Abstract Objective This study aimed to develop and apply a nomogram with good accuracy to predict the risk of CRAB infections in neuro-critically ill patients. In addition, the difficulties and expectations of application such a tool in clinical practice was investigated. Methods A mixed methods sequential explanatory study design was utilized. We first conducted a retrospective study to identify the risk factors for the development of CRAB infections in neuro-critically ill patients; and further develop and validate a nomogram predictive model. Then, based on the developed predictive tool, medical staff in the neuro-ICU were received an in-depth interview to investigate their opinions and barriers in using the prediction tool during clinical practice. The model development and validation is carried out by R. The transcripts of the interviews were analyzed by Maxqda. Results In our cohort, the occurrence of CRAB infections was 8.63% (47/544). Multivariate regression analysis showed that the length of neuro-ICU stay, male, diabetes, low red blood cell (RBC) count, high levels of procalcitonin (PCT), and number of antibiotics ≥ 2 were independent risk factors for CRAB infections in neuro-ICU patients. Our nomogram model demonstrated a good calibration and discrimination in both training and validation sets, with AUC values of 0.816 and 0.875. Additionally, the model demonstrated good clinical utility. The significant barriers identified in the interview include “skepticism about the accuracy of the model”, “delay in early prediction by the indicator of length of neuro-ICU stay”, and “lack of a proper protocol for clinical application”. Conclusions We established and validated a nomogram incorporating six easily accessed indicators during clinical practice (the length of neuro-ICU stay, male, diabetes, RBC, PCT level, and the number of antibiotics used) to predict the risk of CRAB infections in neuro-ICU patients. Medical staff are generally interested in using the tool to predict the risk of CRAB, however delivering clinical prediction tools in routine clinical practice remains challenging.
The aim of this study is to make a functional selection of the highly migratory orbital fat-derived stem cells (OFSCs) using a 3D collagen gel as a selection barrier. Firstly we isolated OFSCs by regular digestion. Passage 2-3 OFSCs were used to verify their multiple differentiation potentials. Then we encapsulated passage 2-6 OFSCs into collagen type I microspheres, followed by a well-established cell migration assay under attraction of two kinds of chemokines -10 ng/ml Fractalkine or 50 ng/ml SDF-1β. After staining and counting, we found that after 3D collagen barrier selection, migrated OFSCs have more sensitive response to the induction of these two chemokines.
Based on the L9(3)1 orthogonal design with the amount of ginger, amount of alum and decocting time as working factors, and using the method of recording comprehensive scores, an experimental study has been made on the optimization of processing technology for Rhizoma Pinelliae by ginger and alum as stipulated in the Pharmacopoeia. The result shows that the best process is to use 15 kg of ginger juice and 8 kg of alum per 100 kg of Pinellia ternata and decoct them together for 2-3 hours till the juice is fully absorbed by Rhizoma Pinelliae.
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