Bacteriological concentration of peritoneal drainage fluid could make an early diagnosis of anastomotic leakage following rectal resection

To investigate that the bacteriological concentration and pH value in peritoneal drainage fluid might serve as indicators of early diagnosis of anastomotic leakage following rectal resection. We prospectively analyzed consecutive patients who were treated for rectal diseases with anastomosis at the department of general surgery, the affiliated hospital of Nanjing University Medical School between August 2018 and December 2020. The bacteriological concentration and the pH value in peritoneal drainage fluid were tested on the first, fourth, seventh days postoperatively. A total of 300 consecutive patients underwent rectal resection were tested. 21 patients present with AL and the overall AL rate was 7%. The bacteriological concentration in peritoneal drainage fluid of AL group was significantly higher than that in non-AL group. The AUC value was 0.98 (95% confidence intervals 0.969–1.000) according to the ROC curve. The best cut-off value was 1143/uL. The sensitivity and specificity were 100% and 93.19% respectively. There was no difference of pH value between the AL and non-AL groups. According the results of present study, a high bacteriological concentration in peritoneal drainage fluid is a good marker for predicting and diagnosing AL following rectal resection. However, owing to the limitation of the sample, there was no validation attempt in the study. A large sample study is needed to validate the conclusion.

Text Classification by Genre Based on Rhythm Features

The article is devoted to the analysis of the rhythm of texts of different genres: fiction novels, advertisements, scientific articles, reviews, tweets, and political articles. The authors identified lexico-grammatical figures in the texts: anaphora, epiphora, diacope, aposiopesis, etc., that are markers of the text rhythm. On their basis, statistical features were calculated that describe quantitatively and structurally these rhythm features.The resulting text model was visualized for statistical analysis using boxplots and heat maps that showed differences in the rhythm of texts of different genres. The boxplots showed that almost all genres differ from each other in terms of the overall density of rhythm features. Heatmaps showed different rhythm patterns across genres. Further, the rhythm features were successfully used to classify texts into six genres. The classification was carried out in two ways: a binary classification for each genre in order to separate a particular genre from the rest genres, and a multi-class classification of the text corpus into six genres at once. Two text corpora in English and Russian were used for the experiments. Each corpus contains 100 fiction novels, scientific articles, advertisements and tweets, 50 reviews and political articles, i.e. a total of 500 texts. The high quality of the classification with neural networks showed that rhythm features are a good marker for most genres, especially fiction. The experiments were carried out using the ProseRhythmDetector software tool for Russian and English languages. Text corpora contains 300 texts for each language.

Evaluation of Serum level of thrombomodulin in cases with preeclampsia

Background Preeclampsia is a multisystmic disorder of unknown cause. Endothelial cell damage has recently been suggested to underlie the pathologic change in preeclamptic pregnancy. Thrombomodulin an endothelial cell surface glycoprotein act as a co-factor for thrombin catalyzed activation of protein C. activated protein C inhibits coagulation by inactivation the coagulation factor Va and VIIIa. Aim of the Work to assess the changes in thrombomodulin level in women with preeclampsia. Patients and Methods This prospective case-control study was conducted on 123 women at Ain Shams University Maternity Hospital. Results Regarding clinic-pathological features of pre-eclampsia patients and healthy control groups, our study found that there was high significant difference (p ≤ 0.01) between hypertensive and normal patients regarding (hypertension, obesity and history of PET). Our study found that there was high significant difference (p ≤ 0.01) between pre-eclampsia patients and healthy control group regarding serum thrombomodulin protein level and serum thrombomodulin protein increases significantly with mild and severe preeclampsia and HELLP syndrome and considered a good marker for evaluation of hypertensive patients with pregnancy. Conclusion serum thrombomodulin protein level is considered a good marker for evaluation of hypertensive patients with pregnancy.

Retinal vessels modifications in acute and post-COVID-19

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by SARS-CoV-2 primarily affecting the respiratory system which can damage vessels walls virtually in any body district. Changes affecting retinal vessels are a good marker for systemic vascular alterations. This study investigated retinal vessels during the acute phase of COVID-19 and after patients recovery. Fifty-nine eyes from 32 COVID-19 patients and 80 eyes from 53 unexposed subjects were included. Mean arteries diameter (MAD) and mean veins diameter (MVD) were assessed through semi-automatic analysis on fundus color photos at baseline and 6 months later in patients and subjects unexposed to the virus. At baseline MAD and MVD were significantly higher in COVID-19 patients compared to unexposed subjects (p < 0.0001). Both MAD and MVD significantly decreased in COVID-19 patients at follow-up (from 97.5 ± 10.9 to 92.2 ± 11.4 µm, p < 0.0001 and from 133.1 ± 19.3 to 124.6 ± 16.1 µm, p < 0.0001, respectively). Despite this reduction vessels diameter remained significantly higher in severe COVID-19 patients compared to unexposed subjects. Transient retinal vessels dilation could serve a biomarker for systemic inflammation while long-lasting alterations seen in severe COVID-19 likely reflect irreversible structural damage to the vessels walls and should be further investigated for their possible effects on tissues perfusion and function.

The Potency of NTHi lic1A Gene as a Biomarker in Determining The Severity of Post-Viral Acute Rhinosinusitis

BACKGROUND: The lic1A gene is an important virulence factor for non-typeable H. influenzae (NTHi), which allows its translocation from the nasopharynx into the sinonasal cavity and modulates more severe inflammatory processes. This study is aimed for identifying the potential correlation between the NTHi lic1A gene expressions and the severity of post-viral acute rhinosinusitis.METHODS: Sixty patients who were diagnosed with post-viral acute rhinosinusitis, were recruited from an ENT clinic in a referral hospital, in Bandung, West Java, Indonesia. All patients underwent a historical assessment and ENT examination. The nasal specimen was taken from the patient’s middle meatal. The NTHi lic1A gene expression was detected using Polymerase Chain Reaction (PCR).RESULTS: We observed that eight patients had the NTHi lic1A (+), with a strong correlation toward the dominant symptoms (nasal obstruction and discharge). In addition, the symptom’s duration of the NTHi lic1A (+) was twice longer than patients with the NTHi lic1A (-). Its severity was significantly more different between the two groups (p=0.034).CONCLUSION: Taken together, the presence of the NTHi lic1A gene is significantly associated with the severity of the disease and the symptom’s duration. Thus, the NTHi lic1A gene could potentially be a good marker for assessing the severity of post-viral acute rhinosinusitis cases in the future.KEYWORDS: H. influenzae, rhinosinusitis, nasal obstruction, virulence factors

Stress Hyperglycemia and Osteocalcin in COVID-19 Critically Ill Patients on Artificial Nutrition

We aimed to study the possible association of stress hyperglycemia in COVID-19 critically ill patients with prognosis, artificial nutrition, circulating osteocalcin, and other serum markers of inflammation and compare them with non-COVID-19 patients. Fifty-two critical patients at the intensive care unit (ICU), 26 with COVID-19 and 26 non-COVID-19, were included. Glycemic control, delivery of artificial nutrition, serum osteocalcin, total and ICU stays, and mortality were recorded. Patients with COVID-19 had higher ICU stays, were on artificial nutrition for longer (p = 0.004), and needed more frequently insulin infusion therapy (p = 0.022) to control stress hyperglycemia. The need for insulin infusion therapy was associated with higher energy (p = 0.001) and glucose delivered through artificial nutrition (p = 0.040). Those patients with stress hyperglycemia showed higher ICU stays (23 ± 17 vs. 11 ± 13 days, p = 0.007). Serum osteocalcin was a good marker for hyperglycemia, as it inversely correlated with glycemia at admission in the ICU (r = −0.476, p = 0.001) and at days 2 (r = −0.409, p = 0.007) and 3 (r = −0.351, p = 0.049). In conclusion, hyperglycemia in critically ill COVID-19 patients was associated with longer ICU stays. Low circulating osteocalcin was a good marker for stress hyperglycemia.

The neuroethics of agency: the problem of attributing mental states to people with disorders of consciousness

How can we be certain that another creature is a conscious being? One path is to rely on introspective reports we can grasp in communication or observation of their behavior. Another path is to infer mentality and consciousness by means of markers tied to their intentional behavior, that is, agency. In this paper we will argue that even if agency is a marker of consciousness in several normal instances (paradigmatically, for mature and healthy human beings), it is not a good marker in several pathological instances, such as the blindsight case, the vegetative state, the akinetic mutism and the locked-in syndrome. If we are right, this can be of great utility in neuroethics; for those kinds of disorders of consciousness are not, after all, instances of complete absence of consciousness.

Association between 10-Year Atherosclerotic Cardiovascular Disease Risk and Vascular Endothelial Function in Patients with Vasospastic Angina

<b><i>Background:</i></b> Endothelial dysfunction is a predictor of atherosclerotic cardiovascular disease (ASCVD) and plays an important role in vasospastic angina (VA). <b><i>Objectives:</i></b> This study evaluated whether flow-mediated dilation (FMD) is also a good marker of 10-year ASCVD risk (10Y-ASCVDR) in patients with VA. <b><i>Methods:</i></b> Based on their clinical history and coronary artery diameter stenosis (DS), patients were retrospectively enrolled into VA (DS &#x3c;50% and positive ergonovine provocation), minor coronary artery disease (mCAD, DS &#x3c;30%), and significant coronary artery disease (sCAD, DS ≥50%) groups. Endothelial function was evaluated by FMD. <b><i>Results:</i></b> Each group contained 50 patients. The 10Y-ASCVDR was significantly higher in the sCAD group than in the VA and mCAD groups (10.86 ± 7.30, 4.71 ± 4.04, and 4.77 ± 4.30, respectively, <i>p</i> &#x3c; 0.001). The FMD was significantly higher in the mCAD group than in the VA and sCAD groups (6.37 ± 4.25, 3.10 ± 2.23, and 3.07 ± 1.89, respectively, <i>p</i> &#x3c; 0.001). A significant correlation was found between the FMD and 10Y-ASCVD in the mCAD group (<i>r</i> = −0.622, <i>p</i> &#x3c; 0.001) and the sCAD group (<i>r</i> = −0.557, <i>p</i> &#x3c; 0.001) but not in the VA group (<i>r</i> = −0.193, <i>p</i> = 0.179). After adjusting for potential confounders such as BMI, C-reactive protein, maximal coronary stenosis, and brachial-ankle pulse wave velocity, multivariate analysis showed that FMD was independently associated with 10Y-ASCVDR in all patients. However, when looking only at the VA group, FMD did not correlate independently with 10Y-ASCVDR. <b><i>Conclusions:</i></b> Unlike mCAD and sCAD, we found no correlation between 10Y-ASCVDR and endothelial function in VA. Thus, our results support that FMD is not a good marker of atherosclerotic cardiovascular risk in VA.