pylori.

CYP2E1 gene polymorphism was more common among patients with GC than HC and PU [48/88 (54.5 %) vs. 67/170 (39.4 %); OR 1.9, 95 % CI 1.1-3.2, p = 0.016) and [PU 18/53 (34 %); OR 2.3 (1-4.7), p = 0.02]. CYP1A2 CC or CT genotypes was lower among patients with GC than HC [50/88 (56.8 %) vs. 120/170 (70.6 %); OR 0.54 (0.31-0.92), p = 0.023]. CYP1A1 polymorphism and CYP1A1-CYP1A2 haplotypes were comparable among different groups. CYP2E1 was also more common in patients with GC than HC and PU in the absence of H. pylori [33/60 (55 %) vs. 19/52 (36.5 %); OR 4 (1.5-11.4), p = 0.007 and

PU 7/22 (31.8 %); OR 3.4 Selleckchem Ricolinostat (1-11.6), p = 0.05]. CYP1A1 (CT + TT) was more common in patients with GC than PU in presence of H. pylori [17/26 (65.4 %) vs. 11/29 (38 %); OR 3.0 (1.03-9.3),

p = 0.045].

The presence of CYP2E1 (96-bp insertion) is associated with increased risk of GC even in absence of H. pylori. CYP1A2 CC or CT is associated with reduced risk of GC.”
“Noonan syndrome is a rare disorder, characterized by several malformations such as dysplasia and stenosis of the pulmonary valve, atrial septal defect and a typical pattern of hypertrophic cardiomyopathy. We describe here a 1-month old girl, who was referred to our center with seizure and apnea. She had wide anterior fontanel, head circumference and sunset eye. Intaventricular hemorrhage by sonography and atrial septal defect and hypertrophy SB203580 chemical structure cardiomyopathy by echocardiography were detected. Clinical and laboratory findings of the patient were compatible with a diagnosis of Noonan syndrome, which was also confirmed by molecular analysis. Candida albicans was grown in the blood and cerebrospinal fluid cultures. Treatment with Amphotrycine B was started for the patient and she responded well to this therapy. Early diagnosis and appropriate diagnosis of a rare condition in the patient Geneticin datasheet with such rare disease are the main keys to avoid further complications and even death of patient.”
“Background: Retaining participants in cohort studies with multiple follow-up waves is difficult. Commonly, researchers are faced with the problem of missing data, which may introduce biased results as

well as a loss of statistical power and precision. The STROBE guidelines von Elm et al. (Lancet, 370:1453-1457, 2007); Vandenbroucke et al. (PLoS Med, 4:e297, 2007) and the guidelines proposed by Sterne et al. (BMJ, 338:b2393, 2009) recommend that cohort studies report on the amount of missing data, the reasons for non-participation and non-response, and the method used to handle missing data in the analyses. We have conducted a review of publications from cohort studies in order to document the reporting of missing data for exposure measures and to describe the statistical methods used to account for the missing data.

Methods: A systematic search of English language papers published from January 2000 to December 2009 was carried out in PubMed.

Similar conditions ML323 inhibitor in other gastrointestinal diseases have led to a malignant transformation (ie, inflammatory bowel disease, celiac disease, etc). MIB-1 (Ki-67) and p53 are monoclonal antibodies that are used to detect early markers for dysplastic changes, possibly leading to cancer development in adult patients with chronic gastroesophageal reflux disease (GERD), Barrett’s esophagus, and/or the adenocarcinoma sequence of the esophagus. Only limited studies of these cell markers have been published in children

with EoE. The aim of this study is to examine p53 and Ki-67 cell markers in children with EoE before and after medical therapy. The immunohistochemical staining of cell markers p53 and Ki-67 was examined in esophageal biopsies of children diagnosed with EoE, GERD, and normal esophagus. In addition, biopsies from adults with EoE and adenocarcinoma were used as positive

controls. In 10 children who were successfully AMN-107 ic50 treated for EoE, immunohistochemical staining was compared before and after medical therapy. The immunohistochemical staining of p53 and Ki-67 was increased in children with EoE compared with children with a normal esophagus but not in children with GERD. Children with EoE posttherapy had significantly lower immunohistochemical staining for both markers compared to pretreatment staining. p53 and Ki-67 markers are associated with cell proliferation in children with EoE but do not represent a premalignant Selleck RXDX-101 (dysplastic) condition of the

esophagus.”
“Background: Apelin is a novel adipocytokine produced by white adipose tissue that binds the APJ receptor with high affinity. Insulin may have a role in regulation of apelin synthesis and secretion from the adipose tissue.

Objective: To investigate blood apelin concentrations in children with type 1 diabetes mellitus (T1DM) and display association of apelin with adiponectin, body mass index (BMI), lipids and insulin sensitivity.

Methods: Thirty patients with T1DM and 45 healthy controls were enrolled. Apelin levels were measured along with BMI, lipids, fasting plasma glucose, HbA1c and adiponectin levels.

Results: Plasma apelin and adiponectin levels were significantly higher in the diabetic group when compared to controls. No correlation was found between the apelin blood concentrations and adiponectin, BMI, lipids and insulin sensitivity.

Conclusions: Children with T1DM have significantly increased circulating apelin levels when compared to healthy controls. However, no significant relation was found between the apelin and BMI, glucose, lipids and adiponectin levels, and also insulin sensitivity.”
“The influence of the solvent-evaporation rate on the formation of of. and P crystalline phases in solution-cast poly(vinylidene fluoride) (PVDF) films was systematically investigated. Films were crystallized from PVDF/N,N-dimethylformamide solutions with concentrations of 2.5, 5.

Good evidence suggests that intrauterine anesthesia is not effective in hysterosalpingography; three good-quality studies reported ACP-196 supplier that pain scores were not reduced, and no good quality studies showed a beneficial effect in that procedure. Evidence was insufficient concerning first-trimester abortion, saline-infusion ultrasonogram, tubal sterilization, and intrauterine device insertion.

CONCLUSION: Intrauterine local anesthesia can reduce pain in several gynecologic procedures including endometrial biopsy, curettage,

and hysteroscopy and may be effective in other procedures as well. (Obstet Gynecol 2012; 120: 669-77) DOI: http://10.1097/AOG.0b013e3182639ab5″
“Two new cycloartane-type glycosides, caspicuside I and caspicuside II, were isolated along with two known saponins, cycloastragenol and astragaloside

IV, from the roots of Astragalus caspicus. As the aglycon group, caspicuside I possesses 3,6,16,(24S),25-pentahydroxycycloartane (cyclocanthagenol), while caspicuside II owns (20R, 24S)-epoxy-3, 6,16, 25-tetrahydroxycycloartane (cycloastragenol). The chemical structures of these new cycloartane-type glycosides were established as 3-O–L-rhamnopyranosyl-16-O–D-xylopyranosyl-cyclocanthogenol and 3-O-[-D-xylopyranosyl(1 3)--D-glucopyranosyl]-6-O–xylopyranosyl-cycloastragenol, respectively. These findings add to a Galunisertib mw growing body of literature demonstrating the high variation of cycloartane-type triterpene glycosides in different species of Astragalus.”
“OBJECTIVE: Suprapubic catheterization is commonly used for postoperative

bladder drainage after gynecologic procedures. However, recent studies have suggested an increased rate of complications compared with urethral catheterization. We undertook a systematic review and meta-analysis of randomized controlled trials comparing suprapubic catheterization and urethral catheterization in gynecologic populations.

DATA Cyclopamine solubility dmso SOURCES: PubMed, EMBASE, CINAHL, Google Scholar, and trial registries were searched from 1966 to March 2012 for eligible randomized controlled trials comparing postoperative suprapubic catheterization and urethral catheterization in gynecologic patients. We used these search terms: “”catheter,”" “”supra(-)pubic catheter,”" “”urinary catheter,”" “”gyn(a)ecological,”" “”catheterization techniques gyn(a) ecological surgery,”" “”transurethral catheter,”" and “”bladder drainage.”" No language restrictions were applied.

METHODS AND STUDY SELECTION: The primary outcome was urinary tract infection. Secondary outcomes were the need for recatheterization, duration of catheterization, catheter-related complications, and duration of hospital stay. Pooled effect size estimates were calculated using the random effects model from DerSimonian and Laird.

The effect of fiber orientation on the pore size has been experimentally investigated based on air-laid, parallel-laid, and cross-laid structures following through-air bonding. It was evident that

there is a discernible difference between the mean flow and maximum pore sizes of these nonwoven materials. The influence on LGK-974 manufacturer pore size was further elucidated by evaluating experimental and theoretical models based on sieving-percolation pore network theory including a model that incorporates directional parameter to account for the effect of fiber orientation. It was established that good agreement with experimental data can be obtained using such a model. (C) 2010 Wiley Periodicals, Inc. J Appl Polym Sci 118: 2668-2673, 2010″
“Pictorial representations of specific environments related to smoking can evoke robust craving to smoke, even in the absence of any proximal cues to smoke (e.g., cigarettes, lighters). To evaluate the salience of smoking environment cues, we developed a novel procedure for bringing smokers’ selleck chemical real world smoking and nonsmoking environments into the laboratory to compare them with standard (i.e., not personalized) environments within a cue-reactivity paradigm. Seventy-two smokers used digital cameras to take pictures of the environments in which they do and do not smoke. They then completed a cue-reactivity

session during which they viewed and rated pictures of smoking and nonsmoking environments, half personal and half standard, all devoid of proximal smoking

cues. As hypothesized, personal environments led to a significantly larger smoking-nonsmoking difference in craving, compared with the standard environments. Personalization also enhanced stimuli vividness, relevance, positive affect, and excitement, as well as heart rate changes from baseline. Implications of these findings for exposure-based research and treatment for addiction, as well as other psychological disorders, are discussed. (C) 2010 Elsevier Ireland Ltd. All rights reserved.”
“Osteonecrosis is a progressive clinical condition with significant morbidity, which primarily affects weight-bearing Vorasidenib joints and is characterized by the death of the bone, or part of it, because of insufficient circulation. The hip is the most common compromised joint. In osteonecrosis of the femoral head (ONFH), the collapse of the femoral head is a result of mechanically weak bone submitted to a load of weight, and can be associated with incapacitating pain and immobility. Both nonsurgical and surgical treatment options have been used with differing levels of success, and nonoperative treatment modalities such as bisphosphonates, statins, anticoagulants, and extracorporeal shock wave therapy (ESWT) for early-stage disease have been described, but exact indications have not been established yet. The aim of this study was to make a systematic review of the use of ESWT in the treatment of ONFH.

9 +/- 1.2 cm) compared to patients aged 45 to 64 years and those >= 65 years old (2.3 +/- 0.9 and 2.5 Ulixertinib supplier +/- 0.8 cm, respectively; P = .05), with transsphenoidal surgery being the treatment of choice in all 3 groups (83, 92, and 84%, not significant). After a mean follow-up of 6 years, there were higher recovery rates from hypopituitarism in patients <45 years old (58% vs. 27% and 24%; P = .04). Visual fields improved in most affected patients in each group following surgery (74, 94, and 86%), with a trend toward more full normalization in the youngest

age group (58% vs. 44% and 41%; P = .09). There were no significant differences in the risk of remnant growth (29 to 39%), rates of radiation therapy, or need for repeated surgeries. There was no disease-related mortality.

Conclusion: Elderly patients with NFPA

have lower rates of recovery selleck chemical from hypopituitarism after treatment compared to younger patients, but the rates of regrowth and need for salvage surgery are similar.”
“The association between polycystic ovary syndrome (PCOS) and recurrent miscarriage (RM) has been long established, but the relative importance of this condition as a cause of RM is far from clear. Previous studies on the prevalence of PCOS in RM have been hampered by a lack of objective and universally accepted criteria for the diagnosis of PCOS, resulting in considerable controversy. However, the Rotterdam criteria have since been accepted as the gold standard for diagnosis of PCOS, and therefore these criteria have been used to produce a much clearer and more objective assessment of the prevalence of PCOS in RM. Three hundred women

with recurrent miscarriage were studied. A diagnosis of PCOS was established via measurement of cycle length and day 21 serum progesterone, determination of the free androgen index and pelvic ultrasonography. All ultrasound reports prior to publication of the Rotterdam criteria were reviewed, ensuring consistency in the diagnosis of a polycystic ovary. Ultrasound scans of 27 patients confirmed polycystic ovaries with a further 10 scans suggestive of polycystic ovaries, DZNeP but with insufficient information for the Rotterdam criteria to be applied. Hence, 27-37 (9.0-12%) patients presented with ultrasonographic polycystic ovaries. Using the Rotterdam criteria, 25-30 (8.3-10%) patients had PCOS. It is concluded that the prevalence of PCOS in RM is considerably lower than has previously been accepted.”
“Purpose of reviewThis article addresses three areas in which new research demonstrates the potential to impact the health of children and adolescents: bullying, adverse childhood experiences (ACEs) and texting to promote behavior change.Recent findingsRecent research on bullying emphasizes its impact on children with chronic medical conditions, and highlights cyber bullying as a rising issue.

Enhancing the tolerance of crop plants to abiotic stresses such as drought has therefore proved to be somewhat elusive in terms of plant breeding. While many C-4 species have significant agronomic importance, most of the research effort on improving drought tolerance has focused on maize. Ideally, drought tolerance has to be achieved without

penalties in yield potential. Possibilities for success in this regard are highlighted by studies on maize hybrids performed over the last 70 years that have demonstrated that yield potential and enhanced stress tolerance are associated traits. However, while our understanding of the molecular mechanisms selleck chemical that enable plants to tolerate drought has increased considerably in recent years, there have been relatively GW2580 purchase few applications of DNA marker technologies in practical C-4 breeding programmes for improved stress tolerance. Moreover, until recently, targeted approaches to drought tolerance have concentrated largely on shoot parameters, particularly those associated with photosynthesis

and stay green phenotypes, rather than on root traits such as soil moisture capture for transpiration, root architecture, and improvement of effective use of water. These root traits are now increasingly considered as important targets for yield improvement in C-4 plants under drought stress. Similarly, the molecular mechanisms underpinning heterosis have considerable potential for exploitation in enhancing drought stress tolerance. While current evidence points to the crucial importance of root traits in drought tolerance in C-4 plants, shoot traits may also be important in maintaining high yields during

drought.”
“Background: In order to reduce the delays encountered through patient transfer, regional care models have been developed that directly transport subsets of acute myocardial infarction (AMI) patients to hospitals with percutaneous coronary intervention (PCI) facilities. Calgary is a Canadian city that implemented this type of model in 2004.

Methods: The study selleck chemicals population included 9768 AMI patients admitted to Calgary hospitals between 1997 and 2007. Administrative data were used to define patients who were directly admitted to the PCI hospital and those transferred there after initial admission to a hospital without specialized cardiac care. The differences in clinical characteristics and mortality trends of patients grouped by hospital delivery site and transfer practice are described.

Results: The proportion of patients directly admitted to a PCI hospital has increased with the implementation of a regional care model. Among patients admitted to non-PCI facilities, the patients who are transferred are younger, more likely to be male, have a shorter length of stay, and have lower proportions of several comorbid conditions.

With increasing Sr doping level, the characteristics of intrinsic Josephson junctions in LNSCO change from a superconductor-insulator-superconductor type to a superconductor-normal metal-superconductor

one. The field dependence of critical current I-c exhibits a periodical perturbation with a large scale of magnetic field. A fourfold symmetry of the angular dependent I-c for the rotation of the CuO2 plane in magnetic fields confirms the vortex pinning effect of the PRIMA-1MET order static stripes. The abrupt jump of voltage at a rather large I-c in LNSCO may be used as a high-power current restrictor or switch. (C) 2010 American Institute of Physics. [doi: 10.1063/1.3524214]“
“Methods: A total of 121 patients without structural heart disease who underwent primary CPVI by a single operator were included learn more in the study (paroxysmal/persistent AF: 77/44). Left atrial diameter was measured by transesophageal echocardiography. Plasma hsCRP concentration was determined by enzyme-linked immunosorbent assay. Based on the follow-up outcomes, patients were divided into two groups, a recurrence group and a nonrecurrence

group. AF recurrence was defined as AF or atrial flutter or atrial tachycardia episodes lasting for >= 30 s during regular follow-up (> 12 months).

Results: A total of 36 (29.8%) patients (paroxysmal/persistent AF: 19 [24.7%]/17 [38.6%]) had AF recurrence in a mean 23 (range, 12-44) month 5-Fluoracil follow-up period. The plasma hsCRP concentration in the recurrence group was significantly higher than that in the nonrecurrence group for all patients (median

[quartile range] 2.22 [1.97] mg/L vs 0.89 [1.30] mg/L, P < 0.001), for patients with paroxysmal AF (2.12 [2.78] mg/L vs 0.84 [1.15] mg/L, P = 0.028), and for those with persistent AF (2.29 [1.08] mg/L vs 0.89 [1.53] mg/L, P = 0.005). Multiple logistic regression analyses showed that the higher level of the plasma hsCRP (P < 0.001) was a significant prognostic predictor of AF recurrence, both for patients with paroxysmal AF (P = 0.012) and those with persistent AF (P = 0.003).

Conclusion: Plasma hsCRP concentration before CPVI was associated with AF recurrence after primary CPVI procedure for both paroxysmal and persistent AF patients. Plasma hsCRP concentration could play a role in prediction of AF recurrence after primary CPVI. (PACE 2011; 34:398-406).”
“Pain following depot intramuscular (IM) injection of oil vehicle-based drugs has been little studied. This study aimed to determine prospectively the prevalence, determinants, severity and functional consequences of pain during the week after IM injection of 1 000 mg testosterone undecanoate (TU) in a 4-mL castor oil vehicle.

33-1.64).

Conclusions-Although EMS use is independently associated with more rapid evaluation and treatment of stroke, more than one third of stroke patients

fail to use EMSs. Interventions aimed at increasing EMS activation should target populations at risk, particularly younger patients and those of minority race and ethnicity.”
“Background and Purpose: Laparoscopic partial nephrectomy (LPN) is the minimally invasive standard of care for the management of a cT(1a) selleck renal mass. We evaluated a novel saline enhanced electrosurgical resection (SEER) device for performance of a nonischemic LPN.

Materials and Methods: Six pigs were used in a nonsurvival pilot study. Energy penetration was characterized by applying the SEER

to the lower pole of each kidney for 30 seconds, 1 minute, and 3 minutes using pure cutting energy at 100W and a drip rate of 1 drip per second. Energy testing was performed with the hilum clamped in six kidneys and without clamping in six kidneys. Subsequently, a nonischemic upper pole LPN was performed with the SEER device, and the kidneys were harvested. The areas of necrosis were sectioned and stained with hematoxylin and eosin. Depth of necrosis was visualized ML323 inhibitor grossly and microscopically for each time point. We also recorded time to perform LPN, estimated blood loss (EBL), and subjective severity of bleeding.

Results: The average operative time was 15.4 minutes. The mean EBL was 44.2mL with nine (75%) cases classified as minimal, 2 (17%) moderate, and 1 (8%) severe bleeding. The mean depth of necrosis on the kidney remnants was 2.97 mm. The mean depth of necrosis for unclamped kidneys at 30 seconds, 1 minute, and 3 minutes was 0.38 mm, 0.88 mm, and 1.27 mm, respectively. The mean depths for the clamped kidneys were 2.73mm, 3.23mm, and 8.68mm respectively. selleck chemicals llc Depth of necrosis was significantly higher in the clamped kidneys at 3 minutes (P = 0.0035).

Conclusions: In the porcine model, the SEER transected parenchyma and collecting system with low resection times and minimal blood

loss. Use of coagulation during resection is the main advantage of a monopolar resection compared with cold scissors. Testing performed for 3 minutes during hilar clamping demonstrated a significantly deeper level of necrosis.”
“Manganese compounds and complexes [MnCl(2), MnBr(2), Mn(OAc)(2), Mn(acac)(2), Mn(acac)(3), Mn(2)(CO)(10)] catalyze Ritter reaction of organic nitriles with 1-bromo- and 1-hydroxyadamantanes. The reaction proceeds in water environment in the absence of acids at 100-130A degrees C over 3-5 h and affords N-(adamantan-1-yl)amides in 75-100% yields.”
“Background-Treatment and control of vascular risk factors reduce the likelihood of recurrent stroke. Present nationally representative data are sparse regarding secondary prevention treatment and control rates.

METHODS: A series of 200 consecutive walk-in patients were interviewed during general practitioners’ office hours. To avoid selection bias, we performed the survey on 31 randomly chosen days, between 11 July 2011 and 31 August 2011, excepting weekends and Thursday afternoons, when GP offices in Bern are closed. The patients were interviewed using a paper based, self-administered questionnaire, which was distributed by a medical student not involved in the medical treatment.

RESULTS: 200 selleck patients were interviewed during the study period. The majority

of walk-in patients interviewed (82%; n = 165) were registered with a GP. When asked about the circumstances of admission and subjective drivers to visit our emergency department, 39% (n = 61) patients reported greater confidence in the hospital emergency department. When asked if they saw a visit to a GP as appropriate, a majority stated that they preferred the hospital to their GP in any kind of emergency and the majority defined an emergency as either a condition requiring rapid attention or a life threatening situation (53%; n = 63).

DISCUSSION: Our study is another small piece of the puzzle to help us to understand why people in “”minor”" medical

emergencies prefer to consult a hospital than their own GP. Our study supported the evidence in current literature that there is a demand for hospital-based AL3818 datasheet ambulatory emergency medicine. Only a future large study on the drivers and barriers to emergency care in Switzerland can provide additional answers.”
“Estimation abilities PD-1/PD-L1 inhibitor are a group of processes that involve functions such as planning, attention, abstract reasoning, and also mnemonic processes, like semantic and working memory. They are allocated in order to solve problems for which the answers are not readily available. Estimation abilities can be measured using the Cognitive Estimation Test (CET). The aim of this article

was to review the use of the CET and other tests of cognitive estimation in healthy and pathological populations. We discussed studies examining correlations between the CET and other measures of executive functions and the importance of the standardization of measures that assess estimation abilities.”
“The objectives were to evaluate preweaning performance, body composition, and efficiency of calves representing straightbred Nellore (NL), F(1), and 3-breed-cross systems. Energy requirements, milk production, and efficiency of 39 cow-calf pairs were recorded from straightbred NL calves from NL cows (10), crossbred (Angus-sired) calves from NL cows (ANL: 9), and crossbred calves (CC; Canchim-sired: 5/8 Charolais, 3/8 Zebu) from ANL (10) and Simmental x NL (10) cows. Cows and their respective calves were individually fed from birth to weaning (17 to 190 d postpartum).

Ibutilide treatment was successful in all patients, with the arrhythmia

recurring early in I patient. There were no complications. J Heart Lung Transplant 2009;28:505-7. Copyright (C) 2009 by the International Society for Heart and Lung Transplantation.”
“Conventional cervical smears have been a great tool to reduce the incidence of cervical cancer; however, many studies have revealed significant false negative rates. To resolve this problem, the liquid based cytology (LBC) method was developed. The LBC method reduces the number of false positive and false negative smear results because LBC achieves an even Ion Channel Ligand Library solubility dmso distribution of monolayered cells, eliminated the obscuring effects of inflammation and blood. Although the LBC method has many advantages, there are several drawbacks. The LBC method Copanlisib PI3K/Akt/mTOR inhibitor requires an adaptation period for cytopathologists and cytotechnicians. Another drawback is the expense of the method. Thus, the LBC method has been questioned, and criticism has been raised regarding the design of the studies that assert its superiority. With a focus on the cytomorphologic and technical differences of LBC compared with conventional cervical smears, a review of the clinical and cost effectiveness of LBC, a brief comparison of two popular

LBC methods, and the basic concepts of study design with respect to LBC are presented in this review.”
“Objective: We investigated how patients’ spiritual and religious needs are addressed by healthcare staff in inpatient palliative care centers in Korea, a multi-religious country.

Methods: We performed a cross-sectional, multicenter survey of terminal cancer patients in inpatient palliative care centers.

Results: Approximately half (50.5%) of the patients reported that their spiritual and religious needs were addressed by healthcare staff. Patients whose needs were addressed reported better quality of life (QoL), as measured using the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire for Palliative Care, than patients whose needs were not addressed (p<0.05), although these groups did not differ when measured using the Comprehensive

QoL Scale. Patients with a religious affiliation Salubrinal cost [adjusted odds ratio (aOR), 2.38; 95% confidence interval (CI), 0.70-8.05], those who were admitted to a religious palliative care center (aOR, 2.61; 95% CI, 0.86-7.96), and those whose religious affiliation was the same as that of the palliative care center (aOR, 2.42; 95% CI, 0.96-6.07) tended to have their spiritual and religious needs addressed, although not statistically significant.

Conclusions: Although patients whose spiritual and religious needs were addressed by healthcare staff showed significantly better QoL, such needs were not addressed in a significant proportion of patients, especially those who were not religious or were admitted to non-religious palliative care centers.