<strong>Introduction:</strong> Gender differences are still quite prevalent in the present time. Although there is literature regarding gender differences in healthcare expenditure in India, there is no da...<strong>Introduction:</strong> Gender differences are still quite prevalent in the present time. Although there is literature regarding gender differences in healthcare expenditure in India, there is no data regarding gender differences in hospital stay, hospital seeking behaviors and mortality. <strong>Aim:</strong> To evaluate the Gender differences in a hospital seeking behavior, mortality and hospital stay. <strong>Methods:</strong> We prospectively analyzed, from a retrospective database, all patients who underwent surgical gastrointestinal, hepato-biliary, pancreatic and splenic surgeries from 1996 to 2018 in our unit. Patients were divided into groups based on gender, admission time period and priority of admission i.e., elective or emergency. Both the gender groups were compared with respect to total procedures done, hospital stay and mortality. Organ specific mortality was calculated as proportions, was analyzed and compared between the groups. Time trends of the same were observed and compared. <strong>Results:</strong> Of 12,411 patients, 7979 (64.3%) were males and 4432 (35.7%) were females. 9191 (74.1%) patients underwent elective procedures whereas 3220 (25.9%) had emergency procedures (<strong>p ≤ 0.001</strong>). Overall mortality was higher in males (n = 473, 5.92%) in comparison to females (n = 185, 4.17%) (p ≤ 0.001). Majority of surgeries in males were of small intestine (22.5%) in which small bowel resection was most commonly done (5.4%), whereas, gallbladder and biliary surgeries (27.4%) were the most common in females in which laparoscopic cholecystectomy was most commonly done (5.8%). Median hospital stay was higher in males (10 days vs 9 days), (<strong>p ≤ 0.001</strong>). Mortality was higher in females in all organ categories except in liver (6.34% vs 2.7%), pancreas (37.3% Vs 18.3%) and spleen (3.38% Vs 1.62%) where mortality was higher for male gender. Highest mortality for females was in small intestinal surgery (34%) and for males, it was pancreatic surgery (37.3%). Highest mortality in males was emergency open pancreatic necrosectomy (21.6%) and that in females was emergency small intestinal surgery (11.9%). Although the number of surgeries in females increased over time (380 in 1996-1999 Vs 951 in 2016-2018), the proportion remained constant (36.3% Vs 38.3% in 1996-1999 and 2016-2018 respectively). <strong>Conclusion:</strong> We conclude that mortality is found to be higher in males after gastrointestinal surgery, which may be explained by the fact that hospital seeking behavior is more in males though it is fairly increasing in females in the recent years.展开更多
Leaching behavior and gastrointestinal bioaccessibility of rare earth elements （REEs） from hospital waste incineration （HWI） fly and bottom ash samples collected from Beijing and Nanjing Cities were assessed. In t...Leaching behavior and gastrointestinal bioaccessibility of rare earth elements （REEs） from hospital waste incineration （HWI） fly and bottom ash samples collected from Beijing and Nanjing Cities were assessed. In the same ash sample, the leaching concentrations of individual REEs determined by the Toxicity Characteristic Leaching Procedure （TCLP） were higher than those detected by the European standard protocol （EN-type test）, thereby suggesting that the low pH value of leaching solution was an important factor influencing the leacha（bility-of REE. The REE bioaccessibility results, which were evaluated using the physiologically based extraction test （PBET）, indicated that REEs were highly absorbed during fgastric phase by dissolution; and subsequently precipitated and/or re-adsorbed in small intestinal phase. The relative amounts of the total REEs extracted by the TCLP method, EN-type test and PBET test were compared. In addition to the pH value of extraction solutions, the chelating role of REEs witllt organic ligands used in the PBET method was also an important parameter affecting REE adsorption in human body. Additionally, this study showed that REEs were extracted by these methods as concomitants of heavy metals and anions （NO3^-, F^-, SO4^2- , and Cl^-） from HWI ash, which probably caused the remarkably complex toxicity on human body by the exposure pathway.展开更多
文摘<strong>Introduction:</strong> Gender differences are still quite prevalent in the present time. Although there is literature regarding gender differences in healthcare expenditure in India, there is no data regarding gender differences in hospital stay, hospital seeking behaviors and mortality. <strong>Aim:</strong> To evaluate the Gender differences in a hospital seeking behavior, mortality and hospital stay. <strong>Methods:</strong> We prospectively analyzed, from a retrospective database, all patients who underwent surgical gastrointestinal, hepato-biliary, pancreatic and splenic surgeries from 1996 to 2018 in our unit. Patients were divided into groups based on gender, admission time period and priority of admission i.e., elective or emergency. Both the gender groups were compared with respect to total procedures done, hospital stay and mortality. Organ specific mortality was calculated as proportions, was analyzed and compared between the groups. Time trends of the same were observed and compared. <strong>Results:</strong> Of 12,411 patients, 7979 (64.3%) were males and 4432 (35.7%) were females. 9191 (74.1%) patients underwent elective procedures whereas 3220 (25.9%) had emergency procedures (<strong>p ≤ 0.001</strong>). Overall mortality was higher in males (n = 473, 5.92%) in comparison to females (n = 185, 4.17%) (p ≤ 0.001). Majority of surgeries in males were of small intestine (22.5%) in which small bowel resection was most commonly done (5.4%), whereas, gallbladder and biliary surgeries (27.4%) were the most common in females in which laparoscopic cholecystectomy was most commonly done (5.8%). Median hospital stay was higher in males (10 days vs 9 days), (<strong>p ≤ 0.001</strong>). Mortality was higher in females in all organ categories except in liver (6.34% vs 2.7%), pancreas (37.3% Vs 18.3%) and spleen (3.38% Vs 1.62%) where mortality was higher for male gender. Highest mortality for females was in small intestinal surgery (34%) and for males, it was pancreatic surgery (37.3%). Highest mortality in males was emergency open pancreatic necrosectomy (21.6%) and that in females was emergency small intestinal surgery (11.9%). Although the number of surgeries in females increased over time (380 in 1996-1999 Vs 951 in 2016-2018), the proportion remained constant (36.3% Vs 38.3% in 1996-1999 and 2016-2018 respectively). <strong>Conclusion:</strong> We conclude that mortality is found to be higher in males after gastrointestinal surgery, which may be explained by the fact that hospital seeking behavior is more in males though it is fairly increasing in females in the recent years.
基金Acknowledgements We would like to acknowledge all of the participators who collected HWI ash samples for this study from both the Beijing and Nanjing sites. This work was financially supported by the National Natural Science Foundation of China （Grant No. 51378180）, the Technology Department of the Henan Science and Technology Fund Project （Nos. 142102210457 and 142102210456）, and the Fundamental Research Funds for the Central Universities （No. 30916014102）.
文摘Leaching behavior and gastrointestinal bioaccessibility of rare earth elements （REEs） from hospital waste incineration （HWI） fly and bottom ash samples collected from Beijing and Nanjing Cities were assessed. In the same ash sample, the leaching concentrations of individual REEs determined by the Toxicity Characteristic Leaching Procedure （TCLP） were higher than those detected by the European standard protocol （EN-type test）, thereby suggesting that the low pH value of leaching solution was an important factor influencing the leacha（bility-of REE. The REE bioaccessibility results, which were evaluated using the physiologically based extraction test （PBET）, indicated that REEs were highly absorbed during fgastric phase by dissolution; and subsequently precipitated and/or re-adsorbed in small intestinal phase. The relative amounts of the total REEs extracted by the TCLP method, EN-type test and PBET test were compared. In addition to the pH value of extraction solutions, the chelating role of REEs witllt organic ligands used in the PBET method was also an important parameter affecting REE adsorption in human body. Additionally, this study showed that REEs were extracted by these methods as concomitants of heavy metals and anions （NO3^-, F^-, SO4^2- , and Cl^-） from HWI ash, which probably caused the remarkably complex toxicity on human body by the exposure pathway.
