The Potential Influence of Common Viral Infections Diagnosed during Hospitalization among Critically Ill Patients in the United States

Viruses are the most common source of infection among immunocompetent individuals, yet they are not considered a clinically meaningful risk factor among the critically ill. This work examines the association of viral infections diagnosed during the hospital stay or not documented as present on admission to the outcomes of ICU patients with no evidence of immunosuppression on admission. This is a population-based retrospective cohort study of University HealthSystem Consortium (UHC) academic centers in the U.S. from the years 2006 to 2009. The UHC is an alliance of over 90% of the non-profit academic medical centers in the U.S. A total of 209,695 critically ill patients were used in this analysis. Eight hospital complications were examined. Patients were grouped into four cohorts: absence of infection, bacterial infection only, viral infection only, and bacterial and viral infection during same hospital admission. Viral infections diagnosed during hospitalization significantly increased the risk of all complications. There was also a seasonal pattern for viral infections. Specific viruses associated with poor outcomes included influenza, RSV, CMV, and HSV. Patients who had both viral and bacterial infections during the same hospitalization had the greatest risk of mortality RR 6.58, 95% CI (5.47, 7.91); multi-organ failure RR 8.25, 95% CI (7.50, 9.07); and septic shock RR 271.2, 95% CI (188.0, 391.3). Viral infections may play a significant yet unrecognized role in the outcomes of ICU patients. They may serve as biological markers or play an active role in the development of certain adverse complications by interacting with coincident bacterial infection

Ecological character displacement in the face of gene flow: Evidence from two species of nightingales

<p>Abstract</p> <p>Background</p> <p>Ecological character displacement is a process of phenotypic differentiation of sympatric populations caused by interspecific competition. Such differentiation could facilitate speciation by enhancing reproductive isolation between incipient species, although empirical evidence for it at early stages of divergence when gene flow still occurs between the species is relatively scarce. Here we studied patterns of morphological variation in sympatric and allopatric populations of two hybridizing species of birds, the Common Nightingale (<it>Luscinia megarhynchos</it>) and the Thrush Nightingale (<it>L. luscinia</it>).</p> <p>Results</p> <p>We conducted principal component (PC) analysis of morphological traits and found that nightingale species converged in overall body size (PC1) and diverged in relative bill size (PC3) in sympatry. Closer analysis of morphological variation along geographical gradients revealed that the convergence in body size can be attributed largely to increasing body size with increasing latitude, a phenomenon known as Bergmann's rule. In contrast, interspecific interactions contributed significantly to the observed divergence in relative bill size, even after controlling for the effects of geographical gradients. We suggest that the divergence in bill size most likely reflects segregation of feeding niches between the species in sympatry.</p> <p>Conclusions</p> <p>Our results suggest that interspecific competition for food resources can drive species divergence even in the face of ongoing hybridization. Such divergence may enhance reproductive isolation between the species and thus contribute to speciation.</p

Outcomes in COVID-19 patients undergoing laparoscopic cholecystectomy/appendectomy in the pre-vaccine era

Background: We hypothesized that COVID-19 positive patients requiring laparoscopic cholecystectomy (lap chole) or appendectomy (lap appy) would have increased inpatient mortality rates compared to all COVID-19 patients. Methods: Retrospective cohort analysis including COVID-19 patients from 1/1/20 to 9/30/20. 82,574 cases identified. Patients excluded if <18 years old or underwent surgery other than lap chole or lap appy. Control groups were patients without surgery (N = 82,145). Exposure groups underwent lap chole (N = 323) or lap appy (N = 106). Primary outcome was inpatient mortality. Secondary outcomes included hospital length of stay (LOS) and complications such as bacterial pneumonia, deep venous thrombosis (DVT), pulmonary embolism (PE), urinary tract infection (UTI), acute myocardial infarction (MI), acute respiratory distress syndrome (ARDS), and respiratory failure (RF). Results: Overall inpatient mortality rate was 32.8% in COVID-19 patients undergoing lap chole (p-value <0.0001), 2.8 % lap appy (p-value 0.93), and 1.2 % in control group. ARDS complication rate was 11.2 % in lap chole (p-value <0.0001), 1.9 % lap appy (p-value 0.71), and 0.2 % in control. Conclusion: COVID-19 patients during the initial wave of the pandemic who underwent lap chole during hospital admission had significantly higher risk of mortality and ARDS while lap appy did not

Complications of Trauma Patients Admitted to the ICU in Level I Academic Trauma Centers in the United States

Background. The aims of this study were to evaluate the complications that occur after trauma and the characteristics of individuals who develop complications, to identify potential risk factors that increase their incidence, and finally to investigate the relationship between complications and mortality. Methods. We did a population-based retrospective study of trauma patients admitted to ICUs of a level I trauma center. Logistic regression analyses were performed to determine independent predictors for complications. Results. Of the 11,064 patients studied, 3,451 trauma patients developed complications (31.2%). Complications occurred significantly more in younger male patients. Length of stay was correlated with the number of complications ( = 0.435, &lt; 0.0001). The overall death rate did not differ between patients with or without complications. The adjusted odds ratio (OR) of developing complication for patients over age 75 versus young adults was 0.7 ( &lt; 0.0001). Among males, traumatic central nervous system (CNS) injury was an important predictor for complications (adjusted OR 1.24). Conclusions. Complications after trauma were found to be associated with age, gender, and traumatic CNS injury. Although these are not modifiable factors, they may identify subjects at high risk for the development of complications, allowing for preemptive strategies for prevention

Programmable IC tester

The modern world is becoming increasingly dependent on electronic systems, and on digital systems such as computers in particular. New applications for computers are found everyday, and demands for more powerful and faster computers to support such applications continue. ICs compose the digital computers prevalent in the market. ICs are referred to as the soul of a digital computer. To be effective, digital systems must work correctly and, when they fail, techniques must be available to detect the presence of a failure and locate its cause. IC testers provide time savings and increased confidence when building and debugging digital electronic system. The objective of this thesis is to make a prototype of an IC tester that would be able to detect defective ICs as well as determining their DC characteristics. The study also aims to provide the Computer Technology students with a tool that would help them in their laboratory experiments. The tester was built and tested in a modular manner. The hardware was assembled and tested thoroughly before the software was tested on the system. This approach enabled the proponents to pinpoint the causes of errors and malfunctions more easily. With the use of an IC tester, it gives the students and the people in the field of electronics a more practical way in debugging a microcomputer system. Their primary objective in using the IC tester is to determine which IC is defective therefore it allows the designers to have confidence with their hardware designs

Determinants of capital structure of selected publicly-listed companies in the Philippines: A behavioral point of view

The primary objective of the research is to determine the effects of the behavioral mindset of the CFOs and their demographic profile in choosing sources of financing in the Philippine setting. The study is conducted using a survey questionnaire that is distributed to publicly listed companies in the Philippine Stock Exchange (PSE). The questionnaire consists of inquiries relating to their capital structures and other empirical finance-related decisions, which determine the relationship of the CFOs behaviour on selecting a source of financing. The results of the study showed that heuristics, framing, age, gender, and educational attainment have a significant effect in the determination of the capital structure of publicly listed firms in the Philippines