PSI Scores Research Articles

WISC-IV performance of children with Chronic Tic Disorder, Obsessive\u2013Compulsive Disorder and Attention-Deficit/Hyperactivity Disorder: results from a German clinical study

BackgroundChronic Tic Disorder (CTD), Obsessive–Compulsive Disorder (OCD) and Attention-Deficit/Hyperactivity Disorder (ADHD) are complex neuropsychiatric disorders that frequently co-occur. The aim of this study was to examine WISC-IV performance of a clinical cohort of children with CTD, OCD and/or ADHD.MethodsN = 185 children aged 6 to 17 years from Germany with CTD, OCD and/or ADHD were examined with the WISC-IV that comprises four index scores (VCI: Verbal Comprehension Index, PRI: Perceptual Reasoning Index, WMI: Working Memory Index, PSI: Processing Speed Index) and a Full Scale Intelligence Quotient (FSIQ). WISC-IV profiles of children with CTD-only, OCD-only, ADHD-only, CTD+ADHD, CTD+OCD and CTD+OCD+ADHD were compared with the WISC-IV norm (N = 1650, M = 100 and SD = 15) and among each other.ResultsUnpaired t-tests revealed that children with ADHD-only showed significant lower PSI scores, whereas children with CTD-only and OCD-only had significant higher VCI scores as compared to the German WISC-IV norm. One-way ANOVA revealed that children with ADHD-only showed significant lower WMI scores as compared to children with CTD+OCD.ConclusionsWe were able to confirm previous evidence on WISC-IV profiles in ADHD in a German clinical sample and contribute new findings on cognitive performance in children with (non-)comorbid CTD and OCD that have to be seen in light of the study’s limitations.

Comparison of the efficacy of PSI, CURB-65, CALL and BCRSS in predicting prognosis and mortality in COVID-19 patients

This study aimed to determine whether the PSI, CURB-65, CALL and BCRSS had any superiority over each other as a prognostic determinant in patients with COVID-19. This prospective cohort study included patients over 18 years of age that presented to the emergency department between May 12 and August 12, 2020 and had a positive COVID-19 polymerase chain reaction (PCR) test. The PSI, CURB-65, CALL and BCRS scores were calculated. SPSS version 22 was used for all statistical analyses. A total of 213 patients with a positive COVID-19 PCR result were included in the study. The total 30-day mortality rate was determined as 14.08%. PSI, CURB-65, CALL and BCRSS had a statistically significant relationship with mortality (p<0.001). The best parameter in predicting mortality was determined as PSI (area under the curve: 0.900; 95% CI: 0.972-0.828). A positive correlation was found between each scoring system, both with the length of hospital stay (PSI, CURB-65, CALL and BCRSS: r=0.696, p=0; r=0.621, p=0; r=0.75, p=0; and r=0.666, p=0, respectively). Scoring systems, which include comorbidity, vital signs as well as laboratory, imaging findings, will be more effective than other scoring systems in determining the mortality in patients with covid-19.

The Evaluation of Pain with Nociceptive and Neuropathic Characteristics from Three Different Perspectives in Amyotrophic Lateral Sclerosis Patients: A Case Controlled Observational Study in Southwestern China.

Background Pain was considered a common and neglected symptom in amyotrophic lateral sclerosis (ALS) and had a substantial impact on the quality of life of ALS patients and their caregivers. However, pain in ALS was mainly evaluated from the perspective of nociceptive pain; only three studies referred to neuropathic pain in ALS, and there has been yet no study considering the neuropathic pain characteristics in ALS patients from China. Therefore, the purpose of our study was to determine characteristics of pain (nociceptive pain and neuropathic pain) by three different types of questionnaires. The correlation between pain and clinical parameters in ALS patients was also evaluated. Methods Patients were eligible if they fulfilled the criteria of probable and definitive ALS according to the revised El Escorial criteria. Healthy normal controls, matched to ALS patients by age and gender, were recruited. Pain was evaluated by numerical pain rating scale (NRS), Brief Pain Inventory (BPI), and Douleur Neuropathique-4 (DN4) in ALS patients and controls. Physical status of ALS patients was evaluated with ALS Functional Rating Scale-revised (ALSFRS-R). Results 65 patients with sporadic ALS and 100 healthy normal controls in Southwestern China were included. Pain in the preceding week was more frequently reported by patients with ALS (30, 46.2%) than controls (36, 36%) (p = 0.193). DN4 score⩾4 was found in three ALS patients and one control (p = 0.480). Ten ALS patients (33.3%) and twenty-eight controls (77.8%) (p < 0.001) received therapy for pain. ALS patients with a DN4 score ≥ 4 had a longer disease duration and a higher PSI and PII score than ALS cases reporting nociceptive pain (p = 0.041, 0.048, and 0.027, respectively). Pain mainly interfered with ALS patients' mood, enjoyment of life, and the Pain Interference Index (PII) score. Conclusions Our findings indicated that pain in our ALS cohorts was insufficiently treated and interfered with patients' mood and enjoyment of life. Most notably, we found that ALS patients with a DN4 score⩾4 may have a longer disease duration and a higher PSI and PII score than ALS patients reporting nociceptive pain, which has never been reported, strongly deserving further validation.

Risk factors for complicated community-acquired pneumonia course in patients treated with β-lactam monotherapy.

We aimed to investigate community-acquired pneumonia (CAP) requiring hospitalisation, empirically treated with b-lactam monotherapy, with 30-day mortality and risk factors predicting its complicated course. A prospective observational study was conducted at the Pulmonology and Allergology Department in a tertiary care university hospital. 253 consecutive patients diagnosed with CAP requiring hospitalisation were enrolled. Hospital admission was based on PSI or CRB-65 scores, severe comorbidities, signs of intoxication, aspiration risk, social risk consider-ations, ineffective prior antibiotic treatment. Fourty seven percent of the subjects had complications on admission, 13% developed new CAP complications during inpatient treatment. Overall, 53% of individuals had a complicated CAP course. 30-day mortality rate was 5.9%. The factors predicting a complicated CAP course were as follows: neuromuscular disease, multilobar opacities on chest X-ray (or computed tomography), and clinically unstable condition as evaluated using Halm's criteria. The mortality rate in CAP patients treated with b-lactam monotherapy is low. Neuromuscular disease, multilobar opacities, and clinically unstable condition as evaluated using Halm's criteria predict a complicated CAP course.

Association between NT-proBNP Level and the Severity of COVID-19 Pneumonia.

In this study, we investigated the association between the plasma NT-proBNP level at admission and the severity of COVID-19 pneumonia. For this retrospective, single-centre cohort study, we enrolled consecutive patients from February 9 to March 4, 2020, in a COVID-19 ward of Hubei General Hospital (East Branch) in Wuhan, which is a government-assigned centre for COVID-19 treatment. Diagnosis was confirmed by microbiological and radiographic findings following the interim guidance of the World Health Organization (WHO). A total of 91 (92.9%) patients were finally included in this study. The median age of the patients was 61 years (IQR, 47–69), and 39 (43.0%) of them were male. Two cases of death were reported (2.3%). Twenty-three patients (25.3%) had NT-proBNP levels above 300 pg/ml. Higher NT-proBNP levels were associated with worse PSI and CT scores. The natural logarithm of the NT-proBNP level was positively correlated with the PSI and CT scores (PSI score: rS = 0.396, P=0.001; CT score: rS = 0.440, P < 0.001). Patients with NT-proBNP ≥300 pg/ml showed a potential risk for higher mortality than patients with NT-proBNP <300 pg/ml (mortality rate, 8.7% vs. 0%; P=0.062). The plasma NT-proBNP level of COVID-19 patients was significantly related to the severity of pneumonia.

Application of validated severity scores for pneumonia caused by SARS-CoV-2

ObjectivesCompare the accuracy of PSI, CURB-65, MuLBSTA and COVID-GRAM prognostic scores to predict mortality, the need for invasive mechanical ventilation (IMV) in patients with pneumonia caused by SARS-CoV-2 and assess the coexistence of bacterial respiratory tract infection during admission. MethodsRetrospective observational study that included hospitalized adults with pneumonia caused by SARS-CoV-2 from 15/03 to 15/05/2020. We excluded immunocompromised patients, nursing home residents and those admitted in the previous 14 days for another reasons. Analysis of ROC curves was performed, calculating the area under the curve for the different scales, as well as sensitivity, specificity and predictive values. Results208 patients were enrolled, aged 63 ± 17 years, 577% were men. 38 patients were admitted to ICU (235%), of these patients 33 required IMV (868%), with an overall mortality of 125%. Area under the ROC curves for mortality of the scores were: PSI 082 (95% CI 073–091), CURB-65 082 (073–091), MuLBSTA 072 (062–081) and COVID-GRAM 086 (070–1). Area under the curve for needing IMV was: PSI 073 (95% CI 064–082), CURB-65 066 (055–077), MuLBSTA 078 (069–086) and COVID-GRAM 076 (067–085), respectively. Patients with bacterial co-infections of the respiratory tract were 20 (9,6%), the most frequent strains being Pseudomonas aeruginosa and Klebsiella pneumoniae. ConclusionsIn our study, the COVID-GRAM score was the most accurate to identify patients with higher mortality with pneumonia caused by SARS-CoV-2; however, none of these scores accurately predicts the need for IMV with ICU admission. 10% of patients admitted presented bacterial respiratory co-infection.

Specific language impairment: speech perception in relation to noise

BackgroundChildren with specific language impairment (SLI) fail to develop age-appropriate language despite being apparently normal in other respects. Those children usually have abnormal speech perception in noise. This work is designed to investigate speech perception in background noise in those children. It included two groups of children: control group (15 children with normal typical language development) and study group (25 children diagnosed with SLI). All children were submitted to intelligence scale, language assessment, full audiological evaluation, and Arabic Pediatric Speech Intelligibility in noise test (PSI).ResultsResults showed no statically significant difference in total and verbal IQ, while non-verbal IQ was significantly lower in the study group. As regard results of speech audiometry, the control group had better SRT and higher WD% than the study group. Expressive, receptive, and total language scores were lower in the study group. Arabic Pediatric Speech Intelligibility in noise test showed significantly increased PSI scores with increasing the SNR from 0 to +8dB in both groups. The comparison between both groups showed a significant higher score in the control group at different S/N recording conditions.ConclusionsChildren with SLI have difficulty in speech perception when compared to typically developed language children. This difficulty is more apparent in the presence of background noise.

Pneumonia severity indices predict prognosis in coronavirus disease-2019

BackgroundEarly recognition of the severe illness is critical in coronavirus disease-19 (COVID-19) to provide best care and optimize the use of limited resources. ObjectivesWe aimed to determine the predictive properties of common community-acquired pneumonia (CAP) severity scores and COVID-19 specific indices. MethodsIn this retrospective cohort, COVID-19 patients hospitalized in a teaching hospital between 18 March-20 May 2020 were included. Demographic, clinical, and laboratory characteristics related to severity and mortality were measured and CURB-65, PSI, A-DROP, CALL, and COVID-GRAM scores were calculated as defined previously in the literature. Progression to severe disease and in-hospital/overall mortality during the follow-up of the patients were determined from electronic records. Kaplan-Meier, log-rank test, and Cox proportional hazard regression model was used. The discrimination capability of pneumonia severity indices was evaluated by receiver-operating-characteristic (ROC) analysis. ResultsTwo hundred ninety-eight patients were included in the study. Sixty-two patients (20.8%) presented with severe COVID-19 while thirty-one (10.4%) developed severe COVID-19 at any time from the admission. In-hospital mortality was 39 (13.1%) while the overall mortality was 44 (14.8%). The mortality in low-risk groups that were identified to manage outside the hospital was 0 in CALL Class A, 1.67% in PSI low risk, and 2.68% in CURB-65 low-risk. However, the AUCs for the mortality prediction in COVID-19 were 0.875, 0.873, 0.859, 0.855, and 0.828 for A-DROP, PSI, CURB-65, COVID-GRAM, and CALL scores respectively. The AUCs for the prediction of progression to severe disease was 0.739, 0.711, 0,697, 0.673, and 0.668 for CURB-65, CALL, PSI, COVID-GRAM, A-DROP respectively. The hazard ratios (HR) for the tested pneumonia severity indices demonstrated that A-DROP and CURB-65 scores had the strongest association with mortality, and PSI, and COVID-GRAM scores predicted mortality independent from age and comorbidity. ConclusionCommunity-acquired pneumonia (CAP) scores can predict in COVID-19. The indices proposed specifically to COVID-19 work less than nonspecific scoring systems surprisingly. The CALL score may be used to decide outpatient management in COVID-19.

The diagnostic performance of galactomannan detection in invasive pulmonary aspergillosis with severe and critically ill influenza

Objective: To analyze the diagnostic performance of serum and bronchoalveolar lavage fluid (BALF) galactomannan (GM) test in invasive pulmonary aspergillosis(IPA) with severe and critically ill influenza. Methods: A retrospective study was performed for 157 patients with severe and critically ill influenza admitted to the Department of Pulmonary and Critical Care Medicine of the First Affiliated Hospital of Wenzhou Medical University from December 2017 to April 2019.Clinical characteristics and serum and BALF GM values were collected. The patients were divided into an IPA group (n=18) and a non-IPA group (n=139). The definition of IPA modified from AspICU algorithm taken as the gold standard (The corresponding clinical manifestations, imaging manifestations and microbiological diagnostic criteria should be met simultaneously), the performance of serum and BALF GM test and their combination to IPA with influenza were analyzed respectively and receiver operating characteristic curve (ROC) was drawn. Results: A total of 157 cases were enrolled, 95 were critically ill, and the mortality of IPA with influenza was 55.6%(10/18). The APACHE Ⅱ score, PSI score, urea nitrogen, influenza severity (Percentage of critically ill influenza) and invasive ventilator in IPA group were (16±6), (110±31), 10.7 (8.4, 17.8) mmol/L, 88.9% and 66.7%, respectively, which were significantly higher than those in non-IPA group [(10±5), (83±30), 5.2 (3.6, 7.6) mmol/L, 56.8% and 24.5%, P<0.05]. All patients received serum GM test and 32 patients performed BALF GM test at the same time. When the cut-off valve of serum GM test was 0.5 μg/L, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 66.7% (12/18), 95.0% (132/139), 63.2% (12/19) and 95.7% (132/138) respectively. When the cut-off value of BALF GM test was 1.0 μg/L, the sensitivity, specificity, PPV and NPV were 80%(8/10),86.4%(19/22),72.7%(8/11)and 90.5%(19/21)respectively. The BALF GM cut-off value of 0.88 μg/L showed the highest diagnostic efficacy for IPA, for which the sensitivity and specificity were 90%(9/10) and 86.4%(19/22). The areas under the ROC curve of serum GM, BALF GM, and the combination of them were 0.81, 0.85, and 0.94 respectively. The difference was statistically significant (P<0.05) and the combined diagnosis efficiency was higher. Conclusions: Critically ill influenza patients should be alert for IPA. The sensitivity of serum GM test in the diagnosis of IPA with influenza was low, while the NPV was high. The optimum BALF GM cut-off value was 0.88 μg/L. The combination with BALF and serum GM test can improve the diagnostic performance.

Which one is superior in predicting 30 and 90 days mortality after COPD exacerbation: DECAF, CURB-65, PSI, BAP-65, PLR, NLR

ABSTRACT Objectives: The major scores associated with the mortality after COPD exacerbations were; DECAF, CURB-65, PSI and BAP-65 scores. We aimed to compare these scores in predicting 30- and 90-day mortality in patients hospitalized with exacerbation of COPD. Methods: The data of 141 patients who were hospitalized with the diagnosis of COPD exacerbation between January 2018 and March 2019 and accepted to participate in the study were prospectively recorded. Results: Age, mean modified-medical-research-council (mMRC) dyspnea score, pleural effusion, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), presence of atrial fibrillation (AF), PaCO2 pressure values were found to be significantly higher at both 30 and 90-days deceased group, while hemoglobin, albumin and pH values were significantly lower (all p < 0.05). DECAF, CURB-65, PSI and BAP-65 scores were significantly higher for both 30 and 90-days mortality (all p < 0.05). DECAF, CURB-65, PSI, BAP-65 scores, PLR, NLR predicted to 30 day and 90 day mortality. But, CURB-65 found (OR 2.968 and 2.284, respectively) superior to others in predicting 30 and 90-days mortality. Conclusions: CURB-65 score is a significant, simple and feasible score for predicting 30 and 90 days mortality in COPD exacerbation and may be routinely used in all patients hospitalized with COPD exacerbation.

Admission lysophosphatidylethanolamine acyltransferase level predicts the severity and prognosis of community-acquired pneumonia.

Early diagnosis and prognosis of patients with community-acquired pneumonia (CAP) are still difficult clinical challenges. This study aimed to investigate the role of lysophosphatidylethanolamine acyltransferase (LPEAT) in CAP and to evaluate the effectiveness of this enzyme as an indicator of disease severity and risk of death in CAP. This retrospective, multi-center study was conducted in 2017. A total of 267 patients with CAP were included. Of these 267 patients, 175 patients had non-severe CAP (non-SCAP) and 92 patients had severe CAP (SCAP). In addition, we recruited 15 healthy volunteers and 42 hospitalized disease controls in our study. The demographic and clinical characteristics were recorded for all participants. Admission levels of LPEAT were determined by quantitative enzyme-linked immunosorbent assay. Admission levels of LPEAT in patients with SCAP were significantly higher, particularly in non-survivors and were not affected by the causative etiology. Furthermore, when the patients were stratified according to PSI and CURB-65 scores, the patients with high severity scores had higher LPEAT levels upon admission than patients with low severity scores. LPEAT also performed well in predicting SCAP in patients with CAP. Moreover, LPEAT could predict the 30-day mortality rate of patients with CAP, and combining LPEAT with the clinical severity score further improved the accuracy of mortality prediction. Elevated LPEAT levels can reliably predict the severity of illness in patients with CAP at the time of admission. Adding LPEAT to clinical scoring methods could improve prognostic accuracy. Trial registration ClinicalTrials.gov, NCT03093220. Registered on March 28th, 2017.

Two Replication Studies of a Time-Reversed (Psi) Priming Task and the Role of Expectancy in Reaction Times

Two experiments involving an international collaboration of experimenters sought to replicate and extend a previously published psi experiment on precognition by Daryl Bem that has been the focus of extensive research. The experiment reverses the usual cause–effect sequence of a standard psychology experiment using priming and reaction times. The preregistered confirmatory hypothesis is that response times to incongruent stimuli will be longer than response times to congruent stimuli even though the prime has not yet appeared when the participant records their judgments. The confirmatory hypothesis for Experiment 1 was not supported. Exploratory analyses indicated that those participants who completed the English-language version rather than a translation showed a significant effect, as was the case in the original study; no significant departure from chance was found in data involving non-English translations. Experiment 2 sought to enhance the predicted effect by having each participant read either a pro-psi or an anti-psi statement at the beginning of the experiment to test the pre-recorded hypothesis that a pro-psi statement would produce a larger effect than an anti-psi statement. The results did not support the primary psi hypothesis and there was no effect in the English-language sample. However, there was mixed support for the effect of the psi statement on performance; those participants who received the pro-psi statement had a greater psi score than those who received the anti-psi statement. As in the original experiment, neither the experimenters’ nor participants’ beliefs were significantly associated with the dependent measure. In sum, the pre-registered confirmatory hypotheses were not supported. The importance of the personality variable Sensation Seeking, a component of extraversion, as a correlate of psi performance is discussed as are the challenges and implications for international collaborations and replication in controversial science.&#x0D; Keywords: priming; expectancy effect; retrocausation; consciousness; sociology; precognition; psi; replication&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Two experiments involving an international collaboration of experimenters sought to replicate and extend a previously published psi experiment on precognition by Daryl Bem that has been the focus of extensive research. The experiment reverses the usual cause-effect sequence of a standard psychology experiment using priming and reaction times. The preregistered confirmatory hypothesis is that response times to incongruent stimuli will be longer than response times to congruent stimuli even though the prime has not yet appeared when the participant records his or her judgments. The confirmatory hypothesis for Study 1 was not supported. Exploratory analyses indicated that those participants who completed the English-language version rather than a translation showed a significant effect, as was the case in the original study; no significant departure from chance was found in data involving non-English translations. Study 2 sought to enhance the predicted effect by having each participant read either a pro-psi or an anti-psi statement at the beginning of the experiment to test the pre-recorded hypothesis that a pro-psi statement would produce a larger effect than an anti-psi statement. The results did not support the primary psi hypothesis and there was no observed association between belief and experience of ESP and psi outcome. However, there was mixed support for the effect of the psi statement on performance; those participants who received the pro-psi statement had a greater psi score than those who received anti-psi statement. As in the original experiment, neither the experimenters’ nor participants’ beliefs or expectations were significantly correlated with the dependent measure. In sum, the pre-registered confirmatory hypotheses were not supported. The importance of the personality variable Sensation Seeking, a component of extraversion, as a correlate of psi performance is discussed as are the challenges and implications for international collaborations and replication in controversial science.&#x0D; &#x0D;

Clinical characteristics of viral pneumonia in patients with chronic obstructive pulmonary disease

Objective: To study the clinical and etiological characteristics of viral pneumonia in patients with chronic obstructive pulmonary disease(VP-COPD), and to identify the risk factors associated with poor prognosis. Methods: From August 1, 2017 to August 1, 2019, totally 235 patients in a general hospital in Beijing were prospectively enrolled in this research, and all patients were diagnosed with viral pneumonia by imaging and etiology. The patients were divided into VP-COPD group(n=60) and VP-nCOPD(viral pneumonia in non-COPD patients) group(n=175). Pathogen detection and clinical characteristics were compared between the two groups.Finally, the binomial logistic regression was used to explore the risk factors associated with severe VP-COPD. Results: Compared with the VP-nCOPD group, the VP-COPD group was older(76.5 vs 66.0 years, P=0.001), and the CURB-65 score(2 vs 1, P= 0.001) and the PSI score(111 vs 85, P<0.001) were higher at admission. Pseudomonas aeruginosa(χ²= 10.308, P= 0.001) and Staphylococcus aureus(χ²= 5.953, P=0.028) were the most common co-infection bacteria. In the VP-COPD group type Ⅱ respiratory failure was more common(23.3% vs 6.8%, P<0.001), the number of severely ill patients was larger(48.3% vs 30.3%, P=0.011), the length of hospital stay was longer(13 vs 8, P<0.001), and the mortality rate during hospitalization was higher(18.3% vs 7.4%, P=0.016) in the VP-nCOPD group. Multivariate analysis showed that the level of blood glucose(OR: 1.73, 95%CI: 1.22-2.44, P= 0.002) and pleural effusion(OR: 133.12, 95%CI: 7.57-2 340.36, P=0.001) were risk factors for severe VP-COPD patients. Conclusion: Viral pneumonia in patients with COPD tended to develop into severe cases and had a poor prognosis.

Aplicación de escalas pronósticas de gravedad en la neumonía por SARS-CoV-2

ObjectivesCompare the accuracy of PSI, CURB-65, MuLBSTA and COVID-GRAM prognostic scores to predict mortality, the need for invasive mechanical ventilation in patients with pneumonia caused by SARS-CoV-2 and assess the coexistence of bacterial respiratory tract infection during admission. MethodsRetrospective observational study that included hospitalized adults with pneumonia caused by SARS-CoV-2 from 15/03 to 15/05/2020. We excluded immunocompromised patients, nursing home residents and those admitted in the previous 14 days for another reasons. Analysis of ROC curves was performed, calculating the area under the curve for the different scales, as well as sensitivity, specificity and predictive values. ResultsA total of 208 patients were enrolled, aged 63±17 years, 57,7% were men; 38 patients were admitted to ICU (23,5%), of these patients 33 required invasive mechanical ventilation (86,8%), with an overall mortality of 12,5%. Area under the ROC curves for mortality of the scores were: PSI 0,82 (95% CI: 0,73-0,91), CURB-65 0,82 (0,73-0,91), MuLBSTA 0,72 (0,62-0,81) and COVID-GRAM 0,86 (0,70-1). Area under the curve for needing invasive mechanical ventilation was: PSI 0,73 (95% CI: 0,64-0,82), CURB-65 0,66 (0,55-0,77), MuLBSTA 0,78 (0,69-0,86) and COVID-GRAM 0,76 (0,67-0,85), respectively. Patients with bacterial co-infections of the respiratory tract were 20 (9,6%), the most frequent strains being Pseudomonas aeruginosa and Klebsiella pneumoniae. ConclusionsIn our study, the COVID-GRAM score was the most accurate to identify patients with higher mortality with pneumonia caused by SARS-CoV-2; however, none of these scores accurately predicts the need for invasive mechanical ventilation with ICU admission. The 10% of patients admitted presented bacterial respiratory co-infection.

Development of pedestrian safety index models for safety of pedestrian flow at un-signalized junctions on urban roads under mixed traffic conditions using MLR

In metropolitan areas of emerging countries, such as India, there has been a fast rise in the number of pedestrians and traffic clashes in recent decades. In order to improve the safety and security of pedestrian services under heterogeneous traffic conditions, it is important to improve pedestrian facilities along city roads. The research study was undertaken to develop Pedestrian Safety Index models using parameters such as crosswalk speed (m/sec), crosswalk markings, vehicle stream speed (km/hr), pedestrian volume, pedestrian safety scores /rankings and crosswalk length (m). Data have been collected and extracted through videographic technique at various un-signalized junctions in the Central Business Districts (CBD) zones and surroundings of Srinagar Metropolitan (SMA) Area, where increase in the number of pedestrian volumes was identified. The amount of pedestrian volumes and average pedestrian speed (m/sec) during peak hours were identified at some of these study locations. Pedestrians have been identified on the basis of different age categories. Pedestrian movements are classified according to the speed and direction of the crossing. The Pedestrian safety index models are developed using SPSS software and tested on dataset obtained at various locations in the Srinagar city. The developed Pedestrian Safety Score Index (PSSI) model results obtained for all selected locations in the city of Srinagar are three to four indicating the ordinary / average safe to danger situation of the PSI scores. The results of the PSSI and Ped ISI model demonstrate the estimation of the correct index value of pedestrian safety at various un-signalized junctions. This research will also help to enhance the pedestrian safety strategies, pedestrian volumes (ped/hr) and also improved pedestrian safety interventions on urban roads under heterogeneous traffic environments.

The predictors of 3-month mortality in community-acquired pneumonia

Aim: The aim of the study was to compare the pneumonia severity scoring systems (PSI, CURB-65) and inflammatory markers (CRP, CAR, NLR and PLR) in predicting community-acquired pneumonia (CAP) patients’ 3-month mortality.Materials and Methods: This study included 113 patients (43 females, 70 males) diagnosed with CAP. Demographics, comorbidities, complete blood count, arterial blood gas, electrolytes, liver-renal functions and radiological findings were evaluated. PSI and CURB-65 were classified: PSI low risk (I-III, point ≤90); PSI moderate-high risk (IV-V, point 91≤); CURB-65; low risk (0-2) and high risk (3-5). All statistical calculations were performed with SPSS 23.0 for Windows.Results: The mean age of the patients was 69.08 ± 16.58 and 3-month mortality rate among the patients hospitalized on admission was 22.4% (n=24). Albumin, hemoglobin, lymphocyte, PaO2 were lower; NLR and lactate were higher in non-survivors. Albumin and lactate were higher in CURB-65 (0-2) and (3-5) groups, respectively. NLR was significantly higher in PSI group (IV-V). Red cell distribution width and lactate were lower in PSI (I-III); basophil and PaO2 were significantly lower in PSI group (IV-V). CRP (AUC 0.744), PSI classification (AUC 0.72) and PSI scoring (AUC 0.746) showed higher mortality prediction. Conclusion: Albumin, hemoglobin, lymphocyte, PaO2 were lower; NLR and lactate were higher in non-survivors. CRP and PSI score are potent predictors of 3-month mortality.

Correlation of serum interleukin-6 level and pneumonia severity index score in patient with community-acquired pneumonia

B iomarkers of pro-inflammatory cytokines have been widely evaluated for their efficacy in the assessment of disease severity. The pleiotropic functions of Interleukin-6 (IL-6) allow it to induce the inflammatory responses acute phase. This study aimed to evaluate the correlation between PSI scores in patients with CAP and IL-6 levels. The study was a cross-sectional study. 26 pneumonia patients who met the inclusion and exclusion criteria were included in this study. IL-6 levels and PSI scores

Non-thyroid disease syndrome: a strong prognostic predictor of death in patients with pneumonia

Introduction: Non-thyroid disease syndrome (NTDS) is a common syndrome in critical diseases and is characterized by below-normal levels of free T3 (fT3) and free T4 (fT4) in the absence of primary thyroid gland pathology. Pneumonias are a group of respiratory system infections that are associated with a high incidence of mortality. Rapid biomarkers are needed to determine the diagnosis and prognosis in patients with pneumonia to optimize treatment potential. This study investigated the effect of changes in thyroid hormone and procalcitonin (PCT) levels on prognosis and mortality in patients with pneumonia. Method: This study was conducted as a retrospective observational study in a tertiary hospital. Between 2019 and 2020, 1118 patients with pneumonia were included in the study. For all participants, PSI scores were calculated and disease severity was determined according to these scores. Patient demographic and disease data were recorded. Discussion and Conclusion: Low fT3 hormone levels in patients diagnosed with pneumonia upon arrival at the emergency department had an important effect on prognosis. Our results indicated that fT3 levels had a reliable predictive effect on prognosis, disease severity, and mortality. In addition, we found that fT3 was superior to PCT in predicting mortality.

Assessment of severity scores in community-acquired pneumonia for adult patients- A cross-sectional study

Background: Current research was carried out to evaluate the severity score such as PSI, SMART-COP and CURB-65 for the capability to forecast the requirement for mechanical ventilation and inotropic support for adult patients. Materials and Methods: Current observational research was carried out in subjects admit with CAP. The evaluation utensils utilized were the CURB-65 score, PSI, and the SMART-COP scores, particularly planned to forecast the necessity for intensive respiratory and vasopressor support. In general result with CAP was too evaluated. Results: Statically significant was observed in sensitivity and specificity for CURB-65scoresinmechanical ventilation and inotropic support. Fifty nine participants have been mandatory required mechanical ventilation and 41 preferred inotropic supports during their hospital stay. Conclusions: CURB 65 and PSI scores, even if extensively utilized for forecasting death in big inhabitants, they are not as much of precise for forecasting results. Keywords: Community-acquired pneumonia; Cross-sectional study; Sensitivity; Specificity.

Characteristics Influencing Academic Librarians’ Political Skills: Keys to Organizational Effectiveness and Career Success

Academic librarians seldom view their organizations through the political frame. Yet, strong political skills are necessary for organizational effectiveness and career success. Using the Political Skills Inventory, survey data were collected in February 2020 from 260 U.S. academic librarians. Respondents scored in the average range on the PSI. Multiple linear regression revealed that length of service as a librarian, supervisory role, and structural frame score significantly influenced respondents’ PSI scores with a modest effect size. Honing their political skills will enable academic librarians to influence organizational decisions and forge new roles for librarians.