Investigation of the Prognostic Values of the Shock Index and Modified Shock Index in Predicting the Clinical Outcomes in Elderly Hospitalized Patients with Coronavirus Disease-2019

Introduction:Advanced age is an independent risk factor for increased mortality in coronavirus disease-2019 (COVID-19). However, the best method for estimating mortality in elderly patients with COVID-19 is still under debate. We performed this study to assess the shock index (SI) and the modified shock index (MSI) for the abovementioned problem.Methods:A retrospective study was conducted including elderly cases (≥65 years) confirmed with COVID-19 who admitted to a tertiary university hospital between March-December 2020. The SI and MSI at the time of the emergency department visits were used to evaluate the intensive care unit admission, ventilator support, septic shock, and 30-day mortality in all patients. The receiver operating characteristic and area under the curve (AUC) were used to measure the overall ability of SI and MSI to predict clinical outcomes.Results:We recruited 334 consecutive COVID-19 patients with a mean age of 75.2±7.3 and an almost equal gender distribution [170 males (50.9%)]. In deceased and surviving patients, the SI was 0.66±0.16 and 0.6±0.1 (p=0.014), while the MSI was 0.95±0.22 and 1.09±0.34 (p=0.003), respectively. In predicting mortality, the AUC of the SI and MSI were 0.590 [95% confidence interval (CI): 0.535 to 0.643] and 0.608 (95% CI: 0.553 to 0.660), respectively.Conclusion:Increased SIs and MSIs are associated with 30-day mortality. SI and MSI can benefit the triage of elderly patients hospitalized for COVID-19. However, it was found that there is no single cut-off value of SI or MSI with optimum accuracy for predicting COVID-19-related clinical outcomes

Exploring the crystallinity of different powder sugars through solid echo and magic sandwich echo sequences

Time-domain nuclear magnetic resonance techniques are frequently used in polymer, pharmaceutical, and food industries as they offer rapid experimentation and generally do not require any considerable preliminary sample preparation. Detection of solid and liquid fractions in a sample is possible with the free induction decay (FID). However, for the classical FID sequence that consists of a single pulse followed by relaxation decay acquisition, the dead time of the probe (ring out of resonance circuitry) occurs and varies between 5 and 15 mu s for standard 10-mm tubes. In such a case, there arises a risk that the signal from the solid fraction cannot be detected correctly. To obtain quantitative measurement on crystalline and more mobile amorphous fractions, alternative sequences to the classical FID in the solid-state nuclear magnetic resonance were developed. Solid echo and magic sandwich echo sequences perform the relaxation decay refocusing somehow excluding the dead time problem and allow detection of the signal from the solid fraction. In this study, knowledge of amorphous/crystal fraction, which is obtained through solid echo and magic sandwich echo, has been explored on powder sugar samples for the purpose of developing a groundwork for a reliable quality control method. Different sugars were examined for the utilization of the sequences. What is important to add and make this study unique is that the method proposed did not involve multiparameter fitting of the "bead" pattern FID signal that normally suffers from ambiguity; just the integration of the fast Fourier transform of the solid echo was needed to calculate the second moment, (M-2)