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Chronic Obstructive Pulmonary Diseases... Jul 2024This present work focused on predicting prognostic outcome of inpatients developing acute exacerbation of chronic obstructive pulmonary disease (AECOPD), and enhancing...
Development and Validation of Machine Learning-Based Models for Prediction of Intensive Care Unit Admission and In-Hospital Mortality in Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease.
BACKGROUND
This present work focused on predicting prognostic outcome of inpatients developing acute exacerbation of chronic obstructive pulmonary disease (AECOPD), and enhancing patient monitoring and treatment by using objective clinical indicators.
METHODS
The present retrospective study enrolled 322 AECOPD patients. Registry data downloaded based on COPD Pay-for-Performance Program database from January 2012 to December 2018 were used to check whether the enrolled patients were eligible. Our primary and secondary outcomes were ICU admission and in-hospital mortality, respectively. The best feature subset was chosen by recursive feature elimination. Moreover, seven machine learning (ML) models were trained for forecasting ICU admission among AECOPD patients, and the model with the most excellent performance was used.
RESULTS
According to our findings, random forest (RF) model showed superb discrimination performance, and the values of area under curve (AUC) were 0.973 and 0.828 in training and test cohorts, separately. Additionally, according to decision curve analysis, the net benefit of RF model was higher when differentiating patients with a high risk of ICU admission at a <0.55 threshold probability. Moreover, the ML-based prediction model was also constructed to predict in-hospital mortality, and it showed excellent calibration and discrimination capacities.
CONCLUSION
The ML model was highly accurate in assessing the ICU admission and in-hospital mortality risk for AECOPD cases. Maintenance of model interpretability helped effectively provide accurate and lucid risk prediction of different individuals.
PubMed: 38967536
DOI: 10.15326/jcopdf.2023.0446 -
The Journal of School Health Jul 2024Youth violence, victimization, and bullying are pervasive in schools across the United States and are detrimental for learning and healthy development. K-12 school...
BACKGROUND
Youth violence, victimization, and bullying are pervasive in schools across the United States and are detrimental for learning and healthy development. K-12 school safety is an increasingly urgent issue to research and understand from multiple perspectives. Physical and psychological safety in school is linked to better student and school outcomes and is fundamental to fostering well-being and prosocial behavior.
METHODS
Despite research demonstrating positive outcomes associated with school safety, there is no comprehensive conceptual model in the literature that considers precursors, strategies, mechanisms, and outcomes of school safety together. The current paper presents an equity-centered comprehensive model of school safety, which is intended as a holistic representation of the multiple factors and pathways that contribute to school safety and positive youth development.
RESULTS
This model can guide research and practice through an equity-centered and comprehensive approach. This model can enable practitioners, researchers, and policymakers to make informed decisions and reach consensus regarding planning and decisions related to reducing violence and establishing supportive school environments.
CONCLUSION
Our model suggests that a comprehensive approach can ensure the safety and well-being of students and staff. By thinking ecologically, schools, communities, and stakeholders can ensure that all aspects of the school context are included in school safety.
PubMed: 38967535
DOI: 10.1111/josh.13485 -
The impact of augmenter of liver regeneration in blunt liver trauma: An experimental model analysis.Ulusal Travma Ve Acil Cerrahi Dergisi =... Jul 2024Traumatic liver injury is an acute event that triggers liver repair. The augmenter of liver regeneration (ALR) has been identified as a growth factor involved in this...
BACKGROUND
Traumatic liver injury is an acute event that triggers liver repair. The augmenter of liver regeneration (ALR) has been identified as a growth factor involved in this process. This study evaluates the impact of ALR on isolated liver blunt trauma and examines its relationship with various time intervals.
METHODS
Forty healthy female Wistar albino rats were divided into five groups (n=8 each). Isolated blunt liver trauma was induced using a custom-designed trauma platform in all groups except for Group 1. The groups were categorized by the timing of euthanasia post-trauma: 2nd (15 minutes), 3rd (30 minutes), 4th (45 minutes), and 5th (60 minutes). Assessments included plasma ALR levels, liver tissue ALR levels (both intact and lacerated), biochemical indices, and liver histological analysis.
RESULTS
Plasma ALR levels in Group 4 were higher than in Groups 1 and 2 (p<0.01). Intact liver ALR levels in Groups 3 and 4 exceeded those in Group 1 (p<0.05, p<0.01, respectively). Intact liver tissue ALR levels in Group 5 were lower than in Groups 3 and 4 (p<0.05, p<0.01, respectively). Lacerated liver tissue ALR levels in Group 5 were higher than those in Groups 2 and 3. In Group 1, the plasma ALR level was higher than the intact liver tissue ALR level (p<0.05). In Group 2, plasma ALR levels exceeded those in intact liver tissue ALR levels (p<0.01). In Group 3, plasma ALR levels surpassed both lacerated and intact liver tissue ALR levels (p<0.05, p<0.001, respectively). In Group 4, the plasma ALR level was higher than the intact liver tissue ALR level (p<0.01), and the lacerated liver tissue level was higher than the intact liver ALR level (p<0.001). Additionally, inflammation scores were higher in Groups 3, 4, and 5 compared to Group 2 (p<0.05, p<0.01, p<0.01, respectively).
CONCLUSION
This study is the first to explore the role of ALR in isolated blunt liver trauma. Following blunt liver trauma, both plasma and liver tissue ALR levels change within minutes.
Topics: Animals; Rats, Wistar; Female; Liver; Rats; Wounds, Nonpenetrating; Liver Regeneration; Disease Models, Animal; Intercellular Signaling Peptides and Proteins; Oxidoreductases Acting on Sulfur Group Donors
PubMed: 38967532
DOI: 10.14744/tjtes.2024.92575 -
Ulusal Travma Ve Acil Cerrahi Dergisi =... Jul 2024In Türkiye, as in other parts of the world, there is a rising trend in individual armament and firearm violence, resembling an epidemic. When fired into the air,...
BACKGROUND
In Türkiye, as in other parts of the world, there is a rising trend in individual armament and firearm violence, resembling an epidemic. When fired into the air, bullets eventually lose the initial speed with which they left the barrel and begin to accelerate downwards under the influence of gravity as they fall to the ground. At this point, these projectiles are referred to as 'tired bullets,' which cause serious injuries and fatalities. This study evaluates autopsy cases of deaths due to tired bullet injuries. We aimed to raise social awareness and contribute to the literature by exploring the forensic, legal, and social dimensions of tired bullet injuries.
METHODS
From 2013 to 2022, 695 forensic autopsies of gunshot wounds were reviewed at the Trabzon Forensic Medicine Group Presidency. Nine cases were identified where individuals had undergone autopsies and the cause of death was attributed to tired bullet injuries. The data for the cases included in the study was sourced from our archive records and the UYAP (National Judicial Network Project) system. The second stage involved analyzing reports of falling bullet injuries from local and national newspaper websites. In the third stage, the Supreme Court decisions regarding perpetrators of tired bullet incidents were examined.
RESULTS
The study included six male and three female cases, with an average age of 32.5 years. Injuries were predominantly located in the head in seven cases, the eye in one case, and the inguinal region in another. In eight cases, the bullet trajectory was from top to bottom. The incidents predominantly occurred in residential areas. It was observed that all cases received coverage in both national and local media, and campaigns against tired bullet injuries were organized. The perpetrators of these injuries were frequently sentenced for murder with probable intent.
CONCLUSION
Tired bullet injuries represent a significant public health issue that necessitates comprehensive preventative measures addressing medical, legal, and social dimensions. There should be national and international campaigns led by the media, involving all public institutions, organizations, and non-governmental organizations to promote individual disarmament, highlight the dangers of firearms, and stress the importance of these initiatives.
Topics: Humans; Wounds, Gunshot; Male; Female; Adult; Middle Aged; Turkey; Autopsy; Young Adult; Adolescent; Cause of Death; Forensic Ballistics
PubMed: 38967528
DOI: 10.14744/tjtes.2024.40245 -
Ulusal Travma Ve Acil Cerrahi Dergisi =... Jul 2024Acute appendicitis (AA) is the primary cause of acute abdomen in patients presenting to the emergency department with abdominal pain. Limited studies have explored the...
BACKGROUND
Acute appendicitis (AA) is the primary cause of acute abdomen in patients presenting to the emergency department with abdominal pain. Limited studies have explored the relationship between serum hepcidin levels and AA. This study aimed to measure serum hepcidin levels in patients undergoing surgery with a preliminary diagnosis of AA and to assess whether these levels can serve as a biochemical marker for diagnosing AA.
METHODS
This study included patients aged 18 or older who presented to the emergency department between April 2018 and May 2019 and underwent surgery with a diagnosis of AA. The cohort comprised 94 patients with surgical pathology results compatible with AA (Group A), 16 patients with results not compatible with AA (Group B), and 42 healthy controls. Serum hepcidin levels were measured from venous blood samples.
RESULTS
Mean hepcidin levels were 1750±285 pg/mL in Group A, 1349±381 pg/mL in Group B, and 1066±225 pg/mL in the control group. Statistically significant differences in serum hepcidin levels were observed between Group A and the control group (p<0.05).
CONCLUSION
Hepcidin levels were significantly higher in patients with AA compared to both the control group and patients with surgically confirmed non-AA pathology. Therefore, hepcidin may serve as a useful adjunct in diagnosing acute appendicitis.
Topics: Humans; Appendicitis; Hepcidins; Male; Female; Adult; Biomarkers; Middle Aged; Case-Control Studies; Young Adult; Acute Disease; Adolescent; Aged
PubMed: 38967527
DOI: 10.14744/tjtes.2024.23187 -
Cancer Medicine Jul 2024Lung adenocarcinoma (LUAD) is the most common malignant tumor in respiratory system. Methyltransferase-like 1 (METTL1) is a driver of m7G modification in mRNA. This...
INTRODUCTION
Lung adenocarcinoma (LUAD) is the most common malignant tumor in respiratory system. Methyltransferase-like 1 (METTL1) is a driver of m7G modification in mRNA. This study aimed to demonstrate the role of METTL1 in the proliferation, invasion and Gefitinib-resistance of LUAD.
METHODS
Public datasets were downloaded from the Gene Expression Profiling Interactive Analysis (GEPIA) and GSE31210 datasets. Malignant tumor phenotypes were tested in vitro and in vivo through biological function assays and nude mouse with xenograft tumors. RNA immunoprecipitation assays were conducted to determine the interaction between METTL1 protein and FOXM1 mRNA. Public transcriptional database, Chromatin immunoprecipitation and luciferase report assays were conducted to detect the downstream target of a transcriptional factor FOXM1. Half maximal inhibitory concentration (IC50) was calculated to evaluate the sensitivity to Gefitinib in LUAD cells.
RESULTS
The results showed that METTL1 was upregulated in LUAD, and the high expression of METTL1 was associated with unfavorable prognosis. Through the m7G-dependent manner, METTL1 improved the RNA stability of FOXM1, leading to the up-regulation of FOXM1. FOXM1 transcriptionally suppressed PTPN13 expression. The METTL1/FOXM1/PTPN13 axis reduced the sensitivity of LUAD cells to Gefitinib. Taken together, our data suggested that METTL1 plays oncogenic role in LUAD through inducing the m7G modification of FOXM1, therefore METTL1 probably is a new potential therapeutic target to counteract Gefitinib resistance in LUAD.
Topics: Humans; Forkhead Box Protein M1; Drug Resistance, Neoplasm; Gefitinib; Animals; Mice; Adenocarcinoma of Lung; Lung Neoplasms; Methyltransferases; Gene Expression Regulation, Neoplastic; Mice, Nude; Cell Line, Tumor; Cell Proliferation; Xenograft Model Antitumor Assays; Disease Progression; Female; Mice, Inbred BALB C; Prognosis; Antineoplastic Agents
PubMed: 38967523
DOI: 10.1002/cam4.7420 -
Therapeutic Drug Monitoring Jul 2024To determine the associations among self-reported vitamin D (VD) supplementation, measured serum 25-hydroxyvitamin D (25[OH]D) concentrations, and all-cause and...
BACKGROUND
To determine the associations among self-reported vitamin D (VD) supplementation, measured serum 25-hydroxyvitamin D (25[OH]D) concentrations, and all-cause and cause-specific mortality risks.
METHODS
Self-reported VD supplementation, serum 25(OH)D concentration, and all-cause and cause-specific mortality data from the National Health and Nutrition Examination Survey 2007-2018 were examined for 10,793 adults ≥20 years from the United States. VD dosage was categorized as <800 or ≥800 IU/d. The mortality status and causes of mortality up to 2019 were determined using the National Death Index. The relationships among VD, 25(OH)D levels, and mortality were analyzed using Cox regression before and after propensity score matching (PSM).
RESULTS
Over a median of 6.6 years, 915 deaths were recorded, 230 because of cardiovascular disease (CVD), 240 because of cancer, and 445 because of other specific causes. Mortality risk did not differ between VD <800 IU/d and ≥800 IU/d before or after PSM. However, serum 25(OH)D concentrations were statistically different before and after PSM. The upper 2 quartiles of 25(OH)D levels were associated with lower all-cause mortality, and the fourth quartile was associated with reduced other-specific mortality before and after PSM. No correlation was found between the 25(OH)D concentration and CVD- or cancer-specific mortality after PSM. The inverse 25(OH)D-mortality relationship was consistent across subgroups.
CONCLUSIONS
Based on this large cohort study, higher 25(OH)D levels are robustly associated with reduced all-cause and other specific mortality but not CVD- or cancer-specific mortality. These findings support the benefits of maintaining adequate VD status for longevity. Further research is required to elucidate these mechanisms and define the optimal VD concentration to reduce mortality. These results underscore the importance of public health strategies for preventing VD deficiency.
PubMed: 38967521
DOI: 10.1097/FTD.0000000000001229 -
Journal of Immunology (Baltimore, Md. :... Jul 2024Stimulator of IFN genes (STING) is a critical component of the innate immune system, playing an essential role in defending against DNA virus infections. However, the...
Stimulator of IFN genes (STING) is a critical component of the innate immune system, playing an essential role in defending against DNA virus infections. However, the mechanisms governing basal STING regulation remain poorly understood. In this study, we demonstrate that the basal level of STING is critically maintained by hypoxia-inducible factor 1 (HIF-1)α through transcription. Under normal conditions, HIF-1α binds constitutively to the promoter region of STING, actively promoting its transcription. Knocking down HIF-1α results in a decrease in STING expression in multiple cell lines and zebrafish, which in turn reduces cellular responses to synthetic dsDNAs, including cell signaling and IFN production. Moreover, this decrease in STING levels leads to an increase in cellular susceptibility to DNA viruses HSV-1 and pseudorabies virus. These findings unveil a (to our knowledge) novel role of HIF-1α in maintaining basal STING levels and provide valuable insights into STING-mediated antiviral activities and associated diseases.
PubMed: 38967520
DOI: 10.4049/jimmunol.2400123 -
Journal of Ethnicity in Substance Abuse Jul 2024Risky substance use can lead to a variety of negative health outcomes, yet treatment is often underutilized by historically minoritized racial/ethnic groups. Screening,...
Risky substance use can lead to a variety of negative health outcomes, yet treatment is often underutilized by historically minoritized racial/ethnic groups. Screening, Brief Intervention and Referral to Treatment (SBIRT) is effective in changing substance use patterns across diverse settings and for diverse demographic groups. However, few studies have focused on whether individuals receive the appropriate level of care based on screening criteria. The purpose of this study was to investigate intervention match/mismatch and factors (e.g., service site, gender, race, ethnicity, age, socio-economic status) that predicted the likelihood of being matched/mismatched to an intervention. A sample of = 3412 were available for analyses and logistic regressions were performed to examine the relationship between matching/mismatching to an intervention and other factors. Of participants, 2222 (65%) were matched to an intervention and 1190 (35%) were mismatched to an intervention. Being older, Hispanic, and receiving SBIRT by health-teams designed to reduce health disparities was related to increased odds of being mismatched. Exploratory results suggested that across predictors, individuals were more likely to receive a lesser intervention than their screening score indicated. Most clients were matched well to intervention as based on screening score. When mismatch occurred, a lower level of care was given. Staff may benefit from attending to more client engagement so that clients return for more intensive interventions; and agencies may need more resources to facilitate client access to services.
PubMed: 38967519
DOI: 10.1080/15332640.2024.2367234 -
International Journal of Surgery... Jul 2024COVID-19 has presented significant obstacles to healthcare. Stem cell therapy, particularly mesenchymal stem cells (MSCs), has emerged as a potential treatment modality...
BACKGROUND
COVID-19 has presented significant obstacles to healthcare. Stem cell therapy, particularly mesenchymal stem cells (MSCs), has emerged as a potential treatment modality due to its immunomodulatory and regenerative properties. This umbrella review aims to synthesize current evidence from systematic reviews on the safety and efficacy of stem cell therapy in COVID-19 treatment.
METHODS
A thorough literature search was performed across Embase, PubMed, Cochrane and Web of Science from December 2019 to February 2024. Systematic reviews focusing on the use of stem cell therapy for COVID-19 were included. Evidence was synthesized by meta-analysis using R software (V 4.3) for each outcome. The certainty of evidence was assessed using the GRADE approach.
RESULTS
A total of 24 systematic reviews were included. Stem cell therapy was associated with reduced mortality (RR 0.72, 95% CI: 0.60-0.86); shorter hospital stays (MD -4.00 days, 95% CI: -4.68 to -3.32), and decreased need for invasive ventilation (RR 0.521, 95% CI: 0.320 to 0.847). Symptom remission rates improved (RR 1.151, 95% CI: 0.998 to 1.330), and a reduction in CRP levels was noted (SMD -1.198, 95% CI: -2.591 to 0.195), albeit with high heterogeneity. For adverse events, no significant differences were found between stem cell therapy and standard care (RR 0.87, 95% CI: 0.607 to 1.265). The certainty of evidence ranged from low to moderate.
CONCLUSION
Stem cell therapy demonstrates a potential benefit in treating COVID-19, particularly in reducing mortality and hospital stay duration. Despite these promising findings, the evidence is varied, and future large-scale randomized trials are essential to confirm the efficacy and optimize the therapeutic protocols for stem cell therapy in the management of the disease. The safety profile is encouraging, with no significant increase in adverse events, suggesting a viable avenue for treatment expansion.
PubMed: 38967503
DOI: 10.1097/JS9.0000000000001786