A Multimodal Approach for the Risk Prediction of Intensive Care and Mortality in Patients with COVID-19

Background: Although several studies have been launched towards the prediction of risk factors for mortality and admission in the intensive care unit (ICU) in COVID-19, none of them focuses on the development of explainable AI models to define an ICU scoring index using dynamically associated biological markers. Methods: We propose a multimodal approach which combines explainable AI models with dynamic modeling methods to shed light into the clinical features of COVID-19. Dynamic Bayesian networks were used to seek associations among cytokines across four time intervals after hospitalization. Explainable gradient boosting trees were trained to predict the risk for ICU admission and mortality towards the development of an ICU scoring index. Results: Our results highlight LDH, IL-6, IL-8, Cr, number of monocytes, lymphocyte count, TNF as risk predictors for ICU admission and survival along with LDH, age, CRP, Cr, WBC, lymphocyte count for mortality in the ICU, with prediction accuracy 0.79 and 0.81, respectively. These risk factors were combined with dynamically associated biological markers to develop an ICU scoring index with accuracy 0.9. Conclusions: to our knowledge, this is the first multimodal and explainable AI model which quantifies the risk of intensive care with accuracy up to 0.9 across multiple timepoints.

A Generation Shift in Mediterranean Diet Adherence and Its Association with Biological Markers and Health in Dalmatia, Croatia

Previous studies have confirmed the beneficial effect of a Mediterranean diet in mitigating health issues related to cardiovascular disease, diabetes and obesity. However, rapid changes in the traditional way of life and the “westernization” of the diet in Mediterranean populations, especially in younger generations, has led to progressive abandonment of healthy dietary patterns. In order to investigate the generation shift in dietary patterns and lifestyle habits in the Mediterranean part of Croatia, we compared two cohorts of 610 women (266 pregnant and 344 non-pregnant) from the same region, but from different age groups. The MDSS score was derived from food frequency questionnaires. The results showed that the young, reproductively active generation (pregnant women) in Dalmatia, Croatia, although having a higher education and socioeconomic status, exhibits a more adverse eating behaviour (lower adherence to the Mediterranean diet) and lifestyle (excessive smoking in pregnancy) than the older population from the same region. Lower MDSS scores across aggregated age groups in both cohorts showed significant association with higher blood lipid levels and higher smoking frequency. In conclusion, Mediterranean diet adherence is associated with biological markers (age, lipid profile) and lifestyle (smoking) in our study, with a more adverse trend observed in the younger generation.

Pre-operative immunomodulatory nutrition and post-operative outcomes of surgical treatment of gastrointestinal surgery: a systematic review

Malnutrition is a major health problem in cancer evident in up to 80% of patients. It was associated with high mortality and morbidity, especially with surgical treatment of cancer. That is why many studies are investigating efficient treatment for this problem. One of these treatments is immunomodulatory nutrition. Immunomodulatory nutrition has shown efficacy towards malnutrition, immune status, and other comorbidities. However, there is still a debate about whether it is efficient or not. Five databases were searched using specific search terms. We only included randomized controlled trials that studied the efficacy of preoperative immunomodulatory nutrition before surgical treatment of gastrointestinal carcinoma. The studies were assessed for the quality of evidence. Twenty-three studies were included for the systematic review. Most studies had a low risk of bias. We assessed the efficacy of immunomodulatory nutrition regarding immune markers, infectious complications, non-infectious complications, biological markers, the length of stay, and mortality. Immunomodulatory nutrition has significantly enhanced immune status, biological markers, and post-operative complications. However, it does not have a significant improvement in the mortality rate or hospitalization duration. The immunomodulatory nutrition has promising results in enhancing immune status, and biological markers. However, its effect on post-operative infectious and non-infectious complications is still under debate. Immunomodulatory nutrition had no effect on mortality rates among cancer patients.

ROLE OF COPPER METAL AND BIOLOGICAL MARKERS IN PATIENTS WITH ENTEROBIASIS

The primary goal of this study was to determine the effect of copper in patients with Enterobius vermicularis infection, as well as its association with IgE and TRFC. The study was carried out with 583 suspected and thirty healthy respondents of the same age who visited the AL-Zahra maternity and pediatrics laboratory, AL-Hakeem hospital, in AL-Najaf province(Iraq) from July 2020 to June 2021. This study aimed to estimate the level of copper, IgE, and TRFC in patients suffering from enterobiasis. The concentration of three biomarkers (copper, IgE, and TRFC) in serum was determined using the ELISA technique as per the manufacturer's instructions while the concentration of copper was assessed by using the colourimetric method. Results of the study revealed that the concentrations of IgE and TRFC significantly increased (P≤0.05) in the blood sample of E. vermiculris infected patients, while the serum concentrations of copper decreased significantly (P≤0.05) compared to the control group. The results of the current study suggested that the E. vermicularis infection alters serum IgE and TRFC concentrations, which significantly impacts copper levels in the blood.