ifferent clinical and research settings. © 2020 International Parkinson and Movement Disorder Society. © 2020 International Parkinson and Movement Disorder Society.BACKGROUND To create equitable access to donor organs for the highest mortality patients, the cardiac transplant allocation system now prioritizes patients with surgically implanted temporary left ventricular assist devices (T-LVADs). The outcomes following a direct bridge from a T-LVAD to orthotopic heart transplant (OHT) are not well delineated. AIM This study investigates the T-LVAD waitlist outcomes and compares the posttransplant outcomes in patients bridged to OHT with surgically implanted T-LVADs to patients bridged with durable continuous-flow left ventricular assist devices (CF-LVADs). METHODS Adults recorded in the United Network for Organ Sharing registry bridged to OHT with a durable CF-LVAD and T-LVADs, with or without temporary right ventricular assist devices (T-RVADs), between 2010 and 2018 were included. Propensity matching and multivariable Cox regression were utilized to compare outcomes. RESULTS Of 504 patients waitlisted with T-LVADs, the majority were transplanted (50%), bridged to CF-LVAD (17%), or recovered (9%). A total of 9047 recipients were bridged to OHT during the study period with 8875 CF-LVADs and 172 T-LVADs.  https://www.selleckchem.com/products/sp2509.html  Early survival in propensity-matched T-LVAD ± T-RVAD patients was similar to CF-LVAD ± T-RVAD patients but reduced at a 1-year follow-up. This difference in survival at 1-year follow-up was attributable to significantly reduced survival in patients with combined T-LVAD + T-RVAD support when compared with CF-LVAD, isolated T-LVAD and combined CF-LVAD + T-RVAD support (80% vs 90% vs 90% vs 91%; P = .005). CONCLUSIONS This study demonstrates that most patients waitlisted with a T-LVAD are successfully bridged to durable therapy or recover, and those bridged to OHT have acceptable posttransplant outcomes, particularly when T-RVADs are not required. © 2020 Wiley Periodicals, Inc.This article proposes a Bayesian mixed effects zero inflated discrete Weibull (ZIDW) regression model for zero inflated and highly skewed longitudinal count data, as an alternative to mixed effects regression models that are based on the negative binomial, zero inflated negative binomial, and conventional discrete Weibull (DW) distributions. The mixed effects ZIDW regression model is an extension of a recently introduced model based on the DW distribution and uses the log-link function to specify the relationship between the linear predictors and the median counts. The ZIDW approach offers a more robust characteristic of central tendency, compared to the mean count, when there is skewness in the data. A matrix generalized half-t (MGH-t) prior distribution is specified for the random effects covariance matrix as an alternative to the widely used Wishart prior distribution. The methodology is applied to a longitudinal dataset from an epilepsy clinical trial. In a data contamination simulation study, we show that the mixed effect ZIDW regression model is more robust than the competing mixed effects regression models when the data contain excess zeros or outliers. The performance of the ZIDW regression model is also assessed in a simulation study under the specification of, respectively, the MGH-t and Wishart prior distributions for the random effects covariance matrix. It turns out that the highest posterior density intervals under the MGH-t prior for the fixed effects maintain nominal coverage when the true variability between random slopes over time is small, whereas those under the Wishart prior are generally conservative. © 2020 John Wiley & Sons, Ltd.AIM AND OBJECTIVE We investigated the correlation between the frailty status of maintenance haemodialysis (MHD) patients and psychosocial factors. BACKGROUND Varying degrees of frailty have been reported in MHD patients, which affect their quality of life. DESIGN We adopted a cross-sectional design in this study. METHODS Clinical data of 187 patients at our centre were collected from December 2017-June 2018 using a cross-sectional survey. Psychosocial factors were measured using the Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale, 10-item Connor-Davidson Resilience Scale (CD-RISC), Chronic Disease Self-Efficacy Scales and Perceived Social Support Scale. Frailty status was estimated using the fatigue, resistance, ambulation, illnesses and loss of weight (FRAIL) scale. Spearman's correlation and multiple logistic regression analysis were conducted to identify the risk factors for frailty. This study complied with the STROBE checklist. RESULTS Of 187 patients, 11 cases (5.9%) of fraipt targeted nursing strategies to alleviate symptoms of frailty and improve physical condition by the following ways postpone the progress of comorbidities, improve sleep quality, control the symptoms of depression, foster psychological resilience and facilitate support from social and family. © 2020 John Wiley & Sons Ltd.BACKGROUND The optimal mitral prosthesis in young patients is unclear. This systematic review and meta-analysis were performed to compare outcomes between bileaflet mechanical mitral valve replacement (mMVR) and bioprosthesis mitral valve replacement (bioMVR) for MVR patients aged less than 70 years. METHODS We searched MEDLINE and EMBASE databases from inception to July 2018 for studies comparing surgical outcomes of mMVR vs bioMVR. RESULTS There were 14 observational studies with 20 219 patients (n = 14 658 mMVR and n = 5561 bioMVR). Patients receiving an mMVR were younger with fewer comorbidities including renal failure, dialysis, and less-infective endocarditis (P  less then  .001). The estimated 10-year mortality ranged from 19% to 49% for mMVR and 22% to 58% for bioMVR among studies. Comparing matched or adjusted data, mMVR was associated with lower operative (risk ratio [RR] 0.61; 95% confidence interval [CI] 0.39, 0.94; P = .03) and long-term (HR 0.81; 95% CI 0.71, 0.92; P = .002) mortality at a median follow-up of 8 years (IQR 6-10 years). Estimated 10-year risk for mitral valve reoperation ranged from 0% to 8% for mMVR and 8% to 22% for bioMVR among matched/adjusted studies. mMVR was associated with lower matched/adjusted risk of reoperation (HR 0.35; 95% CI 0.19, 0.65; P = .001) but with greater risk of bleeding (HR 1.59; 95% CI 1.19, 2.13; P = .002) and a trend to greater risk of stroke and embolism (HR 1.70; 95% CI 0.92, 3.15; P = .09). CONCLUSION Mechanical MVR in patients aged less than 70 years is associated with a lower risk of operative mortality as well as a 20% lower risk of long-term death and 65% lower risk of mitral valve reoperation but 60% greater risk of bleeding compared with bioMVR in matched or adjusted data. © 2020 Wiley Periodicals, Inc.