Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

Data Sharing: Perils and Opportunities

Progress in scientific research depends on the free flow of information, and the exchange of ideas and knowledge. Restricting information flow which is the bedrock upon which future studies are dependent can impede the advancement of research. To ensure that future research can build on the foundation of previous efforts and discoveries, the U.S. National Institutes of Health (NIH) has issued a data sharing policy that reaffirms the philosophy of free sharing. The policy expects researchers who are funded by the NIH to make available final research data, especially unique data, for research purposes to qualified individuals within the scientific community. In implementing this policy, NIH is cognizant of the need to protect the privacy of individuals who participate in experimental studies and the confidentiality of data. Data sharing can be accomplished through a number of methods. The most common method is publishing articles in scientific publications. Researchers also share data through an informal channel, by responding directly to data requests. However, when a large amount of data will be shared, an efficient approach is needed, generally through establishing a network of databases. One should recognize that there are challenges to creating successful networks, which may include fundamental differences in informatics infrastructure and communication tools used at various research sites. Solutions will entail standards for data collection, processing, and archiving to allow interoperability among databases and the ability to query data across databases. Sharing of scientific data is an important and valuable goal. Means to overcome technological challenges are needed to achieve this goal

Biomedical Data Sharing, Security and Standards

The National Institutes of Health (NIH) implemented a policy on data sharing in 2003. The policy reaffirmed the principle that data should be made as widely and freely available as possible while safeguarding the privacy of research participants, and protecting confidential and proprietary data. Restricted availability of unique resources upon which further studies are dependent can impede the advancement of research and the delivery of medical care. Therefore, research data supported with NIH funds should be made readily available for research purposes to qualified individuals within the scientific community.  One approach to sharing data is to establish a network of databases. However, there are a number of barriers to creating successful networks, which can include fundamental differences in informatics infrastructure and communication tools used at various research sites. Solutions will entail standards for data collection, processing, and archiving to allow interoperability among the databases and the ability to query data across databases. Open architectures for data collection as well as software to facilitate communication across different databases are needed

REGULATION OF NITROGENASE IN CLOSTRIDIUM PASTEURIANUM.

Abstract not availabl

The use of immunoaffinity chromatography for the isolation of antigens in hepatitis non-A non-B sera

Two particle-associated antigens were isolated by immunoaffinity chromatography from hepatitis non-A, non-B chimpanzee or patient sera. The immunoadsorbent was prepared by coupling the Affi-Prep 10 matrix with immunoglobulins of a chimpanzee immunized with inactivated viral lysate. An antigen estimated to be 33•5 kilodaltons was isolated from acute phase sera of a hepatitis non-A, non-B infected chimpanzee. Western blot analyses showed that this antigen is immunoreactive using a chronic patient serum as the source of antibodies. The antigen was not found in the preinoculation serum. In addition to the 33•5 kilodalton protein, a second antigen estimated to be 56 kilodaltons was isolated from the serum of an acute hepatitis non-A, non-B patient