had more positive perceptions of their AA, with significantly higher agreement that their AA takes a personal interest in them and that they provide useful advice and guidance to aid academic progress and development. Following model implementation student awareness of the AA role and of who theirs is was significantly greater. Additionally, there were positive improvements in student perceptions of support post-model implementation, with significant increases in the perceptions that academic advisers provided useful advice and guidance, referred to further support as appropriate, and took a personal interest in them. Further, there was a decrease in end of year withdrawal rates post-model implementation.

Curcumin for the clinical treatment of inflammatory bowel diseases: a systematic review and meta-analysis of placebo-controlled randomized clinical trials.

Inflammatory Bowel Disease (IBD), encompassing Crohn disease (CD) and ulcerative colitis (UC), presents complex challenges in management due to dysregulated immune responses and genetic predispositions. This study explored the potential of curcumin as an adjunctive therapy in IBD, assessing its efficacy and safety through a systematic review of clinical trials to enhance treatment strategies and outcomes. To identify placebo-controlled randomized clinical trials on curcumin treatment in IBD, databases such as Medline/PubMed, Scopus, Embase, Web of Knowledge, and Google Scholar were searched till May 2024. Inclusion criteria focused on RCTs comparing curcumin with placebo in IBD patients, with data extraction and analysis conducted using established methodologies and tools for comprehensive synthesis and assessment of study findings. In this meta-analysis, 13 placebo-controlled RCTs on curcumin treatment in IBD were included after screening 362 records and conducting a full-text review. Most trials focused on UC patients and were published post-2010, utilizing oral curcumin with varying dosages and durations. The analysis showed curcumin's significant efficacy in achieving clinical remission and response in UC patients, with heterogeneity observed. Adverse events and withdrawal rates did not significantly differ between curcumin and placebo groups. In CD patients, curcumin did not show superiority over placebo for clinical and endoscopic remission. The findings highlight curcumin's potential as a treatment for UC but indicate inconclusive results for CD, emphasizing the need for further research. The multifaceted mechanisms of curcumin's efficacy in IBD involve anti-inflammatory, antioxidant, microbiota modulatory, and immune-regulating properties. Further research is warranted to enhance understanding and treatment efficacy. https://www.crd.york.ac.uk/PROSPERO/view/CRD42024567247.

Extended inventory planning models for repairable imperfect quality items under withdrawal policies and inspection errors

ABSTRACT The repair process is a widely used policy for handling imperfect quality items in inventory systems. However, most prior studies have made unrealistic assumptions, such as assuming all repaired items return to the system and batch withdrawals with infinite withdrawal rates. These assumptions limit the practical applicability of such models. This study addresses these gaps by developing new economic order quantity and economic production quantity models that account for partial repair success, inspection errors, and both finite and infinite withdrawal rates. Additionally, preventive maintenance is integrated into the economic production quantity model. An analytical derivative-based method is employed to determine optimal replenishment policies for four different cases. Numerical results indicate that the total cost is significantly influenced by the demand rate and is sensitive to system parameters. This study contributes to the literature by providing a more realistic approach to inventory and repair systems, offering insights for practical applications.

Feasibility, safety, and adherence of home-based exercise interventions in people diagnosed with cancer: a systematic review.

This systematic review aims to evaluate the feasibility, safety, and adherence of home-based exercise interventions in people diagnosed with cancer. The primary research question is: Are home-based exercise interventions safe and feasible for people diagnosed with cancer? A comprehensive search of databases including PubMed, EMBASE, and Cochrane Library was conducted in January 2025, focusing on randomized controlled trials (RCTs) that involved home-based exercise interventions people diagnosed with cancer. Studies were included if they reported on safety, feasibility, and health-related outcomes. The Physiotherapy Evidence Database (PEDro) scale was used to assess study quality and risk of bias. Adverse events were categorized by severity, and feasibility which was determined based on recruitment, withdrawal, and adherence rates. From 127 eligible studies involving 10,562 participants, the review found that home-based exercise interventions are generally safe, with less than 3.2% of participants experiencing exercise-related adverse events, most of which were minor. Feasibility was supported by an average recruitment rate of 50.1%, which was calculated as the proportion of eligible participants who consented to participate across the included studies. Additionally, the review found a withdrawal rate of 13.7%, and an adherence rate of 76.2%. However, significant variability in these rates were observed across the studies, highlighting the challenges in maintaining participant engagement. Home-based exercise interventions are feasible and safe for people diagnosed with cancer, with minor adverse events being the most common. However, there is a need for standardized protocols in reporting adverse events and better strategies to improve recruitment and adherence. These findings support the integration of home-based exercise into standard cancer care, offering a practical and safe option for enhancing the health and well-being of cancer survivors. However, the successful implementation of these programs may require additional support from exercise professionals within primary care or community settings to ensure appropriate guidance and adherence. Personalized exercise programs, developed by qualified exercise professionals such as physiotherapists or clinical exercise physiologists, and improved reporting standards are essential to optimizing these interventions.

Withdrawal of Guideline-Directed Medical Therapy in Patients With Heart Failure and Improved Ejection Fraction.

Limited evidence exists on the prognostic role of continuing medical therapy in patients with heart failure (HF) and an ejection fraction (EF) that has improved over time. This study assessed rates of, patient profiles, and associations with morbidity/mortality of renin-angiotensin inhibitors (RASi), angiotensin receptor-neprilysin inhibitors (ARNi), beta-blockers (BBL), and mineralocorticoid receptor antagonists (MRA) withdrawal in patients with HF with improved EF. Patients with a first recorded EF <40% and a later EF ≥40% from the Swedish HF registry between June 11, 2000, and December 31, 2023, were included in this retrospective observational study. Withdrawal was defined as a patient on treatment at the first (reduced) but not at the second (improved) registration. The association between withdrawal and time to first cardiovascular mortality/hospitalization for HF with censoring at 1 year was assessed by Cox regression model using overlap weighting. Of 8728 patients with HF with improved EF (median age, 70 years [25th to 75th percentile, 61-78], 2611 [29.9%] women), 96%, 94%, and 46% received RASi/ARNi, BBL, and MRA, respectively, when EF was <40%. The withdrawal rates at the time of the improved EF registration were 4.4% for RASi/ARNi, 3.3% for BBL, and 17.2% for MRA. Predictors of withdrawal included lower use of other HF medications, higher EF at the later EF registration, and a longer time between the 2 EF assessments. After weighting, withdrawal was independently associated with a higher risk of cardiovascular mortality/hospitalization for HF by 38% for RASi/ARNi and 36% for MRA, but not for BBL. Withdrawal of BBL was associated with a higher risk of the primary outcome in the subgroup of patients with an improved EF of 40% to 49% versus ≥50% (P-interaction 0.03). In patients with HF with improved EF, HF therapy withdrawal was rare. Withdrawing RASi/ARNi and MRA was associated with higher mortality/morbidity at 1 year. No association was found for BBL withdrawal, albeit with a significant heterogeneity for EF at improvement, suggesting better outcomes with continuing BBL only until EF improves up to 50%. These results are hypothesis-generating and highlight the need for randomized controlled trials testing BBL withdrawal in patients with HF with improved EF.

TERRIGEN KOLLEKTORLI QATLAMLARDA NEFT BERAOLUVCHANLIKNI SUYUQLIK OLISH SUR’ATIGA BOG‘LIQLIGINING STATISTIK MODELLARINI TAHLIL QILISH VA ASOSLASH

This article shows the analysis of statistical models of the dependence of oil recovery on the rate of fluid withdrawal in terrigenous reservoirs and the justification of these models. Statistical dependencies are presented for assessing the final oil recovery factor and the geological and physical conditions of their use. Based on these conditions, the correlation method was analyzed. Based on these conditions, the correlation method was analyzed. The results of assessing the level of influence of the liquid withdrawal rate coefficient on the use of methods for increasing production at facilities similar to those considered in statistical models are analyzed.

Long-term outcomes of treatment with levetiracetam and valproate in idiopathic generalized epilepsy.

Long-term outcomes of treatment with levetiracetam and valproate in idiopathic generalized epilepsy.

First prospective, single-arm, multicenter study to evaluate safety and efficacy of the overall thrombectomy system -iNedit, iNdeep, and iNtercept- for acute ischemic stroke. Rationale beyond the study.

The clinical impact of a novel mechanical thrombectomy strategy, which integrates distal access with flow reversal and flow arrest via a distal balloon, all within a single procedure [Safety and Efficacy of the overall throMbectomy system for sTroke (SEMTiC) strategy], has not been tested. The SEMTiC-01 study is the first prospective, multicenter in vivo study evaluating the safety and efficacy of the combined thrombectomy system-iNedit, iNdeep, and iNtercept-in patients with acute ischemic stroke. The study was designed with a sequential structure based on the efficacy endpoint (eTICI ≥2b) reported in the literature [71.1% with a 95% confidence interval of (68.5%, 73.8%)]. An interim analysis was set for 115 patients and a final analysis for 225 patients, ensuring 98% power at a one-sided 0.025 significance level, with a 2.6% non-inferiority margin and a 15% assumed withdrawal rate. SEMTiC-01 is a prospective, multicenter, single-arm, open-label clinical safety and efficacy investigation. Primary efficacy endpoint: expanded treatment in cerebral infarction score (eTICI) ≥2b revascularization within ≤ 3 stent retriever passes. Primary safety endpoint: monitoring serious adverse events within 24 h post-intervention and all-cause mortality at 90 days.

Long-term need and potential for withdrawal of enteral feeding in children with chronic kidney disease stage 5D or 5T.

Children with chronic kidney disease (CKD) stage 5 may require long-term enteral tube feeding. However, the factors associated with the need for tube feeding and the potential for its withdrawal are unclear. This single-center, retrospective cohort study included patients with CKD stage 5D or 5T aged <18 years between 2004 and 2021. We evaluated data on the initiation of enteral tube feeding and its associated factors, the potential and timing of the withdrawal of enteral tube feeding, and improvements in feeding difficulties before and after kidney transplantation. Of the 58 study participants, 33 (57%) received enteral tube feeding for more than 1 month. After adjusting for males and major congenital complications, logistic regression analyses identified a younger age at the initiation of kidney replacement therapy as a factor associated with the need for enteral tube feeding (odds ratio: 1.82, 95% confidence interval: 1.28‒2.56, P < 0.001). During the study period, enteral tube feeding was withdrawn from 24 of the 33 (73%) children (withdrawal rates: 2 years, 26%; 3 years, 50%; and 5 years, 66%). Of the nine patients in whom enteral tube feeding was not withdrawn before kidney transplantation, six underwent withdrawal at 0.1, 0.1, 1.1, 1.6, 2.9, and 3.3 years after kidney transplantation, respectively. The remaining three patients continued enteral tube feeding after kidney transplantation. Although withdrawal from enteral nutrition is difficult in children with CKD stage 5D or 5T, it may be possible with kidney transplantation or over time.

Human induced pluripotent stem cell-cardiomyocytes for cardiotoxicity assessment: a comparative study of arrhythmiainducing drugs with multi-electrode array analysis.

Reliable preclinical models for assessing drug-induced cardiotoxicity are essential to reduce the high rate of drug withdrawals during development. Human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) have emerged as a promising platform for such assessments due to their expression of cardiacspecific ion channels and electrophysiological properties. In this study, we investigated the effects of eight arrhythmogenic drugs-E4031, nifedipine, mexiletine, JNJ303, flecainide, moxifloxacin, quinidine, and ranolazine-on hiPSC-CMs derived from both healthy individuals and a long QT syndrome (LQTS) patient using multielectrode array systems. The results demonstrated dose-dependent changes in field potential duration and arrhythmogenic risk, with LQTS-derived hiPSC-CMs showing increased sensitivity to hERG channel blockers such as E4031. Furthermore, the study highlights the potential of hiPSC-CMs to model disease-specific cardiac responses, providing insights into genetic predispositions and personalized drug responses. Despite challenges related to the immaturity of hiPSC-CMs, their ability to recapitulate human cardiac electrophysiology makes them a valuable tool for preclinical cardiotoxicity assessments. This study underscores the utility of integrating patientderived hiPSC-CMs with advanced analytical platforms, such as multi-electrode array systems, to evaluate drug-induced electrophysiological changes. These findings reinforce the role of hiPSC-CMs in drug development, facilitating safer and more efficient screening methods while supporting precision medicine applications.