Search Results (175)

Background: Accurate and timely prediction of mortality in intensive care unit (ICU) patients, particularly those with COVID-19, remains clinically challenging due to complex immune responses. Proteomic cytokine profiling holds promise for refining mortality risk assessment. Methods: Serum samples from 89 ICU patients (55 discharged, 34 deceased) were analyzed using a multiplex 21-cytokine panel. Samples were stratified into three groups based on time from collection to outcome: ≤48 h (Group 1: Early), >48 h to ≤7 days (Group 2: Intermediate), and >7 days to ≤14 days (Group 3: Late). Cytokine levels, simple cytokine ratios, and previously unexplored complex ratios between pro- and anti-inflammatory cytokines were evaluated. Machine learning-based feature selection identified the most predictive ratios, with performance evaluated by area under the curve (AUC), sensitivity, and specificity. Results: Complex cytokine ratios demonstrated superior predictive accuracy compared to traditional severity markers (APACHE II, SAPS II, SOFA), individual cytokines, and simple ratios, effectively distinguishing discharged from deceased patients across all groups (AUC: 0.918–1.000; sensitivity: 0.826–1.000; specificity: 0.775–0.900). Conclusions: Multiplex cytokine profiling enhanced by computationally derived complex ratios may offer robust predictive capabilities for ICU mortality risk stratification, serving as a valuable tool for personalized prognosis in critical care. Full article

Background and Objectives: Immunodeficiency associated with aging comorbidities increases the vulnerability of geriatric patients to sepsis. Early recognition and management of sepsis are essential in this population. This study evaluated the relationships between RDW, MPV, and MPV/PLT ratios and mortality in geriatric sepsis patients. Materials and Methods: This retrospective study was conducted between 2020 and 2024 in the Intensive Care Unit of the Department of Anesthesiology and Reanimation at a university hospital. Patients aged ≥ 65 years with a SOFA score of ≥2 were included. Demographic data (sex, age, height, weight, and BMI), hemogram parameters (RDW, MPV, and PLT), blood gas, and biochemical values were analyzed. Furthermore, their comorbidities; site of infection; ICU length of stay; vital signs; and SOFA, APACHE II, and SAPS II scores, recorded within the first 24 h following ICU admission, were evaluated. Statistical analysis was performed using the chi-square test, Student’s t-test, the Mann–Whitney U test, the Monte Carlo exact test, and ROC analysis. A p-value of <0.05 was considered statistically significant. Results: A total of 247 patients were included, with 46.2% (n = 114) classified as non-survivors during the 28-day follow-up period. Among them, 64.9% (n = 74) were male, with a mean age of 78.22 ± 8.53 years. Significant differences were also found in SOFA, APACHE-II, and SAPS-II scores between non-survivors and survivors (SOFA: 7.64 ± 3.16 vs. 6.78 ± 2.78, p = 0.023; APACHE-II: 21.31 ± 6.36 vs. 19.27 ± 5.88, p = 0.009; SAPS-II: 53.15 ± 16.04 vs. 46.93 ± 14.64, p = 0.002). On days 1, 3, and 5, the MPV/PLT ratio demonstrated a statistically significant predictive value for 28-day mortality. The optimal cut-off values were >0.03 on day 1 (AUC: 0.580, 95% CI: 0.516–0.642, sensitivity: 72.81%, specificity: 65.91%, p = 0.027), >0.04 on day 3 (AUC: 0.602, 95% CI: 0.538–0.663, sensitivity: 60.53%, specificity: 60.61%, p = 0.005), and >0.04 on day 5 (AUC: 0.618, 95% CI: 0.554–0.790, sensitivity: 66.14%, specificity: 62.88%, p = 0.001). Conclusions: The MPV and MPV/PLT ratios demonstrated statistically significant but limited predictive value for 28-day mortality in geriatric patients with sepsis. In contrast, the limited prognostic value of RDW may be related to variability in the inflammatory response and other underlying conditions. The correlations found between SOFA, APACHE II, and SAPS II scores highlight their importance in mortality risk prediction. Full article

Rare (only 10) observations, made in the southern topside ionosphere during 2015–2016, demonstrate the amplification of westward subauroral polarization streams (SAPS) up to 3000 m/s near the Harang region. The observed amplified SAPS flows were streaming antisunward after midnight and sunward at midnight, where the dusk convection cell intruded dawnward. One SAPS event illustrates the elevated electron temperature (Te; ~5500 K) and the stable auroral red arc developed over Rothera. Three inner-magnetosphere SAPS events depict the Harang region’s earthward edge within the plasmasheet’s earthward edge, where the outward SAPS electric (E) field (within the downward Region 2 currents) and inward convection E field (within the upward Region 2 currents) converged. Under isotropic or weak anisotropic conditions, the hot zone was fueled by the interaction of auroral kilometric radiation waves and electron diamagnetic currents. Generated for the conjugate topside ionosphere, the SAMI3 simulations reproduced the westward SAPS flow in the deep electron density trough, where Te became elevated, and the dawnward-intruding westward convection flows. We conclude that the near-midnight westward SAPS flow became amplified because of the favorable conditions created near the Harang region by the convection E field reaching subauroral latitudes and the positive feedback mechanisms in the SAPS channel. Full article

Background/Objectives: Acute hypoxemic respiratory failure is a significant condition commonly seen in intensive care units (ICUs), yet specific prognostic markers related to it for mortality remain largely unstudied. This study aimed to identify parameters that influence mortality in ICU patients diagnosed with type 1 respiratory failure. Methods: A retrospective cohort study was conducted at a tertiary care hospital, including patients admitted to the ICU between March 2016 and March 2020. The study included patients with type 1 respiratory failure, while exclusion criteria were prior long-term respiratory support, type 2 respiratory failure, and early mortality (<24 h). Data on demographics, comorbidities, support requirements, laboratory values, and ICU scoring systems (APACHE II, SOFA, SAPS II, NUTRIC) were collected. Binomial regression analysis was used to determine independent predictors of 30-day mortality. Results: Out of 657 patients screened, 253 met the inclusion criteria (mean age 70.6 ± 15.6 years; 65.6% male). Non-survivors (n = 131) had significantly higher CCI scores; greater vasopressor requirements; and elevated SAPS II, APACHE, SOFA, and NUTRIC scores. Laboratory findings indicated higher inflammatory markers and lower nutritional markers (albumin and prealbumin, respectively) among non-survivors. In the regression model, SAPS II (OR: 13.38, p = 0.003), the need for inotropic support (OR: 1.11, p = 0.048), NUTRIC score (OR: 2.75, p = 0.014), and serum albumin (inverse; OR: 1.52, p = 0.001) were independently associated with mortality. The model had an AUC of 0.926 and classified 83.2% of cases correctly. When combined, SAPS II and mNUTRIC had more AUC compared to either standalone scoring. Conclusions: SAPS II, vasopressor requirements, mNUTRIC score, and low serum albumin are independent predictors of 30-day mortality in patients with acute hypoxemic respiratory failure. These findings support the integration of nutritional assessment, a combination of available scoring systems and comprehensive scoring into routine ICU evaluations for this patient group. Full article

The accurate estimation of evapotranspiration ($ET$) and its components are vital for water resource management and irrigation planning. This study models tree transpiration ($T$) and $ET$ for grapefruit, litchi, and mango orchards using light gradient-boosting machine (LightGBM) optimized using the Bayesian hyperparameter optimization. Grounds $T$ and $ET$ for these crops were measured using the heat ratio method of monitoring sap flow and the eddy covariance technique for quantifying $ET$. The Sentinel 2 satellite was used to compute field leaf area index ($LAI$). The modelled data were used to partition the orchard $ET$ into beneficial ($T$) and non-beneficial water uses (orchard floor evaporation—$E_s$). We adopted the 10-fold cross-validation to test the model robustness and an independent validation to test performance on unseen data. The 10-fold cross-validation and independent validation on $ET$ and $T$ models produced high accuracy with coefficient of determination ($R^2$) $\ge$ 0.88, Kling–Gupta efficiency ($KGE$) $\ge$ 0.91, root mean square error ($RMSE$) $\le$ 0.04 mm/h, and mean absolute error ($MAE$) $\le$ 0.03 mm/h for all the crops. The study demonstrates that LightGBM can accurately model the transpiration and evapotranspiration for subtropical tree crops using Sentinel 2 data. The study found that $E_s$ which combined soil evaporation and understorey vegetation transpiration contributed 35, 32, and 31% to the grapefruit, litchi and mango orchard evapotranspiration, respectively. We conclude that improvements on orchard floor management practices can be utilized to minimize non-beneficial water losses while promoting the productive water use ($T$). Full article

Grapevine (Vitis vinifera) is a key crop in Mediterranean agriculture, now increasingly threatened by Xylella fastidiosa subsp. Fastidiosa (Xff), the causal agent of Pierce’s disease. This study investigated: (1) the diversity of culturable fungal endophytes in the xylem sap of naturally Xff-infected grapevines, and (2) the interaction between Xff and the pathogenic fungus Sclerotinia sclerotiorum identified in the sap. The xylem sap was collected from Cabernet Sauvignon vines in Mallorca, Spain, and fungal communities were characterized using culture-dependent methods. Both beneficial fungi (e.g., Aureobasidium pullulans, Rhodotorula mucilaginosa) and pathogenic species (e.g., S. sclerotiorum, Cladosporium sp., Alternaria alternata, and the Phoma complex) were isolated from both Xff-positive and Xff-negative plants, indicating similar community profiles. Although limited by small sample size, these findings offer preliminary evidence of complex ecological interactions between Xff and the xylem-associated mycobiota, with potential implications for grapevine health and disease development under varying environmental and management conditions. Further experiments under controlled conditions revealed that grapevines co-inoculated with Xff and S. sclerotiorum showed increased disease severity, suggesting a synergistic interaction. These preliminary results highlight the complex interplay between Xff and the fungal endophytic microbiome, which may modulate grapevine susceptibility depending on environmental and management conditions. Full article

Sustainable rural development seeks to balance social, economic, and environmental needs in rural areas, improving the quality of life of communities and the long-term protection of natural resources. Indigenous local solutions give place to grassroots entrepreneurial initiatives, which together with associative and economic integration are key factors for agricultural production, transformation of products, self-consumption, and commercialization. This study was done in Hñähñu communities with the aim to test if participative workshops based on detonating questions are an effective approach for developing entrepreneurship agriculture initiatives of self-managed social enterprises. The initiatives were proposed by the communities to solve local problems. Three initiatives arose: (1) a community seed bank of local species associated with the Milpa including agave; (2) reforestation with agave to produce agave shoots, leaves, and sap; and (3) a company to produce agave-sap syrup. The participants, based on their traditional knowledge, developed the projects, including economic evaluation, risk analysis, and environmental aspects. Some impacts are the conservation of soil and endangered landraces, accessibility to quality seeds not commercially available, building of local organizational and entrepreneurial capacities, strengthening the community, improving the family’s income, recovery of traditional agroecological techniques, and conservation of agrobiodiversity. In conclusion, the methodology is effective for the Indigenous communities to develop initiatives for sustainable self-managed social enterprises. Full article

Background: An elevated urea–creatinine ratio (UCR) is used as a surrogate for catabolism and elevated protein metabolism in critically ill patients. This study investigated the effect of continuous renal replacement therapy (CRRT) on UCR. Methods: In this retrospective single-centre study, ICU patients from 2011 to 2022 with an ICU stay >2 days before CRRT and a CRRT duration of ≥4 days were included. Patients were grouped by UCR at CRRT initiation into high (UCR ≥ 75 mg/dL:mg/dL) and low groups and compared to matched controls not requiring CRRT. Propensity score matching considered age, sex, bodyweight, SAPS3, SOFA score, and UCR values on baseline and pre-baseline days. Results: In the high UCR group, UCR significantly decreased after CRRT initiation, reaching a significant difference from controls on day 2 (85.0 [IQR: 69.5–96.4] vs. 94.4 [IQR: 83.0–115.2]; p = 0.036) and falling below the threshold of 75 by day 3. In the low group, UCR increased post-CRRT initiation, but was less pronounced than in controls, with significant differences on day 1 (44.0 [IQR: 34.2–59.8] vs. 40.6 [IQR: 32.1–52.5]; p = 0.024). Conclusions: CRRT significantly affects UCR in critically ill patients, showing a marked decrease when compared to matched controls. Full article

Background: Remifentanil, an ultra-short-acting µ-receptor agonist, is used with propofol for optimal laryngeal mask airway (LMA) insertion. However, no studies have assessed its effects when combined with thiopental on LMA conditions. The combined use of thiopental and remifentanil may offer advantages, such as enhanced cardiovascular and respiratory stability. This study aims to compare the administration of thiopental with different doses of remifentanil to assess their combined effects on LMA insertion conditions and success in a prospective, randomised double-blind study. Method: A total of 100 ASA I–II patients (18–65 years), including both male and female participants, were randomly assigned to four remifentanil dose groups (0.5–3 µg.kg⁻¹). Induction involved thiopental (5 mg.kg⁻¹) after remifentanil. LMA insertion conditions were evaluated using a six-variable scale. Systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), heart rate (HR), and bispectral index monitor (BIS) values, as well as apnoea duration, eyelash reflex loss time, and insertion attempts, were recorded at baseline, before insertion, and at 5 min post-insertion. Results: Time to eyelash reflex loss and LMA insertion were shorter in Groups III and IV than in Groups I and II (p < 0.001). Apnoea duration was longest in Group IV, followed by Group III (p < 0.001). Groups III and IV had significantly better LMA placement, mouth opening, and ease of insertion (p < 0.05). Coughing and gagging were highest in Group I (p < 0.001). SAP, MAP, HR, and DAP were significantly lower in Group IV at various time points (p < 0.05). HR was significantly higher in Group I compared to Groups II and III at multiple time points (p < 0.05). Conclusions: The administration of 5 mg.kg⁻¹ thiopental with 2 μg.kg⁻¹ remifentanil has been found to provide a stable haemodynamic response and 96% excellent or satisfactory laryngeal mask insertion conditions without increasing the duration of apnoea. Full article

Ocular fungal infections are slow-progressing conditions that primarily affect the cornea but can also involve the entire eyeball. Candida albicans is one of the most involved species. Both diagnosing and treating these infections require prompt and effective action. However, the currently available treatment options mainly rely on azoles and polyenes, which are known for their poor penetration into ocular tissue and associated toxicity. Moreover, conventional antifungals are usually ineffective when tested against biofilm-associated infections, mainly due to the metabolically inactive state of dormant cells embedded in the extracellular biofilm matrix. Here, analysis of the in vitro antifungal activity of four 2-aminobenzoic acid derivatives synthesized using a green method and their combination with Fluconazole (FLC) showed efficacy against the FLC-resistant clinical isolate of C. albicans under both planktonic and biofilm formation conditions. Results showed that compounds 1 and 2 exhibited the best antifungal activity in the checkerboard association test, presenting a synergistic effect towards antifungal action. The downregulation of HWP, ERG11, and ASL3 genes during biofilm inhibition suggested a reduced capacity of the four compounds for hyphal growth and adhesion, as well as a decrease in pathogenicity due to the downregulation of some SAP genes. In vitro and in vivo toxicity profiles indicated that these compounds exhibited low toxicity, as well as the absence of genotoxic effects. Therefore, green-synthetized 2-aminobenzoic acid derivatives may have potential as antifungal agents for the inhibition of C. albicans growth and biofilm formation. Full article

Background and Objectives: Dexmedetomidine is a potent selective α₂ receptor agonist with analgesic and sedative effects. Many reports indicate that compared to fentanyl, the combination of dexmedetomidine with propofol provides comparably acceptable conditions for a laryngeal mask airway (LMA). However, no study has evaluated the effectiveness of combined dexmedetomidine and thiopental in LMA insertions compared to that of combined dexmedetomidine and propofol. This prospective, randomized, double-blind study aimed to compare the effects of dexmedetomidine with thiopental or propofol on LMA insertion conditions, hemodynamic responses, and pharyngolaryngeal morbidity, which in this study was defined as the presence of postoperative sore throat, dysphagia, or visible blood in the airway following a laryngeal mask airway (LMA) insertion. Materials and Methods: A total of 80 premedicated ASA I-II patients aged 18–65 years were randomized to the propofol group (Group P, n = 40) or thiopental group (Group T, n = 40). Anesthesia was induced by infusing 1 μg·kg⁻¹ dexmedetomidine over 10 min followed by 2.5 mg·kg⁻¹ propofol or 5 mg·kg⁻¹ thiopental. LMA insertion conditions were evaluated on a scale assessing six variables. Systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), heart rate (HR), and bispectral index values were recorded at baseline; 1 min before; and at 1, 2, 3, 4, and 5 min after an LMA insertion. The baseline values for the systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), heart rate (HR), and bispectral index (BIS) values were recorded before dexmedetomidine infusion. Measurements for all patients were then taken 1 min before and at 1, 2, 3, 4, and 5 min after the LMA insertion Results: Demographic data were similar between the groups. In Group P, the time to loss of eyelash reflex and LMA insertion time were significantly shorter, the apnea duration was significantly longer, and the rates of full jaw opening and optimal LMA insertion conditions were significantly higher when compared with those of Group T (p < 0.05). Group P showed a significantly greater percentage decrease in HR compared to that of Group T at 1 min before and 1, 2, and 3 min after the LMA insertion (p < 0.05). Group T had a greater decrease in SAP and MAP at 1 min before insertion, while the SAP decrease was lower in Group T at 3, 4, and 5 min after insertion. The MAP and DAP values after the LMA insertion showed a greater decrease in Group P compared to in Group T (p < 0.05). The incidence of bradycardia was significantly (p < 0.05) higher in Group P than in Group T. There was no significant difference between the groups in terms of the frequency of hypotension, sore throat, presence of blood, or dysphagia at discharge from the recovery unit (p > 0.05). Conclusions: This study showed that the use of dexmedetomidine with thiopental provided comparably acceptable LMA insertion conditions with more stable hemodynamics compared to propofol. Full article

Several studies evaluated the association between adipokines, including leptin, in patients with acute coronary syndrome (ACS). Nevertheless, the results have been inconclusive and conflicting. Therefore, we assessed the pertinent published studies and evaluated the association between leptin levels and ACS. In January 2023, we conducted a comprehensive systematic search using Web of Science, PubMed, Scopus, and Embase. Using the Newcastle–Ottawa Scale, we evaluated the quality of all the articles we included. The principal summary outcome was the mean difference (MD) in leptin levels. We included 16 studies in our systematic review, 10 of which were included in meta-analysis. The MD in leptin levels was then evaluated in each subgroup: the patients with ACS versus the controls, the patients with ACS versus the patients with stable angina pectoris (SAP), and the patients with type 2 diabetes mellitus (T2DM) and ACS versus the patients without diabetes, but with ACS. Respectively, the following MDs were obtained: 10.508 (95% CI 3.670–17.346); 2.408 (95% CI −0.150–4.966); and 17.089 (95% CI 5.565–28.612). The leptin levels were significantly higher in the patients with ACS compared to the healthy controls, as well as in the patients with ACS and T2DM compared to those without T2DM. However, no statistically significant increase in leptin levels was observed when comparing the patients with ACS to those with SAP. Full article

In this study, we investigate the nutrient supply of young corn (Zea mays var. rugosa) plants using conventional biological and chemical methods, as well as the N-glycan and metabolic profile of the plant sap using the MALDI-MS. Corn plants with three different nutrient supplies were grown on sandy soil for 45 days after emergence. In treatment 1 (T1), used as a control, the plants did not receive any nutrient supplementation. Plants in treatment 2 (T2) received “ideal” N-, P-, and K-nutrient supplementation in the form of inorganic fertilizers. In treatment 3 (T3), the plants were provided with the ideal amount of P and K, and a reduced amount of N fertilizer. In addition to the amount of biomass of the young plants, macronutrient content (N, P, K, Ca, and Mg) was measured in the dry matter. We examined the amount of 0.01 M CaCl₂-soluble N fractions of the experimental soils, and the P, K, Ca, and Mg content of their ammonium lactate (AL)-soluble fractions. We were unable to statistically distinguish between T1, T2, and T3 treatments using conventional methods (in this phenophase). Metabolic profiles in the sap from young plants, captured by MALDI-MS, showed significant differences between the control, “ideal”, and N-deficient treatments. This method may also be suitable for early detection of N-deficient conditions in other plants. Full article

Recent advances in drug development allowed for the identification of THRβ-selective thyromimetic TG68 as a very promising lipid lowering and anti-amyloid agent. In the current study, we first investigated the neuroprotective effects of TG68 on in vitro human models of neuroinflammation and β-amyloid neurotoxicity in order to expand our knowledge of the therapeutic potential of this novel thyromimetic. Subsequently, we examined metabolic and inflammatory profiles, along with cognitive changes, using a high-fat diet (HFD) mouse model of obesity. Our data demonstrated that TG68 was able to prevent either LPS/TNFα-induced inflammatory response or β-amyloid-induced cytotoxicity in human microglial (HMC3) cells. Next, we demonstrated that in HFD-fed mice, treatment with TG68 (10 mg/kg/day; 2 weeks) significantly reduced anxiety-like behavior in stretch–attend posture (SAP) tests while producing a 12% BW loss and a significant decrease in blood glucose and lipid levels. Notably, these data highlight a close relationship between improved serum metabolic parameters and a reduction of anxious behavior. Moreover, TG68 administration was observed to efficiently counteract HFD-altered central and peripheral expressions in mice with selected biomarkers of metabolic dysfunction, inflammation, and neurotoxicity, revealing promising neuroprotective effects. In conclusion, our work provides preliminary evidence that TG68 may represent a novel therapeutic opportunity for the treatment of interlinked diseases such as obesity and neurodegenerative diseases. Full article

Trunk sap flow is essential for assessing plant water use efficiency and adaptation, yet the mechanisms underlying drought resistance and water utilization strategies in dry and hot valleys remain poorly understood. This study investigates the sap flow dynamics of four tree species (Albizia kalkora, Diospyros dumetorum, Terminalia franchetii, and Acacia auriculiformis) in a dry and hot valley using Granier’s thermal diffusion probe method. The aims were to analyze interspecific differences and their response mechanisms to environmental factors using a fitted model of sap flow density and transpiration variables, supplemented by Pearson’s and Mantel’s tests. The results showed that (1) the trunk sap flow of each tree species is significantly higher in the wet season than in the dry season. (2) In the dry and wet seasons, the average trunk sap flow rates were in the order Albizia kalkora > Diospyros dumetorum > Terminalia franchetii > Acacia auriculiformis. (3) The correlation between environmental factors and trunk sap flow was in the order photosynthetically active radiation > atmospheric temperature > saturated water vapor pressure difference > relative humidity > wind speed. (4) Deciduous plants demonstrated stronger water-conducting capacities than evergreen plants and native plants exhibited better drought resistance than introduced plants. (5) Acacia auriculiformis and Albizia kalkora were identified as rainfall-sensitive plants, while Diospyros dumetorum and Terminalia franchetii were rainfall-insensitive. By optimizing species selection based on water use efficiency, rainfall sensitivity, and environmental conditions such as light and temperature, this research contributes to enhancing the stability and resilience of ecosystem restoration in arid regions. Full article