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r patients, ICU triage decisions should be discussed during on-hours, and ICU admission policy should be broadened, with a lower admission threshold for critically ill cancer patients.

The ICU denial rate in our study was high (51%). Sixty percent of the ICU triage decisions in cancer patients were made during off-hours, and 22.3% of the patients initially considered "too well to benefit" from ICU admission were subsequently admitted to the ICU. Both decisions during off-hours and a delayed ICU admission were associated with an increased risk of death at 30 days. Our study suggests that in cancer patients, ICU triage decisions should be discussed during on-hours, and ICU admission policy should be broadened, with a lower admission threshold for critically ill cancer patients.This study aimed to develop a method for detection of femoral neck fracture (FNF) including displaced and non-displaced fractures using convolutional neural network (CNN) with plain X-ray and to validate its use across hospitals through internal and external validation sets. This is a retrospective study using hip and pelvic anteroposterior films for training and detecting femoral neck fracture through residual neural network (ResNet) 18 with convolutional block attention module (CBAM) +  + . The study was performed at two tertiary hospitals between February and May 2020 and used data from January 2005 to December 2018. Our primary outcome was favorable performance for diagnosis of femoral neck fracture from negative studies in our dataset. We described the outcomes as area under the receiver operating characteristic curve (AUC), accuracy, Youden index, sensitivity, and specificity. A total of 4,189 images that contained 1,109 positive images (332 non-displaced and 777 displaced) and 3,080 negative images were collected from two hospitals. The test values after training with one hospital dataset were 0.999 AUC, 0.986 accuracy, 0.960 Youden index, and 0.966 sensitivity, and 0.993 specificity. Values of external validation with the other hospital dataset were 0.977, 0.971, 0.920, 0.939, and 0.982, respectively. Values of merged hospital datasets were 0.987, 0.983, 0.960, 0.973, and 0.987, respectively. A CNN algorithm for FNF detection in both displaced and non-displaced fractures using plain X-rays could be used in other hospitals to screen for FNF after training with images from the hospital of interest.Despite the benefits biobanks are expected to bring, there have recently been concerns raised that the public and private non-profit biobanks still prevailing in Europe often fail to reach their initial objectives due to a variety of reasons, including a shortage of funding and insufficient utilization of collections. The necessity to find new ways to manage biobanks has been clearly recognized and one way to do this is to follow the success of some commercial direct-to-consumer genetic testing (DTC GT) companies in the biobanking field. This paper is focused on a double role the return of individual health related findings (IHRF) detected through the biobanking activities can play in the management of biobanks. These findings can be seen as an untapped opportunity to offer health related information to biobank participants. At the same time, the IHRF policy can also serve as an additional tool that can improve biobanking governance. This paper aims to consider diverse IHRF approaches as well as to explore some key ethical concerns related to them. In particular, it reveals how different accounts of personal autonomy shape consent policies related to IHRF and emphasizes ethical controversies related to the commercial DTC GT initiatives as well as some non-profit biobanks.Antibiotic-resistant bacteria result in high mortality in the world. Therefore, it is necessary to find new methods as alternative antibacterial agents that decline bacterial resistance and limit the spread of serious infectious bacterial diseases. Antimicrobial photodynamic therapy (aPDT) is a non-invasive strategy against antibiotic-resistant bacteria. aPDT contains the combination of non-toxic dyes with harmless visible light to create reactive oxygen species (ROS) that selectively lead to microbial cell death. Curcumin and silver nanoparticles (AgNPs) have antibacterial properties. In this study, the aPDT with curcumin plus AgNPs as photosensitizers on planktonic and biofilm forms of Pseudomonas aeruginosa was investigated. Also, the phototoxicity effect of curcumin and AgNPs on human fibroblast cells was studied. Finally, the ROS formation and the glutathione peroxidase (GPx) activity were evaluated. The results showed that the use of curcumin in combination with AgNPs then aPDT reduced the number of bacteria in planktonic and biofilm forms. Curcumin and AgNPs did not show any significant photocytotoxic effect against human normal fibroblast. Finally, the GPx activity was decreased in presence of curcumin in combination with AgNPs then aPDT compared to control. The ROS production in curcumin plus AgNPs then aPDT was higher than the control group. Therefore, curcumin-aPDT plus AgNPs could be suggested as novel strategies in treating multi-drug-resistant bacteria such as P. aeruginosa.Cytolethal Distending Toxin (CDT) belongs to the AB toxin family and is produced by a plethora of Gram-negative bacteria. Eight human-affecting enteropathogens harbor CDT that causes irritable bowel syndrome (IBS), dysentery, chancroid, and periodontitis worldwide. They have a novel molecular mode of action as they interfere in the eukaryotic cell-cycle progression leading to G2/M arrest and apoptosis. CDT, the first bacterial genotoxin described, is encoded in a single operon possessing three proteins, CdtA, CdtB, and CdtC. CdtA and CdtC are needed for the binding of the CDT toxin complex to the cholesterol-rich lipid domains of the host cell while the CdtB is the active moiety. Sequence and 3D structural-based analysis of CdtB showed similarities with nucleases and phosphatases, it was hypothesized that CdtB exercises a biochemical function identical to both these enzymes. CDT is secreted through the outer membrane vesicles from the producing bacteria. It is internalized in the target cells via clathrin-dependent endocytosis and translocated to the host cell nucleus through the Golgi complex and ER. This study discusses the virulence role of CDT, causing pathogenicity by acting as a tri-perditious complex in the CDT-producing species with an emphasis on its potential role as a biomarker and an anti-tumor agent.Despite great developments in inertial microfluidics, there is still a lack of knowledge to precisely define the particles' behavior in the microchannels. In the present study, as a prerequisite to experimental studies, numerical simulations have been used to study the capture efficiency of target particles in the contraction-expansion microchannel, aiming to provide an estimation of the conditions at which the channel performs best. Fluid analysis based on Navier-Stokes equations is conducted using the finite element method to determine the streamlines and vortices. The highest capture efficiency for 10, 15, and 19-micron particles occurs when the center of the vortex is approximately in the middle of the wide section (at the flow rate of 0.35 ml/min). In addition to investigating the effect of particle diameter and input flow rate, the effect of channel geometry parameters (channel height and initial length of the channel) on particle trapping has also been studied. Also, to consider great interest in separating different-sized bioparticles from a sample, a three-stage platform has been designed to separate four types of bone marrow cells and evaluate the possibility of using contraction-expansion channels in this application.

The aim of the study was to investigate whether MRI findings together with epidemiological data could help in differentiating between tuberculous and pyogenic spondylodiscitis.

Clinical records of 260 patients with a suspicion of spondylodiscitis were analysed. Patients were selected using the following inclusion criteria confirmed diagnosis of spondylodiscitis either from pyogenic bacteria or from Mycobacterium tuberculosis and contrast-enhanced MRI performed before treatment. Clinical data concerning age, sex and country-of-origin were also collected. RRx-001 inhibitor For each patient, several MRI-features were evaluated by two-expert musculoskeletal radiologists. A chi-squared test and a multiple logistic regression were used to find the best predictors of tuberculous or pyogenic spondylodiscitis.

114 patients were retrospectively enrolled, 30 with tuberculous and 84 with pyogenic spondylodiscitis. We found 18 MRI-features, significantly different between the two groups. Among these, the most strongly associated withtures of tuberculous and pyogenic spondylodiscitis. The above-mentioned MRI-features and epidemiological data are crucial in the differential diagnosis between these two entities, guiding the choice of the appropriate therapy, especially when a pathogen cannot be clearly identified with other modalities.Restoring degraded forest is essential if we are to reduce human pressure on natural ecosystems and their biodiversity. Forests were nationalized in 1957 in Nepal and as a consequence, forest cover declined from 45% in 1964 to just 29% in 1994. However, as its response, sectoral plans and policies, particularly introduction of community-based forest management programs since the 1980s and conservation activities resulted in large scale forest cover restoration. Here, we examined the forest cover change in the Gandaki River Basin (GRB), the catchment with the largest altitudinal variation (ranging from ± 93 to 8167 m) and environmental and ecological significance. To see how forests have changed since then, we analyzed snapshots of spatiotemporal, ecological and physiographic changes in forest cover, and forest type at decadal intervals from 1996 to 2016 using Landsat 5 and 8 satellite images. We observed an overall gain in forest cover of 207 km2, from 7571 km2 (34.4% of the total area) in 1996 to 7778 km2 (35.3%) in 2016. Of the 21 forest cover types identified, the greatest forest coverage during 2016 was of Schima-Castanopsis forest (25.9%) and hill sal forests (16.4%). In terms of physiographic zones, land below 500 m (Tarai) where most people live, witnessed gradual declines in forest cover, in contrast to large increases in forests above 500 m. Historical examination of forest cover at ecological and physiographic scales helps to identify the elevation-wise distribution of forest resources, vegetation composition, ecosystem characteristics, anthropogenic pressure upon vegetation, and hence the overall influence of LULC upon the environment. These outputs will assist planners, policy makers, and researchers in their formulation of effective basin wide plans and policies to ensure the protection of basin level biodiversity and ecosystem function.

Pediatric lupus nephritis (pLN) is one of the most refractory secondary kidney diseases in childhood. The treat-to-target (T2T) strategy has become the standard treatment for systemic lupus erythematosus (SLE). This study reviewed clinical features, overall remission status, and factors affecting prognosis, to guide pLN management according to T2T strategy.

This single-center retrospective study studied 220 children diagnosed with LN from January 2012 to December 2018, with > 6-month follow-up data on 173 and complete data on 137 patients. Primary outcome was treatment failure (deterioration or no response) at the latest follow-up.

The most common pLN manifestation was proteinuria (81.36%). Females presented more often with rash (P<0.001) and alopecia (P=0.026) than males. Class IV LN (33.33%) was the most common grade on kidney biopsy. Median follow-up was 27.20 months (IQR, 15.78-44.45 months). One-, 3-, and 5-year cumulative overall survival rates were 93.5%, 87.8%, and 86.5%, respectively. The 5-year cumulative kidney survival rate was 97.