METHODS: A cohort of 4,240 Sepsis-3 patients was analyzed, with 783 experiencing 30-day mortality and 3,457 surviving. Fifteen biomarkers were selected using feature ranking methods, including Extreme Gradient Boosting (XGBoost), Random Forest, and Extra Tree, and the Logistic Regression (LR) model was used to assess their individual predictability with a fivefold cross-validation approach for the validation of the prediction. The dataset was balanced using the SMOTE-TOMEK LINK technique, and a stacking-based meta-classifier was used for 30-day mortality prediction. The SHapley Additive explanations analysis was performed to explain the model's prediction.
RESULTS: Using the LR classifier, the model achieved an area under the curve or AUC score of 0.99. A nomogram provided clinical insights into the biomarkers' significance. The stacked meta-learner, LR classifier exhibited the best performance with 95.52% accuracy, 95.79% precision, 95.52% recall, 93.65% specificity, and a 95.60% F1-score.
CONCLUSIONS: In conjunction with the nomogram, the proposed stacking classifier model effectively predicted 30-day mortality in Sepsis patients. This approach holds promise for early intervention and improved outcomes in treating Sepsis cases.
DESIGN: A cross-sectional study design and top-down costing approach, analysing Malaysian diagnosis-related group (DRG) data for AMR patients admitted to MoH hospitals from 2017 to 2020.
SETTING AND PARTICIPANTS: A total of 1190 cases were identified using International Statistical Classification of Diseases-10 version 2010 codes for AMR pathogens.
OUTCOME MEASURES: The study aims to estimate direct healthcare costs for treating AMR patients. Costs per admission were calculated based on each patient's length of stay (LOS). A binary logistic regression model identified cost determinants, with significant factors (p<0.05) further analysed using a multivariate multiple logistic regression. ORs with 95% CIs were determined, and treatment costs were categorised as above or below the annual national base rate.
RESULTS: Findings showed that costs are influenced by the volume of cases identified through DRG codes and LOS, which averaged between 21.7 and 36.4 days. Median admission costs for AMR patients ranged from RM12 476.28 (IQR RM 15 655.93) to RM19 295.11 (IQR RM20 200.28). Both LOS and total costs increased annually, from RM3 711 046.10 in 2017 to RM9 700 249.08 in 2019. Patients over 56 years old and those with severity levels II and III were more likely exceeding the national base rate.
CONCLUSIONS: These findings, explaining 9.3% of the variance in the regression model, can inform policies to reduce the economic burden of AMR and improve patient outcomes, highlighting the need for a comprehensive strategy to address this global health threat.
METHODS: Using a non-randomized, two-district quasi-experimental design (one district assigned to each arm to minimize contamination), knowledge was assessed via a validated questionnaire at baseline, 1 month, and 3 months. All 260 enrolled participants were analyzed under an intention-to-treat approach using a repeated-measures ANCOVA (arm × gender × time); 15 participants (5.8%) were lost to follow-up by 3 months.
RESULTS: Knowledge scores did not differ between arms at baseline or 1 month, but diverged significantly by 3 months, favoring the web-based arm (68.12% vs. 59.13%; adjusted difference = -8.67 percentage points, 95% CI = [-12.61 to -4.74] (conventional minus web-based; the web-based arm scored higher), p
METHODS: Antihyperlipidemic effect was assessed in a high-fat diet-induced hyperlipidemic model in Wistar albino rats. The rats were treated orally with extracts of bashok (J adhatoda, 200 mg/kg bw), tulshi (O tenuiflorum, 200 mg/kg bw), and a combination of bashok and tulshi (50:50), as well as with a reference drug, atorvastatin (10 mg/kg/day), with or without high-fat diet for 14 days. The antioxidative effect was studied using established in vitro models. The studies were supported by experimentally testing the effects of the extracts on membrane stabilization and inhibition of protein denaturation.
RESULTS: The results showed that the serum lipid profile was significantly decreased in the different treatment groups, with bashok having the greatest effect. Body weights, total serum protein, LDH, and relative liver and adipose tissue weights were markedly restored towards baseline values, the lowest atherogenic index being achieved with the combined extract. The combination treatment significantly enhanced total phenolic content and antioxidative capacity and greatly potentiated membrane stabilization, but inhibition of protein denaturation was not significantly affected.
CONCLUSION: The data demonstrate that a combination of Justicia adhatoda and Ocimum tenuiflorum could be developed as a food supplement with antioxidative and antihyperlipidemic benefits.