Heat shock protein 70-2 (HSP70-2) overexpression in breast cancer

Supplementary Methods, Supplementary table, Supplementary Figure Legends. (DOCX 41 kb

FUNGAL INFECTIONS ASSOCIATED WITH COVID-19

To study fungal infections such as Mucormycosis, Aspergillosis, Candidiasis, Cryptococcosis associated with Covid-19. A detailed study was done with the information gathered from the articles in specified databases, online sources, and online published materials to have current details of the situation of fungal infections in covid patients. Fungal infections were seen among covid-19 patients mostly due to opportunistic fungal pathogens such as Mucor, Candida, Aspergillus, and Cryptococcus. The reason behind rising opportunistic fungal infections among covid-19 patients may be the immunocompromised host. The most common species responsible for fungal infections in covid-19 were noticed to be of genus Mucor, A. flavus, and A. fumigatus species of genus Aspergillus, C. albicans species of genus Candida, C. neoformans, and C. gattii species of genus Cryptococcus. Patients suffering or recovered from covid-19 are now facing numerous Secondary Infections. The majority of secondary infections associated with covid-19 are Fungal Infections. Mucormycosis, candidiasis, aspergillosis, cryptococcosis as opportunistic infections are seen widely in the covid-19 treated patients. Rapid progression of such fungal infections is required to be controlled by early diagnosis of infection and by identifying the underlying risk parameters. Protocols for disease management will be beneficial too

Achieving Sustainable Development Goal Related to Water and Sanitation through Proper Sewage Management

Due to urbanization, there is an increasing need for infrastructure and services, leading to pressure on the sewage system. As a result, water contamination and sewage-related illnesses are emerging. On-site sanitary facilities are insufficient, and current sewage systems are outdated, causing freshwater contamination and diseases such as typhoid, malaria, etc. Untreated domestic sewage/wastewater, mining waste, industrial wastewater, agricultural waste, and other contaminants are polluting most aquatic ecosystems worldwide, leading to harm to surface water bodies, sewage drainage systems, surface water, and groundwater. Various sewage disposal methods are discussed, but they are not sustainable. The UN proposed Sustainable Development Goals (SDGs) in response to the need for sustainability and the effects of pollution and population growth. SDG 6 aims to ensure equitable access to safe and affordable drinking water, sanitation, and hygiene. It also includes goals to enhance water quality, increase water usage efficiency, develop integrated water resource management, and restore aquatic ecosystems. Efficient sewage disposal is crucial to reduce detrimental effects on the environment and public health. It is necessary to emphasize SDGs to protect the environment sustainably. It is crucial for the international community to work together to find effective and sustainable solutions to the problem of sewage management

Utilization of mechanical power and associations with clinical outcomes in brain injured patients: a secondary analysis of the extubation strategies in neuro-intensive care unit patients and associations with outcome (ENIO) trial

Background: There is insufficient evidence to guide ventilatory targets in acute brain injury (ABI). Recent studies have shown associations between mechanical power (MP) and mortality in critical care populations. We aimed to describe MP in ventilated patients with ABI, and evaluate associations between MP and clinical outcomes. Methods: In this preplanned, secondary analysis of a prospective, multi-center, observational cohort study (ENIO, NCT03400904), we included adult patients with ABI (Glasgow Coma Scale ≤ 12 before intubation) who required mechanical ventilation (MV) ≥ 24 h. Using multivariable log binomial regressions, we separately assessed associations between MP on hospital day (HD)1, HD3, HD7 and clinical outcomes: hospital mortality, need for reintubation, tracheostomy placement, and development of acute respiratory distress syndrome (ARDS). Results: We included 1217 patients (mean age 51.2 years [SD 18.1], 66% male, mean body mass index [BMI] 26.3 [SD 5.18]) hospitalized at 62 intensive care units in 18 countries. Hospital mortality was 11% (n = 139), 44% (n = 536) were extubated by HD7 of which 20% (107/536) required reintubation, 28% (n = 340) underwent tracheostomy placement, and 9% (n = 114) developed ARDS. The median MP on HD1, HD3, and HD7 was 11.9 J/min [IQR 9.2-15.1], 13 J/min [IQR 10-17], and 14 J/min [IQR 11-20], respectively. MP was overall higher in patients with ARDS, especially those with higher ARDS severity. After controlling for same-day pressure of arterial oxygen/fraction of inspired oxygen (P/F ratio), BMI, and neurological severity, MP at HD1, HD3, and HD7 was independently associated with hospital mortality, reintubation and tracheostomy placement. The adjusted relative risk (aRR) was greater at higher MP, and strongest for: mortality on HD1 (compared to the HD1 median MP 11.9 J/min, aRR at 17 J/min was 1.22, 95% CI 1.14-1.30) and HD3 (1.38, 95% CI 1.23-1.53), reintubation on HD1 (1.64; 95% CI 1.57-1.72), and tracheostomy on HD7 (1.53; 95%CI 1.18-1.99). MP was associated with the development of moderate-severe ARDS on HD1 (2.07; 95% CI 1.56-2.78) and HD3 (1.76; 95% CI 1.41-2.22). Conclusions: Exposure to high MP during the first week of MV is associated with poor clinical outcomes in ABI, independent of P/F ratio and neurological severity. Potential benefits of optimizing ventilator settings to limit MP warrant further investigation

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

The Guiding Star: The Journey of an International Physician From Maternal Fetal Medicine to Fetal Neonatal Neurology.

My path to the American dream took me from maternal fetal medicine in India to fetal and neonatal neurology in the United States, a journey spanning 2 continents, 3 countries, 3 healthcare systems, 4 rounds of the residency match process, 2 residency trainings and 4 fellowships. Through it all I had the good fortune to be guided by a wonderful support system of mentors, family, and friends. This is my story of how and why