Effect of safety valve types on the gas venting behavior and thermal runaway hazard severity of large-format prismatic lithium iron phosphate batteries

The safety valve is an important component to ensure the safe operation of lithium-ion batteries(LIBs).However,the effect of safety valve type on the thermal runaway(TR)and gas venting behavior of LIBs,as well as the TR hazard severity of LIBs,are not known.In this paper,the TR and gas venting behavior of three 100 A h lithium iron phosphate(LFP)batteries with different safety valves are investigated under overheating.Compared to previous studies,the main contribution of this work is in studying and evaluating the effect of gas venting behavior and TR hazard severity of LFP batteries with three safety valve types.Two significant results are obtained:(Ⅰ)the safety valve type dominates over gas venting pressure of battery during safety venting,the maximum gas venting pressure of LFP batteries with a round safety valve is 3320 Pa,which is one order of magnitude higher than other batteries with oval or cavity safety valve;(Ⅱ)the LFP battery with oval safety valve has the lowest TR hazard as shown by the TR hazard assessment model based on gray-fuzzy analytic hierarchy process.This study reveals the effect of safety valve type on TR and gas venting,providing a clear direction for the safety valve design.

Systemic inflammatory index as a predictive marker for the severity of coronary artery disease in individuals with chronic kidney disease

Objective To evaluate the correlation between the inflammatory intensity,as indicated by the systemic inflammatory index(SII),and the severity of coronary artery disease(CAD)in patients with chronic kidney disease(CKD).Methods A total of 280 CKD patients who underwent coronary angiography were enrolled.CAD was evaluated using the Gen-sini score(GS).Patients were divided into the low,medium and high SII groups according to the tertiles of the SII values.Logist-ic regression analysis was conducted to analyze the relationship between SII and GS.The cutoff points for the sensitivity and spe-cificity of SII in predicting GS were estimated by performing the receiver operating characteristic curve analysis.Results Patients in the higher SII group had a higher prevalence of CAD(P=0.013).In addition,the high SII group had more pa-tients with complex CAD(triple-vessel disease and/or left main coronary artery stenosis)and chronic total occlusion lesions,and more patients required revascularization(P<0.05).Correlation analysis suggested a positive relationship between SII and GS,and in comparison to neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio,SII displayed a stronger correlation with GS(r=0.332,P<0.001).Multifactorial logistic regression analysis revealed that SII is independently associated with the severity of CAD(adjusted OR=1.14,95%CI:1.08-1.21,P<0.01),particularly among elderly patients(age≥65 years).Receiver operating charact-eristic curve analysis indicated that the optimal cutoff value for SII in predicting severe coronary artery stenosis(GS>60)was 6.01(sensitivity:76.30%,specificity:53.50%),with an area under the curve(AUC)of 0.705(95%CI:0.642-0.768,P<0.001),which was sta-tistically significantly better than platelet-to-lymphocyte ratio(AUC=0.646,95%CI:0.579-0.713,P<0.001)and neutrophil-to-lym-phocyte ratio(AUC=0.643,95%CI:0.574-0.712,P<0.001).Conclusions In patients with CKD,SII is independently associated with the severity of CAD,especially in individuals aged 65 ye-ars or older.Furthermore,SII functions as a predictive marker for the severity of coronary lesions.

Relationship between mitochondrial respiratory dysfunction of blood mononuclear cells and heart failure severity

Chronic heart failure(CHF)is a clinical syndrome manifested by reduced pumping ability of the heart,increased pressure in heart chambers in both physical activity and at rest.The symptoms of this syndrome are dyspnea,undue fatigability,peripheral edema,which follow structural and functional changes of the myocardium.[1]The growing incidence of CHF,especially among elderly people,is an urgent problem for medicine in the vast majority of industrialized countries.For instance,in Russian Federation,CHF is diagnosed in about 7%of cardiovascular patients.At the same time,this indicator varies from 0.3%in young people(20-29 years old)to 70%in the older age group.[2,3].

Potential role of peripheral blood mononuclear cell' s mitochondrial respiratory dysfunction in heart failure severity prediction in patients with cardioverter-defibrillator implantation indications

Background It has been reported that the mitochondrial respiratory dysfunction (MRD) is important mechanisms affecting the heart failure (HF) pathogenesis.We sought to evaluate the potential role of MRD of peripheral blood mononuclear cells (PBMC) in HF severity prediction in patients with cardioverter-defibrillator implantation indications.Methods In this single-center study patients with HF of New York Heart Association (NYHA) Ⅰ-Ⅲ functional class (FC) and cardioverter-defibrillator implantation indications underwent transthoracic echocardiography (TTE) and MRD assessment using PB-MC.Mitochondrial respiration rate (MRR) indicators (pyruvate+malate+adenosine diphosphate;succinate+adenosine diphosphate;pyruvate+malate–adenosine diphosphate[V4.1];succinate–adenosine diphosphate) were calculated.Correlations between HF NYHA FC,TTE and MRR indicators were evaluated.Based on our data,we developed a risk model regarding HF severity.Results Of 53 (100.0%) HF patients,33 (62.3%) had mild exercise intolerance (1stgroup) and 20 (37.7%) had moderate-to-severe exercise intolerance (2ndgroup).Patients with mild exercise intolerance were likely to have a higher V4.1(P<0.001) values.V4.1was independently associated with moderate-to-severe exercise intolerance in univariate and multivariate logistic regression (OR=0.932,95%CI:0.891–0.975,P<0.001).Conclusions The severity of HF is associated with PBMC mitochondrial respiratory dysfunction in patients with cardioverter-defibrillator implantation indications.Our HF severity risk model including V4.1parameters is able to distinguish patients with mild and moderate-to-severe exercise intolerance.Further investigations of their predictive significance are warranted.

ASLP-DL—A Novel Approach Employing Lightweight Deep Learning Framework for Optimizing Accident Severity Level Prediction

Highway safety researchers focus on crash injury severity,utilizing deep learning—specifically,deep neural networks(DNN),deep convolutional neural networks(D-CNN),and deep recurrent neural networks(D-RNN)—as the preferred method for modeling accident severity.Deep learning’s strength lies in handling intricate relation-ships within extensive datasets,making it popular for accident severity level(ASL)prediction and classification.Despite prior success,there is a need for an efficient system recognizing ASL in diverse road conditions.To address this,we present an innovative Accident Severity Level Prediction Deep Learning(ASLP-DL)framework,incorporating DNN,D-CNN,and D-RNN models fine-tuned through iterative hyperparameter selection with Stochastic Gradient Descent.The framework optimizes hidden layers and integrates data augmentation,Gaussian noise,and dropout regularization for improved generalization.Sensitivity and factor contribution analyses identify influential predictors.Evaluated on three diverse crash record databases—NCDB 2018–2019,UK 2015–2020,and US 2016–2021—the D-RNN model excels with an ACC score of 89.0281%,a Roc Area of 0.751,an F-estimate of 0.941,and a Kappa score of 0.0629 over the NCDB dataset.The proposed framework consistently outperforms traditional methods,existing machine learning,and deep learning techniques.

Impact of interleukin 6 levels on acute lung injury risk and disease severity in critically ill sepsis patients

BACKGROUND Sepsis is a life-threatening condition characterized by a dysregulation of the host response to infection that can lead to acute lung injury(ALI)and multiple organ dysfunction syndrome(MODS).Interleukin 6(IL-6)is a pro-inflammatory cytokine that plays a crucial role in the pathogenesis of sepsis and its complications.AIM To investigate the relationship among plasma IL-6 levels,risk of ALI,and disease severity in critically ill patients with sepsis.METHODS This prospective and observational study was conducted in the intensive care unit of a tertiary care hospital between January 2021 and December 2022.A total of 83 septic patients were enrolled.Plasma IL-6 levels were measured upon admission using an enzyme-linked immunosorbent assay.The development of ALI and MODS was monitored during hospitalization.Disease severity was evaluated by Acute Physiology and Chronic Health Evaluation II(APACHE II)and Sequential Organ Failure Assessment(SOFA)scores.RESULTS Among the 83 patients with sepsis,38(45.8%)developed ALI and 29(34.9%)developed MODS.Plasma IL-6 levels were significantly higher in patients who developed ALI than in those without ALI(median:125.6 pg/mL vs 48.3 pg/mL;P<0.001).Similarly,patients with MODS had higher IL-6 levels than those without MODS(median:142.9 pg/mL vs 58.7 pg/mL;P<0.001).Plasma IL-6 levels were strongly and positively correlated with APACHE II(r=0.72;P<0.001)and SOFA scores(r=0.68;P<0.001).CONCLUSIONElevated plasma IL-6 levels in critically ill patients with sepsis were associated with an increased risk of ALI andMODS.Higher IL-6 levels were correlated with greater disease severity,as reflected by higher APACHE II andSOFA scores.These findings suggest that IL-6 may serve as a biomarker for predicting the development of ALI anddisease severity in patients with sepsis.

Family functioning mediation in tic severity and quality of life for children with Tourette syndrome

BACKGROUND Tourette syndrome(TS)is recognized as a neurodevelopmental disorder profoundly influenced by familial factors,particularly family functioning.However,the relationship among family functioning,tic severity,and quality of life in individuals with TS during childhood and adolescence remains unclear.We hypothesized that family functioning plays a role in the association between the severity of TS and quality of life in children.AIM To determine the role of family functioning in the relationship between TS severity and quality of life.METHODS This study enrolled 139 children(male/female=113/26)with TS.We assessed tic severity using the Yale Global Tic Severity Scale,quality of life via the Tourette Syndrome Quality of Life Scale,and family functioning through the Family Assessment Device.Our analysis focused on correlating these measures and exploring the mediating role of family functioning in the relationship between tic severity and quality of life.Additionally,we examined if this mediating effect varied by gender or the presence of comorbidity.RESULTS We found that family communication dysfunction had a significant mediating effect between tic severity and both psychological symptoms(indirect effect:Β=0.0038,95%confidence interval:0.0006-0.0082)as well as physical and activities of daily living impairment(indirect effect:Β=0.0029,95%confidence interval:0.0004-0.0065).For vocal tic severity,this mediation was found to be even more pronounced.Additionally,in male participants and those without attention deficit hyperactivity disorder,the mediating effect of family communication dysfunction was still evident.CONCLUSION Our study highlights the impact of family functioning on the tic severity and the quality of life in children.This relationship is influenced by gender and comorbid conditions like attention deficit hyperactivity disorder.

Dietary inflammatory index and its impact on severity and recurrence of Tourette syndrome in children

BACKGROUND Tourette syndrome(TS)is a neurodevelopmental disorder characterized by the presence of motor and vocal tics,typically beginning in childhood.Despite signifi-cant research efforts,the exact pathophysiology of TS remains incompletely understood.Recent studies suggest that inflammation may play a role in the severity and progression of TS,pointing to the potential influence of dietary and lifestyle factors on the condition.Currently,research on the specific connection between dietary inflammatory index(DII)and TS is still in its early stages,requir-ing additional clinical and epidemiological studies to validate the strength and specific mechanisms of this connection.METHODS A total of 207 children diagnosed with TS in the pediatric department of Qingdao Chengyang People’s Hospital from January 2022 to January 2023 were selected.They were divided into stable and unstable groups based on follow-up condi-tions.Before enrollment,general information of the children[age,gender,body mass index(BMI),guardian’s education level,DII score,medical history,family history,academic stress,electronic device usage,medication,and disease progression]was assessed,and serum inflammatory levels were measured during follow-up visits.DII scores and Yale Global Tic Severity Scale(YGTSS)scores were calculated.Furthermore,based on YGTSS scores,the children were classified into mild,moderate,and severe groups.The DII,interleukin-6(IL-6),C-reactive protein(CRP),and tumor necrosis factor-alpha(TNF-α)levels in each group were compared.RESULTS Follow-up surveys were completed by 207 children and their guardians.Among them,117 children were in the stable group,and 90 were in the recurrent group.We found no statistically significant differences in age,gender,comorbidities,BMI,and disease duration between the two groups(P>0.05).However,academic stress,electronic device usage,medication,guardian’s education level,and DII scores showed statistically significant differences between the groups(P<0.05).Multifactorial regression analysis revealed that guardian’s anxiety level,DII score,medication,academic stress,and family history were statistically significant factors(P<0.05)affecting the recurrence of TS in children.Therefore,anxiety level,DII score,medication status,electronic device usage,and academic stress were identified as factors influencing the recurrence of TS in children.Among them,DII score,academic stress,and family history had odds ratios(OR)greater than 1,indicating risk factors,whereas medication status and guardian’s education level had OR values less than 1,indicating protective factors.According to the YGTSS scores,children were categorized into mild,moderate,and severe groups.Comparative analysis of DII and inflammatory levels in children with different degrees of tic disorders revealed that the severe group had the highest DII and inflammatory levels,followed by the moderate group,and the mild group had the lowest levels.The trend of TS progression was consistent with the DII results.Receiver operating characteristic curves were plotted to predict disease progression in patients with TS via inflammatory markers.The areas under the curve for IL-6,CRP,and TNF-αwere 0.894(95%CI:0.817-0.969),0.793(95%CI:0.694-0.893),and 0.728(95%CI:0.614-0.843)respectively,with statistically significant differences(P<0.05).According to the Youden index,the optimal cutoff values were IL-6=3.775 ng/L(sensitivity 68.1%and specificity 68.4%),CRP=6.650 mg/L(sensitivity 60.6%and specificity 68.4%),and TNF-α=0.666(sensitivity 60.6%and specificity 71.1%).CONCLUSION We found a certain correlation between DII and the severity,recurrence,and inflammatory levels of TS in children.Reasonable reduction in the intake of pro-inflammatory foods may be beneficial in reducing the risk of disease progression in children with TS.

Study on Correlation of Different Methods of Evaluating Degree of Skin Redness

In order to explore the correlation of 3 different methods of evaluating the degree of skin redness,45 healthy Chinese subjects aged 18~45 were recruited to attend a human efficacy evaluation test.An emulsion product which declares soothing and repair efficacy was used each time in the morning and evening for 4 weeks.Three methods,including visual assessment,image analysis and instrument measurement,were taken to test the related indices of skin redness degree respectively.The improvement of skin redness and the correlation of 3 methods were evaluated by comparing the changes of each index before and after using the product.The results show that the face redness degree score and the image analysis a*value significantly reduce at all time points after using the sample(P<0.05),while the instrument probe a*value significantly reduce at the time point after using for 2 weeks(P<0.05).The correlation coefficient of the face redness degree score and the instrument probe a*value is more than 0.33 and less than 0.67,and the significance level is less than 0.01.Therefore,the sample has soothing and repair efficacy for improving skin redness;and the methods of visual assessment and instrument measurement present moderate positive correlation.

Delta shock index predicts injury severity,interventions,and outcomes in trauma patients:A 10-year retrospective observational study

BACKGROUND Most trauma occurs among young male subjects in Qatar.We examined the predictive values of the delta shock index(DSI),defined as the change in the shock index(SI)value from the scene to the initial reading in the emergency unit(i.e.,subtracting the calculated SI at admission from SI at the scene),at a Level 1 trauma center.AIM To explore whether high DSI is associated with severe injuries,more interventions,and worse outcomes[i.e.,blood transfusion,exploratory laparotomy,ventilator-associated pneumonia,hospital length of stay(HLOS),and in-hospital mortality]in trauma patients.METHODS A retrospective analysis was conducted after data were extracted from the National Trauma Registry between 2011 and 2021.Patients were grouped based on DSI as low(≤0.1)or high(>0.1).Data were analyzed and compared usingχ2 and Student’s t-tests.Correlations between DSI and injury severity score(ISS),revised trauma score(RTS),abbreviated injury scale(AIS),Glasgow coma scale(GCS),trauma score-ISS(TRISS),HLOS,and number of transfused blood units(NTBU),were assessed using correlation coefficient analysis.The diagnostic testing accuracy for predicting mortality was determined using the validity measures of the DSI.Logistic regression analysis was performed to identify predictors of mortality.RESULTS This analysis included 13212 patients with a mean age of 33±14 years,and 24%had a high DSI.Males accounted for 91%of the study population.The trauma activation level was higher in patients with a high DSI(38%vs 15%,P=0.001).DSI correlated with RTS(r=-0.30),TRISS(r=-0.30),NTBU(r=0.20),GCS(r=-0.24),ISS(r=0.22),and HLOS(r=0.14)(P=0.001 for all).High DSI was associated with significantly higher rates of intubation,laparotomy,ventilator-associated pneumonia,massive transfusion activation,and mortality than low DSI.For mortality prediction,a high DSI had better specificity,negative predictive value,and negative likelihood ratio(77%,99%,and 0.49%,respectively).After adjusting for age,emergency medical services time,GCS score,and ISS,multivariable regression analysis showed that DSI was an independent predictor of mortality(odds ratio=1.9;95%confidence interval:1.35-2.76).CONCLUSION In addition to sex-biased observations,almost one-quarter of the study cohort had a higher DSI and were mostly young.High DSI correlated significantly with the other injury severity scores,which require more time and imaging to be ready to use.Therefore,DSI is a practical,simple bedside tool for triaging and prognosis in young patients with trauma.

Systemic immune-inflammation index combined with pediatric appendicitis score in assessing the severity and prognosis for paediatric appendicitis

BACKGROUND Pediatric appendicitis is a common cause of abdominal pain in children and is recognized as a significant surgical emergency.A prompt and accurate diagnosis is essential to prevent complications such as perforation and peritonitis.AIM To investigate the predictive value of the systemic immune-inflammation index(SII)combined with the pediatric appendicitis score(PAS)for the assessment of disease severity and surgical outcomes in children aged 5 years and older with appendicitis.METHODS Clinical data of 104 children diagnosed with acute appendicitis were analyzed.The participants were categorized into the acute appendicitis group and chronic appendicitis group based on disease presentation and further stratified into the good prognosis group and poor prognosis group based on prognosis.The SII and PAS were measured,and a joint model using the combined SII and PAS was constructed to predict disease severity and surgical outcomes.RESULTS Significant differences were observed in the SII and PAS parameters between the acute appendicitis group and chronic appendicitis group.Correlation analysis showed associations among the SII,PAS,and disease severity,with the combined SII and PAS model demonstrating significant predictive value for assessing disease severity[aera under the curve(AUC)=0.914]and predicting surgical outcomes(AUC=0.857)in children aged 5 years and older with appendicitis.CONCLUSION The study findings support the potential of integrating the SII with the PAS for assessing disease severity and predicting surgical outcomes in pediatric appendicitis,indicating the clinical utility of the combined SII and PAS model in guiding clinical decision-making and optimizing surgical management strategies for pediatric patients with appendicitis.

On Evaluating University Teachers’ Morality and Ethics in the New Era

University teachers play an important role in promoting moral and political education among university students.Regular and long-term construction of teachers’morality and ethics will contribute to the success of the fundamental task of cultivating talents.The present study proposes that due to the multiple identities of university teachers,it is necessary to evaluate the construction of teachers’morality and ethics in terms of what to evaluate and how to evaluate?It is expected that the attempt will provide useful guidance for the construction of university teachers’morality and ethics.

Association between Low Ambient Temperature and the Severity of Acute Ischemic Stroke

Objective:To explore the relationships among ambient temperature,ischemic stroke severity,and blood pressure.Methods:Meteorological data(2005–2015)were collected from the Guangzhou Meteorological Data Service.Ischemic stroke patients from the Department of Neurology of the First Affiliated Hospital,Sun Yat-sen University were retrospectively evaluated,each winter from 2005 to 2015.Patient demographics,baseline measurements,and National Institute of Health Stroke Scale(NIHSS)score were evaluated.Results:Three hundred sixty-two patients were included.The median latency from symptom onset to admission was 2 d(IQR:1–3 d).During recruitment,the highest and lowest temperatures were 39℃and 1.3℃,respectively.Hypertension was the most common comorbidity(75.1%).NIHSS scores at admission and discharge were higher in the cold-exposed group than in the controls regardless of the average temperature at admission.In addition,systolic and diastolic blood pressure values at admission were higher in the cold-exposed group than in the controls.When stratified by hypertensive status,the average and minimum temperatures at admission were negatively associated with systolic and diastolic blood pressure values in hypertensive patients.Reductions in the average and minimum temperatures at symptom onset were associated with more severe stroke.Conclusion:Ischemic stroke patients with symptom onset in winter had higher systolic blood pressure values and more serious neurologic deficits upon admission.

Severity Risk Analysis Matrix Ranking (SRAMR) for Oil-Spill Contingency Planning: Asemoku-Agip Pipeline in Perspective

One of the down sides of crude oil exploration and exploitation in the developing nations is its impacts on the environment. A major manifestation of poor crude oil management is oil-spillages. Mitigation strategies have been too expensive, but a cheaper recent way of managing crude-spills is by developing a severity risk analysis matrix ranking (SRAMR). The spatial data-sets deployed in this study were acquired from the USGS, Google Earth Pro, and NOSDRA. A buffer zone of 100 - 400 meters was created to characterize the LULC characteristics of the area. Also, this was to help develop a risk sensitivity characteristic. The study found that the vegetal cover was the environmental resource at high risk to crude-spills in the area, while other land-uses were at low risk of crude-spill. It is hoped that the finding from this study informs policy development and planning for crude oil spill incidents.

Serum and cerebrospinal fluid tau protein level as biomarkers for evaluating acute spinal cord injury severity and motor function outcome

Tau protein, a microtubule-associated protein, has a high specific expression in neurons and axons. Because traumatic spinal cord injury mainly affects neurons and axons, we speculated that tau protein may be a promising biomarker to reflect the degree of spinal cord injury and prognosis of motor function. In this study, 160 female Sprague-Dawley rats were randomly divided into a sham group, and mild, moderate, and severe spinal cord injury groups. A laminectomy was performed at the T8 level to expose the spinal cord in all groups. A contusion lesion was made with the NYU-MASCIS impactor by dropping a 10 g rod from heights of 12.5 mm(mild), 25 mm(moderate) and 50 mm(severe) upon the exposed dorsal surface of the spinal cord. Tau protein levels were measured in serum and cerebrospinal fluid samples at 1, 6, 12, 24 hours, 3, 7, 14 and 28 days after operation. Locomotor function of all rats was assessed using the Basso, Beattie and Bresnahan locomotor rating scale. Tau protein concentration in the three spinal cord injury groups(both in serum and cerebrospinal fluid) rapidly increased and peaked at 12 hours after spinal cord injury. Statistically significant positive linear correlations were found between tau protein level and spinal cord injury severity in the three spinal cord injury groups, and between the tau protein level and Basso, Beattie, and Bresnahan locomotor rating scale scores. The tau protein level at 12 hours in the three spinal cord injury groups was negatively correlated with Basso, Beattie, and Bresnahan locomotor rating scale scores at 28 days(serum: r =-0.94; cerebrospinal fluid: r =-0.95). Our data suggest that tau protein levels in serum and cerebrospinal fluid might be a promising biomarker for predicting the severity and functional outcome of traumatic spinal cord injury.

Value of mean platelet volume in evaluating the severity of acute pancreatitis

Objective:To investigate the changes of mean platelet volume (MPV) in the course of acute pancreatitis (AP) and its value in evaluating the severity of AP.Methods: Retrospectively reviewed the clinical data of 214 patients with acute pancreatitis. According to the severity of the disease, the patients were divided into 64 patients with severe acute pancreatitis, 150 patients with non-severe acute pancreatitis. 63 healthy subjects were used as a control group. Compared the MPV levels between AP group and healthy control group. Compare the levels of MPV, CRP, LDH, Ca2+ and WBC between severe AP group and non-severe AP group. Compared the levels of MPV in acute phase and remission of acute pancreatitis. The receiver operating characteristic (ROC) curve was used to evaluate the value of MPV, CRP, LDH, Ca2+ and WBC in predicting severe acute pancreatitis.Results: Compared with the healthy control group, the MPV levels in the AP group were lower. In the acute phase and the remission period, the MPV levels in the severe AP group were lower than that in the non-severe group. The area under the ROC curve (AUC) of MPV, CRP, LDH, Ca2+ and WBC in predicting severe acute pancreatitis were 0.791, 0.655, 0.708, 0.707, 0.622.Conclusion:AP patients have lower MPV and MPV levels in remission period are higher than that in acute phase. In both acute phase and remission, MPV levels in severe AP group are lower than non-severe AP group. Compared with CRP, LDH, Ca2+ and WBC, MPV has obvious advantage in predicting severe AP.

Fuzzy Based Decision Making Approach for Evaluating the Severity of COVID-19 Pandemic in Cities of Kingdom of Saudi Arabia

The World Health Organization declared COVID-19 a pandemic on March 11,2020 stating that it is a worldwide danger and requires imminent preventive strategies to minimise the loss of lives.COVID-19 has now affected millions across 211 countries in the world and the numbers continue to rise.The information discharged by the WHO till June 15,2020 reports 8,063,990 cases of COVID-19.As the world thinks about the lethal malady for which there is yet no immunization or a predefined course of drug,the nations are relentlessly working at the most ideal preventive systems to contain the infection.The Kingdom of Saudi Arabia(KSA)is additionally combating with the COVID-19 danger as the cases announced till June 15,2020 reached the count of 132,048 with 1,011 deaths.According to the report released by the KSA on June 14,2020,more than 4,000 cases of COVID-19 pandemic had been registered in the country.Tending to the impending requirement for successful preventive instruments to stem the fatalities caused by the disease,our examination expects to assess the severity of COVID-19 pandemic in cities of KSA.In addition,computational model for evaluating the severity of COVID-19 with the perspective of social influence factor is necessary for controlling the disease.Furthermore,a quantitative evaluation of severity associated with specific regions and cities of KSA would be a more effective reference for the healthcare sector in Saudi Arabia.Further,this paper has taken the Fuzzy Analytic Hierarchy Process(AHP)technique for quantitatively assessing the severity of COVID-19 pandemic in cities of KSA.The discoveries and the proposed structure would be a practical,expeditious and exceptionally precise evaluation system for assessing the severity of the pandemic in the cities of KSA.Hence these urban zones clearly emerge as the COVID-19 hotspots.The cities require suggestive measures of health organizations that must be introduced on a war footing basis to counter the pandemic.The analysis tabulated in our study will assist in mapping the rules and building a systematic structure that is immediate need in the cities with high severity levels due to the pandemic.

Acute pancreatitis:A review of diagnosis,severity prediction and prognosis assessment from imaging technology,scoring system and artificial intelligence

Acute pancreatitis(AP)is a potentially life-threatening inflammatory disease of the pancreas,with clinical management determined by the severity of the disease.Diagnosis,severity prediction,and prognosis assessment of AP typically involve the use of imaging technologies,such as computed tomography,magnetic resonance imaging,and ultrasound,and scoring systems,including Ranson,Acute Physiology and Chronic Health Evaluation II,and Bedside Index for Severity in AP scores.Computed tomography is considered the gold standard imaging modality for AP due to its high sensitivity and specificity,while magnetic resonance imaging and ultrasound can provide additional information on biliary obstruction and vascular complications.Scoring systems utilize clinical and laboratory parameters to classify AP patients into mild,moderate,or severe categories,guiding treatment decisions,such as intensive care unit admission,early enteral feeding,and antibiotic use.Despite the central role of imaging technologies and scoring systems in AP management,these methods have limitations in terms of accuracy,reproducibility,practicality and economics.Recent advancements of artificial intelligence(AI)provide new opportunities to enhance their performance by analyzing vast amounts of clinical and imaging data.AI algorithms can analyze large amounts of clinical and imaging data,identify scoring system patterns,and predict the clinical course of disease.AI-based models have shown promising results in predicting the severity and mortality of AP,but further validation and standardization are required before widespread clinical application.In addition,understanding the correlation between these three technologies will aid in developing new methods that can accurately,sensitively,and specifically be used in the diagnosis,severity prediction,and prognosis assessment of AP through complementary advantages.

Association between serum albumin levels and disease severity in adult patients with dengue: A 7-year retrospective cohort study in China's Mainland

Objective:To identify the association between serum albumin levels and disease severity among adult patients with dengue in China's Mainland.Methods:This retrospective cohort study analyzed the data of adult patients(aged≥18 years)hospitalized with laboratory-confirmed dengue in a tertiary center for infectious diseases from 2013 to 2019 in China's Mainland.Serum albumin levels were estimated and compared between patients with severe dengue and non-severe dengue.Additionally,the association between serum albumin levels and severe dengue was evaluated using a generalized linear model[relative risks(RR)].Multivariate logistic regression analysis was performed to identify the potential predictors of severe dengue.Results:Overall,1568 patients were included in this study.Of these patients,34(2.17%)developed severe dengue.The median serum albumin levels were significantly lower in patients with severe dengue than that in those with non-severe dengue(33 g/L vs.37 g/L,P<0.001).After adjustment for age,sex,and comorbidities,hypoalbuminemia(RR 4.877,95%CI 2.193-11.461,P<0.001)was found to be a predictor of severe dengue.Serum albumin levels(OR 1.303,95%CI 1.161-1.462,P<0.001)and age(OR 1.038,95%CI 1.017-1.061,P<0.001)were significant risk factors for severe dengue.The area under the curve for serum albumin levels to distinguish severe dengue was 0.787.Conclusions:Lower serum albumin levels were significantly associated with disease severity in adult patients with dengue.Hypoalbuminemia on admission resulted in at least a four-fold increased risk of severe dengue.

Predictive value of presepsin and acylcarnitines for severity and biliary drainage in acute cholangitis

BACKGROUND Bacteremia,which is a major cause of mortality in patients with acute cholangitis,induces hyperactive immune response and mitochondrial dysfunction.Presepsin is responsible for pathogen recognition by innate immunity.Acylcarnitines are established mitochondrial biomarkers.AIM To clarify the early predictive value of presepsin and acylcarnitines as biomarkers of severity of acute cholangitis and the need for biliary drainage.METHODS Of 280 patients with acute cholangitis were included and the severity was stratified according to the Tokyo Guidelines 2018.Blood presepsin and plasma acylcarnitines were tested at enrollment by chemiluminescent enzyme immunoassay and ultra-high-performance liquid chromatography-mass spectrometry,respectively.RESULTS The concentrations of presepsin,procalcitonin,short-and medium-chain acylcarnitines increased,while long-chain acylcarnitines decreased with the severity of acute cholangitis.The areas under the receiver operating characteristic curves(AUC)of presepsin for diagnosing moderate/severe and severe cholangitis(0.823 and 0.801,respectively)were greater than those of conventional markers.The combination of presepsin,direct bilirubin,alanine aminotransferase,temperature,and butyryl-L-carnitine showed good predictive ability for biliary drainage(AUC:0.723).Presepsin,procalcitonin,acetyl-L-carnitine,hydroxydodecenoyl-Lcarnitine,and temperature were independent predictors of bloodstream infection.After adjusting for severity classification,acetyl-L-carnitine was the only acylcarnitine independently associated with 28-d mortality(hazard ratio 14.396;P<0.001)(AUC:0.880).Presepsin concentration showed positive correlation with direct bilirubin or acetyl-L-carnitine.CONCLUSION Presepsin could serve as a specific biomarker to predict the severity of acute cholangitis and need for biliary drainage.Acetyl-L-carnitine is a potential prognostic factor for patients with acute cholangitis.Innate immune response was associated with mitochondrial metabolic dysfunction in acute cholangitis.