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Background: It is very crucial to recognize infection in immunocompromised patients. The purpose of this study was to explore the diagnostic accuracy of C-reactive protein (CRP) in critically ill immunocompromised patients with sepsis. Aims and Objective: To find out the diagnostic utility of CRP in immunocompromised patients with sepsis. Materials and Methods: This was a cross-sectional study, which included immunocompromised patients with suspected sepsis. Patients were classified into two diagnostic groups: those with nonbacterial sepsis and those with bacterial sepsis, and the values of CRP were estimated. Results: Of 94 patients (63 men and 31 women) with a median age of 56 years (95% CI 53.959.3), 74 (78.5%) had immunosuppression with nonbacterial sepsis and 20 (21.4%) had immunosuppression with bacterial sepsis. CRP concentrations were higher in the group with bacterial sepsis [30.94 ng/ml (95% CI 25.1336.74)] than those with nonbacterial sepsis [7.46 ng/ml (95% CI 7.057.87), P < 0.0001]. CRP concentrations that were >6 mg/L had 93.33% sensitivity but only 63.20% specificity for diagnosing sepsis. The accuracy of diagnosis was 87.23%. The area under the receiver-operating characteristic curve was 0.82 (0.720.92). Conclusion: Despite limited specificity in critically ill immunocompromised patients, CRP concentrations may help to rule out bacterial infection. [Natl J Physiol Pharm Pharmacol 2015; 5(3.000): 166-169]

Passive immunisation with ABO blood group-compatible convalescent plasma will reduce viral burden as neutralising antibodies will binding to the viral spike protein to either prevent interaction with angiotensin-converting enzyme-2 receptor or block the conformational changes in spike protein preventing fusion to host cell membrane and provide immunomodulation. What do we know thus far about convalescent plasma therapy in COVID-19 illness? Since the recent Cochrane review that highlighted very low-certainty evidence on the effectiveness and safety of convalescent plasma in COVID-19 patients [4], Joyner and colleagues have reported safety results from a compassionate use convalescent plasma therapy programme in 5000 adults with COVID-19. Currently, it is uncertain how long these antibodies persist, but in other coronavirus infections, neutralising antibodies may persist at high titres for at least 3 months before declining [12]. [...]collection of plasma around 28 days after recovery will provide an effective product with high titres of neutralising antibodies.

Research and practice in critical care medicine have long been defined by syndromes, which, despite being clinically recognizable entities, are, in fact, loose amalgams of heterogeneous states that may respond differently to therapy. Mounting translational evidence—supported by research on respiratory failure due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection—suggests that the current syndrome-based framework of critical illness should be reconsidered. Here we discuss recent findings from basic science and clinical research in critical care and explore how these might inform a new conceptual model of critical illness. De-emphasizing syndromes, we focus on the underlying biological changes that underpin critical illness states and that may be amenable to treatment. We hypothesize that such an approach will accelerate critical care research, leading to a richer understanding of the pathobiology of critical illness and of the key determinants of patient outcomes. This, in turn, will support the design of more effective clinical trials and inform a more precise and more effective practice at the bedside. The authors propose a new conceptual model of critical illness that moves away from the current syndrome-based framework in favor of more precise biological descriptors—spurred by mounting translational evidence and insights from Coronavirus Disease 2019 (COVID-19) research.

There does not appear to be support for compassionate use access from pharmaceutical companies, and convalescent plasma has been withdrawn following demonstration that it is ineffective in immunocompetent hospitalised patients.3 Synthetic antibody therapy has already been authorised for emergency use in the EU and the USA for patients with mild or moderate disease, and work is in progress to define the criteria for access to these therapies in the UK, in light of the preliminary results of the casirivimab plus imdevimab (REGN-COV2) arm of RECOVERY.4 These results do provide a way forward. MS-H reports a grant from the National Institute for Health Research (NIHR Clinician Scientist Fellowship; NIHR-CS–2016-16-011), during the conduct of the study, and served as Clinical Lead for the UK Convalescent Plasma Trial in critically ill patients with COVID-19, conducted as part of the REMAP-CAP Trial. DML reports non-financial support (travel and subsistence costs) from CSL Behring, personal fees from Merck, and grants from LifeArc, the British Society for Antimicrobial Chemotherapy, Blood Cancer UK, Bristol Myers Squibb, and the UK Medical Research Council, outside of the submitted work.

This article presents results of material characterization studies conducted on historical clay bricks and binder sampled from the brick masonry gallery of the southern quadrangle of the World Heritage Site of Vat Phou in Champasak, Province of Lao PDR. The primary objective of the sampling was to conduct micro-analytical laboratory studies on the binder in the brick masonry to establish the nature of the binding mortar used and to verify the presence of lime in it, if any. In addition, micro-analytical and physicomechanical tests conducted on the historic brick samples were used to establish compatibility with the newly manufactured replacement bricks for use in the restoration of the dilapidated brick gallery. X-ray diffraction technique was used to study the mineral composition in the system, and scanning electron microscopy provided images indicative of the material and binder characteristics. The study revealed that lime was not present in the binding mortar and it could possibly be a natural wood resin. The use of natural resins as a binder in masonry has been a popular theory in Southeast Asia, and these results provide first empirical proof of their use. This study also demonstrates how compatibility checks can be carried out between historic and new replacement bricks through analysis of their pore structure and physical properties. In addition, the test results established that lime was not a component of the ancient binder, which together with the evidence of the resin-based binder provides an important direction for restoration efforts of historical sites in the Mekong River Basin region covering countries such as Lao PDR, Cambodia and Vietnam.

Melioidosis is a tropical infectious disease with diverse clinical presentations. We aimed to investigate the characteristics and mortality risk factors of patients diagnosed with melioidosis in the past 10 years. This was a retrospective cohort study conducted at a quaternary care centre in South India. Clinical, demographic, and biochemical data in patients diagnosed with melioidosis with cultures were collected between January 2011 and December 2020 from medical records. Logistic regression analysis was performed to screen mortality risk factors of melioidosis in addition to descriptive statistics and chi-square analysis. Seventy-three melioidosis patients’ records were analysed, and the most common comorbidity was type 2 diabetes mellitus (n = 53, 72.6%). The patients showed diverse presentations: pulmonary involvement, 30 (41.1%); splenomegaly, 29 (39.7%); abscesses and cutaneous involvement, 18 (24.7%); lymph node, 10 (13.7%); arthritis and osteomyelitis, 9 (12.3%); and genitourinary infection, 4 (5.4%). The mortality was noted to be 15 (20.5%). Logistic regression analysis indicated that chronic kidney disease (OR = 14.0), CRP >100 IU/L (OR = 6.964), and S. albumin <3 gm/dl (OR = 8.0) were risk factors associated with mortality and can guide in risk stratification. Hypoalbuminemia is a novel mortality risk factor, detected in this study, and requires further investigation to validate its utility as a prognostic marker and reveal possible therapeutic benefits in clinical correction.

Electrocardiography (ECG) remains an excellent screening tool for cardiac assessment in Duchenne muscular dystrophy (DMD), but an accurate interpretation requires comparison with age-matched healthy controls. We examined various ECG parameters in children with DMD, in comparison with age-matched controls. Standard 12-lead ECG tracings of serial patients were screened for quality and selected. Controls were healthy, age-matched school-going children. Both quantitative and qualitative ECG parameters were analyzed. After screening, ECGs from 252 patients with DMD (8.32 ± 3.12 years, 2-21 years) and ECGs from 151 age-matched healthy controls (9.72 ± 2.23, 4-19 years) were included. A significantly higher heart rate, shorter R-R interval, and taller R wave in V1 were seen across all age group of DMD in comparison to controls, with the difference increasing with age. While QT prolongation was seen in all age groups of DMD, QTc prolongation was seen only at 10 years or more. Incomplete right bundle branch block (RBBB) and pathological Q waves in inferolateral leads were exclusive in DMD, with the latter declining with age. Evidence for left ventricular (LV) pathology, such as tall R in V5/V6, increase in SV1 + RV6 height, and QRS complex duration, were seen only in the age group of 10 years or more. Stratification based on age and comparison with age-matched healthy subjects showed that several ECG parameters were influenced by age, and it also identified age-dependent evidence for LV pathology and QTc prolongation in DMD.

The global oceans are facing a plethora of pressures, leading to cross-national impacts on marine ecosystems, wildlife, and resource users. Interdisciplinarity is integrating knowledge and methods from different disciplines to generate a comprehensive output. Due to the trans-boundary nature of marine habitats and stressors, interdisciplinary research forms the basis to addressing pressing matters in ocean health and conservation. To this end, the Marine Environment and Resources (MER) master programme was developed at the beginning of the century, enabling students to develop a well-rounded understanding of ocean science. The programme has since become a recognised Erasmus Mundus degree and has had almost 400 graduates. In September 2022, the first MER community summit was held, being a landmark for the building of a long-lasting global community to discuss and deal with priority challenges of the UN Decade of Oceans Science. This summit has highlighted that to understand the state of the oceans and improve conservation efforts, international collaboration is required (including those out with the academic realm). The following article aims to highlight the successes of the programme in aiding the development and training of interdisciplinary researchers from a plethora of backgrounds, uniquely suitable for addressing current problems.

Sows are usually restricted fed during pregnancy to maximize their reproductive efficiency, which may predispose sows to a state of hunger. However, an objective measurement of hunger status has not been established. In the present study, we examined the correlation of plasma hormones and NEFA and selected the best predictors for hunger status using pregnant gilts. Three different levels of feed intake (0.5, 1.0 and 2.0 × maintenance energy intake [0.5M, 1.0M and 2.0M, respectively]) were imposed from Day 28 to 34 of gestation to create different hunger statuses in pregnant gilts. Plasma hormones related to energy homeostasis and NEFA were analyzed to quantify their response to different levels of feed intake. A total of 18 gilts (197.53 ± 6.41 kg) were allotted to 1 of 3 dietary treatments using a completely randomized design. Results showed that BW change, ADG, and G:F from Day 28 to 34 of gestation were higher ( < 0.01) for gilts on the 2.0M feeding level than for gilts on the 0.5M feeding level. Plasma acyl ghrelin concentrations showed a relatively flat pattern during the 24-h period. Plasma acyl ghrelin and NEFA concentrations and areas under the curve (AUC) were greater ( < 0.05) in gilts on the 0.5M level of feed intake than in those on the 2.0M level of feed intake. No differences were observed among the 3 feeding levels in terms of plasma glucagon-like peptide 1 and leptin concentrations. Additionally, consumption time for 1.82 kg feed on Day 35 of gestation was longer ( < 0.01) in gilts fed the 2.0M level of feed intake from Day 28 to 34 of gestation than in those on the 0.5M level of feed intake. Simple linear regression results showed that the AUC of acyl ghrelin was the best predictor for consumption time ( = 0.82), whereas the AUC of NEFA was the best predictor for BW ( = 0.55) or backfat change ( = 0.42) from Day 28 to 34 of gestation. In conclusion, our data suggested that a relative flat pattern existed in pregnant gilts in terms of the diurnal plasma profile of acyl ghrelin and that the level of feed intake of pregnant gilts was negatively correlated with plasma concentrations of acyl ghrelin and NEFA, which, in turn, were negatively associated with feed consumption time. The AUC of acyl ghrelin and NEFA seemed to be the best predictors for hunger status of pregnant gilts.