Search

Abstract The evolution of the COVID-19 pandemic has been associated with variations in clinical presentation and severity. Similarly, prediction scores may suffer changes in their diagnostic accuracy. The aim of this study was to test the 30-day mortality predictive validity of the 4C and SEIMC scores during the sixth wave of the pandemic and to compare them with those of validation studies. This was a longitudinal retrospective observational study. COVID-19 patients who were admitted to the Emergency Department of a Spanish hospital from December 15, 2021, to January 31, 2022, were selected. A side-by-side comparison with the pivotal validation studies was subsequently performed. The main measures were 30-day mortality and the 4C and SEIMC scores. A total of 27,614 patients were considered in the study, including 22,361 from the 4C, 4,627 from the SEIMC and 626 from our hospital. The 30-day mortality rate was significantly lower than that reported in the validation studies. The AUCs were 0.931 (95% CI: 0.90–0.95) for 4C and 0.903 (95% CI: 086–0.93) for SEIMC, which were significantly greater than those obtained in the first wave. Despite the changes that have occurred during the coronavirus disease 2019 (COVID-19) pandemic, with a reduction in lethality, scorecard systems are currently still useful tools for detecting patients with poor disease risk, with better prognostic capacity.

In the last decades, the world population and demand for any kind of product have grown exponentially. The rhythm of production to satisfy the request of the population has become unsustainable and the concept of the linear economy, introduced after the Industrial Revolution, has been replaced by a new economic approach, the circular economy. In this new economic model, the concept of “the end of life” is substituted by the concept of restoration, providing a new life to many industrial wastes. Leaves are a by-product of several agricultural cultivations. In recent years, the scientific interest regarding leaf biochemical composition grew, recording that plant leaves may be considered an alternative source of bioactive substances. Plant leaves’ main bioactive compounds are similar to those in fruits, i.e., phenolic acids and esters, flavonols, anthocyanins, and procyanidins. Bioactive compounds can positively influence human health; in fact, it is no coincidence that the leaves were used by our ancestors as a natural remedy for various pathological conditions. Therefore, leaves can be exploited to manufacture many products in food (e.g., being incorporated in food formulations as natural antioxidants, or used to create edible coatings or films for food packaging), cosmetic and pharmaceutical industries (e.g., promising ingredients in anti-aging cosmetics such as oils, serums, dermatological creams, bath gels, and other products). This review focuses on the leaves’ main bioactive compounds and their beneficial health effects, indicating their applications until today to enhance them as a harvesting by-product and highlight their possible reuse for new potential healthy products.

Background: Prehospital emergency medical services (EMS) are the main gateway for trauma patients. Recent advances in point-of-care testing and the development of early warning scores have allowed EMS to improve patient classification. We aimed to identify patients presenting with major trauma involving life-saving interventions (LSI) using the modified Sequential Organ Failure Assessment (mSOFA) score in the prehospital scenario, and to compare these results with those of other trauma scores. Methods: This was a prospective, ambulance-based, multicenter, training-validation study in trauma patients who were treated in a prehospital setting and subsequently transported to a hospital. The study involved six Advanced Life Support units, 38 Basic Life Support units, and four hospitals. The primary outcome was LSI performed at the scene or en route and intensive care unit (ICU) admission and all-cause two-day in-hospital mortality. We collected epidemiological variables, creatinine, lactate, base excess, international normalized ratio, and vital signs. Discriminative power (area under the receiver operating characteristic curve [AUC]), calibration (observed vs predicted outcome agreement), and decision-curve analysis (DCA, clinical utility) were used to assess the reliability of the mSOFA in comparison to other scores. Results: Between January 1, 2020–April 30, 2022, a total of 763 patients were selected. The mSOFA score’s AUC was 0.927 (95% confidence interval [CI] 0.898–0.957) for LSI, 0.845 (95% CI 0.808–0.882) for ICU admission, and 0.979 (95% CI 0.966–0.991) for two-day mortality. Conclusion: The mSOFA score outperformed the other scores, allowing a quick identification of high-risk patients. The routine implementation in EMS of mSOFA could provide critical support in the decision-making process in time-dependent trauma injuries.

Objective The aim was to explore the association of demographic and prehospital parameters with short-term and long-term mortality in acute life-threatening cardiovascular disease by using a hazard model, focusing on elderly individuals, by comparing patients under 75 years versus patients over 75 years of age.Design Prospective, multicentre, observational study.Setting Emergency medical services (EMS) delivery study gathering data from two back-to-back studies between 1 October 2019 and 30 November 2021. Six advanced life support (ALS), 43 basic life support and five hospitals in Spain were considered.Participants Adult patients suffering from acute life-threatening cardiovascular disease attended by the EMS.Primary and secondary outcome measures The primary outcome was in-hospital mortality from any cause within the first to the 365 days following EMS attendance. The main measures included prehospital demographics, biochemical variables, prehospital ALS techniques used and syndromic suspected conditions.Results A total of 1744 patients fulfilled the inclusion criteria. The 365-day cumulative mortality in the elderly amounted to 26.1% (229 cases) versus 11.6% (11.6%) in patients under 75 years old. Elderly patients (≥75 years) presented a twofold risk of mortality compared with patients ≤74 years. Life-threatening interventions (mechanical ventilation, cardioversion and defibrillation) were also related to a twofold increased risk of mortality. Importantly, patients suffering from acute heart failure presented a more than twofold increased risk of mortality.Conclusions This study revealed the prehospital variables associated with the long-term mortality of patients suffering from acute cardiovascular disease. Our results provide important insights for the development of specific codes or scores for cardiovascular diseases to facilitate the risk of mortality characterisation.

Aim: The development of predictive models for patients treated by emergency medical services (EMS) is on the rise in the emergency field. However, how these models evolve over time has not been studied. The objective of the present work is to compare the characteristics of patients who present mortality in the short, medium and long term, and to derive and validate a predictive model for each mortality time. Methods: A prospective multicenter study was conducted, which included adult patients with unselected acute illness who were treated by EMS. The primary outcome was noncumulative mortality from all causes by time windows including 30-day mortality, 31- to 180-day mortality, and 181- to 365-day mortality. Prehospital predictors included demographic variables, standard vital signs, prehospital laboratory tests, and comorbidities. Results: A total of 4830 patients were enrolled. The noncumulative mortalities at 30, 180, and 365 days were 10.8%, 6.6%, and 3.5%, respectively. The best predictive value was shown for 30-day mortality (AUC = 0.930; 95% CI: 0.919–0.940), followed by 180-day (AUC = 0.852; 95% CI: 0.832–0.871) and 365-day (AUC = 0.806; 95% CI: 0.778–0.833) mortality. Discussion: Rapid characterization of patients at risk of short-, medium-, or long-term mortality could help EMS to improve the treatment of patients suffering from acute illnesses.

Objective To compare the predictive value of the quick COVID-19 Severity Index (qCSI) and the National Early Warning Score (NEWS) for 90-day mortality amongst COVID-19 patients. Methods Multicenter retrospective cohort study conducted in adult patients transferred by ambulance to an emergency department (ED) with suspected COVID-19 infection subsequently confirmed by a SARS-CoV-2 test (polymerase chain reaction). We collected epidemiological data, clinical covariates (respiratory rate, oxygen saturation, systolic blood pressure, heart rate, temperature, level of consciousness and use of supplemental oxygen) and hospital variables. The primary outcome was cumulative all-cause mortality during a 90-day follow-up, with mortality assessment monitoring time points at 1, 2, 7, 14, 30 and 90 days from ED attendance. Comparison of performances for 90-day mortality between both scores was carried out by univariate analysis. Results From March to November 2020, we included 2,961 SARS-CoV-2 positive patients (median age 79 years, IQR 66–88), with 49.2% females. The qCSI score provided an AUC ranging from 0.769 (1-day mortality) to 0.749 (90-day mortality), whereas AUCs for NEWS ranging from 0.825 for 1-day mortality to 0.777 for 90-day mortality. At all-time points studied, differences between both scores were statistically significant (p

Abstract $$\beta $$ β -Thalassemia is one of the dangerous causes of the high mortality rate in the Mediterranean countries. Substantial resources are required to save a $$\beta $$ β -Thalassemia carriers’ life and early detection of thalassemia patients can help appropriate treatment to increase the carrier’s life expectancy. Being a genetic disease, it can not be prevented however the analysis of several indicators in parents’ blood can be used to detect disorders causing Thalassemia. Laboratory tests for Thalassemia are time-consuming and expensive like high-performance liquid chromatography, Complete Blood Count (CBC) with peripheral smear, genetic test, etc. Red blood indices from CBC can be used with machine learning models for the same task. Despite the available approaches for Thalassemia carriers from CBC data, gaps exist between the desired and achieved accuracy. Moreover, the data imbalance problem is studied well which makes the models less generalizable. This study proposes a highly accurate approach for $$\beta $$ β -Thalassemia detection using red blood indices from CBC augmented by supervised machine learning. In view of the fact that all the features do not carry predictive information regarding the target variable, this study employs a unified framework of two features selection techniques including Principal Component Analysis (PCA) and Singular Vector Decomposition (SVD). The data imbalance between $$\beta $$ β -Thalassemia carrier and non-carriers is handled by Synthetic Minority Oversampling Technique (SMOTE) and Adaptive Synthetic (ADASYN). Extensive experiments are performed using many state-of-the-art machine learning models and deep learning models. Experimental results indicate the superiority of the proposed approach over existing approaches with an accuracy score of 0.96.

BackgroundNowadays, there is no gold standard score for prehospital sepsis and sepsis-related mortality identification. The aim of the present study was to analyze the performance of qSOFA, NEWS2 and mSOFA as sepsis predictors in patients with infection-suspected in prehospital care. The second objective is to study the predictive ability of the aforementioned scores in septic-shock and in-hospital mortality.MethodsProspective, ambulance-based, and multicenter cohort study, developed by the emergency medical services, among patients (n = 535) with suspected infection transferred by ambulance with high-priority to the emergency department (ED). The study enrolled 40 ambulances and 4 ED in Spain between 1 January 2020, and 30 September 2021. All the variables used in the scores, in addition to socio-demographic data, standard vital signs, prehospital analytical parameters (glucose, lactate, and creatinine) were collected. For the evaluation of the scores, the discriminative power, calibration curve and decision curve analysis (DCA) were used.ResultsThe mSOFA outperformed the other two scores for mortality, presenting the following AUCs: 0.877 (95%CI 0.841–0.913), 0.761 (95%CI 0.706–0.816), 0.731 (95%CI 0.674–0.788), for mSOFA, NEWS, and qSOFA, respectively. No differences were found for sepsis nor septic shock, but mSOFA’s AUCs was higher than the one of the other two scores. The calibration curve and DCA presented similar results.ConclusionThe use of mSOFA could provide and extra insight regarding the short-term mortality and sepsis diagnostic, backing its recommendation in the prehospital scenario.

This paper studies undergraduate student attitudes towards team-based projects, connecting those attitudes to challenges and overall perception of this work. This study was conducted with 220 students in the context of three subjects taught at a Spanish University, that included collaborative projects as mandatory assignments to be developed over the course of the subject. The instrument was a Likert scale-based questionnaire. As a methodology, the Rasch model was used, making it possible to apply indirect measuring of students’ development level of various skills. The findings point to the difficulty in solving specific communication needs and managing students’ involvement and commitment to the project. The results obtained through Differential Item Functioning analysis (DIF) show that gender, year of study, students’ age, academic degrees, and the context of curricular subjects influence significantly the acquisition of skills related to collaborative work, facilitating or hindering their development among university students. These results have practical implications for the design of collaborative projects within higher education academic programs. They also suggest that the way collaborative work is usually planned is not very effective and should be reconsidered.

The world population is on the rise, which demands higher food production. The reduction in the amount of land under cultivation due to urbanization makes this more challenging. The solution to this problem lies in the artificial cultivation of crops. IoT and sensors play an important role in optimizing the artificial cultivation of crops. The selection of sensors is important in order to ensure a better quality and yield in an automated artificial environment. There are many challenges involved in selecting sensors due to the highly competitive market. This paper provides a novel approach to sensor selection for saffron cultivation in an IoT-based environment. The crop used in this study is saffron due to the reason that much less research has been conducted on its hydroponic cultivation using sensors and its huge economic impact. A detailed hardware-based framework, the growth cycle of the crop, along with all the sensors, and the block layout used for saffron cultivation in a hydroponic medium are provided. The important parameters for a hydroponic medium, such as the concentration of nutrients and flow rate required, are discussed in detail. This paper is the first of its kind to explain the sensor configurations, performance metrics, and sensor-based saffron cultivation model. The paper discusses different metrics related to the selection, use and role of sensors in different IoT-based saffron cultivation practices. A smart hydroponic setup for saffron cultivation is proposed. The results of the model are evaluated using the AquaCrop simulator. The simulator is used to evaluate the value of performance metrics such as the yield, harvest index, water productivity, and biomass. The values obtained provide better results as compared to natural cultivation.

Traditional optimization of open pit mine design is a crucial component of mining endeavors and is influenced by many variables. The critical factor in optimization is the geological uncertainty, which relates to the ore grade. To deal with uncertainties related to the block economic values of mining blocks and the general problem of mine design optimization, under unknown conditions, the best ultimate pit limits and pushback designs are produced by a minimum cut algorithm. The push–relabel minimal cut algorithm provides a framework for computationally efficient representation and processing of the economic values of mining blocks under multiple scenarios. A sequential Gaussian simulation-based smoothing spline technique was created. To produce pushbacks, an efficient parameterized minimum cut algorithm is suggested. An analysis of Indian iron ore mining was performed. The developed mine scheduling algorithm was compared with the conventional algorithm, and the results show that when uncertainty is considered, the cumulative metal production is higher and there is an additional increase of about 5% in net present value. The results of this work help the mining industry to plan mines in such a way that can generate maximum profit from the deposits.

Aim: The development of predictive models for patients treated by emergency medical services (EMS) is on the rise in the emergency field. However, how these models evolve over time has not been studied. The objective of the present work is to compare the characteristics of patients who present mortality in the short, medium and long term, and to derive and validate a predictive model for each mortality time. Methods: A prospective multicenter study was conducted, which included adult patients with unselected acute illness who were treated by EMS. The primary outcome was noncumulative mortality from all causes by time windows including 30-day mortality, 31- to 180-day mortality, and 181- to 365-day mortality. Prehospital predictors included demographic variables, standard vital signs, prehospital laboratory tests, and comorbidities. Results: A total of 4830 patients were enrolled. The noncumulative mortalities at 30, 180, and 365 days were 10.8%, 6.6%, and 3.5%, respectively. The best predictive value was shown for 30-day mortality (AUC = 0.930; 95% CI: 0.919–0.940), followed by 180-day (AUC = 0.852; 95% CI: 0.832–0.871) and 365-day (AUC = 0.806; 95% CI: 0.778–0.833) mortality. Discussion: Rapid characterization of patients at risk of short-, medium-, or long-term mortality could help EMS to improve the treatment of patients suffering from acute illnesses. [ABSTRACT FROM AUTHOR]

Cactus has been used in traditional folk medicine because of its role in treating a number of diseases and conditions. Prickly pear fruit is an excellent source of secondary metabolites (i.e., betalains, flavonoids, and ascorbic acid) with health-promoting properties against many common human diseases, including diabetes, hypertension, hypercholesterolemia, rheumatic pain, gastric mucosa diseases and asthma. In addition, prickly pears are potential candidates for the development of low-cost functional foods because they grow with low water requirements in arid regions of the world. This review describes the main bioactive compounds found in this fruit and shows the in vitro and some clinical studies about the fruit of most important cactus (Opuntia ficus-indica) and its relationship with some chronic diseases. Even though a lot of effort have been done to study the relationship between this fruit and the human health, more studies on Opuntia ficus-indica could help better understand its pharmacological mechanism of action to provide clear scientific evidence to explain its traditional uses, and to identify its therapeutic potential in other diseases. [ABSTRACT FROM AUTHOR]