The suitability of model for end-stage liver disease excluding international normalized ratio (MELD-XI) score to predict the incidence of acute kidney injury (AKI) and in-hospital mortality in adult patients with postcardiotomy cardiogenic shock (PCS) requiring venoarterial extracorporeal membrane oxygenation (VA ECMO) remains uncertain. This study was performed to explore whether the MELD-XI score has the association with the incidence of AKI and in-hospital mortality in these patients.

Adult patients with PCS requiring VA ECMO from January 2012 to December 2017 were enrolled and first classified into AKI group (
 = 151) versus no-AKI group (
 = 132), then classified into survival group (
 = 143) versus no-survival group (
 = 140). Multivariate logistic regressions were performed to identify factors independently associated with AKI and mortality. Baseline data were defined as the first measurement available.

Of 283 patients, the incidence of AKI was 53.36%. The in-hospital mortality rates were 63.e BUN, baseline T-Bil, baseline LVEF, SOFA score and lactate at the initiation of ECMO were associated with AKI. AKI, SOFA score, and VIS at the initiation of ECMO were associated with in-hospital mortality, whereas MELD-XI score was not found to be associated with in-hospital mortality. A specific MELD-XI score as a threshold, as well as its sensitivity and specificity, needs to be confirmed in further studies.
Acute myeloid leukemia (AML) is a heterogeneous disorder with complex genetic basis and adverse prognosis. https://www.selleckchem.com/products/pdd00017273.html Cytogenetics risk, somatic mutations and gene expression profiles are important prognostic factors for AML patients. However, accurate stratification of patient prognosis remains an unsolved problem in AML. This study was to to develop a novel gene profile to accurately classify AML patients into subgroups with different survival probabilities.

Survival-related genes were determined by Kaplan-Meier survival analysis and multivariate analysis using the expression and clinical data of 405 AML patients from Oregon Health & Science University (OHSU) dataset and validated in The Cancer Genome Atlas (TCGA) database. Feature selection was performed by using the Least Absolute Shrinkage and Selection Operator (LASSO) method. With the LASSO model, a prognostic 85-gene score was established and compared with 2 known gene-expression risk scores. The stratification of AML patients was performed by unsupervisgnostic gene signatures in the prediction of prognosis of AML patients.
The concept of hope is an important theme in chronic illness and palliative care and has been associated with increased psycho-spiritual well-being and quality of life. Psycho-spiritual interventions have been described in this population, but no systematic review of hope-enhancing interventions or hopelessness-reducing interventions has been conducted for persons with palliative care diseases.

To describe and assess the effectiveness of interventions in palliative care that measure hope and/or hopelessness as an outcome.

This systematic review and meta-analysis was pre-registered (Prospero ID CRD42019119956).

Electronic databases, journals, and references were searched. We used the Cochrane criteria to assess the risk of bias within studies.

Thirty-five studies (24 randomized controlled trials, 5 quasi-experimental, 6 pre-post studies) involving a total of 3296 palliative care patients were included. Compared with usual/standard cancer care alone, interventions significantly increased hope levels at a medium effect size (
 = 0.61, 95% confidence interval (CI) = 0.28-0.93) but did not significantly reduce hopelessness (
 = -0.08, 95% CI = -0.18 to 0.02). It was found that interventions significantly increase spirituality (
 = 0.70, 95% CI = 0.02-1.37) and decrease depression (
 = -0.29, 95% CI = -0.51 to -0.07), but had no significant effect over anxiety, quality of life, and symptom burden. Overall, quality of evidence across the included studies was rated as low.

Evidence suggests that interventions can be effective in increasing hope in palliative care patients.
Evidence suggests that interventions can be effective in increasing hope in palliative care patients.
Promoting brain health depends on sustaining healthy behaviors across the lifespan. Yet, public adoption of lifestyle behaviors and knowledge of cognitive decline (CD) prevention remains poor. Our multidisciplinary team developed
(MHB) to promote a healthy lifestyle (e.g. diet, exercise, alcohol, sleep) and build cognitive reserve (e.g. memory compensatory strategies). Our objective was to demonstrate early proof-of-concept for MHB by exploring the feasibility, acceptability, and improvement in primary lifestyle outcomes as well as secondary outcomes of self-determination and subjective wellbeing.

Older adults with subjective (self-report only) or objective (confirmed by cognitive testing) CD, referred by neurologists to modify lifestyle risk factors (e.g. sedentary), participated in a non-randomized open pilot of MHB (
 = 24). Participants completed the 8-week MHB group (90 min each) and pre-post outcome measures.

MHB met all a-priori set benchmarks, including good feasibility of
(71% of patients screened) and
(75% completed baseline), and good
(75% completed 6 of 8 sessions and post-testing). Program satisfaction was excellent (100% of participants) and no adverse events were reported. We also observed improvements in primary lifestyle outcomes as well as secondary outcomes of self-determination and subjective well-being.

While MHB demonstrated preliminary feasibility and the potential to modify lifestyle risk factors for CD, the program can be improved. Future work will explore the integration of mindfulness skills with behavioral principles to bolster multidomain lifestyle change, and the live video delivery format to bypass barriers to participation.
While MHB demonstrated preliminary feasibility and the potential to modify lifestyle risk factors for CD, the program can be improved. Future work will explore the integration of mindfulness skills with behavioral principles to bolster multidomain lifestyle change, and the live video delivery format to bypass barriers to participation.