Internal Units Research Articles

Epidemiological and molecular characteristics of carbapenem-resistant Klebsiella pneumoniae from pediatric patients in Henan, China

PurposeCarbapenem-resistant Klebsiella pneumoniae (CRKP) is an emerging global threat, whereas its epidemiological characteristics in children are rarely reported. This study aims to analyze clinical and epidemiological characteristics of CRKP from children in Henan, China.MethodsCRKP strains were isolated from pediatric patients, and the antimicrobial susceptibility of CRKP was determined using broth microdilution methods. The epidemiological characteristics of CRKP, including specimen sources, clinical data, carbapenemase types, virulence factors, MLST and PBRT typing were analyzed.ResultsIn total, 108 CRKP isolates were isolated from specimens including sputum, blood and urine, mainly from preterm pediatric department and internal medical intensive care unit (ICU). Newborns and staying in the ICU were risk factors for crude mortality. 107 isolates exhibited a multi-drug resistant (MDR) phenotype, and one isolate was extensively drug-resistant (XDR). Bacterial susceptibility to colistin, tigecycline and trimethoprim/sulfamethoxazole was 98.10%, 78.50% and 91.43%, respectively. Carbapenemase blaKPC (86.11%) was predominant, followed by blaNDM (5.56%) and blaIMP (2.78%). Two strains co-harbored blaKPC-blaNDM, one had blaKPC-blaIMP, whereas three isolates did not carry any of the analyzed carbapenemase genes. All strains possessed fimH, and 98% of the isolates possessed mrkD. Hypervirulent factors rmpA2 and iucA showed high positive rates (71.30% and 49.07%), with 48.15% of strains containing both genes. MLST analysis identified nine distinct sequence types (STs), with ST11 (82.41%) being the most common, followed by ST2154 (4.63%) and ST307 (3.70%). PBRT analysis revealed IncFII (85.19%) as the most prevalent plasmid.ConclusionIn summary, this study reported the epidemiological features of CRKP in pediatric patients in Henan, China, highlighting the high prevalence of multi-drug-resistant and hypervirulent strains, and underscoring the significance of continuous surveillance.

Check, Please! Supervisor-Learner Dyads Using "Checking" for Clinical Support During Indirect Supervision.

Indirect supervision is essential for granting autonomy to learners. Sometimes referred to as leaving the learner "unsupervised," there is growing recognition that learners and supervisors engage in clinical support through ongoing interactions, albeit at a distance. To understand how the complementary activities of asking for and providing clinical support at a distance come together as indirect supervision by identifying the natural language used between learners and supervisors. A collective case study of 15 attending physician-senior medical resident dyads from 2018 to 2023. Each case consisted of 2 full days of ethnographic observation of the resident on an internal medicine clinical teaching unit in one of three metropolitan hospitals; 2 end of day interviews with each dyad member; and a third interview with the attending after the 2-week rotation. Fifteen internal medicine residents (PGY-2 and PGY-3) who were scheduled to work for the first time with 15 attending physicians. Data collection was iterative with deductive and inductive analysis to identify patterns of communication. The language of "checking," such as checkpoints, checking on, and checking in, was central to communications within dyads. Indirect supervision included attendings using scheduled checkpoints and backstage oversight activities to check on the senior resident's patient care while expecting residents to access their support, as needed, by checking-in with them. Residents checked in with their attending to relay patient information updates, ask questions, and hint at needing their plans doublechecked; these communications had similar formats making them difficult to distinguish but functioned to preserve resident independence while accessing clinical support. Indirect supervision creates clinical support through ongoing communication between learners and supervisors at a distance. It is a collaborative process for mutual reassurance that safe patient care is being provided and that support is available when needed.

How COVID-19 pandemic and Ukrainian crisis shaped mental health services for medical students in Poland?

The mental health of medical students is a crucial concern in contemporary medical education. This manuscript reports the availability and shape of psychological support for medical students in Poland in the backdrop of the COVID-19 pandemic and the Ukrainian crisis. A survey comprising 10 questions was distributed to 22 medical schools in Poland, with a 59% response rate. The findings reveal that psychological support programs are predominantly managed by internal university units. Funding sources vary, with some universities utilizing internal budgets and others leveraging European funds or external projects. The support modalities are primarily hybrid, catering to student preferences. Limitations exist in the number of consultations, although some universities provide extended support based on student needs. Assistance is offered in multiple languages, with additional programs like stress-reduction workshops and mindfulness training being available in several universities. A notable increase in demand for psychological support post-COVID-19 was reported, with some universities establishing their programs during or after the pandemic. The commentary highlights the rising need for mental health services among medical students and underscores the importance of flexible, inclusive, and well-funded support. The effective functioning of these programs aligns with the broader objective of fostering a resilient and emotionally balanced healthcare workforce.

Characteristics and outcomes of patients hospitalized for infection with Influenza A, SARS-CoV-2 or respiratory syncytial virus in the season 2023/2024 in a large German primary care centre

BackgroundIn addition to the persistence of SARS-CoV-2 infections, those with Influenza A/B and RSV have reappeared in 2022/23. To compare the development of prevalence, clinical outcomes and risk factors, we analysed data of the season 2023/24 from the same region/hospital as for 2022/23.MethodsPatients covering the whole age range with a positive polymerase chain reaction (PCR) test for SARS-CoV-2, Influenza A/B, RSV were included from the internal, neurological and paediatric units of the RoMed hospital Rosenheim, Germany/Bavaria, from August 1st 2023 to 29th February 2024.ResultsOf 932 patients included, 912 showed single infections with SARS-CoV-2, Influenza A or RSV (47.9% female, median age 68.0 years; 52.9% SARS-CoV-2, 23.2% Influenza A, 21.8% RSV). Co-infections (2.0%) and Influenza B (0.1%) were negligible. In patients of age ≥ 18 years (n = 628, 68.5% SARS-CoV-2, 26.0% Influenza A, 5.6% RSV), patients with Influenza A were younger compared to SARS-CoV-2 (p < 0.001), with RSV similar to SARS-CoV-2. Heart failure and asthma were the most prevalent comorbidities for RSV, immunosuppression for Influenza A. Admission to Intensive Care Unit (ICU) occurred in 111 patients (17.0% of SARS-CoV-2, 17.2% Influenza A, 28.6% RSV), and 59 patients died (8.8% SARS-CoV-2, 8.6% Influenza A, 20.0% RSV). Low-flow oxygen supplementation and non-invasive ventilation (NIV) were most frequent for RSV (68.6% and 20.0%, respectively), oxygen demand upon admission for Influenza A (39.3%), without differences in high-flow oxygen supply or length of hospital stay. Among patients aged < 18 years (n = 284, 21.4% SARS-CoV-2, 18.0% Influenza A, 57.1% RSV), 15 were admitted to ICU (4.8% SARS-CoV-2, 3.8% Influenza A, 6.0% RSV); none of them died. Oxygen supply via high-flow, low-flow or upon admission was highest for RSV (23.8%, 70.2%, 21.4%, respectively), as well as the length of hospital stay.ConclusionBetween 8/2023 to 2/2024, a large population of patients hospitalized due to respiratory tract infection, showed relative contributions of SARS-CoV-2, Influenza A or RSV similar to those in 2022/23. The findings underline that in both, adults and children, RSV posed a relatively higher clinical risk than Influenza A and SARS-CoV-2, though absolute numbers remained highest for SARS-CoV-2.

Additively Manufactured Stainless Steel Wind Tunnel Model Support Featuring Honeycomb Structures for Vibration Attenuation

Wind tunnel model support (WTMS) is an indispensable component of wind tunnel testing. However, the presence of vibrations within the model‐support system can compromise the accuracy of data and give rise to significant safety hazards. In this study, an approach for vibration attenuation by incorporating honeycomb structures into the design of the WTMS is proposed. To this end, stainless steel WTMSs with integrated honeycomb structures are fabricated by selective laser melting (SLM). Results showed that stainless steels prepared under optimized SLM processing parameters exhibit high crystallinity and consist of single‐phase Fe–Cr–Ni alloy. The stainless steels exhibited robust mechanical properties, including a tensile strength of ≈1 GPa, an elongation of ≈8%, and a compressive strength of ≈1.4 GPa. These exceptional mechanical properties can be attributed to the formation of a cellular structure and tangled dislocations. The first‐order and the third‐order resonant response of WTMS honeycomb structures can be effectively reduced. The vibration reduction mechanism can be attributed to the occurrence of local resonance when the natural frequency of the internal periodic unit of the WTMS closely matched the vibration frequency of the model. The utilization of honeycomb structures holds significant potential for achieving vibration attenuation in WTMS.

Determinants of Government Procurement Fraud Prevention with Organizational Commitment and Ethical Culture as Moderating Variables

This study aims to analyze the various factors that influence the prevention of procurement fraud, including the implementation of the Anti-Bribery Management System (ABMS), Government Internal Control System (SPIP), and the role of the Internal Compliance Unit (UKI), with organizational commitment and ethical culture as moderators. It employs a quantitative causal approach, with data collected through surveys and analyzed using Partial Least Square-Structural Equation Modelling (PLS-SEM). The results demonstrate that the implementation of ABMS, SPIP, and UKI positively impacts the prevention of procurement fraud. Organizational commitment and ethical culture strengthen the influence of SPIP implementation, while ethical culture weakens the role of UKI in preventing fraud. ABMS, SPIP, and UKI are crucial in fraud prevention, but their effectiveness is enhanced by a strong commitment to ethics. While organizational commitment strengthens SPIP's preventive effects, a strong ethical culture may reduce the reliance on UKI in fraud prevention. These findings underscore the importance of comprehensive anti-fraud measures such as the implementation of ABMS, SPIP, and the establishment of UKI in preventing procurement fraud

‘I’d Give My Right Arm to Be Ambidextrous’: Exploration Unit Managers Facing Competing Demands for Differentiation and Integration

This paper examines how managers of internal exploration units – also labeled as innovation labs – address the competing demands of differentiation and integration over time, and the implications for their unit’s ability to execute its intended exploration strategy. Based on a longitudinal study of four exploration units implemented by established firms, we find that their managers face two types of undocumented paradoxical tensions: one related to the evolution of the mandated charter and the other related to the implementation of the performance management system. In response, we show that exploration unit managers adopt four balancing patterns to face these paradoxical tensions: decoupling, conforming, promoting, and synchronizing. These patterns consist of specific combinations of differentiating and/or integrating practices. Drawing on paradox research, we show how each pattern facilitates or impedes the pursuit of the unit’s intended exploration strategy. Our research contributes to the development of a more integrative and systemic understanding of the locus of structural ambidexterity and how it is pursued in practice, and to current debates about the different types of responses adopted when faced with paradoxes. Finally, we provide managerial insights into the management of exploration units and innovation labs within established firms.

Analysis of rogue wave in the mid-infrared supercontinuum under femtosecond weak seed pulse conditions based on deep learning

The generation process of rogue wave (RW) is affected by noise, which is an unstable state, and the existence of RW will reduce the stability of mid-infrared supercontinuum. However, the process of studying RW requires a large amount of data simulation and statistics, and traditional methods are time-consuming and inefficient. Therefore, this paper adopts long short-term memory (LSTM) neural network to obtain the spectrum information after transmission for a certain distance according to the waveform information of the incident pulse. The results show that the LSTM neural network structure can train and predict the peak power, time deviation information, time intensity evolution and spectrum evolution of RW after 10 cm propagation with only changing the number of internal units. And it performs well on both large and small data sets.

MSTAN: multi-scale spatiotemporal attention network with adaptive relationship mining for remaining useful life prediction in complex systems

Abstract In the era of smart manufacturing and advanced industrial systems, the high degree of integration and intelligence of equipment demands higher reliability and safety from systems. Existing methods often rely on historical data for Remaining Useful Life (RUL) prediction to achieve Prognostic and Health Management (PHM). However, the internal units of complex equipment exhibit significant spatial correlation and temporal diversity, making PHM for complex equipment a multidimensional challenge involving both temporal and spatial information, thereby severely limits the effectiveness of RUL prediction for complex systems. Addressing these challenges, this study introduces a multi-scale spatiotemporal attention network with adaptive relationship mining, specifically designed for the remaining useful life (RUL) prediction of such equipment. The core of the proposed method lies in the multi-scale feature perception module, which adeptly extracts varied scale features from multidimensional sensor data. Following this, an innovative adaptive relationship mining module is integrated to uncover multi-order coupling relationships between diverse sensors, enhancing the model’s predictive accuracy. Furthermore, a spatiotemporal attention module is employed to discern and emphasize crucial spatiotemporal correlations. To validate the effectiveness and superiority of the proposed method, the Commercial Modular Aero-propulsion System Simulation (C-MAPSS) dataset is employed for comprehensive performance evaluation, the IEEE 2012 PHM bearing dataset is also adopted to demonstrate the generalization and robustness of the proposed method. The results not only show a notable improvement over existing methods but also offer a more intuitive understanding through visual representations, marking a significant stride in enhancing the safety and efficiency of complex systems.

Localized estimation of event-related neural source activity from simultaneous MEG-EEG with a recurrent neural network

Estimating intracranial current sources underlying the electromagnetic signals observed from extracranial sensors is a perennial challenge in non-invasive neuroimaging. Established solutions to this inverse problem treat time samples independently without considering the temporal dynamics of event-related brain processes.This paper describes current source estimation from simultaneously recorded magneto- and electro-encephalography (MEEG) using a recurrent neural network (RNN) that learns sequential relationships from neural data. The RNN was trained in two phases: (1) pre-training and (2) transfer learning with L1 regularization applied to the source estimation layer. Performance of using scaled labels derived from MEEG, magnetoencephalography (MEG), or electroencephalography (EEG) were compared, as were results from volumetric source space with free dipole orientation and surface source space with fixed dipole orientation. Exact low-resolution electromagnetic tomography (eLORETA) and mixed-norm L1/L2 (MxNE) source estimation methods were also applied to these data for comparison with the RNN method.The RNN approach outperformed other methods in terms of output signal-to-noise ratio, correlation and mean-squared error metrics evaluated against reference event-related field (ERF) and event-related potential (ERP) waveforms. Using MEEG labels with fixed-orientation surface sources produced the most consistent estimates.To estimate sources of ERF and ERP waveforms, the RNN generates temporal dynamics within its internal computational units, driven by sequential structure in neural data used as training labels. It thus provides a data-driven model of computational transformations from psychophysiological events into corresponding event-related neural signals, which is unique among MEEG source reconstruction solutions.

A carbon integrated energy pricing strategy based on non-cooperative game for energy hub in seaport energy system

Seaports are significant energy consumers and sources of carbon emissions within the maritime industry. To address this problem, an energy hub (EH) can be established as an intensive energy interconnection center. This paper proposes a carbon emission flow (CEF) model based on the energy hub in seaport, which monitors the carbon emissions generated by the internal energy conversion unit operating within the hub. Additionally, a carbon integrated energy pricing strategy based on non-cooperative game theory is proposed. Based on duality theory and gradient descent method, an iterative algorithm is designed to seek the global optimal solution satisfying the Nash equilibrium point. The aim of the strategy is to encourage seaport energy consumers to adjust their energy consumption strategy according to the optimal benefits and reduce carbon emissions. A comparative study of three different strategy cases are conducted to evaluate the effectiveness of the proposed strategy. Numerical simulation results show the reduction of the total energy consumption and carbon emissions of the system, which is conducive to realizing the low-carbon operation of the seaport energy system.

Internal Control Unit Strategy in Implementing Internal Control

This study aims to describe the implementation of the Government Internal Control System (SPIP) at Dr. Radjiman Wediodiningrat Mental Hospital, Lawang, Malang and to develop a strategic plan from the Internal Audit Unit (SPI) in conducting supervision of the Mental Hospital. This research is qualitative research. The informants are the Head of SPI and other respondents. In formulating alternative strategies, SWOT analysis is used with the IFAS and EFAS approach methods. The results showed that SPI is in quadrant I (supporting growth strategy), which has strong internal strengths to grow in seizing existing opportunities. The resulting strategy is to improve internal control in the RSJ through the formation of the SPIP Task Force in organizing internal control in the hospital, increasing the knowledge and understanding of the heads of work units, on all matters relating to inherent supervision within the scope of their work units and utilizing information technology by creating a Supervisory Information System application to support supervisory performance, especially in terms of organizing SPIP in the hospital. The implications of this research are significant for enhancing internal control systems and strategic planning within healthcare institutions. By identifying SPI's current position and proposing targeted strategies, this study provides actionable recommendations for improving internal oversight and control mechanisms. The formation of a dedicated SPIP Task Force and the development of a Supervisory Information System application are expected to strengthen internal controls, streamline supervision processes, and enhance overall organizational efficiency.

Directional Adaptive Triboelectric Nanogenerator with Wind-Wave Synergy.

To enhance the adaptability and synergy of the triboelectric nanogenerator (TENG) in a wave environment, this paper introduces a directional adaptive triboelectric nanogenerator (DA-TENG) with wind-water synergistic action for wave energy collection. An innovative design combining a wind vane on the top and fan-shaped blade electrodes internally allows the DA-TENG to adjust its swinging direction adaptively to align with the direction of wave motion. The internal multiple power generation units work in coordination, effectively addressing the issues of low efficiency associated with spherical TENGs in capturing multidirectional wave energy. The DA-TENG demonstrates superior performance under various wind speed conditions, showcasing its practical application potential. Experimental results show that the DA-TENG, equipped with a single tail wind vane and a 700 g mass block, can achieve an output voltage, current, and charge of 374.97 V, 84.77 μA, and 622.69 nC under a mild wind environment. Its peak power density reaches 7.51 W m-3, enabling successful data transmission for a wireless temperature and humidity sensor and powering 248 light-emitting diodes (LEDs). This research expands the possibilities of omnidirectional wave energy collection and the collaborative operation of multiple power generation units, offering an effective method for powering low-power maritime devices.

Impact of building topologies on hill slope stability in Aizawl city

In hilly regions like Aizawl city, wherein houses are mostly built on slopes, the layout of building plays a crucial role in slope stability. Building failures in Aizawl often results from a) non-engineered alterations of slopes b) faulty foundation construction without soil investigation or design. Many residents build and reside on slopes without considering the soil characteristics. To address this, a study was conducted to examine the impact of two common building types - step-back buildings and step-back setback buildings on slope stability in Aizawl. Fifty different sites with varying slope geometries were analysed using Limit Equilibrium Method (LEM), considering soil parameters like cohesion, internal friction angle, unit weight, and slope geometry. The study evaluated slope stability under conditions such as free slope, slope with building loads under static and seismic conditions. The study found that sites with lower slope angles generally demonstrated greater stability, but there were cases where steeper slopes showed better stability due to superior shear strength values. Sites with higher cohesion values exhibited better stability in free slope analysis, while those with higher internal friction angles showed better stability under building loads of both static and seismic condition. To validate the above findings, a sensitivity analysis along with a comparative analysis between step-back and step-back setback building types were conducted. The results indicated that step-back setback buildings offered better stability compared to step-back buildings alone. This suggests that implementing step-back setback buildings could significantly improve slope stability in cities like Aizawl.

Low-carbon operation strategy of virtual power plant considering progressive demand response

Adapting virtual power plants (VPPs) to the development of new power systems has gradually become a trend. Meanwhile, the economical and effective use of demand-side resources in VPPs has become a research hotspot in the field of new energy. This paper proposes a low-carbon operation strategy with progressive demand response (DR). A DR model id established by evaluating the scheduling potential of low-carbon and flexible loads and the DR transfer of different users motivated by incentive mechanisms. Because the changing carbon price in carbon trading also affects the response transfer amount, it is beneficial to reduce the operating cost of the energy system by using consumers’ surplus value according to consumer psychology to guide energy users to participate in DR. Finally, wind, light, user load data and VPP internal unit output are optimized in rolling mode over multiple time scales, and the optimal adjustment results of the previous day are taken as the basis. At the same time, the output deviation penalty function is added to further reduce the system cost. The nonlinear model of DR cost is transformed into a mixed integer linear model, which is modeled on MATLAB software and solved by a CPLEX optimization solver. The case analysis shows that the progressive DR strategy may increase the total operating cost of the system, but reduce the cost of the carbon emission. The proposed model and method can not only improve the feasibility and effectiveness of market supervision strategy, but also provides a useful reference for operators and demand-side users in energy systems to choose strategies.

Optimal Operation of Virtual Power Plants Based on Stackelberg Game Theory

As the scale of units within virtual power plants (VPPs) continues to expand, establishing an effective operational game model for these internal units has become a pressing issue for enhancing management and operations. This paper integrates photovoltaic generation, wind power, energy storage, and constant-temperature responsive loads, and it also considers micro gas turbines as auxiliary units, collectively forming a typical VPP case study. An operational optimization model was developed for the VPP control center and the micro gas turbines, and the game relationship between them was analyzed. A Stackelberg game model between the VPP control center and the micro gas turbines was proposed. Lastly, an improved D3QN (Dueling Double Deep Q-network) algorithm was employed to compute the VPP’s optimal operational strategy based on Stackelberg game theory. The results demonstrate that the proposed model can balance the energy complementarity between the VPP control center and the micro gas turbines, thereby enhancing the overall economic efficiency of operations.

The Tethered Pathway to Organizational Adaptation in Collaboration

Abstract The purpose of this study was to examine how the framework of administrative tethering (AT) provides important guidance and insight at the organizational level to support a strategic management mechanism to ameliorate pressing political, social, and economic issues for the public good. This investigation was an empirical analysis of data collected from the 2020 Federal Employee Viewpoint (FEV) Survey and records attributed to the Department of the Navy (N = 32,416). The Department of the Navy consists of naval forces and marine forces for maritime operations, which conduct internal collaboration and represent cases of both external institution to institution (i2i) collaboration and internal unit to unit (u2u) collaboration. Structural equation modeling (SEM) is a useful analytical approach to examine the relationships among all the measured and latent variables. The resulting SEM analysis evoked the importance of individual behaviors on collaborative efforts.

Bioinspired, anti-fogging and de-icing transparent surfaces with flexible property

In cold environments, natural phenomena like icing, frost, and fog can significantly impede the functionality of optical windows. Consequently, there is a growing demand for optical windows that demonstrate anti-fogging and de-icing characteristics while maintaining flexibility and transparency with high optical clarity. The development of cost-effective and straightforward anti-fogging and de-icing elements encounters various challenges. The remarkable visual acuity of polar bear eyes in challenging weather conditions can be attributed to a tear film that covers the cornea and the thermoregulatory characteristics of their eyeballs. Inspired by the anti-fogging and anti-icing properties of polar bear eyes, a new flexible, transparent surface with heating capabilities has been developed. To address the limitations of conventional slippery surfaces that solely offer anti-fouling properties, a flexible internal heating unit is integrated into the slippery surface through a layered nesting technique to emulate the homothermal features of polar bear eyeballs. The slippery property of the PDMS surface can be attributed to a gel layer containing an auto-secretory lubricant. To preserve its optical properties, a new processing method that combines liquid metal microfluidics and femtosecond laser processing is employed. This technique can create narrow channels with a high length-to-diameter ratio, thereby reducing the impact on the transmission rate. The sample demonstrates self-cleaning, resistance to dust and pollution, and efficient electrical heating properties. Testing on fogging and freezing validates the practicality and effectiveness of these substances for applications in anti-fogging and de-icing.

Assessment of Serum Autophagy Related Protein Beclin1 in Egyptian Adult Beta Thalathemic Patients

Abstract Background Beta-thalassemia is a chronic hemolytic anemia that is inherited in an autosomal recessive manner. It is characterized by reduced hemoglobin levels and red blood cell production. Aim of the Work Assessment of serum autophagy related protein beclin1 in Egyptian adult beta thalathemic patients and Its relation to ineffective erythropoiesis, transfusion requirements, iron overload. Subjects and Methods This is a case control study which was carried out at Ain Shams university hospitals. Internal medicine department, Clinical hematology and stem cell transplantation unit, outpatient clinic and inpatient department, during the period between January 2022 and August 2022. Results Our study revealed significant decreased fertility between patients group and control group (P = 0.011). Transfusion-dependent beta-thalassemia males have a high proportion of fertility impairment and iron overload might contribute to disturbed sperm quality and testicular tissue injury. Such findings might explain the high prevalence of impaired fertility in transfusion-dependent beta- thalassemia patients which agrees with our results. Also our study revealed significant differences between non-transfusion dependent group and transfusion-dependent group regarding spleen size (cm) below costal margin which was increased in (TD group), transfusion per year (ml/yr)(which was increased in (TD group), virology (HIV, HCV,HBV) revealed that percentage of HCV+ve higher in (TD group) with (P &amp;lt; 0.001): Our study revealed significant difference between non-transfusion- dependent group and Transfusion-dependent group regarding percentage of patients of with positive HCV which was increased in Transfusion-dependent group (P = 0.021): In our study Iron chelation therapy was found to be given in a higher percentage of TD patients compared to non TD patients (P &amp;lt; 0.001). Also our study revealed significant difference regarding cardic function(EF%) between patients group and control group (EF found to be lower in patients group than controls) (P &amp;lt; 0.001): Also our study showed that Beclin-1 level is significantly higher in patients group compared to control group (P &amp;lt; 0.001). We couldn’t find previous studies of Beclin-1 level in thalassemia patients. We postulate that Beclin 1 could be used as a marker of worsening cardiac functions in thalassemia patients, but further studies should measure serial levels of Beclin 1 and correlate it with cardiac parameters over longer periods of follow up. Conclusion Beclin 1 level increased in Adult Beta Thalasemia patients and it can be used as a prognostic marker for Adult Beta Thalasemia patients.

Vitamin D levels in patients admitted to the internal medicine intensive care unit and the association with mortality and other clinical outcomes

Vitamin D levels in patients admitted to the internal medicine intensive care unit and the association with mortality and other clinical outcomes