Improving the 3D Printability and Mechanical Performance of Biorenewable Soybean Oil-Based Photocurable Resins.

The general requirement of replacing petroleum-derived plastics with renewable resources is particularly challenging for new technologies such as the additive manufacturing of photocurable resins. In this work, the influence of mono- and bifunctional reactive diluents on the printability and performance of resins based on acrylated epoxidized soybean oil (AESO) was explored. Polyethylene glycol di(meth)acrylates of different molecular weights were selected as diluents based on the viscosity and mechanical properties of their binary mixtures with AESO. Ternary mixtures containing 60% AESO, polyethylene glycol diacrylate (PEGDA) and polyethyleneglycol dimethacrylate (PEG200DMA) further improved the mechanical properties, water resistance and printability of the resin. Specifically, the terpolymer AESO/PEG575/PEG200DMA 60/20/20 (wt.%) improved the modulus (16% increase), tensile strength (63% increase) and %deformation at the break (21% increase), with respect to pure AESO. The enhancement of the printability provided by the reactive diluents was proven by Jacobs working curves and the improved accuracy of printed patterns. The proposed formulation, with a biorenewable carbon content of 67%, can be used as the matrix of innovative resins with unrestricted applicability in the electronics and biomedical fields. However, much effort must be done to increase the array of bio-based raw materials.

Traqueotomía versus traqueostomía, la necesidad de una aclaración lexicográfica / Tracheotomy versus tracheostomy, the need for lexicographical clarification

Con frecuencia se usan en el ámbito sanitario los términos traqueotomía y traqueostomía, pudiendo generar dudas entre los propios profesionales sobre qué definición corresponde a cada término o cuál de ellos debe considerarse más correcto en casos concretos. Se ha realizado una búsqueda de los términos «traqueotomía» y «traqueostomía» en los diccionarios generalistas en idioma español del Diccionario de la Real Academia Española (DRAE) y del Diccionario Histórico de la Lengua Española de la Real Academia Española (DHLE), y de los términos en inglés «tracheotomy» y «tracheostomy» en los diccionarios generalistas en idioma inglés del Oxford Dictionary, del Cambridge Dictionary y del Collins English Dictionary. Asimismo, se ha hecho una búsqueda en los diccionarios de términos médicos en español del Diccionario de Términos Médicos de la Real Academia Nacional de Medicina (DTM) y en inglés del Farlex Dictionary. Los términos se buscaron también en el buscador generalista de Internet Google®. Se analizaron las definiciones desde el punto de vista lexicográfico y etimológico. Las definiciones que aparecen en los diccionarios generalistas, tanto en español como en inglés, son imprecisas, limitadas y adolecen de ambigüedad por mezclar indicaciones desactualizadas con criterios alejados de la etimología. Sin embargo, las definiciones en los diccionarios de términos médicos en ambos idiomas están más ajustadas a la etimología. La traqueotomía identifica estrictamente el procedimiento quirúrgico de realización de una apertura en la cara anterior de la tráquea. La traqueostomía identifica la realización de un orificio que comunica la tráquea con el exterior e implica una modificación del tracto aéreo superior al proporcionar una entrada adicional de la vía respiratoria. Solo en las laringectomías totales la traqueostomía es la única vía de entrada al tracto aéreo. Ambos términos pueden utilizarse sinónimamente cuando una traqueotomía culmina con una traqueostomía. No convendrá utilizar el término traqueostomía cuando se produce el cierre de los planos al final del procedimiento y este no resulta en la creación de un estoma. Los traqueostomas pueden ser cualificados con adjetivos de tiempo de permanencia (temporal/permanente), tamaño (grande/pequeño), forma (redondo/elíptico), o profundidad por sí mismos, sin vincularse a ningún tipo de enfermedad o de indicación quirúrgica. No todos los traqueostomas permanentes tienen lugar en laringectomías totales ni tienen sistemáticamente un carácter irreversible.(AU)

In the healthcare field, the terms “traqueotomía” and “traqueostomía” are frequently used, often leading to confusion among professionals regarding the appropriate definition for each term or which one should be considered more correct in specific cases. A search was conducted for the terms “traqueotomía” and “traqueostomía” in general Spanish-language dictionaries such as the Dictionary of the Royal Spanish Academy (DRAE) and the Historical Dictionary of the Spanish Language of the Royal Spanish Academy (DHLE), as well as for the English terms “tracheotomy” and “tracheostomy” in English general dictionaries like the Oxford Dictionary, the Cambridge Dictionary, and the Collins English Dictionary. Additionally, searches were performed in medical dictionaries in both Spanish, specifically the Dictionary of Medical Terms of the National Academy of Medicine (DTM), and English, including the Farlex Dictionary. The terms were also explored using the Google search engine. Definitions were analyzed from both lexicographical and etymological perspectives. Definitions found in general dictionaries, in both Spanish and English, were found to be imprecise, limited, and ambiguous, as they mixed outdated indications with criteria that deviated from etymology. In contrast, definitions in medical dictionaries in both languages were more aligned with etymology. “Traqueotomía” strictly identifies the surgical procedure of creating an opening in the anterior face of the trachea. “Traqueostomía” identifies the creation of an opening that connects the trachea to the exterior, involving a modification of the upper airway by providing an additional entry for the respiratory pathway. “Traqueostomía” becomes the sole means of entry to the airway in total laryngectomies. Both terms can be used synonymously when a traqueotomía culminates in a traqueostomía. However, it is not appropriate to use the term “traqueostomía” when the procedure concludes with the closure of the planes and does not result in the creation of a stoma. Traqueostomas can be qualified with adjectives indicating permanence (temporary/permanent), size (large/small), shape (round/elliptical), or depth, without being linked to any specific disease or surgical indication. Not all permanent traqueostomas are the result of total laryngectomies, and they do not necessarily have an irreversible character systematically.(AU)

ERRγ1 and Aromatase Expression in Human Placental Tissues from Term Deliveries of Large for Gestational Age (LGA) Newborns.

INTRODUCTION: Being born either large (LGA) or small for gestational age (SGA) has been associated with an increased risk of developing metabolic syndrome in adulthood. However, the mechanism underlying this early programming remained unclear. Estrogen-related receptor gamma (ERRγ) is an orphan nuclear receptor with a high expression in human placenta, particularly ERRγ1. ERRγ has been proposed to play a central role in controlling genes involved in energy metabolism. In placenta, ERRγ1 acts as an oxygen-responsive transcription factor regulating aromatase (Aro) expression during trophoblast differentiation. Aromatase is an enzyme that catalyzes the synthesis of estrogens from androgens and is located in the syncytiotrophoblast. An adequate estrogen-androgen balance is required for normal pregnancy progression. Our aim was to analyze ERRγ1 and Aro mRNA in human placenta from term LGA newborns. We propose that ERRγ1 and CYP19A1 expressions in human placenta from LGA newborns are impaired, which would modify fetal programming of LGA newborns, since an imbalance in intrauterine estrogen-androgen ratio would be occurred Methods: Total RNA was obtained from placental tissues of LGA (GA: 39-41 weeks, n=8) and adequate for gestational age (AGA; 39-40 weeks, n=10) newborns. ERRγ1 and Aro mRNA variants were analyzed by RT2-PCR. Primers for Aro analysis were specific for Total aromatase (TotalAro) binding in exons 2-3 and for Active aromatase (ActAro) in exons 9-10. Aro protein was analyzed by Western-blot. RESULTS: ERRγ1 mRNA was significantly higher in LGA compare to AGA. TotalAro mRNA was significantly lower in LGA in comparison with AGA control. Similar results with Aro protein. In contrast ActAro/TotalAro ratio was higher in LGA compared to the AGA control. CONCLUSIONS: High expression of ERRγ1 as well as ActAro/TotalAro ratio in LGA suggests that ERRγ1 is involved in ActAro variant expression and hence disrupted estrogen-androgen balance in the intrauterine environment. We propose that dysregulation of ERRγ1 in placenta might modify the estrogen-androgen balance in the intrauterine environment in LGA newborns, possibly representing one of the key factors in the regulation of fetal programming.

Screening of variables affecting the selective leaching of valuable metals from waste motherboards' PCBs.

The presence of valuable and hazardous metals in waste printed circuit boards, especially, motherboards, makes their recovery necessary as implies great economic and environmental advantages and develops urban mining processes. Hence, this research is focused on the selective leaching of Cu, Pb, and Sn as base metals using nitric acid and hydrochloric acid and Au, Ag, and Pd as precious metals using thiourea and sodium thiosulfate from waste motherboards' PCBs in a sequential eco-friendly two-stage process. Previously, thiourea and sodium thiosulfate were used as leaching agents to investigate their applicability for the leaching of metals from PCBs in a single-stage process. Screening experimental design was applied to screen the variables affecting the leaching process in order to evaluate their impact on the recovery of metals and select the significant factors. The results demonstrated that base and precious metals can be leached appropriately in two consecutive stages compared to a single-stage process. Nitric acid was found to be a much more efficient agent to leach Cu and Pb in comparison with hydrochloric acid which was more suitable for the leaching of Sn. In the case of precious metals, higher amounts of Au were leached using thiourea, whereas sodium thiosulfate was able to leach more Pd. Roughly similar results were obtained for the leaching of Ag using these leaching agents. Nitric acid concentration, average particle size, temperature, and leaching time were found to be significant to maximize the leaching of Cu and Pb and minimize that for Au, Ag, and Pd in the first stage. Initial pH was the only variable influencing the second stage, in particular, Au leaching by thiourea.

Consumption of foods with a higher degree of processing is associated with overweight and abdominal obesity in women with breast cancer undergoing chemotherapy.

This study evaluated food consumption according to its degree of processing and its relationship with body adiposity in 218 women with breast cancer. Food consumption was categorised according to the NOVA classification. Two groups were formed, the first composed by consumption of in natura, minimally processed foods and culinary ingredients (less processed foods) and the second one of processed and ultra-processed foods (more processed foods). The increase of 5% in the caloric contribution of more processed foods was associated with a 4% increase in the prevalence of overweight (p = 0.028) and 3% in prevalence of abdominal obesity (p = 0.018). This reinforces the importance of evaluating food consumption with a focus on the degree of processing, as it can contribute to the prevention of excess body fat in this group, as this excess is associated with a worse prognosis and survival.

Tracheotomy versus tracheostomy, the need for lexicographical clarification.

In the healthcare field, the terms "traqueotomía" and "traqueostomía" are frequently used, often leading to confusion among professionals regarding the appropriate definition for each term or which one should be considered more correct in specific cases. A search was conducted for the terms "traqueotomía" and "traqueostomía" in general Spanish-language dictionaries such as the Dictionary of the Royal Spanish Academy (DRAE) and the Historical Dictionary of the Spanish Language of the Royal Spanish Academy (DHLE), as well as for the English terms "tracheotomy" and "tracheostomy" in English general dictionaries like the Oxford Dictionary, the Cambridge Dictionary, and the Collins English Dictionary. Additionally, searches were performed in medical dictionaries in both Spanish, specifically the Dictionary of Medical Terms of the National Academy of Medicine (DTM), and English, including the Farlex Dictionary. The terms were also explored using the Google search engine. Definitions were analyzed from both lexicographical and etymological perspectives. Definitions found in general dictionaries, in both Spanish and English, were found to be imprecise, limited, and ambiguous, as they mixed outdated indications with criteria that deviated from etymology. In contrast, definitions in medical dictionaries in both languages were more aligned with etymology. "Traqueotomía" strictly identifies the surgical procedure of creating an opening in the anterior face of the trachea. "Traqueostomía" identifies the creation of an opening that connects the trachea to the exterior, involving a modification of the upper airway by providing an additional entry for the respiratory pathway. "Traqueostomía" becomes the sole means of entry to the airway in total laryngectomies. Both terms can be used synonymously when a traqueotomía culminates in a traqueostomía. However, it is not appropriate to use the term "traqueostomía" when the procedure concludes with the closure of the planes and does not result in the creation of a stoma. Traqueostomas can be qualified with adjectives indicating permanence (temporary/permanent), size (large/small), shape (round/elliptical), or depth, without being linked to any specific disease or surgical indication. Not all permanent traqueostomas are the result of total laryngectomies, and they do not necessarily have an irreversible character systematically.

S/N/O-Enriched Carbons from Polyacrylonitrile-Based Block Copolymers for Selective Separation of Gas Streams.

A series of polyacrylonitrile (PAN)-based block copolymers with poly(methyl methacrylate) (PMMA) as sacrificial bock were synthesized by atom transfer radical polymerization and used as precursors for the synthesis of porous carbons. The carbons enriched with O- and S-containing groups, introduced by controlled oxidation and sulfuration, respectively, were characterized by Raman spectroscopy, scanning electron microscopy, and X-ray photoelectron spectrometry, and their surface textural properties were measured by a volumetric analyzer. We observed that the presence of sulfur tends to modify the structure of the carbons, from microporous to mesoporous, while the use of copolymers with a range of molar composition PAN/PMMA between 10/90 and 47/53 allows the obtainment of carbons with different degrees of porosity. The amount of sacrificial block only affects the morphology of carbons stabilized in oxygen, inducing their nanostructuration, but has no effect on their chemical composition. We also demonstrated their suitability for separating a typical N2/CO2 post-combustion stream.

Neumonitis por hipersensibilidad: a propósito de un caso

La neumonitis por hipersensibilidad o alveolitis alérgica extrínseca se produce como consecuencia de la inhalación repetida de determinadas sustancias orgánicas o antígenos que, en individuos susceptibles, puede producir una inflamación de las paredes alveolares, bronquiolo e intersticio con alteración del intercambio gaseoso. Su presentación clínica puede ser muy diversa según la edad del paciente. Los niños de mayor edad suelen debutar con cuadros de disnea de esfuerzo que progresa hasta aparecer en reposo, hipoxemia y estertores crepitantes en la auscultación. No hay ninguna prueba definitiva que diagnostique por sí misma la enfermedad, pero los hallazgos analíticos, pruebas de imagen y función pulmonar apoyan la sospecha clínica. La medida más importante de tratamiento es evitar la exposición al antígeno responsable. En algunas ocasiones puede ser útil la utilización de corticoides orales. A continuación, presentamos el caso de un menor con datos clínicos de neumonitis por hipersensibilidad secundaria a la exposición a aves con hipertensión pulmonar secundaria. (provisto por Infomedic International)

Hypersensitivity pneumonitis or extrinsic allergic alveolitis occurs because of the repeated inhalation of certain organic substances or antigens which, in susceptible individuals, can cause inflammation of the alveolar, bronchiole and interstice with gas exchange disorder.  Its clinical presentation can be very diverse according to the age of the patient. Older children usually present as dyspnea with exercises that progress to appear at rest, hypoxemia, and rattles on auscultation. There is no definitive test that by itself diagnoses the disease, but laboratory findings, imaging tests, and pulmonary function support clinical suspicion. The most important measure of treatment is to avoid exposure to the responsibility antigen. Sometimes, the use of oral corticosteroids may be useful. Below, we present the case of a minor with clinical data of hypersensitivity pneumonitis secondary to exposure to birds with secondary pulmonary hypertension. (provided by Infomedic International)

Pautas de tratamiento para la infección tuberculosa latente / Treatment guidelines for latent tuberculous infection

Introducción: Los trabajadores de la salud tienen 2 veces más riesgo de padecer Tuberculosis (TB), teniendo un impacto en transmisión de nosocomial en los Centros Sanitarios (CS). Ello resalta el importante papel que desempeñan los Servicios de Prevención de Riesgos Laborales (SPRL). Objetivos: analizar las pautas de tratamiento para la infección tuberculosa latente en los últimos 5 años. Material y Método: Revisión sistemática en MEDLINE con bases de datos PUBMED, SCOPUS, EMBASE, WOS, Cochrane Library Plus, IBECS, LILACS y CISDOC. MeSH “Latent Tuberculosis Infection” y “Latent Tuberculosis/drug therapy”. Estándares de calidad: CONSORT y comprobación de evidencia: sistema SIGN. Resultados: se seleccionaron 5 ensayos clínicos (n= 14.931) que analizaron pautas cortas respecto a Isoniacida en monoterapia, con diferencias significativas a favor de las pautas cortas. Conclusiones: Las pautas cortas sugieren: menos efectos adversos, aumento en la adherencia y mayor tasa de finalización del tratamiento. (AU)

Introduction: Healthcare workers have twice the risk of suffering from tuberculosis. Which has an impact on nosocomial transmission in Health Care Centres (HCC). This highlights the important role played by Occupational Risk Prevention (ORP). Objectives: to analyse the treatment guidelines for latent tuberculosis infection in the last 5 years. Materials and Methods: Systematic review in MEDLINE with PUBMED, SCOPUS, EMBASE, WOS, Cochrane Library Plus, IBECS, LILACS and CISDOC databases. MeSH “Latent Tuberculosis Infection” and “Latent Tuberculosis/drug therapy”. Quality standards: CONSORT and evidence verification: SIGN system.Results: 5 clinical trials (n= 14,931) were selected that analysed short regimens compared to Isoniazid monotherapy, with significant differences in favour of short regimens. Conclusions: Short guidelines suggest, fewer adverse effects, increased adherence, and higher treatment completion rate. (AU)

Structural and Physiological Traits of Compound Leaves of Ceratonia siliqua Trees Grown in Urban and Suburban Ambient Conditions.

Ceratonia siliqua L. (carob tree) is an endemic plant to the eastern Mediterranean region. In the present study, anatomical and physiological traits of successively grown compound leaves (i.e., the first, third, fifth and seventh leaves) of C. siliqua were investigated in an attempt to evaluate their growth under urban and suburban environmental conditions. Chlorophyll and phenolic content, as well as the specific leaf area of the compound leaves were determined. Structural traits of leaflets (i.e., thickness of palisade and spongy parenchyma, abaxial and adaxial epidermis, as well as abaxial and adaxial periclinal wall) were also investigated in expanding and fully expanded leaflets. Fully expanded leaflets from urban sites exhibited increased thickness of the lamina and the palisade parenchyma, while the thickness of the spongy parenchyma was thicker in suburban specimens. The palisade tissue was less extended than the spongy tissue in expanding leaflets, while the opposite held true for the expanded leaflets. Moreover, the thickness of the adaxial and the abaxial epidermises, as well as the adaxial and abaxial periclinal wall were higher in suburban leaflets. The chlorophyll content increased concomitantly with the specific leaf area (SLA) of both expanding and expanded leaflets, and strong positive correlations were detected, while the phenolic content declined with the increased SLA of expanding and expanded leaflets. It is noteworthy that the SLA of expanding leaflets in the suburban site was comparable to the SLA of expanded leaflets experiencing air pollution in urban sites; the size and the mass of leaf blades of C. siliqua possess adaptive features to air pollution. These results, linked to the functional structure of expanding and expanded successive foliar tissues, provide valuable assessment information coordinated with an adaptive process and yield of carob trees exposed to the considered ambient conditions, which have not hitherto been published.

First trimester lower abdominal cysts as early predictor of anorectal malformations.

INTRODUCTION: Prenatal ultrasound diagnosis of anorectal malformations (ARMs) is challenging and often missed as direct visualization of the anal sphincter is not routinely performed, plus the technique is operator-dependent and inaccurate, also in expert hands. Other indirect signs, such as rectosigmoid overdistension or intraluminal calcifications, are occasionally present in late pregnancy. The detection of a cyst of the lower abdomen in the first trimester may be an early sign of ARM. Here we reported our experience and a review of the literature of such cases. MATERIAL AND METHODS: Isolated cases of lower abdomen cysts encountered in the first trimester at the Prenatal Diagnosis Unit during the last 5 years were retrieved and compared with those found in literature. Post-natal clinical data were analyzed to check the presence and type of malformations. RESULTS: A total of three cases of lower abdomen cysts were found in our center and 13 in literature. In our case series all the cysts spontaneously regressed and were no longer visible since the second trimester of pregnancy, while in literature this was reported in only 4 out of 13 cases. ARM was confirmed in all patients at birth or post-mortem. CONCLUSIONS: The finding of a lower abdomen cyst during the first trimester of pregnancy could be an early predictive sign of ARM, even if it disappears during pregnancy. In these cases, we suggest mentioning to the parents the possibility of an ARM during the counseling and to refer the couple to a Colorectal Center.

Predictors and outcomes of hospitalized COVID-19 patients with liver injury

Objective@#To determine incidence, predictors, and impact of liver injury among hospitalized COVID-19 patients@*Methods@#This is a retrospective cohort study of hospitalized COVID-19 patients at the University of the PhilippinesPhilippine General Hospital. Liver injury (LI) was defined as ALT elevation above institutional cut-off (>50 u/L) and was classified as mild (>1x to 3x ULN), moderate (>3x to 5x ULN), or severe (>5x ULN). Significant liver injury (SLI) was defined as moderate to severe LI. Univariate analysis of SLI predictors was performed. The impact of LI on clinical outcomes was determined and adjusted for known predictors -age, sex, and comorbidities.@*Results@#Of the 1,131 patients, 565 (50.04%) developed LI. SLI was associated with male sex, alcohol use, chronic liver disease, increasing COVID-19 severity, high bilirubin, AST, LDH, CRP, and low lymphocyte count and albumin. An increasing degree of LI correlated with ICU admission. Only severe LI was associated with the risk of invasive ventilation (OR: 3.54, p=0.01) and mortality (OR: 2.76, p=0.01). Severe LI, male sex, cardiovascular disease, and malignancy were associated with longer hospital stay among survivors.@*Conclusion@#The liver injury occurred commonly among COVID-19 patients and was associated with important clinicodemographic characteristics. Severe liver injury increases the risk of adverse outcomes among hospitalized patients.

Lignin as a High-Value Bioaditive in 3D-DLP Printable Acrylic Resins and Polyaniline Conductive Composite.

With increasing environmental awareness, lignin will play a key role in the transition from the traditional materials industry towards sustainability and Industry 4.0, boosting the development of functional eco-friendly composites for future electronic devices. In this work, a detailed study of the effect of unmodified lignin on 3D printed light-curable acrylic composites was performed up to 4 wt.%. Lignin ratios below 3 wt.% could be easily and reproducibly printed on a digital light processing (DLP) printer, maintaining the flexibility and thermal stability of the pristine resin. These low lignin contents lead to 3D printed composites with smoother surfaces, improved hardness (Shore A increase ~5%), and higher wettability (contact angles decrease ~19.5%). Finally, 1 wt.% lignin was added into 3D printed acrylic resins containing 5 wt.% p-toluensulfonic doped polyaniline (pTSA-PANI). The lignin/pTSA-PANI/acrylic composite showed a clear improvement in the dispersion of the conductive filler, reducing the average surface roughness (Ra) by 61% and increasing the electrical conductivity by an order of magnitude (up to 10-6 S cm-1) compared to lignin free PANI composites. Thus, incorporating organosolv lignin from wood industry wastes as raw material into 3D printed photocurable resins represents a simple, low-cost potential application for the design of novel high-valued, bio-based products.

Predictors of mortality among inpatients with COVID-19 infection in a tertiary referral center in the Philippines.

Objectives: The aim of this study was to determine the predictors of mortality and describe laboratory trends among adults with confirmed COVID-19. Methods: The medical records of adult patients admitted to a referral hospital with COVID-19 were retrospectively reviewed. Demographic and clinical characteristics, and laboratory parameters, were compared between survivors and non-survivors. Predictors of mortality were determined by multivariate analysis. Mean laboratory values were plotted across illness duration. Results: Of 1215 patients, 203 (16.7%) had mild, 488 (40.2%) moderate, 183 (15.1%) severe, and 341 (28.1%) critical COVID-19 on admission. In-hospital mortality was 18.2% (0% mild, 6.1% moderate, 15.8% severe, 47.5% critical). Predictors of mortality were age ≥ 60 years, COPD, qSOFA score ≥ 2, WBC > 10 × 109/L, absolute lymphocyte count < 1000, neutrophil ≥ 70%, PaO2/FiO2 ratio ≤ 200, eGFR < 90 mL/min/1.73 m2, LDH > 600 U/L, and CRP > 12 mg/L. Non-survivors exhibited an increase in LDH and decreases in PaO2/FiO2 ratio and eGFR during the 2nd-3rd week of illness. Conclusion: The overall mortality rate was high. Predictors of mortality were similar to those of other reports globally. Marked inflammation and worsening pulmonary and renal function were evident among non-survivors by the 2nd-3rd week of illness.

Bacterial coinfection and antimicrobial use among patients with COVID-19 infection in a referral center in the Philippines: A retrospective cohort study.

Objective: This study aimed to describe community-acquired bacterial coinfection (CAI) and antimicrobial use among COVID-19 patients. Methods: Electronic records were retrospectively reviewed, and clinical data, laboratory data, antibiotic use, and outcomes of patients with and without CAI were compared. Results: Of 1116 patients, 55.1% received antibiotics within 48 hours, but only 66 (5.9%) had documented CAI, mainly respiratory (40/66, 60.6%). Patients with CAI were more likely to present with myalgia (p = 0.02), nausea/vomiting (p = 0.014), altered sensorium (p = 0.007), have a qSOFA ≥ 2 (p = 0.016), or require vasopressor support (p < 0.0001). Patients with CAI also had higher median WBC count (10 vs 7.6 cells/mm3), and higher levels of procalcitonin (0.55 vs 0.13, p = 0.0003) and ferritin (872 vs 550, p = 0.028). Blood cultures were drawn for almost half of the patients (519, 46.5%) but were positive in only a few cases (30/519, 5.8%). Prescribing frequency was highest at the start and declined only slightly over time. The mortality of those with CAI (48.5%) was higher compared with those without CAI (14.3%). Conclusion: Overall CAI rate was low (5.9%) and antimicrobial use disproportionately high (55.0%), varying little over time. The mortality rate of coinfected patients was high. Certain parameters can be used to better identify those with CAI and those who need blood cultures.

Clinical characteristics of patients with asymptomatic and symptomatic COVID-19 admitted to a tertiary referral centre in the Philippines.

Objectives: To describe the clinical profile and outcomes of hospitalized patients with coronavirus disease 2019 (COVID-19) across the spectrum of disease severity. Methods: This retrospective study included adult patients with confirmed COVID-19 infection admitted to a referral hospital. Descriptive statistics, tests for trend, Kaplan-Meier curve and log-rank test were used to compare characteristics and outcomes across disease severity categories. Results: Of 1500 patients with COVID-19, 14.8% were asymptomatic, 13.5% had mild disease, 36.6% had moderate disease, 12.3% had severe disease and 22.7% had critical disease. Asymptomatic patients were admitted for a concurrent condition or for isolation. Patients aged >60 years, male gender and with co-morbidities had more severe disease. Fever, cough, shortness of breath, malaise, gastrointestinal symptoms and decreased sensorium were more common in patients with severe disease. Bilateral pulmonary infiltrates were common (51.1%), with sicker patients having more abnormal findings. The overall mortality rate was 15.1%. Adopting a symptom-based strategy reduced the length of hospitalization from a median of 13 [interquartile range (IQR) 7-21] days to 9 (IQR 5-14) days. Conclusion: The clinical profile and outcomes for this cohort of patients with COVID-19 was consistent with published reports. Asymptomatic infection was common, and universal testing may be a valuable strategy in the correct context, given the implications for infection control. A symptom-based strategy was found to reduce the length of hospitalization considerably.

The Influence of the Partitioning of Sugars, Starch, and Free Proline in Various Organs of Cyclamen graecum on the Biology of the Species and Its Resistance to Abiotic Stressors.

The geophyte Cyclamen graecum is native to the eastern Mediterranean. Its beautiful flowers with upswept pink petals appear during early autumn, after the summer drought period and before leaf expansion in late autumn. The floral and leaf development alternates with their cessation in early winter and late spring, respectively. Ecophysiological parameters and processes underlining the life-cycle of C. graecum have not previously been published. Seasonal fluctuations of sugars, starch, and free proline have been investigated in tubers, leaves, pedicels, and petals, as well as petal and leaf water status. At the whole plant level, the seasonal co-existence of leaves and flowers is marked by an elevated soluble sugar content, which was gradually reduced as the above-ground plant parts shed. The sugar content of petals and pedicels was lower than that of leaves and tubers. Leaf starch content increased from late autumn to spring and was comparable to that of tubers. The starch content in petals and pedicels was substantially lower than that of tubers and leaves. In tubers, monthly proline accumulation was sustained at relatively constant values. Although the partitioning of proline in various organs did not show a considerable seasonal variation, resulting in an unchanged profile of the trends between tubers, leaves, and flowers, the seasonal differences in proline accumulation were remarkable at the whole plant level. The pronounced petal proline content during the flowering period seems to be associated with the maintenance of floral turgor. Leaf proline content increased with the advance of the growth season. The values of leaf relative water content were sustained fairly constant before the senescence stage, but lower than the typical values of turgid and transpiring leaves. Relationships of the studied parameters with rainfall indicate the responsiveness of C. graecum to water availability in its habitat in the Mediterranean ecosystem.

Social Organizational Life Cycle Assessment (SO-LCA) and Organization 4.0: An easy-to-implement method.

Organizations often face difficulties when measuring their social performance. The lack of international standards, the qualitative/quantitative nature of data, and the unavailability of primary sources all hinder social impact assessments, especially in manufacturing settings. To fill these gaps, the method proposes a simple application protocol of Social Organizational Life Cycle Assessment (SO-LCA), customized for an Italian ceramic tile manufacturer. The method leverages Industry 4.0 digital technologies to collect real-time primary and site-specific social data, making the social assessment dynamic. The managerial approach adopted for the selection of social metrics and weighting of indicators and indexes, can support the transition of the manufacturing organization into Organization 4.0. The method also provides a contribution to the operational validation of the UNEP guidelines by extending their area of application. Finally, the proposed method gives substance to social responsibility through social accounting, helping the organization to measure the correct social impact starting from the detailed data, namely the decisions made in the business and in production.•Social Organizational Life Cycle Assessment (SO-LCA) application protocol validated in Industry 4.0 environment.•Social metrics directly linked to production and business processes for the dynamic assessment of social performance.•Easy replicability of the method in other organizational contexts.