Profile of Anemia in Cirrhotic Patients at the National Hospital of Niamey

Objective: To study the profile of anemia in cirrhotic patients diagnosed in the Hepato-Gastroenterology (HGE) department of the National Hospital of Niamey. Patients and Method: This was a prospective and descriptive study carried out from August 1, 2023 to February 29, 2024, including cirrhotic patients, with anemia on the blood count, outside of any recent blood transfusion and/or treatment. History of anemia. Results: The diagnosis of anemia was made in 91 patients out of the 100 cirrhotics recorded, 91%. Men were more common, with a sex ratio of 2.79. The average age was 50 ± 14.22 years old. Anemia was moderate in 52.75% of cases (n = 48). It was non-microcytic in 50.55% (n = 46) and iron deficient in 55.56% of cases (n = 20). There was a statistically significant correlation between the severity of anemia and upper gastrointestinal bleeding with a p-value = 0.000. Conclusion: Cirrhotic anemia is multifactorial, which makes its etiological diagnosis complex.

Summary Analysis of National Surveillance on Kashin-Beck Disease from 1990 to 2023

Objective To analyze the epidemiological characteristics and epidemic situation of children with Kashin-Beck disease(KBD)in China,and provide the basis for formulating prevention and control measures.Methods Fixed-point monitoring,moving-point monitoring,and full coverage of monitoring were promoted successively from 1990 to 2023.Some children(7-12 years old)underwent clinical and right-hand X-ray examinations every year.According to the KBD diagnosis criteria,clinical and X-ray assessments were used to confirm the diagnosis.Results In 1990,the national KBD detectable rate was 21.01%.X-ray detection decreased to below 10%in 2003 and below 5%in 2007.Between 2010 and 2018,the prevalence of KBD in children was less than 0.4%,which fluctuated at a low level,and has decreased to 0%since 2019.Spatial epidemiological analysis indicated a spatial clustering of adult patients prevalence rate in the KBD areas.Conclusion The evaluation results of the elimination of KBD in China over the last 5 years showed that all villages in the monitored areas have reached the elimination standard.While the adult KBD patients still need for policy consideration and care.

Terrain or climate factor dominates vegetation resilience?Evidence from three national parks across different climatic zones in China

Vegetation resilience(VR),providing an objective measure of ecosystem health,has received considerable attention,however,there is still limited understanding of whether the dominant factors differ across different climate zones.We took the three national parks(Hainan Tropical Rainforest National Park,HTR;Wuyishan National Park,WYS;and Northeast Tiger and Leopard National Park,NTL)of China with less human interference as cases,which are distributed in different climatic zones,including tropical,subtropical and temperate monsoon climates,respectively.Then,we employed the probabilistic decay method to explore the spatio-temporal changes in the VR and their natural driving patterns using Geographically Weighted Regression(GWR)model as well.The results revealed that:(1)from 2000 to 2020,the Normalized Difference Vegetation Index(NDVI)of the three national parks fluctuated between 0.800 and 0.960,exhibiting an overall upward trend,with the mean NDVI of NTL(0.923)>HTR(0.899)>WYS(0.823);(2)the positive trend decay time of vegetation exceeded that of negative trend,indicating vegetation gradual recovery of the three national parks since 2012;(3)the VR of HTR was primarily influenced by elevation,aspect,average annual temperature change(AATC),and average annual precipitation change(AAPC);the WYS'VR was mainly affected by elevation,average annual precipitation(AAP),and AAPC;while the terrain factors(elevation and slope)were the main driving factors of VR in NTL;(4)among the main factors influencing the VR changes,the AAPC had the highest proportion in HTR(66.7%),and the AAP occupied the largest area proportion in WYS(80.4%).While in NTL,elevation served as the main driving factor for the VR,encompassing 64.2%of its area.Consequently,our findings indicated that precipitation factors were the main driving force for the VR changes in HTR and WYS national parks,while elevation was the main factors that drove the VR in NTL.Our research has promoted a deeper understanding of the driving mechanism behind the VR.

International Healthcare Terminologies for Morbidity New Era: SNOMED and ICD11

The Information Technology (IT) developments have changed the use of Healthcare terminologies from paper-based mortality statistics with the WHO international classifications of diseases (ICD) to the IT-based morbidity implementations for instance for Casemix-based healthcare funding and managing systems. This higher level of granularity is worldwide spread under the umbrella of several national modifications named ICD10 XM. These developments have met the increased use of the International Clinical Reference Terminology named SNOMED. When the updating of WHO ICD10 to WHO ICD11 was decided a merging was envisaged and a WHO SNOMED CT common work proposed a methodology to create a common formal ontology between the 11th version of the WHO International Classification of Diseases and Health Problems (ICD) and the most used in the world clinical terminology named Systematized Nomenclature of Human and Veterinary Medicine - Clinical Terms (SCT). The present work follows this unachieved work and aims to develop a SNOMED-based formal ontology for ICD11 chapter 1 using the textual definitions of ICD11 codes which is a completely new character of ICD and the ontology tools provided by SCT in the publicly available SNOMED Browser. There are two key results: the lexical alignment is complete and the ontology alignment is incomplete with the validated SNOMED concept model can be completed with not yet validated attributes and values of the SNOMED Compositional Grammar. The work opens a new era for the seamless use of both international terminologies for morbidity for instance for DRG/Casemix and clinical management use. The main limitation is that it is restricted to 1 out of 26 chapters of ICD11.

Characterisation of Human-Wildlife Conflicts around the Kahuzi-Biega National Park, Eastern Democratic Republic of Congo

The history of mankind contains so many illustrations of well-classified and violent struggles against various animals over crop production in agricultural fields, attacks on human life or competition in order to have access to certain natural resources. The aim of this study is to characterise the human-wildlife conflicts that occur around the KBNP, especially with regard to primates. Surveys were carried out in 260 households selected using the snowball method. The results showed that human-wildlife conflicts around the KBNP are characterised by the destruction of crops in riparian fields by monkeys, chimpanzees and gorillas, the destruction of houses, physical attacks and zoonoses. Despite the conservation and protection measures for wildlife and local populations put in place by the Park’s managers, conflicts between local populations and the Park’s wild animals are still visible. These conflicts lead to the detention of wild animals by local people roaming in the villages and to poaching on the Park’s boundaries. The weakness of the community management policy on the part of the park managers and the resentment of the indigenous peoples towards the restriction of their access to natural resources are the major constraints on the sustainable management of conflicts between the local populations and the wild animals in the KBNP. The strategies for the sustainable resolution of human-wildlife conflicts around the KBNP must be geared towards and integrated into a community conservation approach.

Exploring impacts of COVID-19 on spatial and temporal patterns of visitors to Canadian Rocky Mountain National Parks from social media big data

COVID-19 posed challenges for global tourism management.Changes in visitor temporal and spatial patterns and their associated determinants pre-and peri-pandemic in Canadian Rocky Mountain National Parks are analyzed.Data was collected through social media programming and analyzed using spatiotemporal analysis and a geographically weighted regression(GWR)model.Results highlight that COVID-19 significantly changed park visitation patterns.Visitors tended to explore more remote areas peri-pandemic.The GWR model also indicated distance to nearby trails was a significant influence on visitor density.Our results indicate that the pandemic influenced tourism temporal and spatial imbalance.This research presents a novel approach using combined social media big data which can be extended to the field of tourism management,and has important implications to manage visitor patterns and to allocate resources efficiently to satisfy multiple objectives of park management.

Influence of Human Activity Intensity on Habitat Quality in Hainan Tropical Rainforest National Park,China

Due to long-term human activity interference,the Hainan Tropical Rainforest National Park(HTRNP)of China has experienced ecological problems such as habitat fragmentation and biodiversity loss,and with the expanding scope and intensity of human activity impact,the regional ecological security is facing serious challenges.A scientific assessment of the interrelationship between human activity intensity and habitat quality in the HTRNP is a prerequisite for achieving effective management of ecological disturbances caused by human activities and can also provide scientific strategies for the sustainable development of the region.Based on the land use change data in 2000,2010,and 2020,the spatial and temporal variations and the relationship between habitat quality(HQ)and human activity intensity(HAI)in the HTRNP were explored using the integrated valuation of ecosystem services and trade-offs(InVEST)model.System dynamics and land use simulation models were also combined to conduct multi-scenario simulations of their relationships.The results showed that during 2000–2020,the habitat quality of the HTRNP improved,the intensity of human activities decreased each year,and there was a negative correlation between the two.Second,the system dynamic model could be well coupled with the land use simulation model by combining socio-economic and natural factors.The simulation scenarios of the coupling model showed that the harmonious development(HD)scenario is effective in curbing the increasing trend of human activity intensity and decreasing trend of habitat quality,with a weaker trade-off between the two compared with the baseline development(BD)and investment priority oriented(IPO)scenarios.To maintain the authenticity and integrity of the HTRNP,effective measures such as ecological corridor construction,ecological restoration,and the implementation of ecological compensation policies need to be strengthened.

An Empirical Study of the Socratic Method in Nongraded English Teaching in Senior High School Under the Background of the New National College Entrance Examination

With the reform of the New National College Entrance Examination(Gaokao),the nongraded education will become an inevitable trend.In senior high school,the traditional test-oriented education is popular.The knowledge is mainly taught by the teachers,and the students passively absorb it.This study examines a problem-oriented Socratic experiment in nongraded English teaching in senior high school.The teachers seek output from students,who respond by interpreting questions,fostering critical thinking,and enhancing problem-solving skills.This teaching experiment indicates that the Socratic method has a significant positive effect on cultivating nongraded senior high English students’critical thinking under the New National College Entrance Examination.

Evaluating the Impacts of Human Activities on Diversity, Abundance, and Distribution of Large Mammals in Nimule National Park, South Sudan

Globally, human activities have a significant impact on the diversity, abundance, and distribution of large mammals in Protected Areas (PAs). These disturbances increase human pressure on biodiversity and species habitats, highlighting the need for conservation. This study aimed to assess the abundance and distribution of large mammals in different habitat types within Nimule National Park (NNP) and understand the impacts of human activities on them. Data on the abundance and distribution of large mammals and their respective habitat types were collected through line transect surveys. Human activity signs were observed and recorded along the transect lines. To estimate the impacts of human activities on the diversity, abundance, and distribution of large mammal species, as well as to identify any significant differences between them and their habitat types, the study utilized the Kruskal Wallis test, Polynomial multiple regressions, and diversity indices. The findings from the Shannon-Weiner and Simpson indices indicated that large mammal species were more diverse inside the park (H’ = 1.136;D = 0.570) compared to the buffer zone (H’ = 0.413;D = 0.171), with 85% (443 out of 510 samples) recorded within Nimule National Park. The species abundance showed a semi-balanced status (0.58). The diversity results among different habitat types revealed that large mammals were more diverse and highly distributed in both open woodlands (244) and dense woodlands (192), while riverine vegetation had the lowest diversity (8). Statistical tests demonstrated a highly significant difference at a 99% confidence interval (p-value = 0.01) between habitat types and identified species of large mammals. Additionally, the results highlighted the high abundance of Uganda kob (274), baboons (141), and warthog (57) across most habitat types, accounting for at least 75% of their distribution. The most prevalent human activities observed were cattle footprints (27%) and cattle dung (14%). Human footprints and tree cutting combined accounted for 9%, indicating the practice of livestock grazing, poaching, encroachment, and fuelwood collection by local communities. However, these activities did not appear to significantly impact the diversity, abundance, and distribution of large mammals in Nimule National Park. Therefore, it is crucial to foster shared responsibilities and engage relevant stakeholders in the management and conservation of large wildlife species. Regular community awareness programs should be implemented to cultivate a sense of ownership. Moreover, it is recommended that a comprehensive survey be conducted on the population status of all mammal species in Nimule National Park, including its surrounding Buffer Zone. Monitoring the impact of human activities on their behavior and habitats using satellite images should also be carried out at least every five to ten years.

Impact of US Financial Sanctions on the Dollar's International Status

In 2022,the United States stepped up its sanctions on Russia.Most notably,it restricted the flow of the Russian Central Bank's foreign exchange(forex)assets,using financial administrative power as a source of strategic leverage.This move should have reduced the appeal of US dollar assets but in reality has not accelerated as expected the decline of the greenback as a store of value.The US dollar's share of global forex reserves increased instead of decreased during 2022 and 2023.Despite the rise of economic costs caused by tightened US financial sanctions,countries that recognize the geopolitical role of the United States have further accepted the dollar's international status;their continued willingness to live with the dollar's“security premium”has given a fillip to the US dollar in the short term,boosting its appeal as a reserve currency.Meanwhile,de-dollarization of forex reserves has yet to reach a sufficient scale,thus falling short of significantly challenging the dollar's reign.From a longer-term perspective,as economic and security conditions shift,countries that accept the dollar's international role or seek de-dollarization may change their choices.As a result,four possible scenarios may arise:(i)the preeminence of the US dollar remains unthreatened;(ii)the international monetary system splits into blocs;(iii)the international monetary system fragments;and(iv)the dollar loses its throne.The author believes that the last scenario is the most likely outcome.

Post-operative morbidity after neoadjuvant chemotherapy and resection for gallbladder cancer: A national surgical quality improvement program analysis

BACKGROUND Gallbladder cancer is the most common malignancy of the biliary tract.Neo-adjuvant chemotherapy(NACT)has improved overall survival by enabling R0 resection.Currently,there is no consensus of guidelines for neoadjuvant therapy in gallbladder cancer.As investigations continue to analyze the regimen and benefit of NACT for ongoing care of gallbladder cancer patients,we examined American College of Surgeons National Surgical Quality Improvement Program(NSQIP)database to determine if there was higher morbidity among the neo-adjuvant group within the 30-day post-operative period.We hypothesized patients who underwent NACT were more likely to have higher post-operative morbidity.AIM To investigate the 30-day post-operative morbidity outcomes between patients who received NACT and underwent surgery and patients who only had surgery.METHODS A retrospective analysis of the targeted hepatectomy NSQIP data between 2015 and 2019 was performed to determine if NACT in gallbladder cancer increased the risk for post-operative morbidity(bile leak,infection rate,rate of converting to open surgery,etc.)compared to the group who only had surgery.To calculate the odds ratio for the primary and secondary outcomes,a crude logistic regression was performed.RESULTS Of the 452 patients,52 patients received NACT prior to surgery.There were no statistically significant differences in the odds of morbidity between the two groups,including bile leak[odds ratio(OR),0.69;95%confidence interval(95%CI):0.16-2.10;P=0.55],superficial wound infection(OR,0.58;95%CI:0.03-3.02;P=0.61),and organ space wound infection(OR,0.63;95%CI:0.18-1.63;P=0.61).CONCLUSION There was no significant difference in the risk of 30-day post-operative morbidity between the NACT and surgery group and the surgery only group.

Scientific Advances and Weather Services of the China Meteorological Administration’s National Forecasting Systems during the Beijing 2022 Winter Olympics

Since the Beijing 2022 Winter Olympics was the first Winter Olympics in history held in continental winter monsoon climate conditions across complex terrain areas,there is a deficiency of relevant research,operational techniques,and experience.This made providing meteorological services for this event particularly challenging.The China Meteorological Administration(CMA)Earth System Modeling and Prediction Centre,achieved breakthroughs in research on short-and medium-term deterministic and ensemble numerical predictions.Several key technologies crucial for precise winter weather services during the Winter Olympics were developed.A comprehensive framework,known as the Operational System for High-Precision Weather Forecasting for the Winter Olympics,was established.Some of these advancements represent the highest level of capabilities currently available in China.The meteorological service provided to the Beijing 2022 Games also exceeded previous Winter Olympic Games in both variety and quality.This included achievements such as the“100-meter level,minute level”downscaled spatiotemporal resolution and forecasts spanning 1 to 15 days.Around 30 new technologies and over 60 kinds of products that align with the requirements of the Winter Olympics Organizing Committee were developed,and many of these techniques have since been integrated into the CMA’s operational national forecasting systems.These accomplishments were facilitated by a dedicated weather forecasting and research initiative,in conjunction with the preexisting real-time operational forecasting systems of the CMA.This program represents one of the five subprograms of the WMO’s high-impact weather forecasting demonstration project(SMART2022),and continues to play an important role in their Regional Association(RA)II Research Development Project(Hangzhou RDP).Therefore,the research accomplishments and meteorological service experiences from this program will be carried forward into forthcoming highimpact weather forecasting activities.This article provides an overview and assessment of this program and the operational national forecasting systems.

Nationalist Trends in the Transformation of New Zealand’s Maori Language Policy

Language is an important carrier of human culture and a specific method for communication between humans.It is one of the most important symbols of human identity and flags of dividing group identity.At present,in the modern national state,the government is paying more attention to language policy and being more and more prudent to it.In the process of making and implementing language policy,the government must take into account a range of factors such as the country’s national history,politics,culture,economy,and relations between different social groups.From the mid-nineteenth century,when New Zealand became a British colony,until the mid-twentieth century,the Maori people were inspired to defend their rights and respect for themselves by the rise of Maori nationalist ideology and Maori political radicalism in a struggle that lasted more than 100 years.Until 1994,there were more than 800 kohanga reo,early childhood institutions that established Maori language instruction independent of the school system,and the nationalism drives to revitalize the Maori national language was at its peak.The process of revolution on Maori language policies in New Zealand reflects a trend of nationalist thoughts from Maori becoming more deep.Exploring the process of change in New Zealand’s Maori language policy will help to develop the study of the social history of indigenous peoples during the colonial period and will contribute to the study of the development of colonized countries and regions in the post-colonial period.The change in New Zealand’s Maori language policy has provided an important example of the preservation and revitalization of the indigenous languages of the world’s former colonies,which is of great significance for the preservation of linguistic and cultural diversity.

National Social Investment Programmes in Nigeria:A Descriptive Analysis of the Socio-Economic Contributions of N-Power Programme in Benue State

This study analysed the socio-economic contributions of N-Power programme amongst the beneficiaries of the scheme in Benue State.Prior to the introduction of N-Power programme,successive administrations in Nigeria have made concerted efforts towards improving the standard of living of the citizenry through the execution of various welfare or social intervention programmes,but not much successes were recorded.Learning from the mistakes of the past regimes,and by way of deliberate state policy,the Buhari’s government initiated a multi-pronged social investment policy,one of which is the N-power programme that came onboard in 2016,which also doubles as the subject of this study.To achieve the goal of this study,a combination of desktop research and survey design was employed.Questionnaires were administered to 390 respondents through a combination of stratified and random sampling techniques.The results of the survey were matched with that of the secondary data obtained through online websites and other related sources.The result indicated that N-Power made positive contributions to the socio-economic life of the beneficiaries in Benue State:specifically,the scheme contributed in poverty eradication,employment generation,skills acquisitions and capacity building.However,some aspect of our findings revealed that the programme has a number of challenges such as:inadequate cash support,delay in monthly cash transfer to beneficiaries,distance participants had to move to their work stations,absence of posting in N-Teach scheme,and lack of adequate working tools amongst others.To salvage this problem the paper recommended the following solutions:expansion of the scheme to cover N-Teach and other aspects,increment in the monthly cash transfer to cushion the high rate of inflation,support for the participants/beneficiaries in transportation and logistics,enrolment of more youth into the various schemes,proper monitoring and evaluation of the implementation of the schemes amongst others.

On the Relationship between Chinese Language Education in Malaysia and Indonesia with Their National Conditions

Chinese language education exists in both Malaysia and Indonesia. The commonalities and individualities of the national conditions of both countries have an impact on their Chinese language education. The official languages scripts, and major beliefs of the two countries are quite similar, and under their influence, local Chinese have special expectations for Chinese language education. Compared to Indonesia, Malaysian Chinese have a larger proportion of the population and a tendency towards marriage, which to some extent is more conducive to the Chinese language education of local Chinese. Both countries’ national conditions and personalities have unfavorable factors for local Chinese language education.

Exploring the Reasons for Changes in National Reading Behaviour from the Perspective of Media Environmentalism

In this paper, through the perspective of Merowitz’s media environmentalism, following the research path of media-scene-behaviour, and based on the results of the national reading survey released by the China Press and Publication Research Institute in the past ten years (2013-2022), we analyse the characteristics of national reading behaviours, explore the reasons for the changes in national reading behaviour in terms of technology, media, and scenarios. It also discusses the future trend of national reading behaviour and the promotion of national reading activities, and puts forward certain countermeasures from the government, schools and the society to make joint efforts to promote national reading.

Epidemiology and Histopathology of Cancers of the Upper Aerodigestive Tract in the ENT and Head and Neck Surgery Department of the Ignace Deen National Hospital

Introduction: Head and neck cancers represent a significant burden of cancer, collectively ranking fourth for cancer incidence and second for cancer mortality worldwide. Objective: To study the epidemiological and histopathological aspects of head and neck cancers in the ENT-CCF department of Ignace Deen National Hospital. Materials and Methods: This was a descriptive retrospective study covering a period of 5 years from September 1, 2016, to September 30, 2021. Results: We collected 43 cases of head and neck cancers, representing a hospital frequency of 1.85%. The mean age was 45.21 ± 13.23 years. Males predominated, accounting for 65.12%, compared to 34.88% for females, with a male-to-female ratio of 1.87. Housewives accounted for 27.90%, followed by farmers at 23.26% and traders/merchants at 18.60%, with 41.86% being uneducated. The main risk factors were tobacco (37.21%) and alcohol (34.88%). Pain (53.49%), dysphonia (51.16%), and dyspnea (39.53%) were the main presenting symptoms. Squamous cell carcinoma (74.42%) and large cell lymphoma (18.60%) were the most commonly cited histological types. Conclusion: Head and neck cancers remain relatively common in our country. Improving prognosis depends on early diagnosis of the condition, resuscitation resources, and prompt management.

Progress in neurorehabilitation research and the support by the National Natural Science Foundation of China from 2010 to 2022

The National Natural Science Foundation of China is one of the major funding agencies for neuro rehabilitation research in China.This study reviews the frontier directions and achievements in the field of neurorehabilitation in China and wo rldwide.We used data from the Web of Science Core Collection(WoSCC) database to analyze the publications and data provided by the National Natural Science Foundation of China to analyze funding information.In addition,the prospects for neurorehabilitation research in China are discussed.From 2010 to 2022,a total of 74,220 publications in neurorehabilitation were identified,with there being an overall upward tendency.During this period,the National Natural Science Foundation of China has funded 476 research projects with a total funding of 192.38 million RMB to support neuro rehabilitation research in China.With the support of the National Natural Science Foundation of China,China has made some achievements in neurorehabilitation research.Research related to neurorehabilitation is believed to be making steady and significant progress in China.

National Image Construction from the Perspective of Multimodal Metaphor-A Case Study of the Opening Ceremony of the Beijing Winter Olympics

The national image is a comprehensive concept with a distinct political feature,including the international image presented to the outside world,and also encompassing the national identity of the people.With the development of globalization,international cultural communication has become a crucial part of shaping the national image,and the opening ceremony of the Beijing Winter Olympics has become an important opportunity for China to showcase its national image to the world in the post-pandemic era.Based on Forceville’s multimodal metaphor theory,this paper examines the metaphorical phenomena contained in the performance and their functions,effects,and purposes in the construction of the national image.It is found that there are many scenes,images,and narratives in the opening ceremony,including war metaphor,competition metaphor,personification metaphor,and other conceptual metaphors.The focus of this paper is on multimodal metaphor in a broad sense,mainly encompassing auditory and visual modes.Through the use of these multimodal metaphors,the opening ceremony of the Winter Olympics builds an image of a vibrant,peace-loving,and responsible country,which not only demonstrates China’s cultural self-confidence,but also expresses the Chinese people’s beautiful vision for the early reunification of the motherland.

Impact of index admission cholecystectomy vs interval cholecystectomy on readmission rate in acute cholangitis: National Readmission Database survey

BACKGROUND Elective cholecystectomy(CCY)is recommended for patients with gallstone-related acute cholangitis(AC)following endoscopic decompression to prevent recurrent biliary events.However,the optimal timing and implications of CCY remain unclear.AIM To examine the impact of same-admission CCY compared to interval CCY on patients with gallstone-related AC using the National Readmission Database(NRD).METHODS We queried the NRD to identify all gallstone-related AC hospitalizations in adult patients with and without the same admission CCY between 2016 and 2020.Our primary outcome was all-cause 30-d readmission rates,and secondary outcomes included in-hospital mortality,length of stay(LOS),and hospitalization cost.RESULTS Among the 124964 gallstone-related AC hospitalizations,only 14.67%underwent the same admission CCY.The all-cause 30-d readmissions in the same admission CCY group were almost half that of the non-CCY group(5.56%vs 11.50%).Patients in the same admission CCY group had a longer mean LOS and higher hospitalization costs attrib-utable to surgery.Although the most common reason for readmission was sepsis in both groups,the second most common reason was AC in the interval CCY group.CONCLUSION Our study suggests that patients with gallstone-related AC who do not undergo the same admission CCY have twice the risk of readmission compared to those who undergo CCY during the same admission.These readmis-sions can potentially be prevented by performing same-admission CCY in appropriate patients,which may reduce subsequent hospitalization costs secondary to readmissions.