A glutathione S-transferase from Thinopyrum ponticum confers Fhb7 resistance to Fusarium head blight in wheat.

Fusarium head blight (FHB), mainly incited by Fusarium graminearum Schwabe, has caused great losses in grain yield and quality of wheat globally. Fhb7, a major gene from 7E chromosome of Thinopyrum ponticum, confers broad resistance to multiple Fusarium species in wheat, and has recently been cloned and identified as encoding a glutathione S-transferase (GST). However, some recent reports raised doubt about if GST is the causal gene of Fhb7. To resolve the discrepancy and validate the gene function of GST in wheat, we phenotyped Fhb7 near-isogenic lines (Jimai22-Fhb7 vs Jimai22) and GST over-expressed lines for FHB resistance. Jimai22-Fhb7 showed significantly higher FHB resistance with a lower percentage of symptomatic spikelets (PSS), Fusarium-damaged kernel (FDK) and Deoxynivalenol (DON) content than susceptible Jimai22 in three experiments. All the positive GST transgenic lines driven by either the maize ubiquitin promoter (MubiP) or its native promoter (NP) with high gene expression in the wheat cultivar 'Fielder' showed high FHB resistance. Only one MubiP-driven transgenic line showed low GST expression and similar susceptibility as Fielder, suggesting high GST expression confers Fhb7 resistance to FHB. Knockout of GST in Jimai22-Fhb7 line using CRISPR-Cas9-based gene-editing showed significantly higher FHB susceptibility compared with the non-edited control plants. Therefore, we confirmed GST as the causal gene of Fhb7 for FHB resistance. Considering its major effect on FHB resistance, pyramiding Fhb7 with other QTLs has a great potential to create highly FHB-resistant wheat cultivars.

Molecular Dynamics Studies of Atomistically Determined Fibrillar Assemblies: Comparison of the Rippled ß-Sheet, Pleated ß-Sheet, and Herringbone Structures.

Pauling and Corey expected that a racemic mixture would result in a rippled ß-sheet, however, it has been known from experiments that the racemic mixtures of triphenylalanine lead to a herringbone structure. Because of the theoretical limitations concerning crystal structures such as rippled ß-sheet, it is inevitable to understand how the interplay of the amino acids prefers a specific structural motif. In this paper we use molecular dynamics to understand the sequence- and enantiomer-dependent structures by comparisons between rippled ß-sheet and pleated ß-sheet, solvated and anhydrous rippled ß-sheet, and rippled ß-sheet and the herringbone structure, based on thermodynamics and structures at the atomic level. The tripeptides select the favored structure that can be stabilized through aromatic or hydrogen bonding interactions between tripeptides. Furthermore, the solubility is determined by the environment of space that is created around the side chains. Our findings provide comprehensive insight into the crystallized fibril motif of the polypeptide.

Investigation of Donor-like State Distributions in Solution-Processed IZO Thin-Film Transistor through Photocurrent Analysis.

The density of donor-like state distributions in solution-processed indium-zinc-oxide (IZO) thin-film transistors (TFTs) is thoroughly analyzed using photon energy irradiation. This study focuses on quantitatively calculating the distribution of density of states (DOS) in IZO semiconductors, with a specific emphasis on their variation with indium concentration. Two calculation methods, namely photoexcited charge collection spectroscopy (PECCS) and photocurrent-induced DOS spectroscopy (PIDS), are employed to estimate the density of the donor-like states. This dual approach not only ensures the accuracy of the findings but also provides a comprehensive perspective on the properties of semiconductors. The results reveal a consistent characteristic: the Recombination-Generation (R-G) center energy ET, a key aspect of the donor-like state, is acquired at approximately 3.26 eV, irrespective of the In concentration. This finding suggests that weak bonds and oxygen vacancies within the Zn-O bonding structure of IZO semiconductors act as the primary source of R-G centers, contributing to the donor-like state distribution. By highlighting this fundamental aspect of IZO semiconductors, this study enhances our understanding of their charge-transport mechanisms. Moreover, it offers valuable insight for addressing stability issues such as negative bias illumination stress, potentially leading to the improved performance and reliability of solution-processed IZO TFTs. The study contributes to the advancement of displays and technologies by presenting further innovations and applications for evaluating the fundamentals of semiconductors.

Long-term outcomes and associated prognostic risk factors of childhood-onset lupus nephritis.

Background: This study investigated the clinical characteristics and kidney outcomes of childhood-onset lupus nephritis (LN), and risk factors associated with prognosis. Methods: We enrolled 216 patients with histologically diagnosed LN during childhood. The Korean Society of Pediatric Nephrology organized a retrospective cohort study of childhood-onset LN in 13 major pediatric nephrology centers in South Korea. Results: The mean age at kidney biopsy was 13.2 ± 3.22 years. The main forms of presentation were nephrotic syndrome and/or hematuria in 152 patients (70.4%), and the most common histological finding was World Health Organization (WHO) class IV in 138 patients (63.9%), followed by WHO class III in 34 patients (15.7%). In the outcome analysis, the mean follow-up period of the patients was 7.8 ± 5.11 years. At last follow-up, 32 patients (14.8%) developed advanced chronic kidney disease (CKD). Male sex and failure to achieve remission at 12 months of treatment were significant risk factors for developing advanced CKD (hazard ratio of 2.57 and 2.29, respectively). Conclusion: Our study demonstrated the clinical characteristics and long-term outcomes of patients with childhood-onset LN. Male sex and failure to achieve remission in the first year of treatment were predictive of advanced CKD. Therefore, prompt awareness and close monitoring of these high-risk patients are needed, which may further improve the prognosis of children with LN.

Clinical outcomes of nephrocalcinosis in preschool-age children: association between nephrocalcinosis improvement and long-term kidney function.

Background: We evaluated the long-term clinical outcomes of nephrocalcinosis (NC) according to etiology and grade in preschool-age children with NC. Methods: We retrospectively analyzed the clinical outcomes and disease grade of children with NC classified into three groups according to etiology: prematurity, tubular disorders, and others. Results: Overall, 67 children were diagnosed with NC [median age, 0.76 years; interquartile range (IQR) 0.46-2.14 years]. The etiologies of NC included prematurity (28.4%), tubular disorders (25.4%), and others (46.3%). Moreover, 56 (83.6%) children were asymptomatic and diagnosed accidentally through kidney ultrasonography. Newly diagnosed underlying diseases were greater in the tubular disorders group than in the other two groups (P = 0.001). Significantly more newly diagnosed NCs were grade 3 than grade 1 (P = 0.003). The median estimated glomerular filtration rate (eGFR) changed from 96.1 (IQR 68.8-119.2) ml/min/1.72 m2 at diagnosis to 90.9 (IQR 76.4-106.4) ml/min/1.72 m2 at the last follow-up, without a significant difference (P = 0.096). Changes in the kidney function did not differ according to etiology. However, patients without improvement in NC grade showed a decrease in eGFR from 98.1 (IQR 71.1-132.9) to 87.4 (IQR 74.0-104.1) ml/min/1.73 m2 (P = 0.023), while patients with improved NC grade did not show any change in the kidney function. Conclusions: Early recognition, especially in NC grade 3, can help uncover further diagnoses, such as tubular disorders. Long-term kidney function depends on whether the NC grade improves.

Functional Group-Dependent Proton Conductivity of Phosphoric Acid-Doped Ion-Pair Coordinated Polymer Electrolytes: A Molecular Dynamics Study.

Toward deployment of high-temperature polymer electrolyte membrane fuel cells (HT-PEMFCs) in our daily lives, multiple research efforts have been dedicated to develop high-performance phosphate-doped polymer electrolytes. Recently, ion-pair coordinated polymers have garnered attention for their high stability and proton conductivity. However, a comprehensive understanding of how proton transport properties are modified by the functional groups present in these polymers is still lacking. In this study, we employ molecular dynamics (MD) simulations to investigate the impact of different functional group types and conversion ratios on conductivity. We find that Grotthuss-type hopping transport predominantly governs the overall conductivity, surpassing vehicular transport by factors of 100-1000. As conductivity scales with proton concentration, we observe that less-bulky functional groups offer advantages by minimizing the volume expansion associated with increased conversion ratios. Additionally, we show that a strong ion-pair interaction between the cationic functional group and the phosphate anion disrupts the suitable intermolecular orientations required for efficient proton hopping between phosphate and phosphoric acid molecules, thereby diminishing the proton conductivity. Our study underscores the importance of optimizing the strength of ion-pair interactions to balance stability and proton conductivity, thus paving the way for the development of ion-pair coordinated polymer electrolytes with improved performance.

Analyzing Acceptor-like State Distribution of Solution-Processed Indium-Zinc-Oxide Semiconductor Depending on the In Concentration.

Understanding the density of state (DOS) distribution in solution-processed indium-zinc-oxide (IZO) thin-film transistors (TFTs) is crucial for addressing electrical instability. This paper presents quantitative calculations of the acceptor-like state distribution of solution-processed IZO TFTs using thermal energy analysis. To extract the acceptor-like state distribution, the electrical characteristics of IZO TFTs with various In molarity ratios were analyzed with respect to temperature. An Arrhenius plot was used to determine electrical parameters such as the activation energy, flat band energy, and flat band voltage. Two calculation methods, the simplified charge approximation and the Meyer-Neldel (MN) rule-based carrier-surface potential field-effect analysis, were proposed to estimate the acceptor-like state distribution. The simplified charge approximation established the modeling of acceptor-like states using the charge-voltage relationship. The MN rule-based field-effect analysis validated the DOS distribution through the carrier-surface potential relationship. In addition, this study introduces practical and effective approaches for determining the DOS distribution of solution-processed IZO semiconductors based on the In molarity ratio. The profiles of the acceptor-like state distribution provide insights into the electrical behavior depending on the doping concentration of the solution-processed IZO semiconductors.

Effects of Post-UV/Ozone Treatment on Electrical Characteristics of Solution-Processed Copper Oxide Thin-Film Transistors.

To realize oxide semiconductor-based complementary circuits and better transparent display applications, the electrical properties of p-type oxide semiconductors and the performance improvement of p-type oxide thin-film transistors (TFTs) are required. In this study, we report the effects of post-UV/ozone (O3) treatment on the structural and electrical characteristics of copper oxide (CuO) semiconductor films and the TFT performance. The CuO semiconductor films were fabricated using copper (II) acetate hydrate as a precursor material to solution processing and the UV/O3 treatment was performed as a post-treatment after the CuO film was fabricated. During the post-UV/O3 treatment for up to 13 min, the solution-processed CuO films exhibited no meaningful change in the surface morphology. On the other hand, analysis of the Raman and X-ray photoemission spectra of solution-processed CuO films revealed that the post-UV/O3 treatment induced compressive stress in the film and increased the composition concentration of Cu-O lattice bonding. In the post-UV/O3-treated CuO semiconductor layer, the Hall mobility increased significantly to approximately 280 cm2 V-1 s-1, and the conductivity increased to approximately 4.57 × 10-2 Ω-1 cm-1. Post-UV/O3-treated CuO TFTs also showed improved electrical properties compared to those of untreated CuO TFTs. The field-effect mobility of the post-UV/O3-treated CuO TFT increased to approximately 6.61 × 10-3 cm-2 V-1 s-1, and the on-off current ratio increased to approximately 3.51 × 103. These improvements in the electrical characteristics of CuO films and CuO TFTs can be understood through the suppression of weak bonding and structural defects between Cu and O bonds after post-UV/O3 treatment. The result demonstrates that the post-UV/O3 treatment can be a viable method to improve the performance of p-type oxide TFTs.

Induction of ICAM1 in Brain Vessels is Implicated in an Early AD Pathogenesis by Modulating Neprilysin.

Intercellular adhesion molecule 1 (ICAM1) is a vessel adhesion protein induced during brain vascular inflammation, which could be closely linked with the development of Alzheimer's disease (AD). This study investigated the effect of ICAM1 on amyloid-degrading enzymes (ADEs) in endothelial cells and their potential involvement in inflammation and AD progression. TNF-α treatment increased ICAM1 in human brain microvascular endothelial cells (HBMVECs) but decreased the neprilysin (NEP) protein level. Knock-down of ICAM1 using siRNA enhanced NEP, which increased the degradation of amyloid-ß. In the brains of 4-month-old AD transgenic mice (APPswe/PSEN1dE9), there were significantly higher levels of ICAM1 expression and amyloid deposits but lower levels of NEP and insulin-degrading enzymes (IDE), demonstrating an inverse correlation of ICAM1 with NEP and IDE expression. Further studies demonstrated significantly increased GFAP protein levels in the brain, specifically localized near blood vessels, of both TNF-α-injected and 4-month-old AD transgenic mice. Taken together, the induction of ICAM1 in endothelial cells suppresses NEP expression, accelerating the accumulation of amyloid-ß in blood vessels. It also enhances leukocyte adhesion to blood vessels stimulating the migration of leukocytes into the brain, subsequently triggering brain inflammation.

Investigation on Atomic Bonding Structure of Solution-Processed Indium-Zinc-Oxide Semiconductors According to Doped Indium Content and Its Effects on the Transistor Performance.

The atomic composition ratio of solution-processed oxide semiconductors is crucial in controlling the electrical performance of thin-film transistors (TFTs) because the crystallinity and defects of the random network structure of oxide semiconductors change critically with respect to the atomic composition ratio. Herein, the relationship between the film properties of nitrate precursor-based indium-zinc-oxide (IZO) semiconductors and electrical performance of solution-processed IZO TFTs with respect to the In molar ratio was investigated. The thickness, morphological characteristics, crystallinity, and depth profile of the IZO semiconductor film were measured to analyze the correlation between the structural properties of IZO film and electrical performances of the IZO TFT. In addition, the stoichiometric and electrical properties of the IZO semiconductor films were analyzed using film density, atomic composition profile, and Hall effect measurements. Based on the structural and stoichiometric results for the IZO semiconductor, the doping effect of the IZO film with respect to the In molar ratio was theoretically explained. The atomic bonding structure by the In doping in solution-processed IZO semiconductor and resulting increase in free carriers are discussed through a simple bonding model and band gap formation energy.

Biodegradable Block Copolymer-Tannic Acid Glue.

Bioadhesives are becoming an essential and important ingredient in medical science. Despite numerous reports, developing adhesive materials that combine strong adhesion, biocompatibility, and biodegradation remains a challenging task. Here, we present a biocompatible yet biodegradable block copolymer-based waterborne superglue that leads to an application of follicle-free hair transplantation. Our design strategy bridges self-assembled, temperature-sensitive block copolymer nanostructures with tannic acid as a sticky and biodegradable polyphenolic compound. The formulation further uniquely offers step-by-step increases in adhesion strength via heating-cooling cycles. Combining the modular design with the thermal treating process enhances the mechanical properties up to 5 orders of magnitude compared to the homopolymer formulation. This study opens a new direction in bioadhesive formulation strategies utilizing block copolymer nanotechnology for systematic and synergistic control of the material's properties.

Cloning of the broadly effective wheat leaf rust resistance gene Lr42 transferred from Aegilops tauschii.

The wheat wild relative Aegilops tauschii was previously used to transfer the Lr42 leaf rust resistance gene into bread wheat. Lr42 confers resistance at both seedling and adult stages, and it is broadly effective against all leaf rust races tested to date. Lr42 has been used extensively in the CIMMYT international wheat breeding program with resulting cultivars deployed in several countries. Here, using a bulked segregant RNA-Seq (BSR-Seq) mapping strategy, we identify three candidate genes for Lr42. Overexpression of a nucleotide-binding site leucine-rich repeat (NLR) gene AET1Gv20040300 induces strong resistance to leaf rust in wheat and a mutation of the gene disrupted the resistance. The Lr42 resistance allele is rare in Ae. tauschii and likely arose from ectopic recombination. Cloning of Lr42 provides diagnostic markers and over 1000 CIMMYT wheat lines carrying Lr42 have been developed documenting its widespread use and impact in crop improvement.

Atomic Structure Evaluation of Solution-Processed a-IZO Films and Electrical Behavior of a-IZO TFTs.

Understanding the chemical reaction pathway of the metal-salt precursor is essential for modifying the properties of solution-processed metal-oxide thin films and further improving their electrical performance. In this study, we focused on the structural growth of solution-processed amorphous indium-zinc-oxide (a-IZO) films and the electrical behavior of a-IZO thin-film transistors (TFT). To this end, solution-processed a-IZO films were prepared with respect to the Zn molar ratio, and their structural characteristics were analyzed. For the structural characteristic analysis of the a-IZO film, the cross-section, morphology, crystallinity, and atomic composition characteristics were used as the measurement results. Furthermore, the chemical reaction pathway of the nitrate precursor-based IZO solution was evaluated for the growth process of the a-IZO film structure. These interpretations of the growth process and chemical reaction pathway of the a-IZO film were assumed to be due to the thermal decomposition of the IZO solution and the structural rearrangement after annealing. Finally, based on the structural/chemical results, the electrical performance of the fabricated a-IZO TFT depending on the Zn concentration was evaluated, and the electrical behavior was discussed in relation to the structural characteristics.

Associated Factors and Health Outcomes of Health Literacy and Physical Frailty Among Older Adults: A Systematic Review.

The current review aimed to systematically describe and synthesize health outcomes and factors associated with health literacy and physical frailty among older adults. Seven electronic databases were searched for observational studies published in English, from database inception to March 31, 2021. The study protocol was registered with PROSPERO. Two reviewers independently performed study selection, data extraction, and quality assessment using the Newcastle-Ottawa Scale. Among the 479 studies identified, nine (6,337 participants) met eligibility criteria. Common factors associated with health literacy and physical frailty were lower educational level, multiple comorbidities, and cognitive dysfunction. Health literacy was mainly associated with self-reported outcomes, whereas physical frailty was related to clinical outcomes. Prospective studies are required to identify the impact of limited health literacy, combined with frailty, on long-term health outcomes in older adults. Health literacy interventions should consider the older adult population with multiple comorbidities. [Research in Gerontological Nursing, 15(1), 39-52.].

Effects of Iodine Doping on Electrical Characteristics of Solution-Processed Copper Oxide Thin-Film Transistors.

In order to implement oxide semiconductor-based complementary circuits, the improvement of the electrical properties of p-type oxide semiconductors and the performance of p-type oxide TFTs is certainly required. In this study, we report the effects of iodine doping on the structural and electrical characteristics of copper oxide (CuO) semiconductor films and the TFT performance. The CuO semiconductor films were fabricated using copper(II) acetate hydrate as a precursor to solution processing, and iodine doping was performed using vapor sublimated from solid iodine. Doped iodine penetrated the CuO film through grain boundaries, thereby inducing tensile stress in the film and increasing the film's thickness. Iodine doping contributed to the improvement of the electrical properties of the solution-processed CuO semiconductor including increases in Hall mobility and hole-carrier concentration and a decrease in electrical resistivity. The CuO TFTs exhibited a conduction channel formation by holes, that is, p-type operation characteristics, and the TFT performance improved after iodine doping. Iodine doping was also found to be effective in reducing the counterclockwise hysteresis in the transfer characteristics of CuO TFTs. These results are explained by physicochemical reactions in which iodine replaces oxygen vacancies and oxygen atoms through the formation of iodide anions in CuO.

Perioperative risk factors for new-onset postoperative atrial fibrillation after coronary artery bypass grafting: a systematic review.

BACKGROUND: Postoperative atrial fibrillation (POAF) is the most common cardiac dysrhythmia to occur after coronary artery bypass grafting (CABG). However, the risk factors for new-onset POAF after CABG during the perioperative period have yet to be clearly defined. Accordingly, the aim of our systematic review was to evaluate the perioperative predictors of new-onset POAF after isolated CABG. METHOD: Our review methods adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. We searched seven electronic databases (PubMed, Embase, CINAHL, PsycArticles, Cochrane, Web of Science, and SCOPUS) to identify all relevant English articles published up to January 2020. Identified studies were screened independently by two researchers for selection, according to predefined criteria. The Newcastle-Ottawa Scale was used to evaluate the quality of studies retained. RESULTS: After screening, nine studies were retained for analysis, including 4798 patients, of whom 1555 (32.4%) experienced new-onset POAF after CABG. The incidence rate of new-onset POAF ranged between 17.3% and 47.4%. The following risk factors were identified: old age (p < 0.001), a high preoperative serum creatinine level (p = 0.001), a low preoperative hemoglobin level (p = 0.007), a low left ventricle ejection fraction in Asian patients (p = 0.001), essential hypertension (p < 0.001), chronic obstructive pulmonary disease (p = 0.010), renal failure (p = 0.009), cardiopulmonary bypass use (p = 0.002), perfusion time (p = 0.017), postoperative use of inotropes (p < 0.001), postoperative renal failure (p = 0.001), and re-operation (p = 0.005). All studies included in the analysis were of good quality. CONCLUSIONS: The risk factors identified in our review could be used to improve monitoring of at-risk patients for early detection and treatment of new-onset POAF after CABG, reducing the risk of other complications and negative clinical outcomes.

Simultaneous Enhanced Efficiency and Stability of Perovskite Solar Cells Using Adhesive Fluorinated Polymer Interfacial Material.

For enhancing the performance and long-term stability of perovskite solar cell (PSC) devices, interfacial engineering between the perovskite and hole-transporting material (HTM) is important. We developed a fluorinated conjugated polymer PFPT3 and used it as an interfacial layer between the perovskite and HTM layers in normal-type PSCs. Interaction of perovskite and PFPT3 via Pb-F bonding effectively induces an interfacial dipole moment, which resulted in energy-level bending; this was favorable for charge transfer and hole extraction at the interface. The PSC device achieved an increased efficiency of 22.00% with an open-circuit voltage of 1.13 V, short-circuit current density of 24.34 mA/cm2, and fill factor of 0.80 from a reverse scan and showed an averaged power conversion efficiency of 21.59%, which was averaged from forward and reverse scans. Furthermore, the device with PFPT3 showed much improved stability under an 85% RH condition because hydrophobic PFPT3 reduced water permeation into the perovskite layer, and more importantly, the enhanced contact adhesion at the PFPT3-mediated perovskite/HTM interface suppressed surface delamination and retarded water intrusion. The fluorinated conjugated polymeric interfacial material is effective for improving not only the efficiency but also the stability of the PSC devices.

Zearalenone Induces Endothelial Cell Apoptosis through Activation of a Cytosolic Ca2+/ERK1/2/p53/Caspase 3 Signaling Pathway.

Zearalenone (ZEN) is a mycotoxin that has been reported to damage various types of cells/tissues, yet its effects on endothelial cells (ECs) have never been investigated. Therefore, this study investigates the potential effects of ZEN using bovine aortic ECs (BAECs). In this study, we found that ZEN induced apoptosis of BAECs through increased cleavage of caspase 3 and poly ADP-ribose polymerase (PARP). ZEN also increased phosphorylation of ERK1/2 and p53, and treatment with the ERK1/2 or p53 inhibitor reversed ZEN-induced EC apoptosis. Transfection of BAECs with small interfering RNA against ERK1/2 or p53 revealed ERK1/2 as an upstream target of p53 in ZEN-stimulated apoptosis. ZEN increased the production of reactive oxygen species (ROS), yet treatment with the antioxidant did not prevent EC apoptosis. Similarly, blocking of estrogen receptors by specific inhibitors also did not prevent ZEN-induced apoptosis. Finally, chelation of cytosolic calcium (Ca2+) using BAPTA-AM or inhibition of endoplasmic reticulum (ER) Ca2+ channel using 2-APB reversed ZEN-induced EC apoptosis, but not by inhibiting ER stress using 4-PBA. Together, our findings demonstrate that ZEN induces EC apoptosis through an ERK1/2/p53/caspase 3 signaling pathway activated by Ca2+ release from the ER, and this pathway is independent of ROS production and estrogen receptor activation.

Prevalence and Associated Factors of Frailty and Mortality in Patients with End-Stage Renal Disease Undergoing Hemodialysis: A Systematic Review and Meta-Analysis.

Hemodialysis is the most common type of treatment for end-stage renal disease (ESRD). Frailty is associated with poor outcomes such as higher mortality. ESRD patients have a higher prevalence of frailty. This systematic review and meta-analysis aimed to identify the prevalence and associated factors of frailty and examine whether it is a predictor of mortality among ESRD patients undergoing hemodialysis. Five electronic databases including PubMed, Embase, CINAHL, Web of Science, and Cochrane Library were searched for relevant studies up to 30 November 2020. A total of 752 articles were found, and seven studies with 2604 participants in total were included in the final analysis. The pooled prevalence of frailty in patients with ESRD undergoing hemodialysis was 46% (95% Confidence interval (CI) 34.2-58.3%). Advanced age, female sex, and the presence of diabetes mellitus increased the risk of frailty in ESRD patients undergoing hemodialysis. Our main finding showed that patients with frailty had a greater risk of all-cause mortality compared with those without (hazard ratio (HR): 2.02, 95% CI: 1.65-2.48). To improve ESRD patient outcomes, healthcare professionals need to assess the frailty of older ESRD patients, particularly by considering gender and comorbidities. Comprehensive frailty screening tools for ESRD patients on hemodialysis need to be developed.

Predictors of unplanned 30-day readmissions after coronary artery bypass graft: a systematic review and meta-analysis of cohort studies.

AIMS: Coronary artery bypass graft (CABG) is one of the most performed cardiac surgery globally. CABG is known to have a high rate of short-term readmissions. The 30-day unplanned readmission rate as a quality measure is associated with adverse health outcomes. This study aimed to identify and synthesize the perioperative risk factors for 30-day unplanned readmission after CABG. METHODS AND RESULTS: We systematically searched seven databases and reviewed studies to identify all eligible English articles published from 1 October 1999 to 30 September 2019. Random-effect models were employed to perform pooled analyses. Odds ratio and 95% confidence interval were used to estimate the risk factors for 30-day unplanned readmission. The 30-day hospital readmission rates after CABG ranged from 9.2% to 18.9% in 14 cohort studies. Among preoperative characteristics, older adults, female, weight loss, high serum creatinine, anticoagulant use or dialysis, and comorbidities were found to be statistically significant. Postoperative complications, prolonged length of hospital stay, and mechanical ventilation were revealed as the postoperative risk factors for 30-day unplanned readmission. However, intraoperative risk factors were not found to be significant in this review. CONCLUSION: Our findings emphasize the importance of a comprehensive assessment during the perioperative period of CABG. Healthcare professionals can perform a readmission risk stratification and develop strategies to reduce readmission rates after CABG using the risk factors identified in this review. Future studies with prospective cohort samples are needed to identify the personal or psychosocial factors influencing readmission after CABG, including perioperative risk factors.