Disrupted epithelial permeability as a predictor of severe COVID-19 development

BackgroundAn impaired epithelial barrier integrity in the gastrointestinal tract is important to the pathogenesis of many inflammatory diseases. Accordingly, we assessed the potential of biomarkers of epithelial barrier dysfunction as predictive of severe COVID‐19.MethodsLevels of bacterial DNA and zonulin family peptides (ZFP) as markers of bacterial translocation and intestinal permeability and a total of 180 immune and inflammatory proteins were analyzed from the sera of 328 COVID‐19 patients and 49 healthy controls.ResultsSignificantly high levels of circulating bacterial DNA were detected in severe COVID‐19 cases. In mild COVID‐19 cases, serum bacterial DNA levels were significantly lower than in healthy controls suggesting epithelial barrier tightness as a predictor of a mild disease course. COVID‐19 patients were characterized by significantly elevated levels of circulating ZFP. We identified 36 proteins as potential early biomarkers of COVID‐19, and six of them (AREG, AXIN1, CLEC4C, CXCL10, CXCL11, and TRANCE) correlated strongly with bacterial translocation and can be used to predict and discriminate severe cases from healthy controls and mild cases (area under the curve (AUC): 1 and 0.88, respectively). Proteomic analysis of the serum of 21 patients with moderate disease at admission which progressed to severe disease revealed 10 proteins associated with disease progression and mortality (AUC: 0.88), including CLEC7A, EIF4EBP1, TRANCE, CXCL10, HGF, KRT19, LAMP3, CKAP4, CXADR, and ITGB6.ConclusionOur results demonstrate that biomarkers of intact or defective epithelial barriers are associated with disease severity and can provide early information on the prediction at the time of hospital admission

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Crystal structure and Hirshfeld surface analysis of methyl 1-(2,4-dichlorobenzyl)-5-methyl-1H-pyrazole-3-carboxylate

The title compound, C13H12Cl2N2O2, crystallizes with six molecules in the asymmetric unit, such that, the 1H-pyrazole rings are essentially planar. The six molecules are stabilized by intramolecular C-H···N and C-H···Cl interactions and the crystal structure is stabilized by intermolecular C-H···O hydrogen bonds, forming molecular sheets into paralel to the (-1 1 0) plane. These sheets are connected to each other by C-H···O hydrogen bonds and C-H···π interactions. In the Hirshfeld surface analysis, the H···H, Cl···H/H···Cl, C···H/H···C, O···H/H···O, N···H/H···N, Cl···Cl, Cl···O/O···Cl interactions add to 95.8% of the intermolecular contacts of the Hirshfeld surface area. The remaining contributions (2.9%) correspond to Cl···C/C···Cl, C···O/O···C, O···O and N···N interactions. Crystal Data for C13H12Cl2N2O2 (M = 299.15 g/mol): Triclinic, space group P-1 (no. 2), a = 12.0505(10) Å, b = 12.3189(11) Å, c = 29.184(3) Å, α = 88.565(4)°, β = 89.296(4)°, γ = 76.833(4)°, V = 4217.0(7) Å3, Z = 12, T = 296(2) K, μ(MoKα) = 0.460 mm-1, Dcalc = 1.414 g/cm3, 83073 reflections measured (2.8° ≤ 2Θ ≤ 47°), 12426 unique (Rint = 0.0411, Rsigma = 0.0235) which were used in all calculations. The final R1 was 0.0662 (I > 2σ(I)) and wR2 was 0.2481 (all data)

An Analysis Levels of Professional Self Esteem, Continual Anxiety and Life Satisfaction

The purpose of this research is analysis in line with determined some variables on professional self esteem, continual anxiety and life satisfaction. The research has been conducted at a state university in Akdeniz region. Participants of the research are 360 volunteer university students, (207 female 57.5% and 153 male 42.5%) who have studied different faculties and departments. It has been used Professional Self Esteem Questionnaire (PSEQ) which had been adapted to Turkish by Arıcak (1999), Constiunal Anxiety Questionnaire (CAQ) which had been adapted to Turkish by Öner and Le Compte, Life Satisfaction Questionnaire (LSQ) which had been adapted to Turkish by Köker (1991) in this research. The data were analysed using by SPSS 22.0 statistical program. According to the results; it had been found significant positive relation (r=0.416) between life satisfaction and professional self esteem points of females. It had been found significant and negative relation (r=-0.317) between continual anxiety and professional self esteem points of males. Besides it had been found that continual anxiety, professional self esteem and gender variables which all of them were predicted to the life satisfaction variable. The conclusions of research were discussed in line with literatur

Crystal structure and Hirshfeld surface analysis of 1-(2,4-dichlorobenzyl)-5-methyl-N-(thiophene-2-sulfonyl)-1H-pyrazole-3-carboxamide

In the title compound, C16H13Cl2N3O3S2, the thiophene ring is disordered in a 0.762(3):0.238(3) ratio by an approximate 180 degrees rotation of the ring around the S-C bond linking the ring to the sulfonyl unit. The dichlorobenzene group is also disordered over two sets of sites with the same occupancy ratio. The molecular conformation is stabilized by intramolecular C-H center dot center dot center dot Cl and C-H center dot center dot center dot N hydrogen bonds, forming rings with graph-set notation S(5). In the crystal, pairs of molecules are linked by N-H center dot center dot center dot O and C-H center dot center dot center dot O hydrogen bonds, forming inversion dimers with graph-set notation R-2(2)(8) and R-1(2)(11), which are connected by C-H center dot center dot center dot O hydrogen-bonding interactions into ribbons parallel to (100). The ribbons are further connected into a three-dimensional network by C-H center dot center dot center dot pi interactions and pi-pi stacking interactions between benzene and thiophene rings, with centroid-to-centroid distances of 3.865(2), 3.867 (7) and 3.853 (2) angstrom. Hirshfeld surface analysis has been used to confirm and quantify the supramolecular interactions

Selectivity of 40 mm square and 50 mm diamond mesh codends for five species in the Eastern Mediterranean demersal trawl fishery

WOS: 000294613400015The aim of this study was to determine the selectivity of 40 mm square (40S) and 50 mm diamond (50D) mesh codend for five species, red mullet (Mullus barbatus), annular sea bream (Diplodus annularis), common pandora (Pagellus erythrinus), axillary sea bream (Pagellus acarne) and blotched picarel (Spicara maena) in the Eastern Mediterranean. Selectivity data were collected by the covered codend method and analyzed. Mean selection curves were analyzed and compared using the between haul variations model for red mullet and annular sea bream. Pooled data were used for common pandora, axillary sea bream and blotched picarel. In total, 22 valid hauls, 10 with 40S and 12 with 50D codends were carried out. The 50% retention lengths (L(50)) of 40S and 50D codend were found as 14.5 and 15.3 cm for red mullet, 9.5 and 11.3 cm for annular sea bream, 13.1 and 15.0 cm for common pandora, 14.4 and 15.3 cm for axillary sea bream, 14.5 and 17.2 cm for blotched picarel, respectively. This study showed that codends with 40S and 50D L(50) results improve the selectivity when considering commercially used 40 mm nominal diamond mesh codend in Turkish seas for given species. However, in multi-species, it seems likely that a separation of species system would potentially be of more value than size-selective systems. Therefore, different selective techniques such as grid and separation panel and behaviour of the species against the gear need to be investigated