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Conventional geodetic methods rely on point measurements, which have drawbacks for detecting and tracking geologic disasters at specific locations. In this study, the time series Interferometric Synthetic Aperture Radar (InSAR) approach was incorporated to estimate non-linear surface deformation caused by tectonic, shoreline reclamation, and other anthropogenic activities in economically important urban regions of Pakistan's southern coast, which possesses around 270 km. The shoreline is extended from the low-populated area on the premises of the Hub River in the west to the highly populated Karachi City and Eastern Industrial Zone, where we collected the Sentinel-1A C-band data from 2017 to 2023 to address urban security and threats to human life and property. The main advantage of opting for the non-linear persistent scatterer interferometric SAR (PSInSAR) approach for this study is that it exposes minute movements without any prior consideration of conventional monitoring techniques, making it valid in continuously varying regions. An average vertical displacement range of - 170 to + 82 mm per year was found, which was used to investigate the potential correlation with the most effective causative parameters of deformation. The densely populated areas of the study area experience an annual subsidence of 170 mm, and the less populated western region experiences an uplift of 82 mm annually. Land deformation varies along the coast of the study area, where the eastern region is highly reclaimed and is affected by erosion. Groundwater table-depleting regions experienced high levels of land subsidence, and tectonic activities controlled vertical displacement in the region. Major variation was detected after an earthquake occurred along fault lines. This study was designed because a non-linear approach is required to address ground movement activities acutely, and it will make it possible to plan surface infrastructure and handle issues brought on by subsidence more effectively.
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Periodontally accelerated osteogenic orthodontics (PAOO) is a periodontal-orthodontic interrelationship procedure that helps in accelerating orthodontic treatment by periodontal procedure reinforcement. This depends on the principle of the regional acceleratory phenomenon which involves inducing changes in the biology of periodontal tissues to fasten the orthodontic tooth movement by creating a surge in the osteopenic environment for tooth movement followed by bone deposition and mineralisation to stabilise the tooth in newly moved position. This PAOO involves the intentional creation of surgical corticotomy cuts followed by a grafting procedure to maintain bone resorption and thickness. Numerous modifications have been incorporated to reduce surgical complications and to improve treatment results by minimally invasive techniques. Hence, this case report incorporated piezosurgery-assisted corticotomy cuts involving the buccal side along with particulate bone grafting to fasten the orthodontic tooth movement, reducing the overall treatment time, root resorption and stabilising the orthodontic treatment results.
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Control charts, used in healthcare operations to monitor process stability and quality, are essential for ensuring patient safety and improving clinical outcomes. This comprehensive research study aims to provide a thorough understanding of the role of control charts in healthcare quality monitoring and future perspectives by utilizing a dual methodology approach involving a systematic review and a pioneering bibliometric analysis. A systematic review of 73 out of 223 articles was conducted, synthesizing existing literature (1995-2023) and revealing insights into key trends, methodological approaches, and emerging themes of control charts in healthcare. In parallel, a bibliometric analysis (1990-2023) on 184 articles gathered from Web of Science and Scopus was performed, quantitatively assessing the scholarly landscape encompassing control charts in healthcare. Among 25 countries, the USA is the foremost user of control charts, accounting for 33% of all applications, whereas among 14 health departments, epidemiology leads with 28% of applications. The practice of control charts in health monitoring has increased by more than one-third during the last 3 years. Globally, exponentially weighted moving average charts are the most popular, but interestingly the USA remained the top user of Shewhart charts. The study also uncovers a dynamic landscape in healthcare quality monitoring, with key contributors, research networks, research hotspot tendencies, and leading countries. Influential authors, such as J.C. Benneyan, W.H. Woodall, and M.A. Mohammed played a leading role in this field. In-countries networking, USA-UK leads the largest cluster, while other clusters include Denmark-Norway-Sweden, China-Singapore, and Canada-South Africa. From 1990 to 2023, healthcare monitoring evolved from studying efficiency to focusing on conditional monitoring and flowcharting, with human health, patient safety, and health surveys dominating 2011-2020, and recent years emphasizing epidemic control, COronaVIrus Disease of 2019 (COVID-19) statistical process control, hospitals, and human health monitoring using control charts. It identifies a transition from conventional to artificial intelligence approaches, with increasing contributions from machine learning and deep learning in the context of Industry 4.0. New researchers and journals are emerging, reshaping the academic context of control charts in healthcare. Our research reveals the evolving landscape of healthcare quality monitoring, surpassing traditional reviews. We uncover emerging trends, research gaps, and a transition in leadership from established contributors to newcomers amidst technological advancements. This study deepens the importance of control charts, offering insights for healthcare professionals, researchers, and policymakers to enhance healthcare quality. Future challenges and research directions are also provided.
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Bibliometria , Qualidade da Assistência à Saúde , Humanos , Segurança do PacienteRESUMO
Control charts help epidemiologists and healthcare professionals monitor disease incidence and prevalence in real time, preventing outbreaks and health emergencies. However, there remains a notable gap in the comprehensive exploration and application of these techniques, particularly in the context of monitoring and managing disease outbreaks. This study analyses and categorizes worldwide control chart applications from 2000 to 2023 in outbreak monitoring in over 20 countries, focusing on corona-virus (COVID-19), and chooses optimal control charts for monitoring US COVID-19 death waves from February 2020 to December 2023. The systematic literature review analyzes available 35 articles, categorizing data by year, variable, country, study type, and chart design. A selected optimal chart is applied to monitor COVID-19 death patterns and waves in the USA. Control chart adoption in epidemiology monitoring increased during the COVID-19 pandemic, with annual patterns showing a rise in 2021 to 2023 (18%, 36%, 41%). Important variables from 2000 to 2019 include influenza counts, Salmonella cases, and infection rates, while COVID-19 studies focus more on cases, infection rates, symptoms, and deaths. Among 22 countries, the USA (29%) is the top applier of control charts. The monitoring of USA COVID-19 deaths reveals 8 waves with varying severity â >â â >â â >â â >â â >â â >â â >â . The associated with the JN.1 variant, highlights ongoing challenges. This study emphasizes the significance of control charts in outbreak monitoring for early disease diagnosis and intervention. Control charts help healthcare workers manage epidemics using data-driven methods, improving public health. COVID-19 mortality analysis emphasizes their importance, encouraging worldwide use.
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COVID-19 , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/mortalidade , SARS-CoV-2 , Monitoramento Epidemiológico , Saúde Global , Pandemias , Surtos de DoençasRESUMO
Maintenance of biological width serves as a primary factor in periodontal-restorative relationships. Crown lengthening (CL) is a technique to prevent violation of biological width, with the laser method offering the advantage of surgical and patient-related outcomes. Laser CL with retraction helps with the excision of tissues, increasing the CL, maintaining the gingival contour with adequate exposure to the finish line to record the tooth preparation features. This helps to achieve the functional and esthetic outcomes essential for restorative dentistry. The marginal fit, contour, and adaptation of the crown can be further enhanced by computer-aided design and computer-aided manufacturing (CAD/CAM) technology improving patient and clinical outcomes. Hence, this case report aims to indulge the laser-assisted procedures and CAD/CAM technology to fabricate and deliver a zirconia crown maintaining the periodontal-restorative factors.
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The qualitative impact of pollutants on water quality is mainly related to their nature and their concentration, but in any case, they determine a strong impact on the involved ecosystems. In particular, refractory organic compounds represent a critical challenge, and several degradation processes have been studied and developed for their removal. Among them, heterogeneous Fenton treatment is a promising technology for wastewater and liquid waste remediation. Here, we have developed mono- and bimetallic formulations based on Co, Cu, Fe, and Mn, which were investigated for the degradation of three model organic dyes (methylene blue, rhodamine B, and malachite green). The treated samples were then analyzed by means of UV-vis spectrophotometry techniques. Bimetallic iron-based materials achieved almost complete degradation of all three model molecules in very short time. The Mn-Fe catalyst resulted in the best formulation with an almost complete degradation of methylene blue and malachite green at pH 5 in 5 min and of rhodamine B at pH 3 in 30 min. The results suggest that these formulations can be applied for the treatment of a broad range of liquid wastes comprising complex and variable organic pollutants. The investigated catalysts are extremely promising when compared to other systems reported in the literature.
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The coronavirus disease 2019 (COVID-19) pandemic, which emerged in late 2019, has caused millions of infections and fatalities globally, disrupting various aspects of human society, including socioeconomic, political, and educational systems. One of the key challenges during the COVID-19 pandemic is accurately predicting the clinical development and outcome of the infected patients. In response, scientists and medical professionals globally have mobilized to develop prognostic strategies such as risk scores, biomarkers, and machine learning models to predict the clinical course and outcomes of COVID-19 patients. In this contribution, we deployed a mathematical approach called matrix factorization feature selection to select the most relevant features from the anonymized laboratory biomarkers and demographic data of COVID-19 patients. Based on these features, developed a model that leverages the deep stacking neural network (DSNN) to aid in clinical care by predicting patients' mortality risk. To gauge the performance of our suggested model, performed a comparative analysis with principal component analysis plus support vector machine, deep learning, and random forest, achieving outstanding performances. The DSNN model outperformed all the other models in terms of area under the curve (96.0%), F1-score (98.1%), recall (98.5%), accuracy (99.0%), precision (97.7%), specificity (97.0%), and maximum probability of correction decision (93.4%). Our model outperforms the clinical predictive models regarding patient mortality risk and classification in the literature. Therefore, we conclude that our robust model can help healthcare professionals to manage COVID-19 patients more effectively. We expect that early prediction of COVID-19 patients and preventive interventions can reduce the mortality risk of patients.
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COVID-19 , Médicos , Humanos , Pandemias , Redes Neurais de Computação , BiomarcadoresRESUMO
BACKGROUND: Smoking, alcohol abuse, and hypertension are - among others, potential risk factors for cardiovascular diseases. These risk factors generate oxidative stress and cause oxidative stress-induced DNA damage, resulting in cellular senescence and senescence-associated secretory phenotype (SASP). The SASP factors in feed-forward response exacerbate inflammation and cause tissue remodeling, resulting in atherosclerotic plaque formation and rupture. RESULTS: Colchicine inhibited ROS generation and mitigated oxidative stress-induced DNA damage. It dampened oxidative stress-induced endothelial cell senescence and improved the expression of DNA repair protein KU80 and aging marker Lamin B1. The drug attenuated the expression of senescence marker P21 at mRNA and protein levels. The pathway analysis showed that colchicine inhibited NF-κB and MAPKs pathways and subdued mTOR activation. Colchicine also attenuated mRNA expression of interleukin (IL)-1ß, IL-6, IL-8, MCP-1, ICAM-1, and E-selectin. Furthermore, colchicine reduced the mRNA and protein expression of matrix metalloproteinase (MMP-2). CONCLUSION: In summary, colchicine blocked oxidative stress-induced senescence and SASP by inhibiting the activation of NF-κB and MAPKs pathways.
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Neonatal hypoxic-ischemic encephalopathy (HIE) is one of the important complications of neonatal asphyxia, which not only leads to neurological disability but also seriously threatens the life of neonates. Over the years, animal models of HIE have been a research hotspot to find ways to cope with HIE and thereby reduce the risk of neonatal death or disability in moderate-to-severe HIE. By reviewing the literature related to HIE over the years, it was found that nonhuman primates share a high degree of homology with human gross neural anatomy. The basic data on nonhuman primates are not yet complete, so it is urgent to mine and develop new nonhuman primate model data. In recent years, the research on nonhuman primate HIE models has been gradually enriched and the content is more novel. Therefore, the purpose of this review is to further summarize the methods for establishing the nonhuman primate HIE model and to better elucidate the relevance of the nonhuman primate model to humans by observing the behavioral manifestations, neuropathology, and a series of biomarkers of HIE in primates HIE. Finally, the most popular and desirable treatments studied in nonhuman primate models in the past 5 years are summarized.
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OBJECTIVES: Prominin 2 (PROM2) gene has been reported as a molecular biomarker of human cancers; however, its role is still controversial. This study was therefore arranged to seek the role of PROM2 in different cancers with Bioinformatics and in vitro analyses. METHODS: A combination of bioinformatics and molecular experiments. RESULTS: Through the utilization of Bioinformatics analysis, it was observed that in 19 out of the 24 human cancers studied, there was a significant increase in the expression of PROM2 compared to the respective control samples. Additionally, the overexpression of PROM2 was linked specifically to a decrease in overall survival (OS) among breast cancer (BRCA), lung adenocarcinoma (LUAD), and uterine corpus endometrial carcinoma (UCEC) patients. Furthermore, advanced molecular investigations were conducted, encompassing RNA sequencing (RNA-seq) as well as targeted bisulfite sequencing (bisulfite-seq) assessments of PROM2. These analyses were performed across an array of lung cancer cell lines (A549, ABC-1, EBC-1, and LK-2) and a normal control lung cell line (MRC-9). Results of these analysis revealed overexpression and reduced methylation of PROM2 within lung cancer cell lines, relative to the corresponding control cell line. This suggests that PROM2 assumes a substantial function in the advancement and course of BRCA, LUAD, and UCEC cancers. Subsequent pathway analysis revealed that genes enriched by PROM2 are actively engaged in four pivotal pathways. Additionally, intriguing associations were observed between PROM2 expression, tumor purity, infiltration of CD8+ T immune cells, and genetic modifications. Moreover, we also predicted a few MicroRNAs (miRNAs), transcription factors (TFs), and potential drugs that could help to understand and better manage these cancers via designing appropriate therapies targeting PROM2. CONCLUSION: Via this study, we effectively revealed PROM2 overexpression as a potential diagnostic and prognostic biomarker of survival in BRCA, LUAD, and UCEC.
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Karakoram Highway (KKH) is frequently disrupted by geological hazards mainly landslides which pose a serious threat to its normal operation. Using documented inventory, optical imagery interpretation, and frequency-area statistics, the features of slope failure, the spatial distribution, and their link to numerous contributing factors have all been effectively explored along the KKH. An updated inventory for the area was recreated using the interferometric synthetic aperture radar (InSAR) persistent scatterer (PS) technology to further investigate millimetre-accurate measurements of slope deformation (Vslope). Utilizing the PS approach, Sentinel-1 data from Jan 2018 to Jan 2022 were processed by which we obtained a deformation rate (VSlope) that varies between 0 and 364 mm/year. A total number of 234 landslides were cited from the literature and classified while 29 new potential landslides were detected and several pre-existing landslides were redefined by the InSAR approach, which was incorporated to generate an updated landslide susceptibility model with 86.6% of prediction precision in the area under curve method. As previous studies done by applying the InSAR technique incorporated a short span temporally and they missed some highly deforming zones like Budalas and Khanabad landslides, contain mean velocities > 50 mm/yr, which we studied individually in this work. In this study, a comprehensive application of the InSAR technique to assessing its performance in detecting and analysing landslides has been applied. The deformation velocity (Vslope) model shows high displacement in some regions, which needed to be further investigated by geoscientists, and the updated developed landslide inventory and susceptibility map can be used for land use planning and landslide mitigation strategies.
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Textile production is one of the main sources of freshwater consumption by industries worldwide. In addition, according to the world bank, 20 % of the wastewater generated globally is caused by textile wet-processing. Textile wet-processing includes the processes in textile production where garments are dyed or given the final functions like water-repellency. Several thousand chemicals were used in this process, some of which are highly toxic. Discharging untreated or insufficiently treated wastewater in water bodies results in high pollution levels, severely impacting the environment and human health. Especially in textile-producing countries like India, environmental pollution and water consumption from textile wet-processing have severe impacts. Next to the high volume of chemicals used in textile production, the high salt concentration in textile wastewater also poses a challenge and is critical for freshwater systems. Moreover, textile wastewater is one of the most difficult to treat wastewater. Currently, used treatment technologies do not meet the requirements to treat textile wastewater. Therefore, the further development of efficient treatment technologies for textile wastewater is critically important. Hence, in the interdisciplinary project, effect-based monitoring demonstrates the efficiency of electrically-driven water treatment processes to remove salts and micropollutants from process water (EfectroH2O), a low-energy Zero Liquid Discharge (ZLD) textile wastewater treatment technology is being developed consisting of a combination of capacitive deionization (CDI) and advanced oxidation processes (AOP). In addition to treatment technology development, methods for evaluating the efficiency of treatment technologies also need to be improved. Currently, mainly physicochemical parameters such as pH, biochemical oxygen demand (BOD) and chemical oxygen demand (COD) are tested worldwide to check water quality. However, these methods are insufficient to make a statement about the toxic potential of such complex mixtures as textile wastewater. Therefore, also next to chemical analyses, effect-based methods (EBM) are used to verify the treated wastewater.
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The hormonal imbalances, including abscisic acid (ABA) and brassinosteroid (BR) levels, caused by salinity constitute a key factor in hindering spikelet development in rice and in reducing rice yield. However, the effects of ABA and BRs on spikelet development in plants subjected to salinity stress have been explored to only a limited extent. In this research, the effect of ABA and BRs on rice growth characteristics and the development of spikelets under different salinity levels were investigated. The rice seedlings were subjected to three different salt stress levels: 0.0875 dS m-1 (Control, CK), low salt stress (1.878 dS m-1, LS), and heavy salt stress (4.09 dS m-1, HS). Additionally, independent (ABA or BR) and combined (ABA+BR) exogenous treatments of ABA (at 0 and 25 µM concentration) and BR (at 0 and 5 µM concentration) onto the rice seedlings were performed. The results showed that the exogenous application of ABA, BRs, and ABA+BRs triggered changes in physiological and agronomic characteristics, including photosynthesis rate (Pn), SPAD value, pollen viability, 1000-grain weight (g), and rice grain yield per plant. In addition, spikelet sterility under different salt stress levels (CK, LS, and HS) was decreased significantly through the use of both the single phytohormone and the cocktail, as compared to the controls. The outcome of this study reveals new insights about rice spikelet development in plants subjected to salt stress and the effects on this of ABA and BR. Additionally, it provides information on the use of plant hormones to improve rice yield under salt stress and on the enhancement of effective utilization of salt-affected soils.
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Landfill leachates are highly contaminated liquid waste, and their treatment and detoxification are a challenging task. The current system of ecotoxicological risk assessment is complex and time-consuming. It is of fundamental importance to develop simpler and faster tools for the evaluation of the treated liquid waste and for an easier preliminary screening of the most active catalytic formulation/reaction conditions of the Fenton-like process. Here, several analytical techniques have been used for the assessment of the reduction of toxicity of the landfill leachate after Fenton process over copper-zirconia catalyst (ZrCu). Ultraviolet-visible (UV-vis) spectroscopy and absorbable organic halogens (AOX) analysis have been coupled to achieve further insight into the degradation of contaminants. In addition, for the first time, the qualitative abatement of organic compounds is monitored through proton nuclear magnetic resonance (1H NMR) analysis, providing a new method for evaluating the effectiveness of the treatment. Spectroscopic techniques reveal that the Fenton process induces a significant abatement of the aromatic and halogen compounds (51%) in the landfill leachate with a reduction of the toxicity that has been confirmed by ecotoxicological test with algae. These results validate the investigated tool for a simple rapid preliminary evaluation of the detoxification efficacy.
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Poluentes Químicos da Água , Poluentes Químicos da Água/análise , Eliminação de Resíduos Líquidos/métodos , Peróxido de Hidrogênio/química , Compostos Orgânicos , OxirreduçãoRESUMO
BACKGROUND: Artificial intelligence (AI) and machine learning (ML) technology design and development continues to be rapid, despite major limitations in its current form as a practice and discipline to address all sociohumanitarian issues and complexities. From these limitations emerges an imperative to strengthen AI and ML literacy in underserved communities and build a more diverse AI and ML design and development workforce engaged in health research. OBJECTIVE: AI and ML has the potential to account for and assess a variety of factors that contribute to health and disease and to improve prevention, diagnosis, and therapy. Here, we describe recent activities within the Artificial Intelligence/Machine Learning Consortium to Advance Health Equity and Researcher Diversity (AIM-AHEAD) Ethics and Equity Workgroup (EEWG) that led to the development of deliverables that will help put ethics and fairness at the forefront of AI and ML applications to build equity in biomedical research, education, and health care. METHODS: The AIM-AHEAD EEWG was created in 2021 with 3 cochairs and 51 members in year 1 and 2 cochairs and ~40 members in year 2. Members in both years included AIM-AHEAD principal investigators, coinvestigators, leadership fellows, and research fellows. The EEWG used a modified Delphi approach using polling, ranking, and other exercises to facilitate discussions around tangible steps, key terms, and definitions needed to ensure that ethics and fairness are at the forefront of AI and ML applications to build equity in biomedical research, education, and health care. RESULTS: The EEWG developed a set of ethics and equity principles, a glossary, and an interview guide. The ethics and equity principles comprise 5 core principles, each with subparts, which articulate best practices for working with stakeholders from historically and presently underrepresented communities. The glossary contains 12 terms and definitions, with particular emphasis on optimal development, refinement, and implementation of AI and ML in health equity research. To accompany the glossary, the EEWG developed a concept relationship diagram that describes the logical flow of and relationship between the definitional concepts. Lastly, the interview guide provides questions that can be used or adapted to garner stakeholder and community perspectives on the principles and glossary. CONCLUSIONS: Ongoing engagement is needed around our principles and glossary to identify and predict potential limitations in their uses in AI and ML research settings, especially for institutions with limited resources. This requires time, careful consideration, and honest discussions around what classifies an engagement incentive as meaningful to support and sustain their full engagement. By slowing down to meet historically and presently underresourced institutions and communities where they are and where they are capable of engaging and competing, there is higher potential to achieve needed diversity, ethics, and equity in AI and ML implementation in health research.
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The purpose of this study was to determine the anticancer potential of Ifloga spicata (I. spicata) against HepG-2 cell line. To assess I. spicata cytoxicity, brine shrimp lethality and MTT assays were performed. In the brine shrimp bioassay, the ethyl acetate fraction had a significant impact with an IC50 of 10 µg/ml. The ethyl acetate and chloroform fractions inhibited HepG-2 cell line effectively (IC50 values 5.54 and 6.52 µg/ml, respectively). The isolated compound, heptadecyl benzoate inhibited growth significantly (IC50, 8.92 µg/ml) while methyl dihydroxybenzoate had modest activity (25.66 µg/ml) against the cell line. Both compounds displayed acceptable pharmacokinetic parameters in the ADME study. In the docking study, the methyl dihydroxybenzoate was involved in two hydrogen bonds with two different residues Thr830 and Asp831. The heptadecyl benzoate carbonyl oxygen exhibited a single hydrogen bond with Lys692. Both showed good interactions with the active site of the (EGFR) tyrosine kinase. Our findings suggest that I. spicata might be a viable source of anticancer natural agents. This discovery raises the prospect of the future development of a new medication for the treatment of liver cancer.
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Soil microbial community is the main indicator having a crucial role in the remediation of polluted soils. These microbes can alter soil pH, organic matter in soils (SOM), soil physic-chemical properties, and potential soil respiration rate via their enzymatic activities. Similarly, heavy metals also have a crucial role in soil enzymatic activities. For this purpose, a number of methods are studied to evaluate the impact of soil pH (a key factor in the formation of biogeographic microbial patterns in bacteria) on bacterial diversity. The effects of pH on microbial activity are glamorous but still unclear. Whereas, some studies also indicate that soil pH alone is not the single key player in the diversity of soil bacteria. Ecological stability is achieved in a pollution-free environment and pH value. The pH factor has a significant impact on the dynamics of microbes' communities. Here, we try to discuss factors that directly or indirectly affect soil pH and the impact of pH on microbial activity. It is also discussed the environmental factors that contribute to establishing a specific bacterial community structure that must be determined. From this, it can be concluded that the environmental impact on soil pH, reducing soil pH and interaction with this factor, and reducing the effect of soil pH on soil microbial community.
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Metais Pesados , Microbiota , Poluentes do Solo , Bactérias , Concentração de Íons de Hidrogênio , Solo/química , Microbiologia do Solo , Poluentes do Solo/farmacologiaRESUMO
Eco-friendly waste utilization helps in the development of sustainable infrastructures. Recently, researchers have focused on the production of road infrastructures using the circular economy concept of human safety. The objective of this study is to investigate and explore the utilization of optimum polymer waste content for the development of polymer-modified asphalt mixtures using response surface methodology (RSM). RSM based on Box-Behnken design (BBD) was employed to optimize experimental design and included three factors: X1, polymer type; X2, polymer contents; and X3, testing day. The optimized responses determined by the RSM were as follows: MS of 42.98 kN, MF of 5.08 mm, and MQ of 8.66 kN/mm, indicating a favorable and consistent precision in comparison with experimental values. Moreover, the Marshall characteristics of samples prepared with PE were quite improved compared to PET. In conclusion, the incorporation of such polymer wastes in road construction is a sustainable and cost-effective way of improving their engineering properties. This study will help in the development of sustainable road infrastructures supporting human safety and environmentally friendly practices.
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BACKGROUND: Aspirin is widely used as a cardioprotective agent due to its antiplatelet and anti-inflammatory properties. The literature has assessed and evaluated its role in hospitalized COVID-19 patients. However, no data are available regarding its role in COVID-19 critically ill patients. This study aimed to evaluate the use of low-dose aspirin (81-100â mg) and its impact on outcomes in critically ill patients with COVID-19. METHOD: A multicenter, retrospective cohort study of all critically ill adult patients with confirmed COVID-19 admitted to intensive care units (ICUs) between March 1, 2020, and March 31, 2021. Eligible patients were classified into two groups based on aspirin use during ICU stay. The primary outcome was in-hospital mortality, and other outcomes were considered secondary. Propensity score matching was used (1:1 ratio) based on the selected criteria. RESULTS: A total of 1033 patients were eligible, and 352 patients were included after propensity score matching. The in-hospital mortality (HR 0.73 [0.56, 0.97], p = 0.03) was lower in patients who received aspirin during stay. Conversely, patients who received aspirin had a higher odds of major bleeding than those in the control group (OR 2.92 [0.91, 9.36], p = 0.07); however, this was not statistically significant. Additionally, subgroup analysis showed a possible mortality benefit for patients who used aspirin therapy prior to hospitalization and continued during ICU stay (HR 0.72 [0.52, 1.01], p = 0.05), but not with the new initiation of aspirin (HR 1.22 [0.68, 2.20], p = 0.50). CONCLUSION: Continuation of aspirin therapy during ICU stay in critically ill patients with COVID-19 who were receiving it prior to ICU admission may have a mortality benefit; nevertheless, it may be associated with an increased risk of significant bleeding. Appropriate evaluation for safety versus benefits of utilizing aspirin therapy during ICU stay in COVID19 critically ill patients is highly recommended.