Self-Assembly of a Dipeptide with a Reduced Amount of Copper into Antifungal and Antibacterial Particles.

With the growing concern over the environmental impact and health risks associated with conventional pesticides, there is a great need for developing safer and more sustainable alternatives. This study demonstrates the self-assembly of antimicrobial and antifungal spherical particles by a dipeptide utilizing a reduced amount of copper salt compared to the commonly employed formulation. The particles can be sprayed on a surface and form an antimicrobial coating. The effectiveness of the coating against the bacteria Pectobacterium brasiliense, a common pathogen affecting potato crops, was demonstrated, as the coating reduced the bacterial load by 7.3 log. Moreover, a comprehensive field trial was conducted, where the formulation was applied to potato seeds. Remarkably, it exhibited good efficacy against three prevalent potato pathogens (P. brasiliense, Pythium spp., and Spongospora subterranea) while demonstrating no phytotoxic effects on the potatoes. These findings highlight the tremendous potential of this formulation as a nonphytotoxic alternative to replace hazardous pesticides currently available in the market.

COVID-19 and Anemia: What Do We Know So Far?

On 11 March 2020, the World Health Organization (WHO) declared the novel SARS-CoV-2 virus responsible for causing COVID-19, a global pandemic. The virus primarily targets the respiratory system but can also affect other systems, notably causing hematological pathologies. Anemia, a common hematologic disorder, is characterized by the reduced oxygen-carrying capacity of red blood cells. The existing literature has a suspected link between anemia and severe COVID-19 cases. Researchers are currently investigating the long-term complications of COVID-19 in anemic patients, as these complications may play a crucial role in predicting patient prognosis. Anemic individuals are at a higher risk of experiencing severe COVID-19 infections due to several contributing pathophysiological mechanisms, including thrombotic, hemorrhagic, and autoimmune etiologies. The primary effect of these mechanisms is a decrease in circulating hemoglobin levels, reducing oxygen availability for cells. This exacerbates the hypoxia caused by COVID-19-induced acute respiratory distress syndrome (ARDS). This review offers a comprehensive overview of the evidence regarding the long-term complications of COVID-19 in anemic patients.

Biomimetic Nanotubes Based on Cyclodextrins for Ion-Channel Applications.

Biomimetic membrane channels offer a great potential for fundamental studies and applications. Here, we report the fabrication and characterization of short cyclodextrin nanotubes, their insertion into membranes, and cytotoxicity assay. Mass spectrometry and high-resolution transmission electron microscopy were used to confirm the synthesis pathway leading to the formation of short nanotubes and to describe their structural parameters in terms of length, diameter, and number of cyclodextrins. Our results show the control of the number of cyclodextrins threaded on the polyrotaxane leading to nanotube synthesis. Structural parameters obtained by electron microscopy are consistent with the distribution of the number of cyclodextrins evaluated by mass spectrometry from the initial polymer distribution. An electrophysiological study at single molecule level demonstrates the ion channel formation into lipid bilayers, and the energy penalty for the entry of ions into the confined nanotube. In the presence of nanotubes, the cell physiology is not altered.

Derivation and validation of a formula to estimate risk for 30-day readmission in medical patients.

OBJECTIVE: To create a simple readmission risk-prediction tool that can be generated easily at the bedside by physicians, nurses, care coordinators and discharge planners. DESIGN: Retrospective cohort study. SETTING: Tertiary academic medical center. PARTICIPANTS: Inpatients aged 18 and older on general internal medicine services. MEASURES: Predictor variables included age, prior hospitalization, high-risk diagnoses, high-risk medications, polypharmacy, depression, use of palliative care and a cumulative score summing these factors (readmission risk score-RRS). The main outcome measure was 30-day readmission. Predictive values were calculated. RESULTS: Readmission increased linearly from 4.9% of those whose RRS score was 0-37.5% of those with highest risk scores (P = 0.0002). We derived a simple formula for readmission risk as 8 and 4% more for each additional readmission risk factor. The positive predictive value for RRS >0 was low, while the negative predictive value for this cutoff was 95%. CONCLUSIONS: An easily calculated 7-point score can be used to estimate readmission risk. This tool may be particularly useful for identifying lower risk patients who may not require intensive intervention, thus aiding in appropriate targeting of resources.

Safety and Efficacy of Brolucizumab in the Treatment of Diabetic Macular Edema and Diabetic Retinopathy: A Systematic Review and Meta-Analysis.

PURPOSE: To investigate the efficacy and safety of brolucizumab in diabetic macular edema (DME) and diabetic retinopathy (DR). METHODS: In this systematic review and meta-analysis, an electronic search was done to acquire all articles describing brolucizumab use in patients with DME and DR. The review was prospectively registered on PROSPERO (CRD42022382625). Collected articles were filtered through two stages by independent reviewers. Data were extracted from the included articles and then analyzed accordingly. RESULTS: Brolucizumab induced significant improvement in best-corrected visual acuity and was either better or non-inferior to other types of anti-VEGF (MD -0.64 mu, 95% CI [-1.15, -0.13], P = .01); the same observation was noted with regards to central subfield macular thickness (CSMT) (MD -138.6 mu, 95% CI [-151.9, -125.3], P = .00001). Brolucizumab was reported to be relatively safe for use in diabetic patients, with few adverse events observed, with a higher frequency of adverse events in relation to the 3 mg dose compared to the 6 mg dose. CONCLUSION: Brolucizumab is a new drug that has potential advantages in efficacy over other anti-VEGF agents in the treatment of DME and DR. It showed significant improvement in BCVA and CSMT with the possibility of a lower dosing schedule compared to other agents. Although observed in low frequency, sight-threatening adverse effects appear to occur more frequently compared to other anti-VEGF agents. The main observed adverse event was retinal vasculitis which was seen more commonly with the 3 mg dose versus the 6 mg dose.

Guillain-Barré syndrome after COVID-19 vaccination: A systematic review and analysis of case reports.

INTRODUCTION: Cases of Guillain-Barré Syndrome (GBS) have been believed to be associated with the novel COVID-19 infection, and also with the following vaccines developed against the infection. Our work aims to investigate the incidence of GBS after COVID-19 vaccination, and describe its clinical characteristics and potential confounders. METHODS: An electronic search was conducted through four databases: PubMed, Scopus, medRxiv, and Google Scholar for all case reports and case series describing after COVID-19 vaccine administration. All published articles from inception until November 1st, 2022 were included. Differences between groups were assessed using Pearson chi-square test. Modified Erasmus GBS Outcome Score (mEGOS) for the ability to walk after GBS was calculated for all cases with sufficient clinical data, and Kaplan-Meier survival analysis was performed to study the effect of vaccine type on the relationship between vaccination time and complication of GBS. RESULTS: About 103 studies describing 175 cases of GBS following COVID-19 vaccination were included. The Acute Inflammatory Demyelinating Polyradiculoneuropathy subtype was the most reported subtype with 74 cases (42.29%). The affected age group averaged around 53.59 ±18.83 years, with AMSAN occurring in a rather older group (63.88 ±20.87 years, p=0.049). The AstraZeneca vaccine was associated with AIDP (n=38, 21.71%) more than other vaccines, p=0.02. The bilateral facial palsy subtype was mostly linked to adenoviral vector vaccinations, accounting for an average of 72% of the total BFP cases. Dysesthesias was the most reported sensory complication (60%, p=0.349). Most GBS patients survived (96%, p=0.036), however, most patients had low mEGOS scores (4 ±3.57, p<0.01). On average, patients developed GBS at 13.43 ±11.45 days from vaccination (p=0.73), and survival analysis for complication of GBS into mechanical ventilation or walking impairment yielded a severely increased probability of complication after 25 days (p<0.01). Intravenous immunoglobulins (p=0.03) along with rehabilitation (p=0.19) were the most commonly used treatment. CONCLUSION: This work investigates the incidence of Guillain-Barré Syndrome after COVID-19 vaccination. Most cases occurred after receiving the AstraZeneca or Pfizer vaccines, and despite low mortality rates, ambulation was compromised in most patients. A higher risk of GBS complication is associated with an onset later than 12-13 days, particularly with Pfizer, AstraZeneca, and Moderna vaccines. No specific predisposing or prognostic factor was identified, and the relation between the COVID-19 vaccines and GBS remain unclear.

Phenolato Ti(IV) hexacoordinate complexes for anticancer chemotherapy: enhancement of solubility, hydrolytic stability, and cytotoxicity.

A new series of five titanium(IV) complexes based on diaminobis(phenolato)-bis(alkoxo) ligands with different substitutions was synthesized and characterized. All complexes were analyzed by X-ray crystallography, and all structures indicated C2 symmetrical octahedral compounds. All complexes exhibited enhanced solubility in aqueous media compared with the parent methylated derivative phenolaTi (up to 0.4 vs. 0.05 mg ml-1 of phenolaTi) due to halogen and alkoxo/hydroxo substitutions, with particularly enhanced water solubility for the methoxylated and hydroxylated derivatives. In particular, high hydrolytic stability was recorded for all derivatives, with the t½ for ligand hydrolysis of more than 8 days, as established by 1H NMR and HR-MS. All complexes were cytotoxic toward human ovarian A2780, colon HT-29, and cervical HeLa cancer cell lines (IC50 values in the range of 0.3-40 µM), with negligible activity toward non-cancerous MRC-5 cells. The halogenated compounds of this series exhibit the best combination of stability and activity, making them highly promising for anticancer applications.

Prevalence of Dry Eye Disease Among Medical Students and Its Association with Sleep Habits, Use of Electronic Devices and Caffeine Consumption: A Cross-Sectional Questionnaire.

Introduction: Dry eye disease (DED) is a common and multifactorial disease of the ocular surface which causes visual disturbance and feelings of discomfort among patients. The prevalence rate among medical students is an important issue to consider. This study investigates the relationship between caffeine consumption, sleeping habits, use of electronic devices, and DED among a convenient sample of medical students in Jordan. Methods: This cross-sectional online survey enrolled medical students from all six medical schools in Jordan. The questionnaire, which was shared via social media platforms, assessed socio-demographics, caffeine consumption amounts and patterns, sleep quality, and the use of electronic devices and their relation to ocular discomfort, DED, and related symptoms. The ocular surface disease index (OSDI) questionnaire was also administered to quantify the symptoms of DED. Results: A total of 1223 students participated in this study (RR=24.46%); 64% were females, and 43% were in their clinical placement years. Of the participants, 317 (25.92%) had normal eyes, and 906 (74.08%) had symptomatic DED. Of the students, 1206 (98.6%) used electronic devices directly before bed, and only 399 (32.62%) used blue-light-protective glasses. Lower DED risk was linked to male gender (OR=0.535, 95% CI 0.392-0.73, p <0.01), clinical years of medical school (OR=0.564, 95% CI 0.424-0.75, p<0.01). Poor sleep quality corresponded to more incidence of DED, regardless of sleeping for 5-6 hours (OR=3.046, 95% CI 1.299-7.139, p=0.01) or for less than 5 hours (OR=3.942, 95% CI 1.824-8.519, p<0.01). Also, caffeine consumption only marginally affected its incidence, but the results were statistically insignificant. Conclusion: Female gender, basic science years, and spending more than 6 hours looking at screens were significantly associated with symptomatic DED. Caffeine consumption did not pose any significant risk to the incidence of DED.

Exploring the Use of YouTube as a Pathology Learning Tool and Its Relationship With Pathology Scores Among Medical Students: Cross-Sectional Study.

BACKGROUND: YouTube is considered one of the most popular sources of information among college students. OBJECTIVE: This study aimed to explore the use of YouTube as a pathology learning tool and its relationship with pathology scores among medical students at Jordanian public universities. METHODS: This cross-sectional, questionnaire-based study included second-year to sixth-year medical students from 6 schools of medicine in Jordan. The questionnaire was distributed among the students using social platforms over a period of 2 months extending from August 2022 to October 2022. The questionnaire included 6 attributes. The first section collected demographic data, and the second section investigated the general use of YouTube and recorded material. The remaining 4 sections targeted the participants who used YouTube to learn pathology including using YouTube for pathology-related content. RESULTS: As of October 2022, 699 students were enrolled in the study. More than 60% (422/699, 60.4%) of the participants were women, and approximately 50% (354/699, 50.6%) were second-year students. The results showed that 96.5% (675/699) of medical students in Jordan were using YouTube in general and 89.1% (623/699) were using it as a source of general information. YouTube use was associated with good and very good scores among the users. In addition, 82.3% (575/699) of medical students in Jordan used YouTube as a learning tool for pathology in particular. These students achieved high scores, with 428 of 699 (61.2%) students scoring above 70%. Most participants (484/699, 69.2%) reported that lectures on YouTube were more interesting than classic teaching and the lectures could enhance the quality of learning (533/699, 76.3%). Studying via YouTube videos was associated with higher odds (odds ratio [OR] 3.86, 95% CI 1.33-11.18) and lower odds (OR 0.27, 95% CI 0.09-0.8) of achieving higher scores in the central nervous system and peripheral nervous system courses, respectively. Watching pathology lectures on YouTube was related to a better chance of attaining higher scores (OR 1.96, 95% CI 1.08-3.57). Surprisingly, spending more time watching pathology videos on YouTube while studying for examinations corresponded with lower performance, with an OR of 0.46 (95% CI 0.26-0.82). CONCLUSIONS: YouTube may play a role in enhancing pathology learning, and aiding in understanding, memorization, recalling information, and obtaining higher scores. Many medical students in Jordan have positive attitudes toward using YouTube as a supplementary pathology learning tool. Based on this, it is recommended that pathology instructors should explore the use of YouTube and other emerging educational tools as potential supplementary learning resources.

A rare case of malignant granular cell tumor of the cheek in a 16-year-old child: a case report.

Introduction and importance: Granular cell tumors (GCTs) are uncommon soft tissue tumors, predominantly benign lesions. Approximately 50% occur in the tongue, with a peak incidence in the fifth and sixth decades of life. However, in this case, a rare presentation of GCTs on the cheek of a 16-year-old young female, including a review of the literature. Methods: The medical records and histopathological slides of the case were retrospectively reviewed. This work has been reported based on Surgical CAse REport (SCARE) criteria. Case presentation: A 16-year-old female presented with a non-painful exophytic and pigmented cheek lesion that is rapidly growing. A primary concern was expressed as cosmetic in nature, a biopsy of the mass was taken, and histopathological findings showed a malignant tumor, mostly consistent with GCTs. She was recommended to have a total excision of the mass. During follow-up, facial MRI findings indicate granulation tissue versus recurrent/residual tumor at the site of surgery, without any evidence of cancer metastasis or spread. Clinical discussion: GCT is a tumor of Schwann cells, which is mostly benign with a 2% risk of malignant transformation. The peak incidence of this tumor is around the age of 50, and it is uncommon in young individuals. Clinically, GCT presents as a single, asymptomatic dermal or subcutaneous, brown-red nodule or papule, which grows slowly with diameter ranging from 0.5 to 3 cm. The definitive treatment for both benign and malignant GCTs is sufficient local excision with safe margins. Conclusion: GCT is an extremely rare tumor, with a peak incidence of fifth and sixth decay of age, which usually appear in the tongue (50% of cases); however, in this case, we present a 16-year-old female with a cheek mass diagnosed as GCT. In short, we think that GCT should be considered as one of the differential diagnoses of solitary facial masses at young ages.

The Prognostic Role of CD73/A2AR Expression and Tumor Immune Response in Periampullary Carcinoma Subtypes.

INTRODUCTION: Periampullary adenocarcinoma (PAAC) is a rare, lethal heterogeneous group of malignancy that differs in their molecular phenotypes. Ecto-5'-nucleotidase (CD73)/adenosine A2A Receptor (A2AR) pathway has shown an emerging role in cancer therapy through modulating the immune response. Therefore, this study aimed to explore the functional role of CD73 and A2AR in pancreatic ductal adenocarcinoma (PDAC) and ampullary carcinoma (AC). MATERIAL AND METHODS: An immunohistochemical study for CD73 and A2AR carried on 48 PDAC cases, 21 AC cases and 34 adjacent non-tumor tissues that were taken from the farthest point of normal pancreatic tissue away from the tumor. RESULTS: CD73 was overexpressed in the PDAC (p < 0.001), and AC (p = 0.004) groups compared to their non-tumor tissues. However, A2AR was overexpressed in the PDAC group (p = 0.003) but not in the AC group (p = 0.359) compared to non-tumor tissue. In the PDAC group, CD73 overexpression was significantly associated with longer overall survival (p = 0.018). In contrary, A2AR overexpression was significantly associated with high grade (p = 0.001) and late- stage (p = 0.01). Both markers had no prognostic impact on AC. In the meantime, tumor immune response showed a negative prognostic role in PDAC and AC. The prognostic role of tumor immune response in the PDAC group was strongly modulated by CD73 and A2AR expression. CONCLUSIONS: PDAC and AC shared CD73 Overexpression while A2AR was overexpressed in PDAC only. In PDAC, CD73 and A2AR showed an opposed  prognostic effect but both had no prognostic impact on AC. In addition, tumor immune response showed a controversial impact on the prognosis of PDAC and AC.

BAR Score Performance in Predicting Survival after Living Donor Liver Transplantation: A Single-Center Retrospective Study.

METHODS: 146 adult liver transplant recipients were included. Univariate and multivariate analyses were used to determine the independent predictors of survival at 3 months, 1 year, and 5 years. The receiver operating characteristic (ROC) curve for the BAR score was plotted, and the area under the ROC curve (AUROC) was calculated. Kaplan-Meier curve and log-rank test were used to compare survival above and below the best cutoff values. RESULTS: The mean age was 52.45 ± 8.54 years, and 59.6% were males. The survival rates were 89, 78.8, and 72% at 3 months, 1 year, and 5 years, respectively. The BAR score demonstrated a clinically significant value in the prediction of 3-month (AUROC = 0.89), 1-year (AUROC = 0.76), and 5-year survival (AUROC = 0.71). Among the investigated factors associated with survival, BAR score <10 points was the only independent predictor of 3-month (OR 7.34, p < 0.0001), 1-year (OR 3.37, p=0.001), and 5-year survival (OR 2.83, p=0.044). CONCLUSIONS: BAR is a simple and easily applicable scoring system that could significantly predict short- and long-term survival after LDLT. A large multicenter study is warranted to validate our results in the Egyptian population.

Ocular manifestations of recent viral pandemics: A literature review.

Viral pandemics often take the world by storm, urging the medical community to prioritize the most evident systemic manifestations, often causing ocular manifestations to go unnoticed. This literature review highlights the ocular complications of the Monkeypox, SARS-CoV-2, MERS, Ebola, H1N1, and Zika viruses as the most recent viral pandemics. Research into the effects of these pandemics began immediately. Moreover, it also discusses the ocular complications of the vaccines and treatments that were used in the scope of the viral pandemics. Additionally, this review discusses the role of the eye as an important route of viral transmission, and thereafter, the International recommendations to reduce the incidence of viral transmission were mentioned. Lastly, this paper wants to lay out a platform for researchers who want to learn more about how viruses show up in the eye.

Effects of ABO blood groups and RH-factor on COVID-19 transmission, course and outcome: A review.

ABO and Rh blood grouping systems are two of the non-modifiable risk factors that play an important role in the susceptibility, severity and outcomes of COVID-19 infection. This review explores these associations all over the world, in an attempt to conclude a clear idea for future reference in clinical practice. In the present review, a link has been drawn between blood groups and COVID-19 transmission, course and prognosis, as literature suggests that blood group O plays a protective role against the infection, while blood group A exhibits a higher risk of exacerbation. In contrast with Rh negative individuals, Rh positive individuals are prone to more severe infection and complications, despite the fact that the underlying mechanisms of this association remain understudied. Nevertheless, the connection remains subject to controversy; since some studies report doubts about it. Thus, this association requires further investigation.

Ocular Vascular Events following COVID-19 Vaccines: A Systematic Review.

The main aim of this study is to investigate the current evidence regarding the association between COVID-19 vaccination and ocular vascular events. The protocol is registered on PROSPERO (CRD42022358133). On 18 August 2022, an electronic search was conducted through five databases. All original articles reporting individuals who were vaccinated with COVID-19 vaccines and developed ophthalmic vascular events were included. The methodological quality of the included studies was assessed using the NIH tool. A total of 49 studies with 130 ocular vascular cases were included. Venous occlusive events were the most common events (54.3%), which mostly occurred following the first dose (46.2%) and within the first five days following vaccination (46.2%). Vascular events occurred more with the Pfizer and AstraZeneca vaccines (81.6%), and mostly presented unilaterally (73.8%). The most frequently reported treatment was intravitreal anti-VEGF (n = 39, 30.4%). The majority of patients (90.1%) demonstrated either improvement (p = 0.321) or persistence (p = 0.414) in the final BCVA. Ophthalmic vascular events are serious vision-threatening side effects that have been associated with COVID-19 vaccination. Clinicians should be aware of the possible association between COVID-19 vaccines and ocular vascular events to provide early diagnosis and treatment.

Successful use of venous graft from native liver with hepatocellular carcinoma during living donor liver transplantation with no impact on recurrence rate: A retrospective cohort study.

Introduction: There are still debates regarding using portal vein (PV) from liver with hepatocellular carcinoma (HCC) for vascular reconstruction. This study aimed to assess the feasibility and patency of PV venous graft from an explanted liver with HCC for the reconstruction of the hepatic veins tributaries or PV in living donor liver transplantation (LDLT) and to see if it has any risk on recurrence of HCC. Patient and methods: We conducted a retrospective study on 81 patients with HCC who underwent LDLT from April 2004 to July 2022. Results: Venous graft from native liver PV was used for vascular reconstruction in 31 patients as follows; reconstruction of V5 in 7 patients, V8 in 4 patients, V6 in 3 patients, combined V5 and V8 in 4 patients, V6 with V5/V8 in 5 patients, and as Y shape venous graft for 2 PV reconstruction in 8 patients. The implantation of the new conduit PV graft after reconstruction of the anterior sector tributaries was direct to the IVC in 8 patients, and to the common orifice of the left and middle hepatic veins in 12 patients. The 1 month, 3 months, and 1-year overall patency of the venous graft was 93.5%, 90.3%, and 84%, respectively. Nine patients had recurrent HCC. In multivariate analysis, the independent risk factors for HCC recurrence were AFP >400 ng/mL (HR = 1.47, 95% CI: 1.69-2.31, P = 0.01), moderate/poor differentiated tumor (HR = 3.06, 95% CI: 2.58-6.29, P = 0.02), and microvascular invasion (HR = 2.51, 95% CI: 1.05-1.93, P = 0.01). Using a PV venous graft had no risk factor for HCC recurrence (P = 0.9). Conclusion: The use of PV venous graft of native liver with HCC for venous reconstruction is a feasible and valuable option in LDLT with good patency rates and no risk of HCC recurrence.

Crosslinked Elastomers: Structure-Property Relationships and Stress-Optical Law.

We present a combination of independent techniques in order to characterize crosslinked elastomers. We combine well-established macroscopic methods, such as rheological and mechanical experiments and equilibrium swelling measurements, a more advanced technique such as proton multiple-quantum NMR, and a new method to measure stress-induced segmental orientation by in situ tensile X-ray scattering. All of these techniques give access to the response of the elastomer network in relation to the crosslinking of the systems. Based on entropic elasticity theory, all these quantities are related to segmental orientation effects through the so-called stress-optical law. By means of the combination of these techniques, we investigate a set of unfilled sulfur-vulcanized styrene butadiene rubber elastomers with different levels of crosslinking. We validate that the results of all methods correlate very well. The relevance of this approach is that it can be applied in any elastomer materials, including materials representative of various industrial application, without prerequisite as regards, e.g., optical transparency or simplified formulation. Moreover, the approach may be used to study reinforcement effects in filled elastomers with nanoparticles.

Impact of COVID-19 infection on liver and alimentary tract: clinical insight.

Aim of the study: Our aim was to evaluate the impact of COVID-19 infection on the liver and alimentary tract. Material and methods: This is a retrospective multicenter study that was performed in non-intensive care units (ICU) at Minia, Assiut, and Sohag University Hospitals from March 1st, 2020 to August 1st, 2020. The clinical characteristics of 1238 consecutively confirmed COVID-19 discharged cases were enrolled. Patients with respiratory distress were recorded as severe cases, while others were recorded as mild-moderate cases. Patients with ≥ 2× upper limit of normal of alanine aminotransferase (ALT), aspartate aminotransferase (AST), or bilirubin were defined as patients with liver injury, while others were recorded as patients without liver injury. Results: The severe group included 460 patients (37.2%) while the mild-moderate group included 778 patients (62.8%). Fever, white blood cell (WBC) and C-reactive protein (CRP) levels were significantly higher in the severe group (p < 0.05). The hepatic injury group included 296 patients (23.9%) while the group without hepatic injury included 942 patients (76.1%). Males were more likely to have liver injury (p < 0.05). Fever and abdominal pain were significantly higher in the hepatic injury group. Patients with liver injury had increased levels of WBCs, CRP and chest computed tomography (CT) score and had a longer hospital stay (p < 0.05). Chest CT score was a predictor of liver injury (p < 0.05). Conclusions: Liver injury in non-ICU hospitalized COVID-19 patients is common but it is mild and has a good prognosis. Liver injury may be related to the degree of chest CT lesions.

Prognostic factors for long-term survival after pancreaticoduodenectomy for periampullary adenocarcinoma. A retrospective cohort study.

BACKGROUND: Periampullary adenocarcinoma (PAAC) had a poor prognosis, and pancreaticoduodenectomy (PD) remains the only potentially curative treatment. The study aimed to identify the impact of different clinicopathological factors on long-term survival following PD for PAAC. PATIENTS AND METHODS: This study is a retrospective cohort study for the patients who underwent PD for pathologically proven PAAC from January 2010 to January 2019. Statistical analysis was done using Cox regression multivariate analyses for independent risk factors for survival. RESULT: There were 137 patients with PAAC who underwent PD, 79 patients (57.7%) underwent pylorus-preserving PD. Pancreatico-jejunostomy was done in 108 patients (78.8%). The primary analysis showed that risk factors for poor long-term survival include patients with co-morbidities like hypertension or ischemic heart disease, Carbohydrate Antigen 19-9 > 400U/ml, tumor size > 3 cm, poor tumor differentiation, positive lymph nodes invasion, lymphovascular invasion, and Perineural invasion. Multivariate analysis demonstrated that large tumor size > 3 cm (HR: 0.177, 95%CI: 0.084-0.374, P = 0.002), poorly differentiated tumor (HR: 0.059, 95%CI: 0.020-0.0174, P = 0.016), and perineural invasion in the pathological study (HR: 0.101, 95%CI: 0.046-0.224, P = 0.006) were independent risk factors for poor 5-years survival. The prognosis was better in ampullary adenocarcinoma (5-year survival was 42.1%) than pancreatic adenocarcinoma (5-year survival was 24.3%). The 1, 3, 5 and 7-year overall survival rates were 84.5%, 57.4%, 35.9% and 20.1% respectively. CONCLUSION: It seems from the current study that Tumor size > 3 cm, poor tumor differentiation, and Perineural invasion were independent predictors of poor survival in patients with PAAC.

The Bayesian adaptive lasso regression.

Classical adaptive lasso regression is known to possess the oracle properties; namely, it performs as well as if the correct submodel were known in advance. However, it requires consistent initial estimates of the regression coefficients, which are generally not available in high dimensional settings. In addition, none of the algorithms used to obtain the adaptive lasso estimators provide a valid measure of standard error. To overcome these drawbacks, some Bayesian approaches have been proposed to obtain the adaptive lasso and related estimators. In this paper, we consider a fully Bayesian treatment for the adaptive lasso that leads to a new Gibbs sampler with tractable full conditional posteriors. Through simulations and real data analyses, we compare the performance of the new Gibbs sampler with some of the existing Bayesian and non-Bayesian methods. Results show that the new approach performs well in comparison to the existing Bayesian and non-Bayesian approaches.