Despite recent advances in the prevention and treatment of ischemic heart disease (IHD), treatment of patients with heart failure secondary to myocardial infarction remains a therapeutic challenge. Heart transplantation has emerged as a viable option but is fraught with problems of supply. Mechanical assist devices are extremely expensive and dynamic cardiomyoplasty has shown only limited success in the clinical setting. Recent insights into the pathogenesis of myocardial diseases and the progress made in the field of molecular biology have resulted in the development of new strategies at molecular as well as cellular levels for cardiac muscle repair. One such strategy is to augment ventricular function by means of cellular cardiomyoplasty through intracardiac cell grafting using adult and fetal cardiomyocytes, stem cells, and autologous skeletal myoblasts.
Sepsis-3 Definition: Sepsis is defined as life-threatening organ dysfunction due to a dysregulated host response to infection. The clinical criteria of sepsis include organ dysfunction, which is defined as an increase of two points or more on the sequential organ failure assessment (SOFA). For patients with infection, an increase of 2 SOFA points yields an overall mortality rate of 10%. Patients with suspected infection who are likely to have a prolonged intensive care unit (ICU) stay or to have in-hospital mortality can be promptly identified at the bedside with a quick SOFA (qSOFA) score of 2 or higher.Importance: The sepsis-3 criteria have emphasized the value of a change of two or more points on the SOFA, introduced the qSOFA, and removed the systemic inflammatory response syndrome (SIRS) criteria from the sepsis definition.Objective: To externally validate and assess the discriminatory capacities of an increase in the SOFA score by two or more points, the presence of two or more SIRS criteria, or a qSOFA score of 2 or more points for outcomes in 5109 patients, the vast majority of whom were postcardiac surgery patients who were admitted to a Cardiothoracic Surgical ICU in Singapore.Design, Setting, and Participants: A retrospective cohort analysis of 5109 patients with an infection-related primary admission diagnosis in the cardiothoracic intensive care unit (CTICU) at the National University Hospital (NUH) in Singapore from 2010 to 2016.
Exposures:The SOFA, qSOFA, and SIRS criteria were applied to the data representing the worst condition within 24 hours of ICU admission.Main Outcomes and Measures: The primary outcome was in-hospital mortality.Discrimination was assessed using the area under the receiver operating characteristic curve (AUROC).Results: In 5109 patients, the average mortality of patients with an increase in the SOFA scores of less than 2 points was 3.5% (n = 64), and it was 6% (n = 199
The novel coronavirus disease 2019 (COVID-19) has caused a global pandemic. Some studies have suggested a negative association between sunlight intensity and COVID-19 infection, alluding to the belief that it might be safe to go out on sunny days. This paper examined whether solar radiation mitigated the association between human mobility and COVID-19 infection in Europe using a dynamic panel data model to investigate the effect of human mobility, solar radiation, and their interaction on COVID-19 infection. The results revealed that outgoing mobility was positively correlated and solar radiation was negatively correlated with COVID-19 infection at lag levels of 1, 2, and 3 weeks. The coefficients of the interaction items indicated that solar radiation negatively moderated the relationship between outgoing mobility and the number of daily new confirmed cases at 2- and 3-week lag levels. However, the moderating effect was limited and unable to eliminate the positive effect of outgoing mobility on COVID-19 infection. Thus, these results suggested that solar radiation only weakly mitigated the relationship between human mobility and COVID-19 infection, providing policy implications that mobility should still be restricted on sunny days during the COVID-19 pandemic.
Supplementary Information
The online version contains supplementary material available at 10.1007/s11356-021-15738-w.
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