Simulation of 5-Fluorouracil Intercalated into Montmorillonite Using Spartan ’14: Molecular Mechanics, PM3, and Hartree-Fock

Molecular mechanics calculations, based on equations such as the one below, are used to investigate a colorectal cancer drug, 5-fluorouracil, intercalated into a clay, montmorillonite. This combination is currently being considered as a drug delivery system. The swelling of clays has been studied since the 1930s and is still not fully understood. Spartan ’14 is used for the calculations. Semi-empirical and ab initio basis set scaling is also examined since there are roughly 300 atoms involved in the full model.

Exploring the effects of coronary artery disease as a preexisting comorbidity on mortality in hospitalized septic patients:a retrospective observation study

Background:Sepsis has high prevalence and mortality rate,and it is imperative to identify populations at risk of poor sepsis outcomes.Septic patients with preexisting chronic comorbidities are shown to have worse sepsis outcomes.By identifying comorbidities with greater influence on sepsis progression,we can direct limited resources to septic patients with comorbidities and reduce health care costs.Chronic comorbidities can impact the risk of developing sepsis and having worse outcomes.Coronary artery disease(CAD)is a common comorbidity,especially in the elderly,and a leading cause of death globally.We wished to investigate the influence of CAD as a comorbidity on sepsis and hypothesized that preexisting CAD would increase mortality in hospitalized septic patients.Methods:We conducted retrospective observational study using patient data from Freeman Health System in Joplin,MO.We analyzed patient records from Freeman Health System database from January 1,2019,to June 30,2020.Septic patients were identified using the International Classification of Diseases,Tenth Revision sepsis codes.To identify septic patients with preexisting CAD,we used International Classification of Diseases,Tenth Revision codes for CAD.We compared mortality rates for septic patients with and without CAD.Results:Two-sample proportion test was conducted to test the difference in mortality between septic patients with and without preexisting CAD.The difference in mortality for the total population was−0.016(P=0.553).In the male and female subgroups,the differences in mortality were 0.0122(P=0.739)and−0.0511(P=0.208),respectively.The differences in mortality in patients aged 40 to 64 years and 65 years and older were−0.0077(P=0.870)and 0.0007(P=0.983),respectively.The statistical tests failed to find significant differences when comparing septic patients with and without preexisting CAD.There was no significant difference in the age and sex subgroups.Conclusion:Our study showed that CAD alone was not associated with higher mortality due to sepsis in our population.

Congestive heart failure and sepsis:a retrospective study of hospitalization outcomes from a rural hospital in Southwest Missouri

Background:Sepsis is the leading cause of death in hospitalized patients and significant effort has been made to facilitate early diagnosis and management.However,aggressive treatment can have negative effects,especially in patients with unstable volume status,such as those with congestive heart failure.Methods:We used electronic medical records to perform a retrospective study looking at hospital outcomes in patients from Southwest Missouri who were admitted with sepsis and had a comorbid diagnosis of hypertensive heart failure.Our primary outcome was in-hospital mortality.Results:We studied a total of 184 patients with the diagnosis of hypertensive heart failure with sepsis,and 348 patients with the diagnosis of sepsis that served as the baseline group.There was a total of 37(20%)deaths in the hypertensive heart failure group and a total of 94(27%)deaths in the baseline group.Conclusion:Our study showed no significant difference between the baseline group and those with hypertensive heart disease with heart failure.

Compliance with SEP-1 guidelines is associated with improved outcomes for septic shock but not for severe sepsis

Background: In 2018, the Centers for Medicaid and Medicare Services (CMS) issued a protocol for the treatment of sepsis. This bundle protocol, titled SEP-1 is a multicomponent 3 h and 6 h resuscitation treatment for patients with the diagnosis of either severe sepsis or septic shock. The SEP-1 bundle includes antibiotic administration, fluid bolus, blood cultures, lactate measurement, vasopressors for fluid-refractory hypotension, and a reevaluation of volume status. We performed a retrospective analysis of patients diagnosed with either severe sepsis or septic shock comparing mortality outcomes based on compliance with the updated SEP-1 bundle at a rural community hospital. Methods: Mortality outcome and readmission data were extracted from an electronic medical records database from January 1, 2019, to June 30, 2020. International Classification of Diseases (ICD)-10 codes were used to identify patients with either severe sepsis or septic shock. Once identified, patients were separated into four populations: patients with severe sepsis who met SEP-1, patients with severe sepsis who failed SEP-1, patients with septic shock who met SEP-1, and patients with septic shock who failed SEP-1. A patient who met bundle criteria (SEP-1 criteria) received each component of the bundle in the time allotted. Using chi-squared test of homogeneity, mortality outcomes for population proportions were investigated. Two sample proportion summary hypothesis test and 95% confidence intervals (CI) determined significance in mortality outcomes. Results: Out of our 1122 patient population, 437 patients qualified to be measured by CMS criteria. Of the 437 patients, 195 met the treatment bundle and 242 failed the treatment bundle. Upon comparing the two groups, we found the probable difference in mortality rate between the met(14.87%) and failed bundle(27.69%) groups to be significant(95% CI: 5.28-20.34, P = 0.0013). However, the driving force of this result lies in the subgroup of patients with severe sepsis with septic shock, which show a higher mortality rate compared to the subgroup with just severe sepsis. The difference was within the range of 3.31% to 29.71%. Conclusion: This study shows that with septic shock obtained a benefit, decreased mortality, when the SEP-1 bundle was met. However, meeting the SEP-1 bundle had no benefit for patients who had the diagnosis of severe sepsis alone. The significant difference in mortality, found between the met and failed bundle groups, is primarily due to the number of patients with septic shock, and whether or not those patients with septic shock met or failed the bundle.

The scaling of bite force and constriction pressure in kingsnakes(Lampropeltis getula):Proximate determinants and correlated performance

Across the diversity of vertebrates,bite force has been studied and suggested to have important ecological and evolutionary consequences.However,there is a notable lineage of vertebrates that use this performance trait yet are missing from the bite-force literature:the snakes.Snakes often rely on biting during prey subjugation and handling.Many snakes bite and hold prey while a constriction coil is formed or while venom is being delivered,or both.Others use biting exclusively without employing any additional prey-handling behaviors.In addition to biting,constriction is an important predation mechanism.Here,I quantify bite force and constriction pressure in kingsnakes(Lampropeltis getula).Furthermore,I explore the proximate determinants of bite force as well as the relationship between biting and constriction performance.Bite force increased linearly with all head and body measures.Of these,head height was the best predictor of bite force.Bite force in kingsnakes was within the range of values reported for lizards,but their relative performance was lower for their head size compared to lizards.Peak constriction pressure also increased with all body measures.Biting and constricting use 2 different parts of the musculoskeletal system and are positively and significantly correlated with one another.Future work targeting a greater diversity of snakes that rely more heavily on biting may reveal a greater range of bite performance in this diverse and successful vertebrate group.