Lethality Rate Research Articles

Phases of systemic inflammation in septic and haemorrhagic shocks

Shocks of different origin (both septic and aseptic) be be considered clinical equivalents of systemic inflammation (SI) with following main manifestations : pronounced hypercytokinemia, other markers of systemic inflammatory response (SIR), coagulopathy, multiple organ failure (MOF), hypothalamic-pituitary-adrenal (HPA) distress, systemic tissue alteration. In general, these phenomena are directly and inversely related to systemic microcirculatory disturbances which determine the pathogenesis of distinct shock states. The aim of our study was to identify the features of SI phases in the development of two variants of septic shock, i.e., acute course (first week of the process) and prolonged/subacute sepsis (2 to 6 weeks from the onset of manifestations), as well as haemorrhagic shock studied 4-12 hours from the onset of massive blood loss. To verify the SI phases, we used the previously proposed SI scale, including the value of six SIR levels (RL-0-5), as well as additional criteria of SI, i.e., evaluation of clinical MOF grade (SOFA scale), plasma D-dimers ( 500 ng/mL), cortisol ( 1380 nmol/mL), tissue alteration markers, e.g., myoglobin ( 800 ng/mL) and/or troponin I ( 0.2 ng/mL). To calculate RL in SIR, plasma CRP and four cytokines (IL-6, IL-8, IL-10, TNF) were determined. The presence of SI was established if the SI scale exceeded 5 points (numerical RL values + presence of additional criteria, each equal to 1 point). The time and severity of the developing critical state, as well as the RL scores, were taken into account when reviewing the phases.
 There were three main SI phases: (1) evolving condition, (2) cytokine storm/phlogogenic hit (SD-4-5), and depressive (exhausting) phase. The latter was characterized by relatively low SIR values (RL-2-3). The lethality rate for shock in the presence of acute sepsis (n = 13) was 71.4%, reaching 94.1% in prolonged sepsis (n = 17). For haemorrhagic shock after massive blood loss, if not resolved within 24 hoursm the mortality rates was 53.8% (n = 13). Development of shock in acute sepsis, and haemorrhagic shock (within 4 to 12 hours after the onset of massive blood loss) is accompanied by the severity of critical-phase cytokine storm/PPS with a predominance of RL-5 in cases of lethal outcomes, and by a depression phase (RL-2-3) in prolonged sepsis. Overall mortality (for all groups) was 66.7% in the PS phase, 89.5% in the depressive phase and 15.4% in the evolvingl phase of haemorrhagic shock (with possible transition from this phase to the more critical SI phases until lethal outcome).
 Shock states of both septic and aseptic origin are based on a typical pathological process of SI, which should be distinguished from the signs of SIR characteristic of high-intensity canonical inflammation. It is characterized by higher cytokinemia (cytokine storm phase) or by the presence of additional SI phenomena with relatively moderate SIR levels (depressive SI phase). Thus, the depressive phase of SI is more fatal for disease outcome compared to the cytokine storm phase with higher intensity of SIR.

The G protein-coupled receptor-related gene signatures for predicting prognosis and immunotherapy response in bladder urothelial carcinoma.

Bladder urothelial carcinoma (BLCA) is the most common malignant tumor of the urinary tract with a high lethality rate, and its immunotherapy resistance and tumor recurrence have become a major challenge in its clinical treatment. G Protein-Coupled Receptors (GPRs) are the largest family of receptors on the cell membrane surface, involved in multiple signaling pathways, and are excellent targets for oncology drug action. The transcriptome profile, single cell transcriptome profile, and clinical data of BLCA were extracted and integrated from TCGA and GEO databases, respectively. The GPR-related genes were obtained from GSEA-MSigDB database. The GPR-related gene signatures of 15 genes were constructed by using the methods of least absolute shrinkage and selection operator regression, multifactor Cox model. At the same time, tumor microenvironment (TME)-score signatures were constructed based on the immune microenvironment of BLCA, and GPR-TME-score signature was further constructed. The stability of this model was verified by using the external dataset GSE160693. We constructed risk groups by combining BLCA patient prognostic information, and with the help of BLCA scRNA transcriptome profiling, we explored differences in prognosis, immune scores, cell-cell interactions, tumor mutational burden, immune checkpoints, and response to immunotherapy in each risk group. We found that the GPR-TME-score signature was an independent prognostic factor for BLCA patients. the TME-score was a protective factor for the prognosis of BLCA patients. Among BLCA patients, GPR-high + TME-low risk group had the worst prognosis, while GPR-high + TME-high risk group had the best prognosis, and the latter had better immune score and immunotherapy response. The above differences in immune response among the subgroups may be related to the higher immune cell infiltration in the GPR-high + TME-high group. GPR-related gene signatures and TME are closely related to BLCA prognosis and immunotherapy, and GPR-related gene signature can be a useful tool to assess BLCA prognosis and immunotherapy response.

Phloretin-induced STAT3 inhibition suppresses pancreatic cancer growth and progression via enhancing Nrf2 activity

BackgroundPancreatic ductal adenocarcinoma (PDAC) is a malignant pancreatic tumor charactered by a rapid progression and high lethal rate. Hyperactivation of STAT3 signaling exerts a vital effect on the growth and progression of PDAC. While dietary flavonoid phloretin has anti-inflammatory and antioxidant activities, it remains unclear whether phloretin has anti-tumor effects on PDAC. PurposeThe focus of the present study is to elucidate the effects of phloretin on PDAC and investigate its underlying molecular mechanisms. Study design and methodsEffect of phloretin were assessed in the pancreatic cancer cells (PCCs) by colony formation assay, real-time cell analysis, flow cytometry, Immunofluorescence staining, and cell migration assay. The expressions of mRNA and protein were respectively analyzed by quantitative PCR and Western blotting. A xenograft model was used to appraise the antitumor efficacy of phloretin. ResultsPhloretin treatment significantly restrained cell viability and metastasis, induced DNA injury and ROS accumulation, and triggered mitochondrial-dependent apoptosis in PCCs. Mechanistically, phloretin exhibits anti-tumor potential via inactivating STAT3 signaling and enhancing Nrf2 activity. STAT3 overexpression and Nrf2 silencing partially relieved phloretin-induced inhibition on cell growth and metastasis in PCCs. Phloretin remarkably blocked pancreatic tumor growth and metastasis in vivo. ConclusionsPhloretin suppresses pancreatic cancer growth and progression through inhibition of STAT3 mediated by enhancing Nrf2 activity. Phloretin may serve as a promising therapeutic agent for PDAC.

Pediatric infectious emergencies-from febrile seizure to purpura fulminans

Febrile seizures, which are relatively common in young children, are often triggered by an infection and resolve quickly. Prompt presentation to a pediatric department is mandatory after any first seizure and every time for children ≤ 12months. Central nervous system (CNS) diseases in childhood are able to cause seizures or other neurological disorders. Even the slightest suspicion of aseizure with CNS involvement must be promptly treated. In case of doubt, both an antiviral and an antibacterial treatment are started in parallel, which can be stopped after detecting the pathogen. Lumbar puncture is strictly indicated unless there are contraindications. Meningococcal sepsis is asevere clinical feature comprising high fever, chills and disorders of consciousness. The first skin symptoms are petechiae as ared flag sign. With progression, potentially lethal purpura fulminans may develop. Waterhouse-Friderichsen syndrome is asevere complication of acute bacterial meningitis. Lethality rate is 35%. The pediatric assessment triangle and the ABCDE algorithm help to identify critically ill children in a standardized, structured, and rapid manner.

Legionnaires' Disease in Occupational Settings: A Cross-Sectional Study from Northeastern Italy (2019).

In Italy, Legionnaires' Disease (LD) causes >1000 hospital admissions per year, with a lethality rate of 5 to 10%. Occupational exposures could reasonably explain a substantial share of total cases, but the role of Occupational Physicians (OPs) in management and prevention of LD has been scarcely investigated. The present survey therefore evaluates the knowledge, attitudes and practices (KAP) regarding LD from a convenience sample of Italian OPs, focusing on their participation in preventive interventions. A total of 165 OPs were recruited through a training event (Parma, Northeastern Italy, 2019), and completed a specifically designed structured questionnaire. The association between reported participation in preventive interventions and individual factors was analyzed using a binary logistic regression model, calculating corresponding multivariable Odds Ratio (aOR). Overall, participants exhibited satisfactory knowledge of the clinical and diagnostic aspects of LD, while substantial uncertainties were associated epidemiological factors (i.e., notification rate and lethality). Although the majority of participating OPs reportedly assisted at least one hospital (26.7%) and/or a nursing home (42.4%) and/or a wastewater treatment plant, only 41.8% reportedly contributed to the risk assessment for LD and 18.8% promoted specifically designed preventive measures. Working as OPs in nursing homes (aOR 8.732; 95% Confidence Intervals [95%CI] 2.991 to 25.487) and wastewater treatment plants (aOR 8.710; 95%CI 2.844 to 26.668) was associated with participation in the risk assessment for LD, while the promotion of preventive practice was associated with working as an OP in hospitals (aOR 6.792; 95%CI 2.026 to 22.764) and wastewater treatment plants (aOR 4.464, 95%CI 1.363 to 14.619). In other words, the effective participation of the OP in the implementation of preventive measures appears uncommon and is limited to certain occupational settings. Collectively, these results highlight the importance of tailoring specifically designed information campaigns aimed to raise the involvement of OPs in the prevention of LD in occupational settings other than healthcare.

Результаты оценки качества работы регионального сосудистого центра Оренбургской области (на примере оказания медицинской помощи пациентам с острым инфарктом миокарда)

Diseases of the circulatory system are an urgent medical and social problem. Cardiovascular disease is a common cause of death among more than half of all deaths in the Russian Federation, from 54,7 to 58,1 thousand people died from myocardial infarction every year in the last years. The regional vascular centers’ work is aimed at reducing the death rate of Russians from vascular accidents and improving their quality of life. The purpose of the study is the quality control of specialized medical care for patients with a acute myocardial infarction in Regional Vascular Center of the Orenburg region. Materials and methods. The study was conducted on the basis of the Orenburg Regional Clinical Hospital “Voynov”, where the Regional Vascular Center exists for 10 ten years. The assessment presents bed performance indicators and special indicators of the quality of work of vascular centers for the period 2018–2022. The work uses statistical and search methods of research. Results. It has been established that due to the pandemic of the new coronavirus infection Covid‑19, such an indicator of the activity of the Regional Vascular Center of the Orenburg Region as the work of a bed was found in the intensive care unit in 2021, is up to 285.8 days, in the cardiology department in 2020 is 253,6 days. The lethality rate of the arbitration department was maximum in 2018 and 2020, the composition of 9,9% each, storage – in 2021 (7,2%). At the same time, this indicator was lower than the target mortality rate from the acute infantry department in the Orenburg region, equal to 12,4%. With the exception of a period of decreasing coverage of patients with thrombolytic therapy, which is associated with an increase in percutaneous coronary lesions performed on an emergency basis, the maximum number of exercising cases was performed 862 patients in 2021. Among patients with coronary syndrome, an increase in the coverage of medical rehabilitation was revealed, so in 2022 the proportion of such cases reached 28,2%. Conclusions. Thus, the period of pandemic of a new coronavirus infection Covid‑19 seriously influenced the indicators of the Regional Vascular Orenburg Region, but at the same time, we can see the improvement in the quality of the work of the consumption center to global control.

PH-responsive PLGA/gelatin porous microspheres containing paclitaxel used for inhibition of cancer cell proliferation

Multi-functional drug-loaded microsphere system can overcome drug resistance and selectively transport drugs to tumor tissues, thus reducing the toxicity to normal tissues, and can achieve long-term effect through drug release, thus becoming a new way to treat tumor-related diseases. Poly (lactic-co-glycolic acid) PLGA/gelatin composite microspheres were prepared by an emulsion solvent evaporation technique. The microsphere shows that it has positive charge and pH response, which is more suitable for the weak acid environment of tumor and has certain targeting effect. At the same time, the scanning electron microscope showed that the surface was loose and rough, and the internal structure was porous, and the morphology was novel. In addition, UV spectrophotometer was used to test the drug loading rate and encapsulation efficiency of the microspheres. For smooth PLGA and PLGA/gelatin microspheres, the latter has better drug loading rate of 11.66% and encapsulation rate of 89.22%. The results showed that among pure paclitaxel, PLGA and PLGA/gelatin microspheres, the latter had the better than performance in the lethal rate of lung cancer cells and could achieve the goal of continuous lethal. Therefore, the preparation of porous drug-loaded microspheres in this study is pH responsive, and can achieve the goal of safe, targeted and efficient inhibition of cancer cell proliferation, and inspire the follow-up anti-cancer research.

The Italian data on SARS-CoV-2 infection in transplanted patients support an organ specific immune response in liver recipients.

The study of immune response to SARSCoV-2 infection in different solid organ transplant settings represents an opportunity for clarifying the interplay between SARS-CoV-2 and the immune system. In our nationwide registry study from Italy, we specifically evaluated, during the first wave pandemic, i.e., in non-vaccinated patients, COVID-19 prevalence of infection, mortality, and lethality in liver transplant recipients (LTRs), using non-liver solid transplant recipients (NL-SOTRs) and the Italian general population (GP) as comparators. Case collection started from February 21 to June 22, 2020, using the data from the National Institute of Health and National Transplant Center, whereas the data analysis was performed on September 30, 2020.To compare the sex- and age-adjusted distribution of infection, mortality, and lethality in LTRs, NL-SOTRs, and Italian GP we applied an indirect standardization method to determine the standardized rate. Among the 43,983 Italian SOTRs with a functioning graft, LTRs accounted for 14,168 patients, of whom 89 were SARS-CoV-2 infected. In the 29,815 NL-SOTRs, 361 cases of SARS-CoV-2 infection were observed. The geographical distribution of the disease was highly variable across the different Italian regions. The standardized rate of infection, mortality, and lethality rates in LTRs resulted lower compared to NL-SOTRs [1.02 (95%CI 0.81-1.23) vs. 2.01 (95%CI 1.8-2.2); 1.0 (95%CI 0.5-1.5) vs. 4.5 (95%CI 3.6-5.3); 1.6 (95%CI 0.7-2.4) vs. 2.8 (95%CI 2.2-3.3), respectively] and comparable to the Italian GP. According to the most recent studies on SOTRs and SARS-CoV-2 infection, our data strongly suggest that, in contrast to what was observed in NL-SOTRs receiving a similar immunosuppressive therapy, LTRs have the same risk of SARS-CoV-2 infection, mortality, and lethality observed in the general population. These results suggest an immune response to SARS-CoV-2 infection in LTRS that is different from NL-SOTRs, probably related to the ability of the grafted liver to induce immunotolerance.

Parathyroid Hormone-Related Protein Promotes the Proliferation of Patient-Derived Glioblastoma Stem Cells via Activating cAMP/PKA Signaling Pathway.

Glioblastoma (GBM) is an aggressive primary brain tumor characterized by its heterogeneity and high recurrence and lethality rates. Glioblastoma stem cells (GSCs) play a crucial role in therapy resistance and tumor recurrence. Therefore, targeting GSCs is a key objective in developing effective treatments for GBM. The role of Parathyroid hormone-related peptide (PTHrP) in GBM and its impact on GSCs remains unclear. This study aimed to investigate the effect of PTHrP on GSCs and its potential as a therapeutic target for GBM. Using the Cancer Genome Atlas (TCGA) database, we found higher expression of PTHrP in GBM, which correlated inversely with survival. GSCs were established from three human GBM samples obtained after surgical resection. Exposure to recombinant human PTHrP protein (rPTHrP) at different concentrations significantly enhanced GSCs viability. Knockdown of PTHrP using target-specific siRNA (siPTHrP) inhibited tumorsphere formation and reduced the number of BrdU-positive cells. In an orthotopic xenograft mouse model, suppression of PTHrP expression led to significant inhibition of tumor growth. The addition of rPTHrP in the growth medium counteracted the antiproliferative effect of siPTHrP. Further investigation revealed that PTHrP increased cAMP concentration and activated the PKA signaling pathway. Treatment with forskolin, an adenylyl cyclase activator, nullified the antiproliferative effect of siPTHrP. Our findings demonstrate that PTHrP promotes the proliferation of patient-derived GSCs by activating the cAMP/PKA signaling pathway. These results uncover a novel role for PTHrP and suggest its potential as a therapeutic target for GBM treatment.

CRYPTOCOCCAL INFECTION IN PLHIV : SERIES OF 12 CASES AT THE LABORATORY OF MOHAMMED VI UNIVERSITY HOSPITAL OF MARRAKECH

Background: Cryptococcal infection is opportunistic and causes high morbidity and mortality among severely immunocompromised patients, specially those living with HIV/AIDS (PLHIV). Cryptococcus neoformans is the most frequently identified species, incriminated in 90% of cryptococcal meningitis (CM). Methods: This is a descriptive retrospective study over a 2-years period (2021 - 2022) involving 12 PLHIV in whom we have isolated Cryptococcus neoformans from cerebrospinal fluid (CSF), blood culture, respiratory or skin specimen. All patients received antifungal therapy, associated to therapeutic lumbar punctures for those who presented with increased intracranial pressure. The clinical examination findings, laboratory data and evolution under treatment of these patients were reviewed. Results: The twelve patients were all HIV-infected adults, with median age of 41.25 ± 12.22 years and male predominance with a sex ratio of 1:2. All patients had low CD4 T-cell counts at diagnosis (<100 cells/µl). Neurological involvement existed in all patients of this cohort : Isolated CM was diagnosed in three cases (25%). Nine patients (75%) had disseminated cryptococcosis: Central nervous system (CNS) with positive hemoculture in six cases, CNS and pulmonary involvement with positive hemoculture in two cases, CNS and cutaneous involvement with positive hemoculture in one case. Cryptococcus neoformans was identified in all cases. Of the twelve patients, seven (58%) survived with good response to the treatment. Lethality rate was 42%. Conclusion: This study demonstrates cryptococcal disease is a high mortality infection in PLHIV.Priority should be given to access to rapid diagnostic CrAgtests to accessibility to liposomal amphotericin B. This could improve the clinical outcome of the patients in our moroccan context.

THE NEW INCREASE IN THE RATE OF CONTAMINATION AND DEATHS RESULTING FROM SPOTTED FEVER IN BRAZIL

Rocky Mountain spotted fever is an infectious, acute febrile disease of variable severity. It can range from mild and atypical clinical forms to severe forms, with a high lethality rate. Rocky Mountain spotted fever is caused by a bacterium of the genus Rickettsia, transmitted by tick bites. In Brazil, two species of rickettsiae are associated with clinical conditions of Spotted Fever. Rickettsia rickettsii, which leads to Brazilian Spotted Fever (BSF), considered a serious disease, registered in the north of the state of Paraná and in the states of the Southeast Region. Rickettsia parkeri, which has been recorded in environments of the Atlantic Forest (Rio Grande do Sul, Santa Catarina, Bahia and Ceará), producing less severe clinical conditions.The objective of this article wasto describe through a literature review, Rocky Mountain spotted fever in Brazil, forms of transmission, treatment, mortality and clinical manifestations.In Brazil, the main vectors are ticks of the genus Amblyomma, such as A. sculptum (= A. cajennense) known as the star tick, A. aureolatum and A. ovale. However, potentially, any species of tick can harbor the bacteria that cause Rocky Mountain Spotted Fever, such as the dog tick.

Conditional Reprogramming Modeling of Bladder Cancer for Clinical Translation.

The use of advanced preclinical models has become increasingly important in drug development. This is particularly relevant in bladder cancer, where the global burden of disease is quite high based on prevalence and a relatively high rate of lethality. Predictive tools to select patients who will be responsive to invasive or morbid therapies (chemotherapy, radiotherapy, immunotherapy, and/or surgery) are largely absent. Patient-derived and clinically relevant models including patient-derived xenografts (PDX), organoids, and conditional reprogramming (CR) of cell cultures efficiently generate numerous models and are being used in both basic and translational cancer biology. These CR cells (CRCs) can be reprogrammed to maintain a highly proliferative state and reproduce the genomic and histological characteristics of the parental tissue. Therefore, CR technology may be a clinically relevant model to test and predict drug sensitivity, conduct gene profile analysis and xenograft research, and undertake personalized medicine. This review discusses studies that have utilized CR technology to conduct bladder cancer research.

Oil-contaminated sites act as high-risk pathogen reservoirs previously overlooked in coastal zones

In addition to the organic pollutants and disturbance to the microbial, plant and animal systems, oil contamination can also enrich opportunistic pathogens. But little is known about whether and how the most common coastal oil-contaminated water bodies act as reservoirs for pathogens. Here, we delved into the characteristics of pathogenic bacteria in coastal zones by constructing seawater-based microcosms with diesel oil as a pollutant. 16S rRNA gene full-length sequencing and genomic exploration revealed that pathogenic bacteria with genes involved in alkane or aromatic degradation were significantly enriched under oil contamination, providing a genetic basis for them to thrive in oil-contaminated seawater. Moreover, high-throughput qPCR assays showed an increased abundance of the virulence gene and enrichment in antibiotics resistance genes (ARGs), especially those related to multidrug resistance efflux pumps, and their high relevance to Pseudomonas, enabling this genus to achieve high levels of pathogenicity and environmental adaptation. More importantly, infection experiments with a culturable P. aeruginosa strain isolated from an oil-contaminated microcosm provided clear evidence that the environmental strain was pathogenic to grass carp (Ctenopharyngodon idellus), and the highest lethality rate was found in the oil pollutant treatment, demonstrating the synergistic effect of toxic oil pollutants and pathogens on infected fish. A global genomic investigation then revealed that diverse environmental pathogenic bacteria with oil degradation potential are widely distributed in marine environments, especially in coastal zones, suggesting extensive pathogenic reservoir risks in oil-contaminated sites. Overall, the study uncovered a hidden microbial risk, showing that oil-contaminated seawater could be a high-risk pathogen reservoir, and provides new insights and potential targets for environmental risk assessment and control.

Epidemiological features of Meningococcal infection in Tbilisi

Aim of the study was to identify of epidemiological features of meningococcal infection in Tbilisi in two reporting periods (1992-1999yy and 2017-2021yy). In 1992-1999, the incidence rate reached its maximum in 1993 (2.3 per 100,000 population), and in 2017-2021 it did not exceed one. In the second reporting period in 2020, the maximum rate was recorded in the conditions of the coronavirus pandemic (0.36), which should be due to the prolonged interaction of children with healthy carriers. The age index in both reporting periods is for children aged 0-4 and was 21.4 and 8.81, respectively. Seasonality occurs in winter-spring in the second reference period, although in the first reference period it occurs at all times of the year, which can be explained by the failure of preventive measures in the 90s. The rate of lethality in the first reporting period is almost three times less than in the second reporting period, which may be the reason for not registering deaths in the 90s. We consider it appropriate to introduce vaccination in risk groups.

Post-vaccine COVID-19 acute myocarditis: Case report

COVID-19 vaccines have reduced both lethality and hospitalization rates of the novel coronavirus disease. Nevertheless, multiple side effects have been reported in the literature, most often are harmless. We report two cases of acute myocarditis, hospitalized in the emergency department for chest pain occurring after the second dose of mRNA vaccine AstraZeneca

A novel HCP (heparin-binding protein-C reactive protein-procalcitonin) inflammatory composite model can predict severe acute pancreatitis

Severe acute pancreatitis (SAP) presents with an aggressive clinical presentation and high lethality rate. Early prediction of the severity of acute pancreatitis will help physicians to further precise treatment and improve intervention. This study aims to construct a composite model that can predict SAP using inflammatory markers. 212 patients with acute pancreatitis enrolled from January 2018 to June 2020 were included in this study, basic parameters at admission and 24 h after hospitalization, and laboratory results such as inflammatory markers were collected. Pearson's test was used to analyze the correlation between heparin-binding protein (HBP), procalcitonin (PCT), and C-reactive protein (CRP). Risk factors affecting SAP were analyzed using multivariate logistic regression, inflammatory marker models were constructed, and subject operating curves were used to verify the discrimination of individual as well as inflammatory marker models and to find the optimal cut-off value based on the maximum Youden index. In the SAP group, the plasma levels of HBP, CRP, and PCT were 139.1 ± 74.8 ng/mL, 190.7 ± 106.3 mg/L and 46.3 ± 22.3 ng/mL, and 25.3 ± 16.0 ng/mL, 145.4 ± 67.9 mg/L and 27.9 ± 22.4 ng/mL in non-SAP patients, with a statistically significant difference between the two groups (P < 0.001), The Pearson correlation analysis showed a positive correlation between the three values of HBP, CRP, and PCT. The results of the multivariate logistic regression analysis showed that HBP (OR = 1.070 [1.044–1.098], P < 0.001), CRP (OR = 1.010 [1.004–1.016], P = 0.001), and PCT (OR = 1.030[1.007–1.053], P < 0.001) were risk factors for SAP, and the area under the curve of the HBP-CRP-PCT model was 0.963 (0.936–0.990). The HCP model, consisting of HBP, CRP, and PCT; is well differentiated and easy to use and can predict the risk of SAP in advance.

Failure Factors &amp; Prediction Model of Indonesian Medical Doctor Proficiency &amp; Competency Test (UKMPPD) within COVID-19 Pandemic

&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Coronavirus Disease 2019 drastically modulate the healthcare world. The pandemic's immense transmission and lethality rate enforce the Indonesian Medical Doctor Proficiency &amp;amp; Competency Test to discard practical measures and rely only on a written exam. These with pandemic social and physical restrictions impede prospective doctors’ learning opportunities leading to easier failure. Henceforth, the present study has high urgency to identify and manage failure factors, especially in the pandemic.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The cross-sectional study examines 75 clinical medical students through purposive analysis with an online questionnaire in August 2021. Data are analyzed with Chi-Square, Mann-Whitney, and binary logistics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Result: &lt;/strong&gt;Respondents have an average age of 24.15 (1.322) years old, majorly female (82.7%), and pass as first takers (86.7%) with 1.27 (0.949) off-campus tutelage. The significant factors for the test failure are depression and economic status. The study developed a failure prediction model with the area under the curve 0.845, cut-off 366.5, 80.0% sensitivity, and 84.6% specificity.&lt;/p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Intrinsic, extrinsic, and academic factors have significant roles in the failure outcome. For this reason, preparation is crucial not only among individuals but also institutions. The study also provides feedback about the importance of mental health and economic status for Indonesian medical students

Carboxymethyl chitosan/sodium alginate hydrogel films with good biocompatibility and reproducibility by in situ ultra-fast crosslinking for efficient preservation of strawberry

Strawberry is a seasonal and regional fruit. Thus, strawberry waste caused by spoilage and decay is an urgent problem that must be solved. Developing hydrogel films (HGF) for multifunctional food packaging can effectively slow down strawberry. Based on the carboxymethyl chitosan/sodium alginate/citric acid with excellent biocompatibility, preservation effect, and ultrafast (10 s) coating on the strawberry surface, HGF specimens were designed and prepared through the electrostatic interaction of opposite charges between polysaccharides. The prepared HGF specimen exhibited excellent low moisture permeability and antibacterial properties. Its lethality rates against both Escherichia coli and Staphylococcus aureus were more than >99 %. The HGF could keep strawberries fresh for up to 8, 19, and 48 days at 25.0, 5.0, and 0 °C, respectively, by delaying the fruits' ripening, dehydration, microbial invasion, and respiration rate. The HGF dissolved and regenerated five times still exhibited good performance. The water vapor transmission rate of the regenerative HGF could reach 98 % of that of the original HGF. The regenerative HGF could maintain the freshness of strawberries for up to 8 days at 25.0 °C. This study provides new insight into an alternative film design for convenient, green, and renewable alternative films to delay perishable fruit spoilage.

One-year impact of COVID-19 pandemic on renal replacement therapy and kidney transplantation in a tertiary center in Southern Brazil.

Patients on renal replacement therapy (RRT) and kidney transplant recipients (KTR) present multiple factors that may increase the risk of death from coronavirus disease 2019 (COVID-19). This study aimed to evaluate the incidence and impact of COVID-19 in RRT patients and KTRs. Between March 2020 and February 2021, we monitored the RRT population of thirteen dialysis facilities that refer patients for transplantation to our center, a tertiary hospital in Southern Brazil. In the same period, we also monitor COVID-19 incidence and mortality in our KTR population. Demographical, clinical, and COVID-19-related information were analyzed. We evaluated 1545 patients in the dialysis centers, of which 267 (17.4%) were infected by COVID-19 and 53 (19.9%) died. Among 275 patients on the kidney transplant waiting list, 63 patients (22.9%) were infected and seven (11.1%) died. COVID-19 was the leading cause of death (29.2%) among patients on the waiting list. Within the population of 1360 KTR, 134 (9.85%) were diagnosed with COVID-19 and 20 (14.9%) died. The number of kidney transplants decreased by 56.7% compared with the same period in the previous twelve months. In the study period, patients on RRT and KTRs presented a high incidence of COVID-19 and high COVID-19-related lethality. The impact on the patients on the transplant waiting list was less pronounced. The lethality rate observed in both cohorts seems to be related to age, comorbidities, and disease severity.

Quercetin Inhibits Colorectal Cancer by Enhancing Apoptosis viaPI3K/Akt Pathway

CRC is the second leading cancer globally, with a high lethality rate. The primary treatment of CRC is still surgery andchemotherapy with limited therapeutic effects. Quercetin, a component of traditional Chinese medicine, has shown itsability to anti-tumor and induce cell apoptosis through PI3K/AKT signalling pathway. This study aims to figure out howconcentrations of quercetin and different treatment durations will influence the effects of induction of apoptosis. Theexperiments will use CL40 cells. Cell apoptosis is measured by flow cytometry, and cell growth by MTT assay. Thephospho-AKT level is measured by anti-p-AKT Western Blot. Our research will determine the relationship betweentherapeutic effects, drug concentrations, and treatment durations. Further studies on the side effects of quercetin andmethods to mitigate the side effects in the systematic use of quercetin should be done. Moreover, a more specificmechanism for the function of quercetin is waiting to clarify