Citrullinated Histone H3 Level as a Novel Biomarker in Pediatric Clinical Sepsis

BACKGROUND: Sepsis is still leading cause of death in critically ill children. Early recognition of sepsis and treatments are needed to reduce its mortality. The use of citrullinated Histone H3 (Cit-H3) as an early sepsis marker and outcome predictor has been validated in previous studies among adults. However, only one study in pediatric meningococcal sepsis was reported with contradictory results. This study aims to determine Cit-H3 levels in pediatric clinical sepsis and analyze its association with sepsis severity and survival rate.METHODS: A prospective observational cohort study involving 67 pediatric subjects clinically diagnosed with sepsis was conducted. Cit-H3 levels, Pediatric Logistic Organ Dysfunction-2 (PELOD-2) score, and Pediatric Sequential Organ Failure Assessment (pSOFA) score were assessed at the time of diagnosis (0-hour) and 48 hours later. Pearson Correlation test was used to determine the correlation between Cit-H3 levels with PELOD-2 and pSOFA scores and receiver operating curve to find the cut-off of Cit-H3 levels on clinical sepsis patients.RESULTS: Among clinically sepsis patients, the median Cit-H3 level was 1,210 (800-32,160) ng/mL, with optimal cut-off point ≥1200 ng/mL (sensitivity 83.3% and specificity 75.7%) to discriminate sepsis. The median Cit-H3 levels at 0-hour were lower in survivor compared to non-survivor group (p=0.016). Cit-H3 level was able to predict mortality with optimal cut-off point ≥1,200 ng/mL, sensitivity 72.2% and specificity 57.1% (AUC of 69.2%; p=0.017). Using survival analysis, Cit-H3 was significantly associated with the mortality rate (p=0.023; hazard ratio of 3.45).CONCLUSION: Cit-H3 level could be potential to predict pediatric sepsis events and its outcome.KEYWORDS: citrullinated histone H3, neutrophil extracellular traps, pediatric sepsis, PELOD-2 score, pSOFA score, survival

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Serum Ferritin Predicts Neither Organ Dysfunction Nor Mortality in Pediatric Sepsis Due to Tropical Infections

Frontiers in Pediatrics ◽

10.3389/fped.2020.607673 ◽

2020 ◽

Vol 8 ◽

Author(s):

Vijai Williams ◽

Nisha Menon ◽

Prateek Bhatia ◽

Manisha Biswal ◽

Sreejesh Sreedharanunni ◽

...

Keyword(s):

Organ Dysfunction ◽

Tertiary Care ◽

Discriminatory Power ◽

Percentage Change ◽

Critically Ill Children ◽

Total Leucocyte Count ◽

Logistic Organ Dysfunction ◽

Pediatric Sepsis ◽

Tropical Infections ◽

Organ Dysfunctions

Objective: To evaluate serial ferritin levels measured in the initial 72 h of admission as a biomarker for new and progressive multi organ dysfunction syndrome (NPMODS) and mortality (unfavorable outcomes) in critically ill children with sepsis due to tropical infections.Material and Methods: In this prospective observational study from a tertiary care teaching hospital in India, children 3 month to 12 years with a diagnosis of acute febrile illness and any two features suggesting tropical infections [cytopenia (platelet count <1,00,000/cu.mm, total leucocyte count <4,000/cu.mm), hepatomegaly and/or splenomegaly, lymphadenopathy, systemic signs (rash, edema), respiratory distress, and encephalopathy not accounted by localized infection] were eligible for inclusion. Children with known or suspected disorder of iron metabolism were excluded. Primary outcome was to determine the association of serial ferritin levels with mortality and NPMODS. Secondary outcomes included estimation of the prevalence of hyperferritinemia and comparison of risk prediction scores with serial ferritin measurement in predicting unfavorable outcomes.Measurements and Main Results: In the 202 children enrolled, diagnosis could be established in 133 (65.8%) children. Scrub typhus and dengue were the most common infections. Median (IQR) ferritin measured at admission (n = 183) and on day 3 (n = 120) of hospital stay were 798 (378, 3,205) μg/L and 429 (213,680) μg/L, respectively. Majority (n = 180, 89.1%) had MODS at admission defined as per International pediatric sepsis consensus conference. NPMODS occurred in 47 (23.3%) children of whom 37 (18.3%) died. Children with three or less organ dysfunctions had lower mortality. Neither admission ferritin values nor the percentage change over 72 h was different between children with favorable and unfavorable outcomes. Pediatric Risk of Mortality (PRISM-III) and daily Pediatric Logistic Organ Dysfunction score (dPELOD2 score) were significantly different in those with unfavorable outcomes. Admission ferritin levels and percentage change in 72 h had poor discriminatory power for mortality with AUC of 0.53 (0.53, 0.67) and 0.50 (0.50, 0.64), respectively. dPELOD2 had the best discriminatory power for mortality with AUC of 0.89 (0.89, 0.95).Conclusions: Serial ferritin estimation predicted neither organ dysfunction nor mortality in pediatric sepsis with tropical infections. dPELOD-2 and PRISM-III predicted unfavorable outcomes better than ferritin. The current diagnostic criteria for MODS overestimated organ dysfunctions in tropical infections and hence may need modification with further validation in this epidemiological cohort.

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Pediatric Multi-Organ Dysfunction Syndrome: Analysis by an Untargeted “Shotgun” Lipidomic Approach Reveals Low-Abundance Plasma Phospholipids and Dynamic Recovery over 8-Day Period, a Single-Center Observational Study

Nutrients ◽

10.3390/nu13030774 ◽

2021 ◽

Vol 13 (3) ◽

pp. 774

Author(s):

Mara L. Leimanis-Laurens ◽

Karen Ferguson ◽

Emily Wolfrum ◽

Brian Boville ◽

Dominic Sanfilippo ◽

...

Keyword(s):

Mass Spectrometry ◽

Intensive Care ◽

Critically Ill ◽

Organ Dysfunction ◽

Lipid Profiles ◽

Critically Ill Children ◽

P Value ◽

Time Points ◽

Logistic Organ Dysfunction ◽

Multi Organ Dysfunction Syndrome

Lipids are molecules involved in metabolism and inflammation. This study investigates the plasma lipidome for markers of severity and nutritional status in critically ill children. Children with multi-organ dysfunction syndrome (MODS) (n = 24) are analyzed at three time-points and cross-referenced to sedation controls (n = 4) for a total of N = 28. Eight of the patients with MODS, needed veno-arterial extracorporeal membrane oxygenation (VA ECMO) support to survive. Blood plasma lipid profiles are quantified by nano-electrospray (nESI), direct infusion high resolution/accurate mass spectrometry (MS), and tandem mass spectrometry (MS/MS), and compared to nutritional profiles and pediatric logistic organ dysfunction (PELOD) scores. Our results show that PELOD scores were not significantly different between MODS and ECMO cases across time-points (p = 0.66). Lipid profiling provides stratification between sedation controls and all MODS patients for total lysophosphatidylserine (lysoPS) (p-value = 0.004), total phosphatidylserine (PS) (p-value = 0.015), and total ether-linked phosphatidylethanolamine (ether-PE) (p-value = 0.03) after adjusting for sex and age. Nutrition intake over time did not correlate with changes in lipid profiles, as measured by caloric and protein intake. Lipid measurement in the intensive care environment shows dynamic changes over an 8-day pediatric intensive care unit (PICU) course, suggesting novel metabolic indicators for defining critically ill children.

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POS1418 REALIZING EARLY RECOGNITION OF ARTHRITIS IN TIMES OF INCREASED TELEMEDICINE: THE VALUE OF PATIENT-REPORTED SWOLLEN JOINTS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.235 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 992.1-992

Author(s):

C. Rogier ◽

B. Van Dijk ◽

E. Brouwer ◽

P. De Jong ◽

A. Van der Helm - van Mil

Keyword(s):

Early Recognition ◽

Pearson Correlation ◽

Correlation Coefficients ◽

Self Report ◽

Symptom Duration ◽

Likelihood Ratios ◽

Predictive Values ◽

Patient Level ◽

Patient Reported ◽

Joint Examination

Background:Early diagnosis and management of patients with inflammatory arthritis(IA) are critical to improve long-term patient-outcomes. Assessment of joint swelling at joint examination is the reference of IA-identification; early access clinics are constructed to promote this early recognition of IA. However, due to the COVID-19 pandemic the face-to-face capacity of such services is severely reduced. The accuracy of patient-reported swelling in comparison to joint examination has been extensively evaluated in established RA (ρ 0.31-0.67), but not in patients suspected for IA.[1]Objectives:To promote evidence based care in the era of telemedicine, we determined the accuracy of patient-reported joint swelling for actual presence of IA in persons suspected of IA by general practitioners(GP).Methods:Data from two Dutch Early Arthritis Recognition Clinics were studied. These are screening clinics (1.5-lines-setting) where GPs send patients in case of doubt on IA. At this clinic patients were asked to mark the presence of swollen joints on a mannequin with 52 joints. For this study the DIP joints and the metatarsal joints were excluded and, therefore, a total of 42 joints were assessed for self-reported joint swelling. Clinically apparent IA of ≥1 joint determined by the physician was the reference to calculate sensitivity, specificity, positive and negative likelihood ratios (LR+,LR-), and positive and negative predictive values (PPV, NPV) on patient-level. Pearson correlation coefficients(ρ) were determined. Predictive values depend on the prevalence of a disease in a population. Because the prevalence of IA in a 1.5-lines-setting will differ from a primary care setting, post-test probabilities of IA were estimated for two lower prior-test probabilities as example, namely 20% (estimated probability in patients GPs belief IA is likely) and 2% (prior-test probability with less preselection by GPs), using likelihood ratios and nomograms.Results:A total of 1637 consecutive patients were studied. Median symptom duration was 13 weeks. 76% of patients marked ≥1swollen joint at the mannequin. 41% of patients had ≥1swollen joint at examination by rheumatologists. ρ was 0.20(patient-level)-0.26(joint-level).The sensitivity of patients-reported joint swelling was high, 87%, indicating that the majority of patients with IA had marked swelling on the mannequin. However the specificity was 31%, indicating that 69% of persons without IA had also done so. The LR+ was 1.25; the LR- 0.43. The PPV was 46%, the NPV 77%. Thus the PPV increased hardly (from 41% to 46%) and the NPV somewhat (from 59% to 77%). Also in settings with prior-test probabilities of 20% and 2%, estimated PPVs (from respectively 20% and 2% to 24% and 2%) and NPVs (from respectively 80% and 98% to 90% and 99%) hardly increased.Conclusion:Patient-reported joint swelling had little value in distinguishing patients with/without IA for different prior-test probabilities, and is less valuable in comparison to self-reported flare detection in established RA.References:[1]Barton JL, Criswell LA, Kaiser R, et al. Systematic review and metaanalysis of patient self-report versus trained assessor joint counts in rheumatoid arthritis. J Rheumatol 2009;36:2635-2641.Disclosure of Interests:None declared

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Are Saliva Tests Important in the Prediction of Carious Disease?

Applied Sciences ◽

10.3390/app11135932 ◽

2021 ◽

Vol 11 (13) ◽

pp. 5932

Author(s):

Daniela Luminita Ichim ◽

Liliana Sachelarie ◽

Alexandra Burlui

Keyword(s):

Health Promotion ◽

Pearson Correlation ◽

Coefficient Of Determination ◽

Data Series ◽

Study Group ◽

Complex Phenomenon ◽

Oral Health Promotion ◽

Group 4 ◽

Carious Lesions ◽

Pearson Correlation Test

(1) Background: The appearance and progression of carious lesions represent a complex phenomenon of interactions of microbial factors (the action of bacteria on the tooth), of the factors related to the host, to the diet, and to the time factor. Which hasan influence on the rate of microbismof the oral cavity on the installation of carious disease? (2) Methods: In order to correctly assess the cariogenic risk of an individual, it is recommended to perform twoor more tests based on different principles (microbiological, clinical, epidemiological). The representative data series for the investigation were analyzed statistically and by applying the Pearson correlation test considering the coefficient of determination R for all pairs of data series. (3) Results: Salivary tests played animportant role in establishing control sessions, in carrying out prophylactic caries therapy, and establishing prognosis. The existence of a statistical associationwas confirmed between the prevalence of dental caries and the results of salivary tests for the study group. (4) Conclusions: The results of the saliva tests can be used in oral health promotion.

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Malondialdehyde levels can be measured in serum and saliva by using a fast HPLC method with visible detection / Determinarea printr-o metodă HPLC-VIS rapidă a concentraţiilor serice şi salivare ale malondialdehidei

Revista Romana de Medicina de Laborator ◽

10.1515/rrlm-2016-0029 ◽

2016 ◽

Vol 24 (3) ◽

pp. 319-326 ◽

Cited By ~ 1

Author(s):

Erzsébet Fogarasi ◽

Mircea Dumitru Croitoru ◽

Ibolya Fülöp ◽

Enikő Nemes-Nagy ◽

Robert Gabriel Tripon ◽

...

Keyword(s):

Oxidative Stress ◽

Lipid Peroxidation ◽

Free Radicals ◽

Unsaturated Fatty Acids ◽

Pearson Correlation ◽

Living Organism ◽

Hplc Method ◽

Limit Of Quantification ◽

Pearson Correlation Test ◽

Repeated Sample

Abstract Oxidative stress appears when the amount of free radicals that are formed in a living organism exceed its spin-trapping ability. One of the most dangerous free radicals that are formed in the human body is the hydroxyl radical. It can alter several biomolecules, including the unsaturated fatty acids; this process is known as lipid peroxidation and can lead to cell necrosis and generation of several harmful byproducts including malondialdehyde, which serves also as a biomarker of oxidative stress. A new HPLC method with visible detection was developed for the detection of malondialdehyde in human serum and saliva samples. The method was verified in terms of specificity, linearity, limits of detection (0.35 ng/ml), limit of quantification (1.19 ng/ml), recovery (90.13±10.25 – 107.29±14.33) and precision (3.84±1.49% – 6.66±1.76%). An analysis time of only 1 minute was obtained and no interferences from the matrices were observed. Statistical analysis (Pearson correlation test) showed a moderate correlation (R = 0.5061, p = 0.0099) between serum and saliva concentrations (N = 25). The possibility of measuring salivary concentrations of malondialdehyde extents the applications of oxidative stress/lipid peroxidation estimations to categories of population unreachable before (pregnant women, small children, etc); repeated sample studies are also easier to make.

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Are metric parameters sufficient alone in evaluation of the patellar instability? New angular measuring parameters

Journal of Orthopaedic Surgery ◽

10.1177/2309499016684498 ◽

2017 ◽

Vol 25 (1) ◽

pp. 230949901668449 ◽

Cited By ~ 1

Author(s):

Alper Deveci ◽

Deniz Cankaya ◽

Serdar Yilmaz ◽

Ersin Celen ◽

Bulent Sakman ◽

...

Keyword(s):

Statistical Analysis ◽

Strong Correlation ◽

Patellar Instability ◽

Pearson Correlation ◽

Trochlear Groove ◽

Rotational Movement ◽

Pearson Correlation Test ◽

Angular Measuring ◽

Metric Measurement ◽

Tibia Shaft

Purposes: When the evaluation of patellar instability is examined from the aspect of the conical-cylindrical anatomy of the tibia, metric measurement parameters such as the tuberositas tibia (TT)–trochlear groove (TG) and patellar tendon (PT) insertion–trochlear groove (TG) distances are not sufficient. We asked whether defined angular parameters reveal the rotational movement of the tuberositas tibia on the tibia shaft, additional to the metric parameters and there is a correlation between the metric and angular parameters. Methods: 19 patients with patellar instability and 22 patients without patellar instability were evaluated. For all patients, two angle and three length parameters were evaluated on the slices taken. Evaluations were made of the TT-TG, the midpoint of the PT insertion-TG distances, the anatomic midpoint of the dome of the TT-TG, the TG-PT angle, and the TG-dome angle (DA). The Pearson correlation test was used for the statistical analysis of correlations between groups. Results: A statistically significant increase was determined in the patellar instability group in the TG-DA and TG-PT angle values compared to the group without patellar instability ( p < 0.05). In both groups, a positive and strong correlation was determined between the TT-TG and the TG-PT and dome of the TT-TG distances, but no statistically significant correlation was determined between the tuberositas TT-TG and TG-PT angle and TG-DA. Conclusion: Metric parameters may not be sufficient alone in the evaluation of patellar instability. Metric parameters should be supported by additional angular parameters which reveal the rotational movement of the TT on the tibia shaft.

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Construction Sector Contribution to Economic Stability: Malaysian GDP Distribution

Sustainability ◽

10.3390/su13095012 ◽

2021 ◽

Vol 13 (9) ◽

pp. 5012

Author(s):

Wesam Salah Alaloul ◽

Muhammad Ali Musarat ◽

Muhammad Babar Ali Rabbani ◽

Qaiser Iqbal ◽

Ahsen Maqsoom ◽

...

Keyword(s):

Sustainable Development ◽

Construction Industry ◽

Pearson Correlation ◽

Impulse Response Function ◽

Equilibrium Analysis ◽

Construction Sector ◽

Causality Test ◽

Vector Error Correction ◽

The World ◽

Pearson Correlation Test

The construction sector exerts an exceptional impact on economic development all over the world. Adequate buildings and infrastructures made by the construction sector ensure that a country reaches certain targets like social development, industrialization, freight transportation, sustainable development, and urbanization. This study aims to determine the construction sector’s connectivity with other sectors through complex linkages that contribute immensely to the economy and gross domestic product (GDP). The data were collected from the Department of Statistics Malaysia and the World Bank from the year 1970 to 2019, and the Pearson correlation test, the cointegration test, and the Granger causality test were conducted. The vector error correction model (VECM) was created for short-term and long-term equilibrium analysis and impulse response function (IRF) was performed to study construction industry behavior. Afterwards, the forecasting was done for the year 2020 to 2050 of the Malaysian economy and GDP for the required sectors. It was revealed that some sectors, such as agriculture and services, have forward linkages while other sectors, such as manufacturing and mining, are independent of construction sector causality, which signifies the behavior of the contributing sectors when a recession occurs, hence generating significant revenue. The Malaysian economy is moving towards sustainable production with more emphasis on the construction sector. The outcome can be used as a benchmark by other countries to achieve sustainable development. The significance of this study is its usefulness for experts all over the world in terms of allocating resources to make the construction sector a sustainable sector after receiving a shock. A sustainable conceptual framework has been suggested for global application that shows the factors involved in the growth of the construction industry to ensure its sustainable development with time.

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Evaluating Employees' Commitment in Islamic Work Ethics Perspective

GATR Global Journal of Business Social Sciences Review - GATR Global Journal of Business and Social Science Review (GJBSSR) Vol.7(1) Jan-Mar 2019 ◽

10.35609/gjbssr.2014.2.4(10) ◽

2014 ◽

Vol 2 (4) ◽

pp. 87-94

Author(s):

Nur`Ain Achim ◽

Hairunnisa Ma’amor ◽

Norhidayah Mohd Rashid

Keyword(s):

Affective Commitment ◽

Pearson Correlation ◽

Future Research ◽

Kuala Lumpur ◽

Continuance Commitment ◽

Work Ethics ◽

Financial Firms ◽

Pearson Correlation Test ◽

The Relationship ◽

Structured Questionnaire

Objective - The study purposes three objectives, which is to recognize the level of employees' commitment (EC) among employees, to identify the level of IWE application among employees, and to investigate the relationship between EC and IWE. Methodology/Technique - The data was collected through a structured questionnaire from employees working at selected financial firms in Kuala Lumpur and has been statistically analysed using SPSS. Findings - The results showed that the levels of employees' commitment and IWE among employees are high, however the Pearson correlation test shows there is no significant relationship between EC and IWE. Hence, it is recommended for future research to explore a different angle of the management dimension to be tested with IWE and expand the context into a multidisciplinary field. Novelty - This research helps to broaden the employees' knowledge about the work ethics in Islamic perspectives and apply it in their organization. Type of Paper - Empirical Keywords : Organizational commitment; employees commitment; affective commitment; normative commitment; continuance commitment; Islamic; work ethics.

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THE INFLUENCE OF STUDENTS LEARNING STYLE AND LEARNING INTEREST ON THE LEARNING OUTCOMES OF PHYSICS CLASS X IPA DURING THE COVID-19 PANDEMIC

Jurnal Ilmu Pendidikan Indonesia ◽

10.31957/jipi.v9i3.1800 ◽

2021 ◽

Vol 9 (3) ◽

pp. 132-143

Author(s):

Albert Lumbu ◽

Bonefasius Y Boy ◽

Muhamad Akbar

Keyword(s):

Learning Styles ◽

Learning Outcomes ◽

Learning Style ◽

Significant Influence ◽

Pearson Correlation ◽

Physics Learning ◽

Significance Level ◽

Pearson Correlation Test ◽

Learning Interest ◽

Learning Together

This study aims to determine whether there are: 1) the influence of learning styles on physics learning outcomes, 2) the influence of interest in learning on physics learning outcomes, 3) the influence of learning styles and interest in learning together on physics learning outcomes in class X SMA Negeri 1 Nimboran . This research was conducted at SMA Negeri 1 Nimboran in April - May 2021. The subjects in this study were all 52 students of class X majoring in science and the objects of research were learning styles, interest in learning and physics learning outcomes. The instruments used are questionnaires and documentation. Data analysis was carried out using the Pearson correlation test with a significance level of 0.05 and a regression test which resulted in conclusions as a result of the study. The results showed that, 1) there was a significant influence of learning style on physics learning outcomes with a contribution of 50.8%, 2) there was a significant influence of interest in learning on physics learning outcomes with a contribution of 60.9%, 3) there were significant influence of learning style and interest in learning, together on the learning outcomes of physics with a contribution of 64.3% influence

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Negative Correlation between Placental Growth Factor and Endocan-1 in Women with Preeclampsia

Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics ◽

10.1055/s-0038-1670713 ◽

2018 ◽

Vol 40 (10) ◽

pp. 593-598 ◽

Cited By ~ 1

Author(s):

Marta Hentschke ◽

Edson da Cunha Filho ◽

Matias Vieira ◽

Letícia Paula ◽

Hiten Mistry ◽

...

Keyword(s):

Growth Factor ◽

Negative Correlation ◽

Pearson Correlation ◽

Maternal Plasma ◽

Placental Growth Factor ◽

Analysis Of Covariance ◽

Angiogenic Factor ◽

Vascular Endothelial ◽

Pearson Correlation Test ◽

The Difference

Objective To analyze endocan-1, a biomarker of vascular endothelial related pathologies, and the placental growth factor (PlGF), an angiogenic factor and a placental dysfunction marker in patients with preeclampsia (PE). Methods Case-control study conducted at Hospital São Lucas, in the city of Porto Alegre, Brazil. Endocan-1 and PlGF levels were quantified in the maternal plasma using the MagPlexTH-C microsphere system (MAGPIX System, Luminex, Austin, Texas, US) and evaluated through analysis of covariance (ANCOVA) and adjusted by body mass index (BMI), gestational age and maternal age. To estimate the difference between the groups, the mean ratio (MR) and the 95% confidence interval (95%CI) were calculated. The Pearson correlation test was used to establish any association between endocan-1 and PlGF levels. The null hypothesis was rejected when p < 0.05. Results The group of patients was composed by normotensive (n = 67) patients and patients with PE (n = 50). A negative correlation between endocan-1 and the PlGF was noted in the entire normotensive group (linear correlation coefficient [r] = −0.605; p < 0.001), as well as in the PE group (r = −0.545; p < 0.001). Conclusion Endocan-1 levels are increased in patients with PE, and are inversely correlated with PlGF levels. We suggest that it is important to analyze angiogenic and proinflammatory molecules concomitantly in women with PE to better understand the pathophysiology of the disease. Both molecules are strong candidates for PE biomarkers, and future studies will examine any mechanisms connecting these factors in PE.

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