Cryptococcosis and Cryptococcal Meningitis: A Narrative Review and the Up-to-Date Management Approach.

Cryptococcosis is a fungal infectious disease that enormously impacts human health worldwide. Cryptococcal meningitis is the most severe disease caused by the fungus Cryptococcus, and can lead to death, if left untreated. Many patients develop resistance and progress to death even after treatment. It requires a prolonged treatment course in people with AIDS. This narrative review provides an evidence-based summary of the current treatment modalities and future trial options, including newer ones, namely, 18B7, T-2307, VT-1598, AR12, manogepix, and miltefosine. This review also evaluated the management and empiric treatment of cryptococcus meningitis. The disease can easily evade diagnosis with subacute presentation. Despite the severity of the disease, treatment options for cryptococcosis remain limited, and more research is needed.

Metabolic Dysfunction-Associated Steatohepatitis and Progression to Hepatocellular Carcinoma: A Literature Review.

The prevalence of metabolic-associated fatty liver disease (MAFLD) is increasing globally due to factors such as urbanization, obesity, poor nutrition, sedentary lifestyles, healthcare accessibility, diagnostic advancements, and genetic influences. Research on MAFLD and HCC risk factors, pathogenesis, and biomarkers has been conducted through a narrative review of relevant studies, with a focus on PubMed and Web of Science databases and exclusion criteria based on article availability and language. Steatosis marks the early stage of MASH advancement, commonly associated with factors of metabolic syndrome such as obesity and type 2 diabetes. Various mechanisms, including heightened lipolysis, hepatic lipogenesis, and consumption of high-calorie diets, contribute to the accumulation of lipids in the liver. Insulin resistance is pivotal in the development of steatosis, as it leads to the release of free fatty acids from adipose tissue. Natural compounds hold promise in regulating lipid metabolism and inflammation to combat these conditions. Liver fibrosis serves as a significant predictor of MASH progression and HCC development, underscoring the need to target fibrosis in treatment approaches. Risk factors for MASH-associated HCC encompass advanced liver fibrosis, older age, male gender, metabolic syndrome, genetic predispositions, and dietary habits, emphasizing the requirement for efficient surveillance and diagnostic measures. Considering these factors, it is important for further studies to determine the biochemical impact of these risk factors in order to establish targeted therapies that can prevent the development of HCC or reduce progression of MASH, indirectly decreasing the risk of HCC.

Effect of once-a-day milk feeding on behavior and growth performance of pre-weaning calves.

OBJECTIVE: The objectives of the present study were to evaluate the effects of once-a-day milk feeding on growth performance and routine behavior of preweaning dairy calves. METHODS: At 22nd day of age, twenty-four Holstein calves were randomly assigned to one of two treatment groups (n = 12/treatment) based on milk feeding frequency (MF): i) 3 L of milk feeding two times a day; ii) 6 L of milk feeding once a day. The milk feeding amount was reduced to half for all calves between 56 and 60 days of age and weaning was done at 60 days of age. To determine the increase in weight and structural measurements, each calf was weighed and measured at 3 weeks of age and then at weaning. The daily behavioral activity of each calf was assessed from the 22nd day of age till weaning (60th day of age) through Nederlandsche Apparatenfabriek (NEDAP) software providing real-time data through a logger fitted on the calf's foot. RESULTS: There was no interaction (p≥0.17) between MF and sex of the calves for routine behavioral parameters, body weight and structural measurements. Similarly, there was no effect of MF on routine behavioral parameters, body weight and structural measurements. However, the sex of the calves affected body weight gain in calves. Male calves had 27% greater total body weight and average daily gain than female calves. There was no effect of the sex of the calves on behavioral measurements. Collectively, in the current study, no negative effects of a once-a-day milk feeding regimen were found on routine behavioral and growth parameters of preweaning calves in group housing. CONCLUSION: Once-a-day milk feeding can be safely adopted in preweaning calves from 22nd day of age.

"Extending the Technology Acceptance Model (TAM) to Predict University Students' Intentions to Use Metaverse-Based Learning Platforms".

Metaverse, which combines a number of information technologies, is the Internet of the future. A media for immersive learning, metaverse could set future educational trends and lead to significant reform in education. Although the metaverse has the potential to improve the effectiveness of online learning experiences, metaverse-based educational implementations are still in their infancy. Additionally, what factors impact higher education students' adoption of the educational metaverse remains unclear. Consequently, the aim of this study is to explore the main factors that affect higher education students' behavioral intentions to adopt metaverse technology for education. This study has proposed an extended Technology Acceptance Model (TAM) to achieve this aim. The novelty of this study resides in its conceptual model, which incorporates both technological, personal, and inhibiting/enabling factors. The empirical data were collected via online questionnaires from 574 students in both private and public universities in Jordan. Based on the PLS-SEM analysis, the study identifies perceived usefulness, personal innovativeness in IT, and perceived enjoyment as key enablers of students' behavioral intentions to adopt the metaverse. Additionally, perceived cyber risk is found as the main inhibitor of students' metaverse adoption intentions. Surprisingly, the effect of perceived ease of use on metaverse adoption intentions is found to be insignificant. Furthermore, it is found that self-efficacy, personal innovativeness, and perceived cyber risk are the main determinants of perceived usefulness and perceived ease of use. While the findings of this study contribute to the extension of the TAM model, the practical value of these findings is significant since they will help educational authorities understand each factor's role and enable them to plan their future strategies.

Diffuse St Depression With St Elevation Avr In Acute Coronary Syndrome And Its Association With Significant Left Main Or Three Vessel Coronary Artery Disease And Its Confounders.

BACKGROUND: : Global ST depression in 8 or more leads along with ST elevation in aVR has been considered as hallmark of widespread sub-endocardial ischemia. It has been associated with left main (LM) stem or three vessel disease (3VD). But different studies have shown different results. We collected data from patients to see association of these ECG changes with significant LM stem disease and/or significant (3VD). METHODS: TIt was a prospective observational study performed at tertiary care cardiac center. All patients with acute coronary syndrome (ACS) having global ST depression and ST Elevation in aVR (that is ST depression of at least 0.5 mv in ≥8 leads along with ST elevation in aVR of at least 0.5 mv) and have undergone coronary angiogram were included. RESULTS: Our study included 404 patients with above mentioned ECG findings. We observed significant LM stem or significant 3VD in 67% (n=274), 3VD in 55% (n=222) and significant LM stem in only 29% (n=118). Risk factors like diabetes, hypertension and smoking increase probability of these ECG changes up to 40.4%, 32.1% and 33.3% for significant LM stem disease and 62.7%, 57.1% and 57.5% for significant 3VD. Magnitude of ST elevation in aVR leads ≥1 mm increase sensitivity for LM stem disease 35% and for 3VD up to 60.4% and TIMI score ≥4 up to 36.7% for significant LM stem disease and 62.5% for significant 3VD. CONCLUSIONS: : Global ST depression along with ST elevation in aVR in patients with ACS has low probability for significant LM stem intermediate probability for significant 3VD. Factors like presence of diabetes, hypertension, smoking, magnitude of ST elevation in aVR, and TIMI score improves its diagnostic yield.

Effects of peripartal glucose precursor supplementation on lactation performance and metabolic health of primiparous and multiparous dairy cows.

OBJECTIVE: Hyperketonemia remains a major metabolic issue of serious milk production and a major health concern in early lactation cows. Oral supplementation of glucose precursors (GP) can be used to prevent hyperketonemia in dairy cows. The objective of this study was to compare the beneficial effects of orally supplementing a mixture of GP on metabolic health indicators and milk production status of primiparous (PP) and multiparous (MP) dairy cows. METHODS: Twenty-eight Holstein cows were blocked by expected date of parturition, previous lactation yield, and parity. The cows were randomly allocated to one of the four treatment groups (n = 7 cows/group) based on their parity and GP supplementation: i) PP cows fed basal diet only (PP-CON), ii) PP cows with oral supplementation of GP (PP-GP), iii) MP cows fed basal diet only (MP-CON), and iv) MP cows with oral supplementation of GP (MP-GP). Glucose precursor (glycoline liquid) was orally drenched (300 mL/d) in GP cows from 7 days prepartum through 7 days postpartum. Other than GP supplementation, all cows were fed similar pre- and postpartum basal diets. RESULTS: In both pre- and postpartum periods, serum glucose concentration was increased, whereas ß-hydroxybutyrate and free fatty acids were decreased in GP cows compared with the CON cows. Milk yield and milk components were statistically not different between GP and CON cows over the first 9 week of lactation. The yield of actual milk, energy-corrected milk, 63-days cumulative milk, colostrum yield, and calf birth weight remained higher in MP cows compared with PP cows. CONCLUSION: Oral drenching of GP around calving can be recommended to successfully improve the metabolic health and reduce the negative effects of hyperketonemia not only in MP but also in PP dairy cows.

Diagnostic Modalities Used in Diagnosing Gastroparesis: A Clinical Review.

Gastroparesis is associated with abnormal gastric motility characterized by delayed gastric emptying without any obvious mechanical gastric outlet obstruction or blockage. Gastroparesis is associated with significant morbidity and mortality. It is pertinent to make a timely diagnosis of gastroparesis so that prompt treatment can be initiated. The purpose of this clinical review article is to help the internist and the primary care providers to get a better idea of various diagnostic modalities used in diagnosing gastroparesis. We have also discussed the advantages and disadvantages of various diagnostic modalities based on the latest evidence.

Epidemiology, Clinical Features, Diagnosis and Management of Monkeypox Virus: A Clinical Review Article.

The start of 2022 was marked by the sudden surge in the detection of the viral disease - monkeypox. The recent and ongoing COVID-19 epidemic makes the re-emerging of viral zoonosis particularly worrisome. The rapid spread of the monkeypox virus has sparked concerns about the start of a new epidemic. In this review, I summarize the epidemiology, clinical signs, and symptoms, transmission, diagnosis, management, and prevention of the monkeypox virus. Clinicians need to have a high index of suspicion for monkeypox in patients with high-risk factors presenting with new onset progressive rash. Patients with confirmed or suspected monkeypox infections need to be isolated until all the lesions have resolved.

Impacts of the COVID-19 pandemic on household food waste behaviour: A systematic review.

Food waste has adverse economic, social, and environmental impacts and increases the prevalence of food insecurity. Panic buying at the beginning of the COVID-19 outbreak raised serious concerns about a potential rise in food waste levels and higher pressure on waste management systems. This article aims to investigate the impact of COVID-19 on food waste behaviour and the extent to which it occurs using the systematic review method. A total of 38 articles were identified and reviewed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The findings showed that the COVID-19 pandemic led to reductions in household food waste in most countries. Several changes in shopping and cooking behaviours, food consumption, and managing inventory and leftovers have occurred due to COVID-19. Based on these insights, we predicted that some desirable food-management habits would be retained, and others would roll back in the post-COVID-19 world. The review contributes to the food waste literature by offering a comprehensive overview of behavioural changes during the COVID-19 pandemic and future research directions.

People's expectations and experiences of big data collection in the Saudi context.

Big data and machine learning technologies facilitate various business intelligence activities for businesses. However, personal data collection can generate adverse effects on consumers. Big data collection can compromise people's sense of autonomy, harming digital privacy, transparency and trust. This research investigates personal data collection, control, awareness, and privacy regulation on people's autonomy in Saudi. This study used a hybrid analytical model that incorporates symmetrical and asymmetrical analysis via fuzzy set qualitative comparative analysis (fsQCA) to analyze consumer sense of autonomy regarding big data collection. The symmetrical shows that 'Control' had the most significant influence on people's autonomy, followed by 'Big data collection' and 'Awareness'. The fsQCA shows 84% of the variation, explaining the people's autonomy.

Engineering of cardiac microtissues by microfluidic cell encapsulation in thermoshrinking non-crosslinked PNIPAAm gels.

Multicellular agglomerates in form of irregularly shaped or spherical clusters can recapitulate cell-cell interactions and are referred to as microtissues. Microtissues gain increasing attention in several fields including cardiovascular research. Cardiac microtissues are evolving as excellent model systems for drug testingin vitro(organ-on-a-chip), are used as tissue bricks in 3D printing processes and pave the way for improved cell replacement therapiesin vivo. Microtissues are formed for example in hanging drop culture or specialized microwell plates; truly scalable methods are not yet available. In this study, a novel method of encapsulation of cells inpoly-N-isopropylacrylamid(PNIPAAm) spheres is introduced. Murine induced pluripotent stem cell-derived cardiomyocytes and bone marrow-derived mesenchymal stem cells were encapsulated in PNIPAAm by raising the temperature of droplets formed in a microfluidics setup above the lower critical solute temperature (LCST) of 32 °C. PNIPAAM precipitates to a water-insoluble physically linked gel above the LCST and shrinks by the expulsion of water, thereby trapping the cells in a collapsing polymer network and increasing the cell density by one order of magnitude. Within 24 h, stable cardiac microtissues were first formed and later released from their polymer shell by washout of PNIPAAm at temperatures below the LCST. Rhythmically contracting microtissues showed homogenous cell distribution, age-dependent sarcomere organizations and action potential generation. The novel approach is applicable for microtissue formation from various cell types and can be implemented into scalable workflows.

Impact of COVID-19 on the Gastrointestinal Tract: A Clinical Review.

Coronavirus disease 2019 (COVID-19) has spread rapidly throughout the world, causing a pandemic that has resulted in more than 5 million deaths globally. The gastrointestinal (GI) tract is known to have high expression of angiotensin-converting enzyme 2 (ACE2) receptors in the human body, making it prone to direct damage from the cellular invasion of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Numerous GI symptoms have been reported among patients with COVID-19. This systemic review details the mechanism and effects of COVID-19 on the GI tract along with the hepatobiliary and pancreatic systems.

Interaction Analysis of MRP1 with Anticancer Drugs Used in Ovarian Cancer: In Silico Approach.

Multidrug resistance (MDR) is one of the major therapeutic challenges that limits the efficacy of chemotherapeutic response resulting in poor prognosis of ovarian cancer (OC). The multidrug resistance protein 1 (MRP1) is a membrane-bound ABC transporter involved in cross resistance to many structurally and functionally diverse classes of anticancer drugs including doxorubicin, taxane, and platinum. In this study, we utilize homology modelling and molecular docking analysis to determine the binding affinity and the potential interaction sites of MRP1 with Carboplatin, Gemcitabine, Doxorubicin, Paclitaxel, and Topotecan. We used AutoDock Vina scores to compare the binding affinities of the anticancer drugs against MRP1. Our results depicted Carboplatin < Gemcitabine < Topotecan < Doxorubicin < Paclitaxel as the order of binding affinities. Paclitaxel has shown the highest binding affinity whereas Carboplatin displayed the lowest affinity to MRP1. Interestingly, our data showed that Carboplatin, Paclitaxel, and Topotecan bind specifically to Asn510 residue in the transmembrane domains 1 of the MRP1. Our results suggest that Carboplatin could be an appropriate therapeutic choice against MRP1 in OC as it couples weakly with Carboplatin. Further, our findings also recommend opting Carboplatin with Gemcitabine as a combinatorial chemotherapeutic approach to overcome MDR phenotype associated with recurrent OC.

Homozygous mutation in MCM7 causes autosomal recessive primary microcephaly and intellectual disability.

BACKGROUND: Minichromosomal maintenance (MCM) complex components 2, 4, 5 and 6 have been linked to human disease with phenotypes including microcephaly and intellectual disability. The MCM complex has DNA helicase activity and is thereby important for the initiation and elongation of the replication fork and highly expressed in proliferating neural stem cells. METHODS: Whole-exome sequencing was applied to identify the genetic cause underlying the neurodevelopmental disease of the index family. The expression pattern of Mcm7 was characterised by performing quantitative real-time PCR, in situ hybridisation and immunostaining. To prove the disease-causative nature of identified MCM7, a proof-of-principle experiment was performed. RESULTS: We reported that the homozygous missense variant c.793G>A/p.A265T (g.7:99695841C>T, NM_005916.4) in MCM7 was associated with autosomal recessive primary microcephaly (MCPH), severe intellectual disability and behavioural abnormalities in a consanguineous pedigree with three affected individuals. We found concordance between the spatiotemporal expression pattern of Mcm7 in mice and a proliferative state: Mcm7 expression was higher in early mouse developmental stages and in proliferative zones of the brain. Accordingly, Mcm7/MCM7 levels were detectable particularly in undifferentiated mouse embryonal stem cells and human induced pluripotent stem cells compared with differentiated neurons. We further demonstrate that the downregulation of Mcm7 in mouse neuroblastoma cells reduces cell viability and proliferation, and, as a proof-of-concept, that this is counterbalanced by the overexpression of wild-type but not mutant MCM7. CONCLUSION: We report mutations of MCM7 as a novel cause of autosomal recessive MCPH and intellectual disability and highlight the crucial function of MCM7 in nervous system development.

The effect of GnRH administration/insemination time on follicular growth rate, ovulation intervals, and conception rate of Nili Ravi buffalo heifers in 7 -day-CIDR Co-synch.

The present study aimed to compare two different insemination times (72 vs 84 h) associated with an ovulation induction (GnRH) in a 7-day CIDR Co-synch to improve the conception rate of Nili Ravi buffalo heifers. Forty Nili Ravi buffalo heifers were randomly separated into two treatments based on artificial insemination (AI) timing (72 vs 84 h). All heifers were subjected to controlled internal drug release (CIDR), containing 1.38 g of progesterone for 7 days. On CIDR removal, both treatments received 150 µg of prostaglandin intramuscularly. In 7-day CIDR Co-synch (n = 20), animals were injected 100 µg of GnRH administration intramuscularly and inseminated concurrently at 72 h after CIDR removal. The remaining half (n = 20) were injected and inseminated concurrently at 84 h of CIDR removal. Pregnancy diagnosis was performed on day 40 of timed artificial insemination (TAI) with ultrasound. The follicular growth rate between 72 h after PGF2α/CIDR removal to pre-ovulatory follicle in 7-day CIDR Co-synch was more (0.102 ± 0.005 mm vs 0.079 ± 0.003 mm; P = 0.01) at 84 than 72 h. The interval from GnRH administration/TAI to ovulation was high (26.8 ± 1.64 h vs. 15.1 ± 1.25 h, P = 0.01) in 72 than 84 h. Conception rates were considerably higher in buffalo heifers inseminated at 84 h (65%) than 72 h (25%) in 7-day CIDR Co-synch protocol. In conclusion that in Nili Ravi buffalo heifers, GnRH administration/TAI after 84 h of CIDR removal allows greater follicular growth rate and shortens interval from AI to ovulation compared to the GnRH administration/TAI after 72 h of CIDR removal in 7-day CIDR-Co-synch protocol.

The Role of Oxidative Stress and Antioxidant Balance in Pregnancy.

It has been widely known that oxidative stress disrupts the balance between reactive oxygen species (ROS) and the antioxidant system in the body. During pregnancy, the physiological generation of ROS is involved in a variety of developmental processes ranging from oocyte maturation to luteolysis and embryo implantation. While abnormal overproduction of ROS disrupts these processes resulting in reproductive failure. In addition, excessive oxidative stress impairs maternal and placental functions and eventually results in fetal loss, IUGR, and gestational diabetes mellitus. Although some oxidative stress is inevitable during pregnancy, a balancing act between oxidant and antioxidant production is necessary at different stages of the pregnancy. The review aims to highlight the importance of maintaining oxidative and antioxidant balance throughout pregnancy. Furthermore, we highlight the role of oxidative stress in pregnancy-related diseases.

The Role of Polyphenols in Regulation of Heat Shock Proteins and Gut Microbiota in Weaning Stress.

Gut microbiota is the natural residents of the intestinal ecosystem which display multiple functions that provide beneficial effects on host physiology. Disturbances in gut microbiota in weaning stress are regulated by the immune system and oxidative stress-related protein pathways. Weaning stress also alters gut microbiota response, limits digestibility, and influences animal productive performance through the production of inflammatory molecules. Heat shock proteins are the molecular chaperones that perform array functions from physiological to pathological point of view and remodeling cellular stress response. As it is involved in the defense mechanism, polyphenols ensure cellular tolerance against enormous stimuli. Polyphenols are nature-blessed compounds that show their existence in plenty of amounts. Due to their wider availability and popularity, they can exert strong immunomodulatory, antioxidative, and anti-inflammatory activities. Their promising health-promoting effects have been demonstrated in different cellular and animal studies. Dietary interventions with polyphenols may alter the gut microbiome response and attenuate the weaning stress related to inflammation. Further, polyphenols elicit health-favored effects through ameliorating inflammatory processes to improve digestibility and thereby exert a protective effect on animal production. Here, in this article, we will expand the role of dietary polyphenol intervention strategies in weaning stress which perturbs gut microbiota function and also paid emphasis to heat shock proteins in gut health. This review article gives new direction to the feed industry to formulate diet containing polyphenols which would have a significant impact on animal health.

Comparative analysis of scheduling algorithms for radio resource allocation in future communication networks.

BACKGROUND: Wireless links are fast becoming the key communication mode. However, as compared to the wired link, their characteristics make the traffic prone to time- and location-dependent signal attenuation, noise, fading, and interference that result in time varying channel capacities and link error rate. Scheduling algorithms play an important role in wireless links to guarantee quality of service (QoS) parameters such as throughput, delay, jitter, fairness and packet loss rate. The scheduler has vital importance in current as well as future cellular communications since it assigns resource block (RB) to different users for transmission. Scheduling algorithm makes a decision based on the information of link state, number of sessions, reserved rates and status of the session queues. The information required by a scheduler implemented in the base station can easily be collected from the downlink transmission. METHODS: This paper reflects on the importance of schedulers for future wireless communications taking LTE-A networks as a case study. It compares the performance of four well-known scheduling algorithms including round robin (RR), best channel quality indicator (BCQI), proportional fair (PF), and fractional frequency reuse (FFR). The performance of these four algorithms is evaluated in terms of throughput, fairness index, spectral efficiency and overall effectiveness. System level simulations have been performed using a MATLAB based LTE-A Vienna downlink simulator. RESULTS: The results show that the FFR scheduler is the best performer among the four tested algorithms. It also exhibits flexibility and adaptability for radio resource assignment.

The adoption of cryptocurrency as a disruptive force: Deep learning-based dual stage structural equation modelling and artificial neural network analysis.

In recent years, the growth of cryptocurrency has undergone an enormous increase in cryptocurrency markets all around the world. Sadly, only insignificant heed has been paid to the unveiling of determinants of cryptocurrency adoption globally, particularly in emerging markets like Malaysia. The purpose of the study is to examine whether the application of deep learning-based dual-stage Partial Least Square-Structural Equation Modelling (PLS-SEM) & Artificial Neural Network (ANN) analysis enable better in-depth research results as compared to single-step PLS-SEM approach and to excavate factors which can predict behavioural intention to adopt cryptocurrency. The Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) model were extended with the inclusion of trust and personnel innovativeness. The model was further validated by introducing a new path model compared to the original UTAUT2 model and the moderating role of personal innovativeness between performance expectancy and price value, with a sample of 314 respondents. Contrary to previous technology adoption studies that used PLS-SEM & ANN as single-stage analysis, this study further enhanced the analysis by applying a deep learning-based dual-stage PLS-SEM and ANN method. The application of deep learning-based dual-stage PLS-SEM & ANN analysis is a novel methodological approach, detecting both linear and non-linear associations among constructs. At the same time, it is regarded as a superior statistical approach as compared to traditional hybrid shallow SEM & ANN single-stage analysis. Also, sensitivity analysis provides normalised importance using multi-layer perceptron with the feed-forward-back-propagation algorithm. Furthermore, the deep learning-based dual-stage PLS-SEM & ANN revealed that trust proved to be the strongest predictor in driving user intention. The introduction of this new methodology and the theoretical contribution opens the vistas of the extant body of knowledge in technology-adoption related literature. This study also provides theoretical, practical and methodological contributions.

Zwolle Risk Score for Safety Assessment of Same-day Discharge after Primary Percutaneous Coronary Intervention.

OBJECTIVES: The Zwolle risk score (ZRS) has been considered to be a useful tool for the systematic evaluation of patients for early discharge after primary percutaneous coronary intervention (PCI). Therefore, aim of this study was to evaluate the clinical utility of ZRS for the same-day discharge strategy after primary PCI at a tertiary care cardiac center of Karachi, Pakistan. METHODS: This study was conducted at a tertiary care cardiac center between August 2019 and July 2020. Patients discharged within 24 h (same-day) of the primary PCI procedure were included. Patients were stratified as high- and low-risk based on ZRS score; low-risk (≤3) and high-risk (≥4). All patients were followed during 30-days post-procedure period for major adverse cardiac events (MACE). RESULTS: Out of 487 patients, 83.2% (405) were male and mean age was 54.6 ± 10.87 years. Mean ZRS was 2.34 ± 1.64 with 16.0% (78) patients in high-risk (≥4) group. 30-days MACE rate was observed to be 5.3% (26) with significantly higher rate among high-risk patients as compared to low-risk patients 12.8% (10) vs. 3.9% (16); p = 0.004 respectively with OR of 3.61 [1.57-8.29]. The area under the curve (AUC) of ZRS for prediction of 30-day MACE was 0.67 [95% CI: 0.58-0.77], ZRS ≥4 had sensitivity of 38.5% and specificity of 85.2% with AUC of 0.62 [95% CI: 0.50-0.74] for prediction of 30-day MACE. CONCLUSION: ZRS showed moderate discriminating potential in identifying patients with high-risk of MACE at 30-day after same-day discharge after primary PCI.