Higher Chance Of Survival Research Articles

Dual Detection of microRNAs by a Signal-Off Colorimetric Nanobiosensor Based on Novel Split DNAzyme Nanostructure.

Breast cancer is the most common cancer and the second cause of cancer-related death in women, especially in the age of 20-59years. It is very important to diagnose it in the early stages of development due to high chance of survival. In this research, the early detection of two microRNAs involved in breast cancer including miR-21 and miR-155 was performed simultaneously using a nanobiosensor based on a special G-quadruplex structure and a colorimetric manner. This nanobiosensor contains two probes (p1, p2) that play a role in the formation of a special structure called DNA-G4. This structure has peroxidase-like properties and can oxidize TMB and produce a blue color. The diagnostic method is designed as a signal off, where the hybridization of probes with microRNA sequences, no DNA-G4 structure is formed and no color change is observed. The results of this study showed that the linear range of response is in the range of 2 to 10nm and limit of detection in buffer, blood and urine samples was calculated as 0.43nM, 0.54nM, and 0.62nM (R2 = 0.98), respectively. Evaluation using the method for cancer monitoring can be a simple, fast and cost-effective technique.

Profile and predictors of outcome for code blue cases in a tertiary care hospital in Mangalore

Back ground Code Blue is a common emergency code used in cases of cardiac arrest in hospitals to alert trained emergency response teams. The use of codes is mainly to convey essential information quickly to staff while preventing misunderstandings and panic among hospital visitors. This study aimed to determine the profiles and outcomes of patients with activated code blue calls. Methods This retrospective record-based study included all patients who had a code blue declared in the year 2022. Data was collected from the patient files from medical records department and analyzed with descriptive and inferential statistical methods. Results A total of 86 code blue calls were analyzed in this study. In terms of age distribution, the age group 60-80 years had the highest percentage of code blue cases. Code blue cases were more announced in males in the study (55.8%). For the announced code blue cases, it was identified that CPR if initiated by the staff on scene before the arrival of the code blue team had higher survival chance (60.0%). Asystole was the most common rhythm detected initially (66.3%) upon arrival of the code blue team. It was found that if the response time was lesser than 2 min, the patients had a higher chance of survival (53.3%). Conclusions In conclusion, CPR performed by a trained code blue team in a hospital can help improve outcomes. The initiation of bystander CPR has been proven to have favorable outcomes. Better training of staff can result in better outcomes.

Outcome of patients with primary CNS lymphoma treated with methotrexate based regimens: A retrospective study.

e19051 Background: Primary central Nervous system Lymphoma is an aggressive Non-Hodgkins Lymphoma with 5-year survival of only 30 percent. Few studies have addressed the comparison of induction treatment regimens with various risk stratification groups with no consensus on the optimal methotrexate dose for best complete overall response and survival outcome. Our retrospective study compares induction treatment regimens, identifies different risk stratification factors, and provides insight into the best induction treatment regimen with determination of optimal methotrexate dose. Methods: Design: Retrospective Primary Outcomes: Complete response rate, overall survival rate with risk stratification based on histology, Ki-67, and initial albumin level. Results: 77 patients 18 years of age and older with PCNSL at NCC and LAC between June 2015 and July 2022 were included in the study. Overall, 50% of patients were treated with CALGB50202 induction regimen,19% with R-MPV,12 % with De-Angelis regimen. CALGB 50202 has the highest survival rate of 63.4% followed by R-MPV with 22% survival rate followed by De-Angelis regimen with 0% survival rate with chi-square test P-value < 0.001 during the study period. Similarly, CALGB 50202 has the highest CR rate of 61.9% followed by R-MPV with CR rate of 16% followed by De-Angelis regimen with the lowest CR rate of 2.4%.CR rate comparison is statistically significant with P-value of < 0.0001. The study assessed optimum methotrexate dose. The mean and median total methotrexate dose in patients who were alive during the study period was 74.3 grams and 81.7 grams respectively as compared to mean value of 34.2 grams and median of 19.3 grams in patients who died with a p-value of 0.0019.Comparing survival based on histology as germinal center versus non-germinal center PCNSL, the later has higher mortality rate of 64.7 % as compared to 11.8 % in patient with germinal center PCNSL.Ki-67 was assessed as >80% and <80%.Among patients who were alive during the study period,48.8% have Ki-67 > 80% as compared to only 12.2%.On the other hand, among the patients who died,47.1% of patients have Ki-67 <80%,indicating lower ki-67 associated a lower survival outcome as depicted on the Kaplan Meier curve with P-value of 0.004. Patients with normal initial albumin have a higher chance of survival (78%) vs 22% in the group with low albumin level with p-value of 0.0005. Conclusions: CALGB 50202 had the highest CR and survival rates followed by R-MPV regimen in patients with primary CNS lymphoma. The total dose of methotrexate patient receives was an important factor for survival and CR and the optimal total methotrexate dose was 70-80 grams. Normal initial albumin, high Ki-67, and germinal center histology favored better survival.

Where the wild things aren’t: exploring the utility of rapid, small-scale translocations to improve site selection for shellfish restoration

The assessment of site suitability is a crucial step for informing future successful species reintroductions. It ensures that translocated species have the highest chance of survival in their new environment while minimising ecological risks. However, it can be challenging when risk factors are unknown, especially when working with sessile species that cannot easily relocate to more favourable conditions. Under these scenarios, rapid (1-2 week-long), small-scale (< 1 m2) experimental translocations can help reduce uncertainty and improve restoration outcomes. This study conducted small-scale experimental translocations of green-lipped mussels, Perna canaliculus, to 11 shallow coastal sites spread across Tīkapa Moana/the Hauraki Gulf, Aotearoa/New Zealand to investigate the relationship between predator abundance, environmental factors, and mussel loss to help refine existing site selection criteria. The total number of known mussel predators counted from timelapse images was used as a proxy for potential predator pressure. Translocated mussel survival ranged from 10 - 99% and was best predicted by current speed, wind direction, predator abundance, water clarity, and depth (adjusted R2 = 0.505). Predator abundance was best explained by site location (p = 0.001) and had weak correlations among environmental parameters (Rho = 0.067). These results suggest that small, short-term (1-2 week) experimental translocations can help to refine site selection criteria and reduce uncertainty in the site-selection process for larger-scale shellfish reintroduction efforts with unknown and/or hard-to-control risk factors.

On the Feasibility of Using REBOA Technology for the Treatment of Patients with Polytrauma

Introduction According to domestic and foreign authors, the leading cause of death in victims with polytrauma is blood loss. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is one of the new promising ways to manage bleeding in patients in a state of traumatic shock. There are a large number of publications in the world scientific literature indicating the high effectiveness of this technology in the treatment of bleeding. However, in the Russian Federation, this method has not yet entered into everyday practice, and scientific research on this matter is scarce. AIM Based on literature data and analysis of our own sample, to justify the need to use REBOA technology for the treatment of victims with polytrauma.Material and methods A retrospective analysis of the medical records of patients with polytrauma admitted to the N.V. Sklifosovsky Research Institute for Emergency Medicine in 2021 was carried out. Data from medical records and the Results of forensic medical examinations were studied. The main sample included victims with polytrauma (Injury Severity Score, ISS, of more than 17 points) delivered from the scene of the incident in a state of traumatic shock (systolic blood pressure, SBP, of less than 90 mm Hg) and a verified source of bleeding. To assess the potential survival of victims, we used the Trauma Score and Injury Severity Score (TRISS) scale.Results Of the 92 patients with polytrauma, 19 patients (20.6%) had indications for REBOA. The most common sources of bleeding were injuries to the pelvic ring, 14 (73.7%), abdomen, 11 (57.9%), and chest, 7 (36.8%). In 6 victims (31.5%), there were combined abdomen and pelvic injuries as the area of blood loss. The mean age of the victims was 48.8±19.9 years, the mean ISS value was 39.4±20.1. On admission, the mean SBP was 62.4±31.5 mm Hg, and heart rate — 91.8±43.3 beats/min. In 8 victims (42.1%), norepinephrine was administered immediately upon hospitalization at an average dose of 837.5±537.0 ng/kg/min. As a result of their injuries, 15 patients (78.9%) died, and 4 were discharged from the hospital. According to the Conclusions of forensic experts, the leading cause of death was blood loss in 11 (61.1%), severe traumatic brain injury (TBI) in 4 (22.2%), and infectious complications in 3 cases (16.7%).The TRISS was calculated for each patient. In order to identify the most potentially viable patients with indications for REBOA, we excluded 5 patients with severe TBI (the mean TRISS was 20.9±11.1%), and 5 patients with the TRISS of less than 50% (the mean TRISS was 10.0±14.1%), the latter died from hemorrhagic shock. Among the remaining 9 patients with higher TRISS values, 5 (26.3%) who died had the mean TRISS of 80.5±15.8%, comparable to the mean TRISS of 83.3±2.4% in the 4 survivors.Conclusion 1. According to foreign and domestic publications, the technology of resuscitation endovascular balloon occlusion of the aorta (REBOA) is effective for stopping internal bleeding in patients with polytrauma. 2. When analyzing our own sample of patients, it was proven that 20.6% of patients with polytrauma had indications for the use of REBOA. Most of them (78.9%) died. The main cause of death was hemorrhagic shock. 3. About a quarter of patients (26.3%) with indications for REBOA had a potentially high chance of survival. In the future, the use of this technology may reduce the number of deaths.

Clinical Presentation and Outcome of Critically Ill Patients with Inflammatory Bowel Disease

Introduction: Admission to the intensive care unit severely affects inflammatory bowel disease (IBD) patients. This study aimed to determine factors associated with mortality in IBD patients admitted to the intensive care unit. Methods: A retrospective cohort study was performed, analyzing data of all IBD patients admitted to the Department of Intensive Care Medicine at the University Medical Center Hamburg-Eppendorf between 2013 and 2022. Bivariate comparisons and multivariate regression analyses were performed to identify factors associated with mortality. Results: Overall, 439 IBD patients were admitted to the intensive care unit, representing 0.56% of total admissions. In 98 of these patients, IBD-associated complications were accountable for admission (22.3%). In detail, 39 (40.8%) patients were admitted after IBD-related surgery, 36 (35.7%) due to infections, and 23 (23.5%) due to medical conditions such as bleeding or electrolyte derangement. A total of 16 (16.3%) of these patients died within 90 days after admission. Parameters associated with increased mortality were age (p < 0.001), later age at diagnosis (p 0.026), catecholamine therapy (p 0.003), mechanical ventilation (p < 0.001), renal replacement therapy (p < 0.001), and parenteral nutrition (p 0.002). Prior treatment with anti-TNF therapy was associated with a higher chance of survival (p 0.018). There was no association between prior immunosuppressant therapy and admission because of infections (p 0.294). Conclusions: 16.3% of IBD patients admitted to the intensive care unit died within 90 days after admission. Prior treatment with anti-TNF therapy was associated with a higher chance of survival.

Analysis of the survival of technology-based companies linked to business incubators

ABSTRACT Technology-Based Enterprises (TBE) contribute to the economic development of nations through the diffusion of knowledge and innovation, thus being important for the economic growth and competitiveness of territo-ries and countries. Studies point out the difficulties in creating EBTs as well as the high mortality rate. Thus, this study aimed at analysing the survival of incubated and graduated EBTs linked to business incubators in the state of Minas Gerais, Brazil, considering the explanatory variables at the company, incubator, and municipality levels. Non-parametric and semi-parametric survival analysis statistical methods were used to, first, perform a descriptive analysis of survival characteristics and, second, evaluate the relationship of explanatory variables with survival time. A sample of 603 companies was used, obtained from the InovaData-MG platform, with a record of being active or inactive from January 1990 to December 2019, according to the Brazil-ian IRS website. The results pointed out that when disengaging from incuba-tors, graduated companies are subject to a higher risk of failure, and that in-cubated ventures that also went through an acceleration programme have a higher chance of survival. Failure rates showed a non-linear relationship with firm age. Firm-specific, microeconomic, and industry specifications have important implications for the survival of the studied EBTs. This study used a new data set and a statistical technique not usually employed, which allowed us to offer an important contribution to the prediction of the mortality of EBTs, helping the formulation of more assertive public policies for the growth and development of these companies.

Symptoms, Electrolyte Disturbances and Serum Albumin Levels in Palliative Oncology Patients Admitted Through Emergency: Characteristics and Survival Outcomes.

Our research aimed to examine the characteristics of palliative oncology patients hospitalised through an emergency to look for the symptom profile, characteristics of dyselectrolytemia and blood investigations, and possible associations with mortality. After institutional review board approval, a retrospective, observational study of patients hospitalised in our tertiary care specialty oncology hospital was undertaken. Records of hospitalised cancer patients admitted from the emergency department under palliative care from January 2019 to October 2021 were examined. As all admissions during this period were through emergency due to institution COVID-19 protocols, all elective admissions were excluded from the study. Data collected included patient characteristics, blood investigations, and comorbid history of systemic diseases and factors that could be associated with electrolyte imbalance. There were 157 emergency admissions during the study period. A majority were patients with solid tumours (92.4%). Pain was the most frequent cardinal symptom, along with other symptoms (68/157) or in isolation (33/157), followed by reduced oral intake (32/157) and altered sensorium (24/157). sixty-six patients died within the hospitalisation period. On long-term follow-up, only 8 (5.1%) were surviving. Hyponatraemia (43%), Hypoalbuminaemia (66%), and altered renal function (33.1%) were prevalent. We observed a weak positive correlation between sodium levels and outcome (r = 0.199, P = 0.016) and a strong positive correlation between albumin levels and survival outcomes (r = 0.329, P = 0.000). Patients with normal albumin had a higher chance of survival (odds ratio: 33.1225, 95% confidence interval: 3.415-321.20, P = 0.003). Pain-reduced oral intake and altered sensorium are common emergency symptoms in oncology palliative care. Mortality is high in these patients. Hyponatraemia, hypoalbuminaemia, and deranged renal functions were commonly seen. Normal sodium and albumin levels were associated with higher chances of survival, and the association was strong for serum albumin levels. This may have prognostic utility.

The Implication of Growth Arrest-Specific 5 rs145204276 Polymorphism and Serum Expression of Sirtuin 1, Transforming Growth Factor-Beta, and microRNA-182 in Breast Cancer.

Breast cancer (BC) patients have a higher chance of survival if it is diagnosed at an early stage, which is essential for efficient treatment of the condition. The results of an elevated risk of cancer, including BC, previously associated with the ins/del polymorphism rs145204276 in the promoter region of growth arrest-specific 5 (GAS5) are still up for debate. Thus, this study aimed to appraise the frequency of the GAS5 rs145204276 variant with BC risk and demonstrate the potential impact of the sirtuin 1 (SIRT-1), transforming growth factor-beta (TGF-β), and microRNA-182 (miR-182) expression and their diagnostic value in BC. Blood samples of 155 patients with BC and fibroadenoma and 80 healthy controls were analyzed for GAS5 rs145204276 single nucleotide polymorphism (SNP), SIRT-1, TGF-β, and miRNA-182 expression levels. Ins/ins genotype and ins allele frequencies for GAS5 rs145204276 were considerably higher in BC patients compared with controls. Patients with BC had significantly greater serum levels of TGF-β, miR-182, and SIRT-1 expression. The SIRT-1, TGF-β, and miR-182 genes provide novel, noninvasive diagnostic biomarkers for BC.

Шакал (Canis aure¬us) на півночі Полісся України: виявлення у природі, статус та повільне розселення

The golden jackal continues to slowly inhabit the north of Central Polissia and to disperse. Mostly single individuals are found. The social structure of the jackal is flexible and groups of more than two individuals are found in places of food concentration. A similar situation occurred in the Ubort River valley near the Ukrainian–Belarusian border, when visual encounters of jackal family consisting of probably 3–4 animals were very frequent near the burial place of livestock corpses. In the north of Central Polissia of Ukraine, the jackal has been recorded since 2014. The species is rare here. According to the registration of tracks, this predator is found on a less forested forest ridge between the settlements of Ovruch–Velidnyky–Slovechno–Levkovychi and in the valley of the Ubort River, which is a natural corridor of the species’ northward dispersal. Given Ukraine’s course towards EU membership and the position of the Baltic countries on the jackal, our country will obviously have to take into account the special status of the jackal as a species that has expanded its range on its own. Accordingly, this predator should not be considered an invasive species. Obviously, the problem with the jackal in forested regions of north of Ukraine will be much less severe than in the south in the floodplains of large rivers. In the Polissia, in trophically rich broadleaf forests with mosaic forest cover, the jackal is likely to coexist successfully with the wolf. Interspecific relations between wolves and jackals do not take the form of direct pursuit, but rather by marking territory. It has been found that jackals respond to chemical and visual markings of wolves during dispersal and try to quickly leave areas with high wolf population density. Unlike solitary wolves in the wild, solitary jackals are able to forage for food much more efficiently and therefore have a higher chance of survival in the wild. The preconceived notion of the jackal as a problematic species may not allow for an unbiased assessment of its impact on ecosystems. In its relations with humans, the jackal in the Polissia is a less problematic species compared to wolves, foxes, or American minks. It is necessary to inform the Ukrainian public, authorities and politicians about existing international legal instruments and European experience in managing populations of carnivorous mammals, including the golden jackal.

Comparative analysis of clinical characteristics of COVID-19 among vaccinated and unvaccinated patients in a major treatment facility in Ghana.

To compare clinical characteristics of COVID-19 among vaccinated and unvaccinated patients in a major treatment facility in Ghana. A retrospective study drawing on data from COVID-19 patients' records visiting the facility from March 2021 to December 2021. Ghana Infectious Disease Centre, Ga East Municipality, Greater Accra Region, Ghana. In-patients and outpatients who reported to the facility from 1st March 2021 to December 2021 were included in the study, and patients with missing data on vaccination were excluded. underlying conditions, symptoms, case management information, hospital service rendered (OPD, HDU or ICU), length of hospital stay, treatment outcome. The study included 775 patient records comprising 615 OPD and 160 hospitalised cases. Less than one-third (26.25%; 42) of the patients hospitalised were vaccinated compared to almost 40.0% (39.02%; 240) of the patients seen at the OPD. Vaccinated individuals were nearly three times (aOR = 2.72, 95%CI:1.74-4.25) more likely to be managed on an outpatient basis as compared to the unvaccinated. The death rate among the vaccinated group and the unvaccinated were (0.71%; 2) and (3.45%; 17), respectively, with a significant reduction in the risk of dying among the vaccinated compared to the unvaccinated (aOR = 0.13, 95%CI: 0.028 0.554). Less than half of the in-patient and OPD patients were vaccinated. Mild infections, fewer days of hospitalisation, outpatient treatment and higher chances of survival were associated with being vaccinated against SARS-CoV-2. Prudent measures should be implemented to encourage the general public to take up SARS-CoV-2 vaccines. None declared.

Tunicate Invasiveness under Varying Conditions of Salinity and Temperature

Sea squirts could be colonial or solitary and could easily adapt to many regions around the world because of their short lifespan, abilities to quickly gain energy supply, and relatively small biomass. An investigation was carried out to determine the degree of invasiveness of the tunicate through experimenting the viability of sea squirts under different salinities and temperatures designed to model the different environments of the globe where the sea squirt would potentially invade. Due to the inherently adaptive abilities of the sea squirt in their simple requirement of food, energy, and environment, sea squirts, whether colonial or solitary, have high chances of survival in anywhere with the minimal amount of energy and plankton food source [1]. The results of the experiment showed the high adaptability of the sea squirt in its thriving life functions under almost all the conditions given in the experiment, and a comparative competitive advantage over other filtering marine organisms.

Abstract 254: Patients With Signs of Life on Hospital Arrival Have a Higher Chance of Survival and Favorable Neurological Outcomes Following Traumatic Cardiac Arrest

Introduction: The clinical impact of signs of life (SOL) in traumatic cardiac arrest (TCA) remain to be elucidated. A previous study compared TCA patients with pulseless electrical activity (PEA) to those with asystole, but survival was not significantly different between the groups. Other obvious SOL (i.e., fine extremity/eye movement, light reflection, agonal respiration) have not yet been examined in TCA. Hypothesis: We hypothesized that TCA patients with SOL on hospital arrival have a higher chance of survival and good neurological outcomes. Aim: To examine survival and neurological outcomes in TCA patients with or without SOL. Methods: Retrospective review of data from the Japan Trauma Data Bank (2019-2021). The inclusion criteria were patients with TCA on arrival. The exclusion criteria were patients with burns, abbreviated injury scale score&gt; 6 in any region, and missing survival or SOL data. SOL was defined as follows: extremity or eye movement, light reflex, gasping, pulseless electrical activity with electrical heart activity &gt; 40 beats per minute. The primary outcome was survival at discharge. The secondary outcome was favorable neurological outcome (Glasgow Outcome Scale score of 4 or 5) at hospital discharge. Patients with and without SOL were compared using univariable analysis. Results were described with odds ratio (ORs) and 95% confidence intervals (CI). Results: A total of 2,136 patients (121 with SOL and 2,015 without SOL) were included. The characteristics of patients with or without SOL were as follows: age (median age 60.5 years old [interquartile range: 42-80 years] vs. 55.2 [38-75]), gender (male: 83/121 (68.6%) vs. 1,321/2,015 (65.9%), Injury Severity Score (32.9 [22-43] vs. 33.7 [22-41]), blunt trauma (97/121 (82.2%) vs. 1,711/2,015 (84.9%)), and transportation time (15.1 min [7-18] vs. 13.3 [7-16]). The patients with SOL showed higher survival compared with the patients without SOL (11/121 (8.5%) vs. 24/2015 (1.2%), OR 1.9 [CI 1.38-2.85]). A similar trend was observed for favorable neurological outcomes (5/95 (5.3%) vs. 7/1,440 (0.5%), OR 2.41 [CI 1.26-3.60]). Conclusions: TCA patients with SOL at arrival showed higher survival and favorable neurological outcomes at hospital discharge compared with TCA patients without SOL.

P07.10.A CLINICAL OUTCOMES OF SPOT-SCANNING PROTON BEAM THERAPY FOR IDH-MUTANT CNS WHO GRADE 2 AND 3 GLIOMA

Abstract BACKGROUND The latest WHO brain tumour classification puts utmost emphasis on prognostic significance of isocitrate dehydrogenase (IDH) mutation. IDH-wildtype tumours are now automatically considered CNS WHO grade 4 and associated with poor prognosis. On the contrary, patients with IDH1/2-mutant tumours have a favourable outcome. A high chance of long-term survival justifies the use of proton beam therapy (PBT) in these patients as it reduces unnecessary dose to unaffected brain and, consequently, late side effects. The data on outcomes specific for IDH-mutant tumours, in particular CNS WHO grade 3, remains limited. In this study we analysed the results of PBT in patients with IDH-mutant glioma of both CNS WHO grade 2 and 3 treated at our institution. MATERIAL AND METHODS The analysis included 30 patients enrolled in MedAustron prospective registry study (NCT03049072), who were diagnosed with CNS WHO Grade 2 and 3 glioma with IDH1/2 mutation. The median patient age was 38.8 years (range: 20.3 - 77.9) and male to female ratio was 16:14. The median time from last surgery to PBT was 91 days. CNS WHO grade 2 tumours (n =17) were treated with 54-54.04 Gy RBE total dose in 27-30 fractions and CNS WHO grade 3 tumours (n = 13) received 59.6-60 Gy RBE in 30-33 fractions. Fifteen (50%) and 24 (80%) of patients received temozolomide-based concomitant and adjuvant chemotherapy, respectively. Follow-up including MRI was obtained at 3, 6 and 12 months post PBT completion and then annually. RESULTS The median follow-up was 46.1 months (range: 13-69). Actuarial 3-year PFS of the whole cohort was 84.7% (95%CI: 64.1%-94%) and OS was 95.8% (95%CI: 73.9%-99.4%). At latest follow-up, 14 out of 17 patients with CNS WHO grade 2 (82.4%) and 8 out of 13 CNS WHO grade 3 tumours (61.5%) remained progression-free. Two patients died due to disease progression. This corresponded to actuarial 3-year PFS and OS of 86.8% (95%CI: 56.6%-96.6%) and 91.7% (95%CI: 53.9%-98.8%) for CNS WHO grade 2 and 83.3% (95%CI: 48.2%-95.5%) and 100% for CNS WHO grade 3 tumours, respectively. No risk factors of death and disease progression could be identified. Specifically, no significant differences were observed between CNS WHO grade 2 and 3 tumours for neither OS nor PFS (p = 1.0 and p = 0.32, respectively). The average time to progression in patients with treatment failure was 35.3 months. Only one patient (3.3%) developed grade ≥ 3 toxicity (G3 transient seizures). Radiation-induced brain lesions (RIBL) were identified in 11 patients (36.7%), out of which 10 (90.9%) remained asymptomatic. The median time to RIBL onset was 11.48 months and median duration in patients in whom RIBL eventually resolved was 14.8 months. CONCLUSION Our clinical data demonstrate that PBT is a safe and effective treatment of IDH-mutant glioma. Due to favourable and comparable outcomes of both grade 2 and 3 IDH-mutant tumours it is a valuable therapeutic option for both patient groups.

Exploration of pyroptosis-associated prognostic gene signature and lncRNA regulatory network in ovarian cancer

Ovarian cancer (OC), is a tumor that poses a serious threat to women's health due to its high mortality rate and bleak prognosis. Pyroptosis, a type of programmed cell death, is important for determining the prognosis of a patient's prognosis for cancer and may represent a novel target for treatment. However, research into how prognosis is impacted by pyroptosis-related genes (PRGs) is poorly understood. In this study, a prognostic model was created using bioinformatic analysis of PRGs in OC. In OC, we discovered 18 pyroptosis regulators that were either up- or down-regulated. By analyzing prognoses, we developed a 9-genes based prognostic model. Each OC patient received a risk score that could be used to categorize them into two subgroups: those with high risk and/or low chance of survival and those with low risk and/or high chance of survival. Functional enrichment and immunoinfiltration analysis indicated that low expression of immune pathways in high-risk group may account for the decrease of survival possibility. In Multivariable cox regression studies, age, clinical stage and the prognostic model were discovered to be independent factors impacting the prognosis for OC. To forecast OC patient survival, a predictive nomogram was developed. Furthermore, we found a correlation between predictive PRGs and clinical stage, indicating that AIM2, CASP3, ZBP1 and CASP8 may play a role in the growth of tumor in OC. After detailed and complete bioinformatics analysis, the lncRNA RP11-186B7.4/hsa-miR-449a/CASP8/AIM2/ZBP1 regulatory axis was identified in OC. Our study may provide a novel approach for prognostic biomarkers and therapeutic targets of OC.

Age‐ and health‐related non‐linear inheritance taxation

AbstractThis paper studies the design of optimal non linear bequest taxation when individuals differ in wage, survival and probability to become dependent at the old age. Following the recent health and economic literature, we assume that agents with higher wage have higher survival chances and lower risks to become dependent. Agents make precautionary savings for their old age taking into account the uncertainty on their health. They exhibit joy of giving utility, so that they also set aside money for their heirs. In the absence of annuity and long‐term care (LTC) insurance markets, heirs obtain different levels of bequests, depending on whether the donor died early or late in life and whether he was healthy at time of death. We assume that the government does not observe the decomposition of bequests between voluntary and involuntary ones. Instead, it observes the timing of death and the health condition at death of the donor. We show that, under asymmetric information, on top of marginal income taxation, the bequests left by low‐income individuals in case of early death should be taxed at the margin. To the opposite, bequests obtained later in life need not be taxed or subsidized at the margin.

The Beginning of an ECLS Center: First Successful ECPR in an Emergency Department in Romania-Case-Based Review.

According to the latest international resuscitation guidelines, extracorporeal cardiopulmonary resuscitation (ECPR) involves the utilization of extracorporeal membrane oxygenation (ECMO) in specific patients experiencing cardiac arrest, and it can be considered in situations where standard cardiopulmonary resuscitation efforts fail if they have a potentially reversible underlying cause, among which we can also find hypothermia. In cases of cardiac arrest, both witnessed and unwitnessed, hypothermic patients have higher chances of survival and favorable neurological outcomes compared to normothermic patients. ECPR is a multifaceted procedure that requires a proficient team, specialized equipment, and comprehensive multidisciplinary support within a healthcare system. However, it also carries the risk of severe, life-threatening complications. With the increasing use of ECPR in recent years and the growing number of centers implementing this technique outside the intensive care units, significant uncertainties persist in both prehospital and emergency department (ED) settings. Proper organization is crucial for an ECPR program in emergency settings, especially given the challenges and complexities of these treatments, which were previously not commonly used in ED. Therefore, within a narrative review, we have incorporated the initial case of ECPR in an ED in Romania, featuring a successful resuscitation in the context of severe hypothermia (20 °C) and a favorable neurological outcome (CPC score of 1).

Some Remarks about Asteroid Impact Triggered “Bioaerosol” Escape during a Putative Microbial Exchange between Early Earth and Mars

In general, Panspermia theory discusses the possibility of the spread of life in the universe. The migration of living organisms between planets is crucial in such a “fertilization” process. This study focuses on one particular case and phase of such migration: the possible material transport between the early Earth and Mars with a focus on the phase of escape, i.e., the ejection of a microorganism-containing material into space. Specific characteristics of asteroid impacts and one of the possible processes, which may be able to transfer microorganisms to space, were investigated. The comparison of the terrestrial and Martian paleoenvironment showed that theoretically, early Mars, similar to Earth, might allow biological evolution and might be able to harbor life. Determining various pressure zones regarding the survivability of the mechanical compression in the case of an impact and the characterization of specific physical parameters of the ejected debris lead to the identification of the pressure—mass/size conflict and the conclusion, which indicates two possible ways of material escape. The possibly “common” and known way is the material ejection close to ground zero. It guarantees big enough debris to protect its passengers during their travel. Still, the survival rate at/close to ground zero is supposedly low, and the heat and overpressure-related compression may sterilize the material even before boarding. An alternative way, discussed in this study, provides a higher chance of survival further from the impact center. Still, the possibility of the ejectile reaching the escaping velocity and the minimum required size is low. Although solving such a problem is out of the scope of this manuscript, searching for an ideal combination of various parameters is a possible challenge for future studies.

Clinical Usefulness of Machine Learning Approaches as a Non-Invasive Technology in Reducing Hepatitis Disease Mortality

Hepatitis is a viral infection that causes inflammation of the liver. However, other factors can cause the disease, including secondary effects from drugs, toxins, alcohol, and autoimmune hepatitis. The autoimmune form of the disease occurs when the body produces antibodies against the liver tissue, and many people worldwide are affected by it. Various clinical factors and parameters are examined in diagnosing hepatitis disease, which is analyzed by performing various tests of these factors and parameters. As a result of the vastness of the parameters under examination, it is challenging and complicated for the experts in this field to perform the analysis process on these parameters on a large scale. Healthcare experts can now identify the factors influencing the death rate of patients with high speed and accuracy thanks to emerging technologies such as machine learning, which is a subset of artificial intelligence. In this study, KNN and SVM machine learning techniques were used to analyze the positive effect of clinical parameters such as LIVER BIG, LIVER FIRM, SPLEEN PALPABLE, and ANOREXIA on patients' survival or death rates. This study investigates and analyzes the results of the implementation in two parts. The first part deals with determining the positive impact of these clinical parameters on the death and survival rate of patients, and the second part examines the performance of machine learning techniques based on the evaluation criteria of accuracy (ACC), error rate (ERR), specificity (SPE), and negative prediction value (NPV).Based on the implementation finding of machine learning techniques on data related to hepatitis patients, it has been determined that patients with positive LIVER BIG, LIVER FIRM, SPLEEN PALPABLE, and ANOREXIA clinical parameters can have a high chance of survival. On the other side, The SVM technique outperformed the KNN technique by ACC 94.05%, ERR 16.02%, SPE 93.07%, and NPV 85.7% in an analysis of the performance of machine learning techniques.

Perceived Life Expectancy Among Dialysis Recipients: A Scoping Review

Greater prognostic understanding is associated with higher quality care at the end of life. We undertook a scoping review to explore how long dialysis recipients expect to live. Scoping Review. People with kidney failure over 18 years old. Studies were identified by searching Medline, Embase, APA PsycINFO, HMIC, and ProQuest database for terms related to "life expectancy", "self-estimated", and "end stage kidney disease". Search strategies reported 349 unique, potentially eligible studies, with 8 studies meeting the inclusion criteria after screening. Significant mismatches between dialysis recipients and their health care provider's estimations of prognosis were reported, with patients predicting significantly higher life expectancies than health care professionals and almost no agreement between patient and nephrologist's estimates of 1-year survival. Documented cognitive impairment did not affect 1-year or 5-year prognosis estimates, nor did gender, age, time on dialysis, or discussing perceived life expectancy. Dialysis recipients who thought they were on the transplant list or who self-identified as African American reported higher perceived life expectancy, whereas people who were 75 years or older, or with fair or poor self-reported health status reported a lower perceived life expectancy. Those with a lower perceived life expectancy preferred care focusing on relieving pain and discomfort, whereas people who thought they had a higher chance of survival were significantly more likely to prefer life-extending care. There is a marked paucity of research in this area, with most studies conducted in North American cohorts. Optimistic patient prognostic expectations persist in dialysis recipients. Given the effects of perceived life expectancy on treatment choices and subsequent quality of life, it is important that transparent discussions regarding prognosis are conducted with people receiving dialysis and their families. Understanding illness severity and prognosis allows people to make decisions and prioritize areas of their lives that are important to them. We undertook a scoping review to explore how long dialysis recipients expect to live. We found significant mismatches between the perceived life expectancy of people treated with dialysis and their health care providers. Perceived life expectancy influenced treatment choices; thus, those who thought they would die sooner prioritized care focusing on relieving pain and discomfort. Those who thought they had a higher chance of survival were more likely to prefer life-extending care (with potential effects on quality of life). It is important to have frank discussions about prognosis with people receiving dialysis, to empower individuals and help them make informed decisions about their care.