Respiratory rate­oxygenation (ROX) index for predicting high-flow nasal cannula failure in patients with and without COVID-19.

BACKGROUND: The predictive value of the respiratory rate­oxygenation (ROX) index for a high-flow nasal cannula (HFNC) in patients with COVID-19 with acute hypoxemic respiratory failure (AHRF) may differ from patients without COVID-19 with AHRF, but these patients have not yet been compared. We compared the diagnostic accuracy of the ROX index for HFNC failure in patients with AHRF with and without COVID-19 during acute emergency department (ED) visits. METHODS: We performed a retrospective analysis of patients with AHRF treated with an HFNC in an ED between October 2020 and April 2022. The ROX index was calculated at 1, 2, 4, 6, 12, and 24 h after HFNC placement. The primary outcome was the failure of the HFNC, which was defined as the need for subsequent intubation or death within 72 h. A receiver operating characteristic (ROC) curve was used to evaluate discriminative power of the ROX index for HFNC failure. RESULTS: Among 448 patients with AHRF treated with an HFNC in an ED, 78 (17.4%) patients were confirmed to have COVID-19. There was no significant difference in the HFNC failure rates between the non-COVID-19 and COVID-19 groups (29.5% vs. 33.3%, p = 0.498). The median ROX index was higher in the non-COVID-19 group than in the COVID-19 group at all time points. The prognostic power of the ROX index for HFNC failure as evaluated by the area under the ROC curve was generally higher in the COVID-19 group (0.73-0.83) than the non-COVID-19 group (0.62-0.75). The timing of the highest prognostic value of the ROX index for HFNC failure was at 4 h for the non-COVID-19 group, whereas in the COVID-19 group, its performance remained consistent from 1 h to 6 h. The optimal cutoff values were 6.48 and 5.79 for the non-COVID-19 and COVID-19 groups, respectively. CONCLUSIONS: The ROX index had an acceptable discriminative power for predicting HFNC failure in patients with AHRF with and without COVID-19 in the ED. However, the higher ROX index thresholds than those in previous publications involving intensive care unit (ICU) patients suggest the need for careful monitoring and establishment of a new threshold for patients admitted outside the ICU.

Effects of packaging and temperature abuse on the quality of red pepper (Capsicum annuum L.) powder.

Storage stability of pepper (Capsicum annuum L.) powder packaged using 2 different film pouches of Ny/PE and PET/Al/PE inserted with moisture absorbent and oxygen scavenger was investigated during storage at 25 °C for 5 months and at 40 °C for 14 days. The moisture content of red pepper powder did not change significantly in PET/Al/PE packaging but decreased significantly in Ny/PE packaging after the abuse of storage temperature. The color of red pepper powder was quite stable in all packaging treatments. Other quality characteristics of all packaged pepper powder, including microbial cell count, capsaicinoids, ascorbic acid, and free sugar content, were also maintained near their initial levels with no appreciable changes during storage. Red pepper powder with a moisture content of 13-14% and packaged with a film with high gas-barrier properties can be stored for more than 5 months even if there is an unexpected temperature abuse during storage.

Predicting the probability of good neurological outcome after in-hospital cardiac arrest based on prearrest factors: validation of the good outcome following attempted resuscitation 2 (GO-FAR 2) score.

The Good Outcome Following Attempted Resuscitation (GO-FAR) 2 score is a prognostic tool developed to support decision-making for do-not-attempt-resuscitation (DNAR) orders by predicting neurological outcomes after in-hospital cardiac arrest (IHCA) based on prearrest variables. However, this scoring system requires further validation. We aimed to validate the GO-FAR 2 score for predicting good neurological outcome in Korean patients with IHCA. A single-centre registry of adult patients with IHCA from 2013 to 2017 was analysed. The primary outcome was discharge with good neurological outcome (Cerebral Performance Category score of 1 or 2). The patients were divided into four categories according to the GO-FAR 2 score: very poor (≥ 5), poor (2-4), average (- 3 to 1), and above-average (< - 3) likelihood of good neurological outcome. Of 1,011 patients (median age, 65 years), 63.1% were men. The rate of good neurological outcome was 16.0%. The proportions of patients categorised as having very poor, poor, average, and above-average probability of good neurological outcome were 3.9%, 18.3%, 70.2%, and 7.6%, respectively. In each category, good neurological outcome was observed in 0%, 1.1%, 16.8%, and 53.2%, respectively. Among patients in below-average categories (very poor + poor, GO-FAR 2 score ≥ 2), only 0.9% had good outcome. GO-FAR 2 score ≥ 2 showed a sensitivity of 98.8% and a negative predictive value of 99.1% in predicting good neurological outcome. The GO-FAR 2 score can predict neurological outcome after IHCA. In particular, GO-FAR 2 score ≥ 2 may support decision-making for DNAR orders.

Pre-arrest comorbidity burden and the future risk of out-of-hospital cardiac arrest in Korean adults.

OBJECTIVE: To investigate the impact of pre-arrest comorbidities on future out-of-hospital cardiac arrest (OHCA) development using a nationwide dataset. METHODS: This population-based, matched case-control study used the national health insurance claims data relevant to OHCA in South Korea from January 2009 to December 2018. Case patients were randomly matched to controls by age, sex and date of cardiac arrest. Controls were defined as patients who did not experience OHCA based on claim codes in national health screening data. The comorbidity burden was assessed using the Charlson Comorbidity Index (CCI). RESULTS: A total of 191 370 OHCA patients were matched to 347 568 controls. The mean CCI in the case group was 3.76, which was significantly higher than that in the control group (1.75, p<0.001). Overall, OHCA was 1.35 (95% CI 1.34 to 1.35) times more likely to occur with every 1 point increase in the CCI. All other comorbidities constituting the CCI were associated with the OHCA risk (p<0.001). Patients with CCI ≥3 presented an OR of 3.71 (95% CI 3.67 to 3.76) for the risk of OHCA occurrence. This association was more pronounced in patients aged <70 years than in those aged ≥70 years (OR (95% CI) 16.07 (15.48 to 16.68) vs 6.50 (6.33 to 6.68)). CONCLUSION: A high burden of pre-arrest comorbidity was associated with a higher risk of OHCA development, which was more pronounced in patients with less advanced age.

Vitamin D deficiency on admission to the emergency department is a mortality predictor for patients with septic shock treated with early protocol-driven resuscitation bundle therapy.

BACKGROUND: Vitamin D is an important immune modulator and is associated with susceptibility to infection. However, past studies have reported inconsistent results regarding the association between vitamin D deficiency and mortality in patients with sepsis, and early-stage data regarding septic shock are limited. This study aimed to determine the relationship between vitamin D deficiency on admission to the emergency department (ED) and mortality in patients with septic shock. METHODS: We analyzed prospectively collected data on adult patients with septic shock who were treated with protocol-driven resuscitation bundle therapy in the ED between September 2019 and February 2021. Septic shock was defined by the sepsis-3 definition and vitamin D deficiency was defined as a 25-hydroxyvitamin D <20 ng/ml. The primary outcome was 30-day mortality. RESULTS: A total of 302 patients were included, 236 (78.1%) patients had vitamin D deficiency; it was significantly higher in non-survivors than in survivors (89.3% vs. 73.9%, P = 0.004). Mortality was higher in vitamin D deficient patients than in non-deficient patients (31.8% vs. 13.6%, P = 0.004). In multivariate analysis, vitamin D deficiency (odds ratio [OR], 2.43; 95 % confidence interval [CI], 1.03-5.74), hyperlactatemia (OR, 3.65; 95 % CI, 1.95-6.83), Sequential Organ Failure Assessment scores (OR, 1.22; 95% CI, 1.09-1.36), and albumin levels (OR, 0.39; 95% CI, 0.21-0.73) were significantly associated with 30-day mortality. CONCLUSIONS: Vitamin D deficiency was prevalent in patients with septic shock visiting the ED and was associated with mortality.

Characteristics of Patients Who Visited Emergency Department: A Nationwide Population-Based Study in South Korea (2016-2018).

The utilization of the emergency department (ED) has been continuously increasing and has become a burden for ED resources. The aim of this study was to describe the characteristics, outcomes, common diagnoses, and disease classifications of patients who were referred to the ED. This nationwide epidemiologic study examined the data from adult patients (>18 years) who visited EDs from 1 January 2016 to 31 December 2018. Most EDs in Korea provide data from ED patients to the National Emergency Medical Center (NEMC). The disposition of ED patients was classified as discharge, admission, death, and re-transfer. From 2016 to 2018, the proportion of referred patients out of the total ED visits increased from 7.3% to 7.8%. The referred patients were older (61.1 vs. 50.5 years), had worse vital signs, longer ED lengths of stay (409.1 vs. 153.3 min), and higher admission (62.3 vs. 16.9%) and re-transfer rates (4.4 vs. 1.9%) than the direct-visit patients. Among the referred patients in the 3 years, 62.3% were hospitalized, and the most common disease classification was "disease of the digestive system" (19.8%). The most common diagnosis was pneumonia (6.0%), followed by urinary tract infection, gastrointestinal bleeding, and hepatobiliary infection. The number of patients referred to EDs is increasing, and more than 60% of referred patients are hospitalized. Detailed characteristics of these patients will be helpful for improving ED management and the distribution of medical resources.

Association between Vitamin D deficiency and Neurologic Outcomes in Patients after Cardiopulmonary Resuscitation.

AIM: We investigated the association between vitamin D deficiency and neurologic outcomes after cardiopulmonary resuscitation. METHOD: Data from the prospective cardiac arrest registry in the emergency department between October 2019 and April 2021 were retrospectively analyzed. Blood samples were obtained during cardiopulmonary resuscitation wherein 25-hydroxyvitamin D serum levels were analyzed; deficiency was defined as levels < 10 ng/mL. The primary outcome was neurologic outcomes at 3 months assessed using the modified Rankin Scale. RESULT: A total of 195 patients (mean age, 64.5 ±â€Š16.1 years; 135 [69.2%] men) were included. A significantly greater proportion of patients with poor outcomes had vitamin D deficiency compared with those with good outcomes (49.4% vs. 18.2%, P = 0.001). The area under the curve for a sustained return of spontaneous circulation and 3-month poor neurologic outcomes was 0.595 (P = 0.031) and 0.704 (P < 0.001), respectively. In a multivariate analysis, vitamin D deficiency (odds ratio [OR]: 10.22; 95% confidence interval [CI]: 1.47-70.82, P = 0.019), initial shockable rhythm (OR: 0.03; 95% CI: 0.00-0.84, P = 0.040), low flow time (OR: 1.10; 95% CI: 1.03-1.16, P = 0.003), and thrombocytopenia (OR: 10.66; 95% CI: 1.13-100.41, P = 0.039) were significantly associated with 3-month poor neurologic outcomes. CONCLUSION: The prevalence of vitamin D deficiency in patients with cardiac arrest was 44% and was associated with poor neurological outcomes at 3 months.

Dynamic changes in arterial blood gas during cardiopulmonary resuscitation in out-of-hospital cardiac arrest.

We aimed to investigate the prognostic value of dynamic changes in arterial blood gas analysis (ABGA) measured after the start of cardiopulmonary resuscitation (CPR) for return of spontaneous circulation (ROSC) in patients with out-of-hospital cardiac arrest (OHCA). This prospective observational study was conducted at the emergency department of a university hospital from February 2018 to February 2020. All blood samples for gas analysis were collected from a radial or femoral arterial line, which was inserted during CPR. Changes in ABGA parameters were expressed as delta (Δ), defined as the values of the second ABGA minus the values of the initial ABGA. The primary outcome was sustained ROSC. Out of the 80 patients included in the analysis, 13 achieved sustained ROSC after in-hospital resuscitation. Multivariable logistic analysis revealed that ΔpaO2 (odds ratio [OR] = 1.023; 95% confidence interval [CI] = 1.004-1.043, p = 0.020) along with prehospital shockable rhythm (OR = 84.680; 95% CI = 2.561-2799.939, p = 0.013) and total resuscitation duration (OR = 0.881; 95% CI = 0.805-0.964, p = 0.006) were significant predictors for sustained ROSC. Our study suggests a possible association between ΔpaO2 in ABGA during CPR and an increased rate of sustained ROSC in the late phase of OHCA.

Effect of Agar/AgNP Composite Film Packaging on Refrigerated Beef Loin Quality.

Fresh beef loin was packaged with 0-2% silver nanoparticles (AgNPs) incorporated agar films to investigate the effect of antimicrobial packaging on meat quality changes in terms of microbiological and physicochemical properties. Raw beef cuts were directly inoculated with Listeria monocytogenes and Escherichia coli O157:H7 and stored in the air-sealed packages combined with the agar films at 5 °C for 15 days. Beef samples showed low susceptibility to the agar/AgNP composite films, resulting in about one log reduction of the inoculated pathogenic bacteria in viable cell count during storage. However, the composite films could partly prevent beef samples from directly contacting oxygen, maintaining the meat color and retarding oxidative rancidity. Experimental results suggested that the AgNP-incorporated agar films can potentially be applied in packaged raw meats as an active food packaging material to inhibit microbial and physicochemical quality deterioration during distribution and sale.

Subcutaneous fat area at the upper thigh level is a useful prognostic marker in the elderly with femur fracture.

BACKGROUND: The aim of this study was to evaluate prognostic value of body tissue composition at the upper thigh level for 1 year mortality in elderly patients with proximal femur fracture. METHODS: This retrospective cohort study included consecutive elderly (aged ≥65) patients diagnosed with proximal femur fracture based on the findings of pelvic bone computed tomography (CT) performed at the emergency department of a tertiary care hospital and treated with surgery between 2010 and 2017. The cross-sectional area of subcutaneous fat and skeletal muscle at the upper thigh level was measured using CT. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for 1 year mortality were estimated using a Cox proportional hazards model. Survival based on the SFA quartiles was assessed using nonparametric Kaplan-Meier survival analysis and compared used log-rank tests. RESULTS: Among 876 elderly patients included in this study, the median age was 79.0 years, and 646 (73.7%) patients were female. A total of 93 (10.6%) died within 1 year after admission to the emergency department. Survivors had a significantly higher median subcutaneous fat area (SFA) than non-survivors (170.2 vs. 133.0 cm2 , P < 0.001), but no significant difference was observed between the skeletal muscle area (median, 156.7 vs. 160.3 cm2 , P = 0.504) and muscle density (median, 19.0 vs. 19.1 HU, P = 0.861) of both groups. After adjustment of other clinical characteristics and body compositions, the multivariate Cox proportional hazard analysis showed that SFA (adjusted HR, 0.987; 95% CI, 0.982-0.992; P < 0.001) was independently associated with 1 year mortality. With 384 deaths during 51 322 person-months of follow-up, the median estimated survival duration of all the patients was 92.8 months (95% CI, 80.8-104.7 months). The patients with SFA in the third (165.6-195.0 cm2 ) and fourth (>195.0 cm2 ) quartiles showed significantly longer survival duration than those with SFA in the first (<131.4 cm2 ; median survival time, 51.3 months) and second (131.4-165.5 cm2 ; median survival time, 88.7 months) quartiles (P < 0.001 by log-rank test). CONCLUSIONS: The SFAs measured at the upper thigh level and 1 year mortality are positively associated in elderly patients with proximal femur fracture. SFA may be an independent prognostic biomarker for 1 year mortality of femur fracture.

Long-Term Outcomes After In-Hospital Cardiac Arrest: Does Pre-arrest Skeletal Muscle Depletion Matter?

Background: Skeletal muscle depletion is prevalent in elderly patients and is associated with unfavorable outcomes in patients with chronic diseases. However, the relationship between skeletal muscle mass and neurological outcomes following in-hospital cardiac arrest (IHCA) has not been evaluated. The aim of this study was to investigate whether skeletal muscle status before cardiac arrest is an independent factor affecting neurological outcomes in patients with IHCA. Methods: We reviewed a prospectively enrolled registry of IHCA patients. Consecutive adult patients (>18 years) admitted to a tertiary care hospital from 2013 to 2019 were included in the study. Of these, 421 patients who underwent abdominopelvic computed tomography within 3 months of cardiac arrest were included. Skeletal muscle index (SMI) was measured at the third lumbar vertebra, and skeletal muscle depletion was defined using sex- and body mass index-specific cutoffs of SMI. The primary outcome was a Cerebral Performance Category score of 1 or 2 at 6 months after cardiac arrest, which was considered a good neurological outcome. Results: Of the 421 patients, 248 (58.9%) had skeletal muscle depletion before IHCA. The patients without skeletal muscle depletion showed significantly better neurological outcomes at 6 months after cardiac arrest than those with pre-arrest muscle depletion (20.8 vs. 10.9%, p = 0.004). The absence of skeletal muscle depletion was significantly associated with good neurological outcomes in a multivariable logistic analysis (OR = 3.49, 95% confidence intervals: 1.83-6.65, p < 0.001), along with the absence of diabetes, presence of active cancer, shockable rhythm, and short resuscitation duration. Conclusion: Pre-arrest skeletal muscle depletion was associated with long-term mortality and poor neurological outcomes after IHCA. Skeletal muscle depletion may be used as a tool to identify at-risk patients who may benefit from aggressive treatments.

Extracellular Water to Total Body Water Ratio in Septic Shock Patients Receiving Protocol-Driven Resuscitation Bundle Therapy.

(1) Bio-electrical impedance analysis (BIA) is a rapid, simple, and noninvasive tool for evaluating the metabolic status and for assessing volume status in critically ill patients. Little is known, however, the prognostic value of body composition analysis in septic shock patients. This study assessed the association between parameters by body composition analysis and mortality in patients with septic shock in the emergency department (ED). (2) Data were prospectively collected on adult patients with septic shock who underwent protocol-driven resuscitation bundle therapy between December 2019 and January 2021. The primary outcome was 30-day mortality. (3) The study included 261 patients, the average ratio of extracellular water (ECW) to total body water (TBW) was significantly higher in non-survivors than in survivors (0.414 vs. 0.401, p < 0.001). Multivariate analysis showed that ECW/TBW ≥ 0.41 (odds ratio (OR), 4.62; 95% confidence interval (CI), 2.31-9.26, p < 0.001), altered mental status (OR, 2.88; 95% CI, 1.28-6.46, p = 0.010), and lactate level (OR, 1.24; 95% CI, 1.12-1.37, p < 0.001) were significantly associated with 30-day mortality in patients with septic shock. (4) ECW/TBW ≥ 0.41 may be associated with 30-day mortality in patients with septic shock receiving protocol-driven resuscitation bundle therapy in the ED.

C-reactive Protein for Stroke Detection in the Emergency Department in Patients With Dizziness Without Neurological Deficits.

Background: Stroke diagnosis can be challenging in patients with dizziness without neurologic deficits. The aim of this study was to evaluate the predictive value of C-reactive protein (CRP) for identifying acute stroke in such patients. Methods: Data from adult patients (>18 years) admitted to the emergency department from August 2019 to February 2020 were evaluated. The study subjects were 1,188 patients presenting with dizziness without neurological deficits whose serum CRP level was measured within 2 h of arriving at the emergency department and who underwent brain magnetic resonance imaging. The relationship between CRP and acute stroke was analyzed using univariable and multivariable models. Results: Acute stroke was detected in 53 (4.4%) patients (40 with brain infarction, 10 with vertebrobasilar insufficiency, 2 with intracerebral hemorrhage, and 1 with subarachnoid hemorrhage). The CRP levels did not differ significantly between the acute stroke and non-stroke groups [0.10 (0.10-0.31) vs. 0.10 (0.10-0.16), P = 0.074]. The area under receiver operating characteristic curve of CRP for acute stroke was not statistically significant (0.567, P = 0.101). On multivariable analysis, the following variables were associated with acute stroke: age (odds ratio [OR], 1.041; 95% confidence interval [CI], 1.011-1.071), history of cerebrovascular accidents (OR, 1.823; 95% CI, 1.068-3.110), white blood cell count (OR, 1.126; 95% CI, 1.017-1.248), and hemoglobin (OR, 1.316; 95% CI, 1.056-1.640). However, CRP (P = 0.183) was not associated with acute stroke. Conclusion: Serum CRP levels do not have significant discriminative value for identifying acute stroke in patients with dizziness without definite neurologic deficits.

Predictive value of pre-arrest albumin level with GO-FAR score in patients with in-hospital cardiac arrest.

We investigated whether combining the pre-arrest serum albumin level could improve the performance of the Good Outcome Following Attempted Resuscitation (GO-FAR) score for predicting neurologic outcomes in in-hospital cardiac arrest patients. Adult patients who were admitted to a tertiary care hospital between 2013 and 2017 were assessed. Their pre-arrest serum albumin levels were measured within 24 h before the cardiac arrest. According to albumin levels, the patients were divided into quartiles and were assigned 1, 0, 0, and, - 2 points. Patients were allocated to the derivation (n = 419) and validation (n = 444) cohorts. The proportion of favorable outcome increased in a stepwise manner across increasing quartiles (p for trend < 0.018). Area under receiver operating characteristic curve (AUROC) of the albumin-added model was significantly higher than that of the original GO-FAR model (0.848 vs. 0.839; p = 0.033). The results were consistent in the validation cohort (AUROC 0.799 vs. 0.791; p = 0.034). Net reclassification indices of the albumin-added model were 0.059 (95% confidence interval [CI] - 0.037 to 0.094) and 0.072 (95% CI 0.013-0.132) in the derivation and validation cohorts, respectively. An improvement in predictive performance was found by adding the ordinal scale of pre-arrest albumin levels to the original GO-FAR score.

A Case Study of Quantizing Convolutional Neural Networks for Fast Disease Diagnosis on Portable Medical Devices.

Recently, the amount of attention paid towards convolutional neural networks (CNN) in medical image analysis has rapidly increased since they can analyze and classify images faster and more accurately than human abilities. As a result, CNNs are becoming more popular and play a role as a supplementary assistant for healthcare professionals. Using the CNN on portable medical devices can enable a handy and accurate disease diagnosis. Unfortunately, however, the CNNs require high-performance computing resources as they involve a significant amount of computation to process big data. Thus, they are limited to being used on portable medical devices with limited computing resources. This paper discusses the network quantization techniques that reduce the size of CNN models and enable fast CNN inference with an energy-efficient CNN accelerator integrated into recent mobile processors. With extensive experiments, we show that the quantization technique reduces inference time by 97% on the mobile system integrating a CNN acceleration engine.

Publisher Correction: Feed gas effect on plasma inactivation mechanism of Salmonella Typhimurium in onion and quality assessment of the treated sample.

A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has been fixed in the paper.

Feed gas effect on plasma inactivation mechanism of Salmonella Typhimurium in onion and quality assessment of the treated sample.

A submerged dielectric barrier discharge (DBD) plasma reactor was used to inactivate artificially inoculated reference strains of Salmonella Typhimurium ATCC 14028 on sliced onion (3 cm × 3 cm). Salmonella Typhimurium reductions obtained after 10 min of treatment were 3.96 log CFU/slice and 1.64 log CFU/slice for clean dry air and N2 feed gas, respectively. Variations observed in Optical Emission Spectra (OES) for different feed gases are responsible for the inactivation level variations of Salmonella Typhimurium. The physiochemical properties of the onion slices, such as quercetin content, ascorbic acid content and color parameters, were monitored before and after treatment and the changes that occurred were measured to be in the acceptable range. Quercetin content was reduced only 3.74-5.07% for 10 min treatment, higher reduction was obtained for the use of clean dry air than that of N2 feed gas. Ascorbic acid loss was measured to be 11.82% and 7.98% for a 10 min treatment with clean dry air and N2 feed gas, respectively. The color parameters did not show significant changes upon treatment (p > 0.05) of the same duration for the uses of different feed gases.

Contrast-induced nephropathy in patients with active cancer undergoing contrast-enhanced computed tomography.

PURPOSE: This study was performed to measure the incidence and identify potential predictors of contrast-induced nephropathy (CIN) in cancer patients without chronic kidney disease and with normal or near-normal baseline serum creatinine measures who underwent contrast-enhanced computed tomography (CECT). Severity of CIN was reported based on the RIFLE (risk, injury, failure, loss of kidney function, and end-stage renal disease) classification of acute kidney injury. METHODS: A retrospective analysis was performed on 820 cancer patients who presented at our emergency department from October 2014 to March 2015. CIN was defined as an increase in creatinine concentration of ≥0.5 mg/dL or ≥25 % above baseline that occurred 48 to 72 h after CECT. RESULTS: The incidence of CIN was 8.0%. Serial CT examination [odds ratio (OR) 4.09; 95% confidence interval (CI) 1.34-12.56], hypotension before the CT scan (OR 3.95; 95% CI 1.77-8.83), liver cirrhosis (OR 2.82; 95% CI 1.06-7.55), BUN/creatinine >20 (OR 2.54; 95% CI 1.44-4.46), and peritoneal carcinomatosis (OR 1.75; 95% CI 1.01-3.00) were independently associated with CIN. Of 66 CIN patients, 44 met any of the severity criteria of the RIFLE classification. Five of these patients died during hospitalization but only one death was related to renal failure. CONCLUSIONS: Even when the baseline serum creatinine is ≤1.5 mg/dL, a significant portion of cancer patients are still at risk of CIN. Consecutive CECT examinations, hypotension before CT, liver cirrhosis, dehydration, and peritoneal carcinomatosis seem to predispose patients to CIN.

Microbial reduction efficacy of various disinfection treatments on fresh-cut cabbage.

To reduce the pathogenic microorganisms of fresh-cut vegetables, various sanitizers applied at different concentrations and against four different bacteria inoculated in high or low initial loads were tested on shredded cabbage. The bacteria were reduced by 1 log CFU g(-1) after being exposed to over 100 ppm sodium hypochlorite, over 1% hydrogen peroxide, over 50 ppm peroxyacetic acid, and three types of electrolyzed water (EW) for 1 min. When the efficacy of the sanitizer was compared in the low initial bacterial load of 10(3)-10(4) CFU g(-1), a significant reduction in the inoculated bacteria was observed with the acidified EW treatment, followed by the 50 ppm peroxyacetic acid and the neutral EW treatment, which was more efficient than the 100 ppm sodium hypochlorite treatment. The efficacy of the various sanitizers used could be also influenced by different bacterial species.

Preparation and characterization of bio-nanocomposite films of agar and silver nanoparticles: laser ablation method.

Silver nanoparticles (AgNPs) were prepared by a laser ablation method and composite films with the AgNPs and agar were prepared by solvent casting method. UV-vis absorbance test and transmission electron microscopy (TEM) analysis results revealed that non-agglomerated spherical AgNPs were formed by the laser ablation method. The surface color of the resulting agar/AgNPs films exhibited the characteristic plasmonic effect of the AgNPs with the maximum absorption peaks of 400-407 nm. X-ray diffraction (XRD) test results also exhibited characteristic AgNPs crystals with diffraction peaks observed at 2θ values of 38.39°, 44.49°, and 64.45°, which were corresponding to (111), (200), and (220) crystallographic planes of face-centered cubic (fcc) silver crystals, respectively. Thermogravimetric analysis (TGA) results showed that thermal stability of the agar/AgNPs composite films was increased by the inclusion of metallic silver. Water vapor barrier properties and surface hydrophobicity of the agar/AgNPs films increased slightly with the increase in AgNPs content but they were not statistically significant (p>0.05), while mechanical strength and stiffness of the composite films decreased slightly (p<0.05). The agar/AgNPs films exhibited distinctive antimicrobial activity against both Gram-positive (Listeria monocytogenes) and Gram-negative (Escherichia coli O157:H7) bacterial pathogens.