Nutrition and Water Deprivation Negatively Impacts Adult Longevity of Lucilia eximia (Diptera: Calliphoridae)

Introduction: Forensic entomology is the utilization of arthropod science in legal practice. Blow flies (Diptera: Calliphoridae) are a prevalent family in medicolegal investigations due to their colonization of vertebrates, including living or deceased humans. Longevity of insects associated with legal investigations is an important life-history trait that could be useful in determining a minimum time of colonization (TOC) interval. Lucilia eximia (Wiedemann) (Diptera: Calliphoridae) is known to colonize remains and cause myiasis; however, this species is understudied. The purpose of this study was to investigate the longevity of L. eximia adults with and without resources. Methods: Lucilia eximia adults were placed in six different mesh cages at a 1:1 sex ratio, where flies in three cages were fed and provided water, while those in the remaining cages were not. Cages were placed in a walk-in incubator set to 24°C, 60% RH, and a 14:10 L:D. Mortality was recorded daily. Results:Males and females did not live significantly longer than each other within either treatment. Life span of adults provided resources was 58.41 ± 27.79 d, while deprived individuals lived 1.61 ± 0.49 d. Rate of mortality was nearly 6X greater for those deprived of food and water than those provided such resources. Conclusions: Access to food and water impacted adult longevity. Forensic entomologists could potentially estimate time since adult emergence based on mortality proportion of adults present in relation to environmental conditions and access to food in an enclosed environment (e.g., building). However, such a method will need to be validated.

Hyperinflammatory conditions, gender differences and mortality in Indian COVID-19 patients

PurposeEvidence suggests that COVID-19 induces hyperinflammatory conditions and causes relatively more deaths in males than females. The purpose of this study was to analyze gender differences associated with various hyperinflammatory conditions (HIC) and mortality in the Indian COVID-19 patientsMethodsThis study was conducted at the Era’s Lucknow Medical College and Hospital (ELMCH), ERA University, which is located in the northern part of India. Starting from July 4, 2020 till December 3, 2020 a total of 2997 patients were treated at ELMCH. We randomly collected blood samples from 150 severe COVID-19 patients (required oxygen) between August 10 and September 15, 2020 for analyzing the following HIC and associated laboratory markers: hyperferritinaemia (serum ferritin), hematological dysfunctions (lymphocytopenia and neutrophil to lymphocyte ratio), cytokinaemia (C-reactive protein), coagulopathy (D-dimer), liver inflammation (aspartate aminotransferase), renal inflammation (blood urea and creatinine), and hyperglycemia (random blood glucose). The threshold values/cut off limits of these laboratory markers used for analyzing the risk of mortality in male and female COVID-19 patients were set according to the scale validated recently by Webb et al, (2020).ResultsIn the above cohort of consecutively admitted COVID-19 patients, analysis of various HIC revealed hyperferritinaemia (odd ratio: 2.9, 95% CI 1.4-6.0), hematological dysfunctions (odd ratio: 2.10, 95% CI 1.0-4.2), hepatic inflammation (odd ratio: 2.0, 95% CI 0.52-7.40), and coagulopathy (odd ratio: 1.5, 95% CI 1.50, 95% CI 0.50-4.60) were more prevalent and sever in male COVID-19 patients. Approximately 86% male to 64% female COVID-19 patients developed lymphocytopenia. Regarding mortality, while hyperferritinaemia (odd ratio: 1.70, 95% CI 0.37-7.43) and cytokinaemia (odd ratio: 1.60, 95% CI 0.37 −7.30) were strongly associated with mortality in male COVID-19 patients, coagulopathy (odd ratio: 3.30, 95% CI 0.31-35), and hematological dysfunctions (odd ratio: 1.70, 95% CI 0.27-10) were more commonly associated with mortality in female COVID-19 patients. Nearly 80% male and female COVID-19 patients, who died had developed ≥2 criteria of HIS criteria. Chronic renal disease was associated with more deaths in female than male COVID-19 patients (odd ratio: 2.0, 95% CI 0.54 - 7.4). While the mortality proportion was slightly higher in male (6.3%) than female (4.5%) COVID-19 patients, survival curves of the two genders were not different (hazard ratio: 1.02, 95% CI 0.71-1.40, P = 0. 953).ConclusionDistinct HIC were associated with the severity, and mortality in male and female COVID-19 patients. Coagulopathy and renal injury were detrimental, specifically, for female COVID-19 patients. The overall mortality proportion was around 5.3%. The above results suggest that gender differences associated with COVID-19 severity and mortality arise due to differences in various HIC. These results may help in developing personalized or gender based treatments for COVID-19 patients.

Hubungan Variabilitas Glukosa 72 Jam Pertama Perawatan ICU dengan Mortalitas ICU pada Pasien Kritis

Pendahuluan. Hiperglikemia saat perawatan merupakan faktor risiko yang dapat ditatalaksana dengan optimal untuk menurunkan mortalitas. Penelitian hubungan variabilitas glukosa terhadap mortalitas telah diteliti, namun menggunakan indikator yang bervariasi. Penelitian ini dilakukan untuk mengkaji hubungan variabilitas glukosa yaitu rerata perubahan glukosa absolut (mean absolute glucose change, MAG) dan simpang baku glukosa terhadap mortalitas pasien kritis.Metode. Studi kohort retrospektif dilakukan pada 280 pasien yang dirawat di intensive care unit (ICU) dan high care unit (HCU) Rumah Sakit dr. Cipto Mangunkusumo (RSCM) Jakarta periode Januari 2012-Agustus 2013. Variabel MAG dan simpang baku glukosa dibagi menjadi 4 kuartil. Analisis hubungan antara MAG dan simpang baku glukosa dengan mortalitas dilakukan dengan uji chi Square. Untuk mengeluarkan faktor perancu (skor MSOFA, indeks komorbiditas Charlson,hipoglikemia, dan hiperglikemia) dilakukan uji regresi logistik.Hasil. Nilai median MAG dan simpang baku gukosa masing-masing adalah 3,3 mg/dL/jam dan 38,3 mg/dL. Proporsi mortalitas yang lebih tinggi didapatkan pada kuartil atas MAG dan simpang baku glukosa dibandingkan kuartil bawah. Berdasarkan uji chi square, didapatkan hasil OR MAG kuartil atas terhadap mortalitas OR 4,26 (IK 95% 1,98-9,15) dan OR simpang baku glukosa kuartil atas terhadap mortalitas OR 2,78 (IK 95% 1,35-5,71). Setelah dilakukan uji regresi logistik didapatkan fully adjusted OR 3,34 (IK 95% 1,08-10,31) untuk MAG dan 0,90 (IK 95% 0,28-2,88) untuk simpang baku glukosa.Simpulan. Proporsi mortalitas MAG kuartil atas (>8,1 mg/dL/jam) lebih tinggi daripada kuartil bawah (<1,3 mg/dL/jam). Proporsi mortalitas simpang baku glukosa kuartil atas (>59 mg/dL) lebih tinggi daripada kuartil bawah (<22,7 mg/dL). Namun demikian, hasil tersebut tidak bermakna secara statistik.Kata kunci: mortalitas, rerata perubahan glukosa absolut, simpang baku glukosa, variabilitas glukosa Association of Glucose Variability in the First 72 Hours of ICU Care with ICU Mortality in Critically-III PatientsIntroduction. Hyperglycemia during hospitalization is a risk factor that can be managed in order to reduce mortality. Inspite of hyperglycemia, glucose variability also brings negative outcome to cells. Studies about glucose variability effect to mortality had been studied using many variables of glucose variability. Methods. Retrospective cohort study is done to 280 critical ill patient in ICU and HCU in Cipto Mangunkusumo Hospital who admitted to critical care between January 2012-August 2013. MAG change and glucose standard deviation are divided into 4 quartiles. Relationship between MAG change and glucose standard deviation are analyzed using Chi Square test. To control the confounders (MSOFA score, Charlson comorbidities index, hypoglycemia, and hyperglycemia), logistic regression is done.Results. Median of MAG change is 3.3 mg/dL/hour and median of glucose standard deviation is 37.63 mg/dL. Mortality proportion is higher in upper quartile of MAG change and glucose standard deviation compared to lower quartile. OR of upper quartile MAG change to ICU mortality is OR 4.26 (95% CI 1.98-9.15) and OR of upper quartile glucose standard deviation to ICU mortality is OR 2.78 (95% CI 1.35-5.71). These results are adjusted to MSOFA score, hypoglycemia, and hyperglycemia. In logistic regression test, fully adjusted OR are 3.34 (95% CI 1.08-10.31) and 0.90 (95% CI 0.28-2.88) for MAG change and glucose standard deviation, respectively. Conclusions. Mortality proportion of upper quartile of MAG change (>8.1 mg/dL/hour) is higher than lower quartile (<1.3 mg/dL). Mortality proportion of upper quartile glucose standard deviation (>59 mg/dL) is higher than lower quartile(<22.7 mg/dL), but the difference is not statistically significant. Keywords: glucose standard deviation, glucose variability, mean absolute glucose change, mortality

A review of radical prostatectomy outcomes in active surveillance patients—The Sunnybrook experience.

104 Background: Prostate cancer is the most prevalent non-cutaneous cancer among North American men. Approximately 50% of these are favorable risk cancers; the NCCN guideline recommends active surveillance for these patients. Patients are generally followed by serial PSAs, DREs and/or TRUS-guided biopsies with triggers identified for each test. Consequently, about 30% of these cancers will be reclassified to a higher risk and require definitive treatment. Cases treated with radical prostatectomy (rP) give important insights into the biology of these cancers. Methods: The ASURE database of active surveillance patients was used to identify cases; a retrospective chart review was completed. The following variables were extracted: primary reason for rP; % biochemical failure; % of patients requiring salvage radiation or hormone therapy; Gleason score (GS), tumor size staging and nodal status in the rP specimen; cause and rate of mortality; proportion of patients treated for PSA-doubling times less then 3 years presenting with a GS greater than 7. Descriptive statistics were used to summarize the results. Results: Of 566 patients in the ASURE database, the charts of 26 patients having an rP were extracted. The primary cause for an rP was a PSA-doubling times less than 3 years (57% of patients) followed by a biopsy indicating a GS of 4+3 or greater (19%). 7% of patients (2/26) were not reclassified but preferred to be treated with rP. 4 patients had biochemical failure (15%) all 4 had salvage therapy. There was 1 cause-specific death. 85% of rP specimens had GS 7, while the remaining had GS 6. Half of these GS 7 individuals had PSA doubling times of less than 3 years. Conclusions: Radical prostatectomy appears to be an effective deferred treatment for patients who are reclassified on active surveillance as evidenced by low prostate-cancer mortality, low rates of biochemical failure acceptable use of salvage therapy. Of interest is that the majority patients with PSAdt < 3 y have Gleason 7 disease on specimen. No significant financial relationships to disclose.

The effect of age and diet on the reproductive performance of Sudan Nilotic ewes

Two flocks of 42 multiparous (M) and 27 primiparous (P) Nilotic ewes (Southern Sudan) were used in an experiment conducted at the Animal Production Research Centre, Khartoum N., Sudan, to study the effect of age and diet on reproductive performance. Each age group (M and P) was subdivided into two diet groups, fed either a sorghum (So) or a molasses (Mo)-based diet. The two diets were approximately isoenergetic (12·2 and 11·4 MJ ME/kg DM for So and Mo diets, respectively) and isonitrogenous (217 g CP/kg). These diets were formulated from sorghum and groundnut cake or molasses and urea as main sources of energy and protein, respectively. Each of the four diet groups of ewes was further divided into 6 subgroups (replicates) of similar body weights housed and fed together for two successive gestation periods. The results showed that the diet treatments had no significant effect on age and weights at first oestrous (210, 238 days and 22, 20 kg) and at first lambing (407, 418 days and 30, 28 kg) of the PSo and PMo groups, respectively. Age of the ewes and the diet treatments had no significant effects (P>0·05) on feed intake, conception weight, litter size, lamb birth weight, gestation period, postpartum anoestrous period, lambing interval, sex ratio of offspring as well as conception, fertility, abortion and lambing proportions. Primiparous ewes (P) had significantly (P<0·05) higher pre-weaning lamb mortality proportion, whereas the sorghum-based diet groups had higher (P<0·05) gestation body gain and lambing weights.It was concluded that Nilotic ewes, compared with the other African sheep breeds reviewed, reach sexual maturity at an earlier age and are highly prolific due to their short postpartum anoestrous period. The results also highlight the importance of molasses and urea as efficient and good substitutes for sorghum grains and oil cakes, respectively, in the diets of ewes.