I n t r o d u c t i o n: A high neutrophil-to-lymphocyte ratio (NLR) has been reported to be a strong biomarker of inflammation.

A i m: We sought to evaluate the impact of NLR on long-term all-cause and cardio-vascular (CV) mortality in hemodialysis (HD) patients.

Ma t e r i a l a n d Me t h o d s: A total of 84 chronic kidney disease (CKD) stage 5 patients with 54 of them on HD, with a median age of 61.5 (51.3–74.8) years were enrolled. The association between NLR and clinical biomarkers was investigated. Multivariable Cox regression analysis was used to find significant predictors of all-cause and CV mortality at follow-up.

R e s u l t s: The median NLR (interquartile range) was 3.0 (2.1–4.1). Patients with NLR ≥3.9 (the highest tertile) had higher five-year all-cause mortality then remaining patients (53.6% vs. 30.4%; p = 0.039). On the contrary, only a trend towards increased CV mortality was observed (25.0% vs. 42.9%; p = 0.10). NLR ≥3.9 was a significant predictor of all-cause mortality at five years [hazard ratio (95%CI): 2.23 (1.10– 4.50); p = 0.025] in Cox regression model adjusted for age, gender, and diabetes status. Similarly, while using NLR as continuous variable a significant association between NLR and all-cause mortality was confirmed even after adjustment for covariates [hazard ratio per 1 unit increase (95%CI): 1.26 (1.06–1.51); p = 0.009] with the area under the receiver operating characteristic (ROC) curve of 0.64. Correlations between NLR and WBC, concentration of fibrinogen, albumin were observed.

C o n c l u s i o n s: Asymptomatic inflammation measured by NLR showed an association with long-term all-cause mortality in stage 5 CKD patients, even while white blood cell count was in the normal range.

Various theories have been put forward on the demographic and health effects and consequences of socioeconomic development. In this study, we used the theoretical findings of the epidemiologic transition as a starting point to examine the 2020 values of the three main cancer indicators (incidence, mortality, prevalence). These values were compared with socioeconomic development variables for 170 countries. The countries were grouped using hierarchical clustering, and linear discriminant analysis was used to evaluate how appropriate the clustering was. Principal component analysis was used to examine, by group, which parameters are significant in each principal component and what background factors underlie the data. The results seem to confirm the association between cancer and socioeconomic background.

Maternal mortality has posed a great problem in the health sector of most African countries. Nigeria’s maternal mortality ratio remains high despite efforts made to meet millennium development goal 5 (MDG5). This study used the Lagos state community health survey 2011 and the Lagos state health budget allocations 2011 to examine the effect of government expenditure on maternal mortality ratio. Factors like inadequate transportation facilities, lack of awareness, inadequate infrastructures, which contribute to high maternal mortality rate, can be traced back to revenue though under different ministries. The other ministries need to work and support the ministry of health in the fight against maternal, especially in Lagos state. Secondary data was compiled from the state budget, records of death in different local governments in the state and relevant reviewed literature. Regression analysis was used to analyze the hypothesis and it was discovered that government expenditure does not have a significant effect on maternal mortality based on the R-square coefficient. However, correlation coefficient gives a contrasting result. Hence, further research work, government expenditure from other local government areas need to be taken into consideration to arrive at a valid conclusion. It is difficult to ascertain how much of the revenue allocated was put to appropriate use, due to a high level of corruption.

Background/Aim: Factors influencing the survival of the nursing home population have not yet been clearly defined. The aim of the study was to investigate the impact of nutritional, mental, functional, disease and pharmacological factors on the survival of nursing home residents with severe disabilities.
Material and Methods: A retrospective cohort study was conducted with a 9-year follow-up period among nursing home residents with a Barthel score ≤40. The initial assessment included the following scales: Mini Nutritional Assessment Short-Form (MNA-SF), Abbreviated Mental Test Score (AMTS), the Barthel Index, and blood pressure (BP) measurements. Comorbidities, medications and all-cause mortality were extracted from medical records. The analyzed cohort was divided into two groups: Deceased — residents who died ≤3 years and Survivors — those who survived >3 years of observation.
Results: Survivors (n = 40) and Deceased (n = 48) did not differ significantly in terms of age, sex, systolic and diastolic BP, the Barthel Index, number of diseases and medications used. Survivors had significantly higher scores in MNA-SF (p <0.001) and AMTS (p <0.003) than Deceased. Moreover, Survivors had hyper-tension significantly more often and took aspirin and ACE inhibitors (p <0.05). The multivariable logistic regression analysis showed that the MNA-SF score significantly affected mortality [OR = 0.62, (95%CI, 0.46– 0.84), p <0.001].
Conclusion: Higher MNA-SF scores were a factor that significantly affected the survival of nursing home residents, while functional status assessed using the Barthel Index had no effect on survival. MNA-SF was found to be a useful tool for assessing the risk of death in a nursing home.

I n t r o d u c t i o n: Fecal calprotectin (FC) rises significantly in intestinal inflammation accompanied by neutrophil activation — such as Clostridium diffi cile infection (CDI). The aim of the study was to evaluate the benefi t of FC testing in assessing the severity of CDI.

Ma t e r i a l s a n d M e t h o d s: The study group included 76 patients with CDI hospitalized in the Jagiellonian University Hospital in Krakow from July 2017 till January 2018. FC levels were measured using an EIA (Enzyme Immunoassay). Demographic, clinical information and blood tests were recorded using standardized data collection forms. The selection of patients into non-severe and severe groups was carried out in accordance with the ESCMID criteria (European Society of Clinical Microbiology and Infectious Diseases) and some modifications to those criteria were proposed.

R e s u l t s: The studied population included 76 patients (39 men and 37 women) with CDI aged from 24 to 98 years (mean: 72). Median calprotectin level was 739 (Q25–Q75: 612–799 μg/g), characteristic of patients with colitis. A statistically signifi cant diff erence in FC concentration in patients with severe vs non-severe CDI was observed (severe — 770 vs non-severe — 659 μg/g, p = 0.009). FC directly correlated with platelets level; however, no correlation between FC level and the blood parameters prognostic for CDI (leukocyte, neutrophil count, albumin, creatinine levels) was found.

C o n c l u s i o n: FC level is an indication of ongoing intestinal inflammation in CDI patients. FC level significantly correlated with CDI severity, which demonstrates that FC could serve as a predictive marker for assessing CDI severity.

The United Nations General Assembly established the Sustainable Development Goals in 2015 to achieve an equitable and sustainable future for all by 2030. This study aims to model the relationship between government revenue per capita, quality of governance and the targets of several of these goals, including the coverage of the critical determinants of health; water, sanitation, healthcare, and education. We used government revenue because the policies and practices of international and multinational organisations - including corporations and banks - are more likely to influence revenue rather than government spending in countries in which they are engaged. Also, government revenue reflects a government's ability to spend across all sectors rather than just health or education. An unbalanced non-linear panel data model was employed, and annual data on 217 countries over the period 1960-2000 was used. The coverage of the Sustainable Development Goal variables was expressed as percentages and measures of the quality of governance included in the model. A linear relationship between revenue and the determinants of health would not be appropriate; therefore, we employ a logistic function. A standard panel logistic function would impose the same shape “S” curve on all countries, which is inappropriate. Therefore, we augment the parameters of the logistic function with measures of the quality of governance in each country, which allows each country to have a different “S” shape as the quality of its governance varies. Our study found that increased government revenue is associated with increased progress towards the Sustainable Development Goals. An improvement in the quality of governance could amplify this effect. This modelling and its accompanying visualisations can predict the potential of an increase in government revenue in an individual country regarding progress towards the Sustainable Development Goals.

Postharvest insect pests constitute major threats to food security because they cause qualitative and quantitative damage to agricultural produce. Therefore, eco-friendly and cost-effective measures should be used for their management. In this study, five botanical powders ( Trema orientalis and Crataeva religiosa leaves; and Citrus tangelo, Citrus maxima and Citrus aurantifolia peels) were admixed with Spintor® [1.25 active ingredient (a.i.) mg · kg ^–1] and evaluated as toxicants against Tribolium castaneum. Each botanical powder and spintor was solely applied at 1000 mg · kg ^–1 millet seeds. Spintor-botanical powder mixtures admixed at a ratio of 1 : 1 (w/w) were applied at 500 and 1000 mg · kg ^–1, corresponding to 0.313 and 0.625 a. i. mg · kg ^–1 for spintor in the mixtures, respectively. On the 14th day of exposure, the Citrus species admixed with spintor and applied at 500 mg · kg ^–1 evoked significantly (p < 0.05) higher percentage mortality (72.22–90.28%) than what was observed in the mixture of spintor with T. orientalis (22.08%) or the mixture of spintor with C. religosa (17.92%) applied at 500 mg · kg ^–1. There was a significant difference (p < 0.05) in the Kaplan-Meier estimates of the treatments against the insects. The time required to kill 50% of the assayed insects (LT50) when Citrus species were admixed with spintor at 500 mg · kg ^–1 (10 days) was shorter than 14 days observed in the mixture of spintor with T. orientalis or C. religiosa. Therefore, admixing spintor with any of the Citrus powders [at 1 : 1 (w/w)] applied at 500 mg · kg ^–1 seed is recommended for the protection of millet seeds against T. castaneum.,

The COVID-19 pandemic has significantly reduced the number of orthopedic surgeries world-wide. The main reason for this was an introduction of numerous restrictions in the field of mobility, which resulted in reduction of circumstances predisposing to injuries. This had a positive impact on the overall readiness of the health system to fight the pandemic, thanks to saving human and material resources that could be successfully allocated in order to fight a new, previously unknown threat. On the other hand, such aimed administration of the system was not indifferent in terms of care quality directed towards traumatized patients, often requiring immediate measures (risk of infection transmission). This study aims to evaluate in-hospital mortality in patients with COVID-19 operated on proximal femur fractures. An attempt was also made to determine predictors influencing mortality rate among patients operated over the analyzed period.