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The clinical efficacy and safety of complement C5a inhibitors for patients with severe COVID-19 remains unclear.The PubMed, Embase, Cochrane Library, and ClinicalTrials.gov databases were searched from their inception to 27 September 2022. Only studies that assessed the usefulness of C5a inhibitors for the treatment of patients with severe COVID-19 patients were included. The primary outcome was the risk of 28-day mortality.Six studies, including four randomized controlled trials (RCTs) and two non-RCTs, were included. The study group receiving C5a inhibitors had a significantly lower risk of mortality compared with the control group (23.6% [70/297] vs 39.2% [136/347]; odds ratio [OR], 0.53; 95% confidence interval [CI]: 0.37-0.76;C5a inhibitors could help reduce the risk of mortality in patients with severe COVID-19 infection while being as safe as placebos. These findings support the promising role of C5a inhibitors in the treatment of severe COVID-19.

The large gap between the demand for, and the supply of organs worldwide makes promoting organ donation an important global social issue. Even after someone has signed a consent form or registered for organ donation, ethically, the hospital still requires a family member's written permission before organ donation can proceed. As a result, a family member rather than the patient makes the final decision. This study investigated the willingness of the family members of hypothetical patients in intensive care units (ICUs) suffering from an irreversible condition to sign an organ donation consent form. A cross-sectional survey was conducted among family members of ICU patients recruited from one medical center in southern Taiwan from April to October 2014, which followed the STROBE guidelines. Of 110 ICU family members, 71 (64.5%) were willing to donate the organs of hypothetical patients with irreversible conditions. Based on logistic regression, family support, attitude, and knowledge of organ donation significantly predicted 34% of the variance in willingness to sign consent. Attitude toward organ donation and behavioral knowledge of organ donation correlated significantly with a willingness to sign a consent form. This study found that family support and organ donation attitudes were important factors in predicting the willingness to sign a consent form for the organ donation of hypothetical patients. The study provides evidence that nurses and healthcare staff need to consider family support and educate families on organ donation to encourage potential donors to accept and agree to organ donation.

Considering the popularity and particularity of basketball, the athletes face a potential "Sport Commitment Crisis" due to immense pressures from academics, training, employment, and college. To date, research in sports has demonstrated the relationship between coach trust and sport commitment; however, the relationship among teammates is yet to be explored. We examined whether teammate trust is related to commitment and if prosocial and antisocial behaviors mediate these relationships. Right after a game, the college basketball players (N = 570) were asked to complete a multi-section questionnaire measuring the aforementioned variables. Structural equation modeling (SEM) revealed that athletes' perceptions of their teammates' trust were positively related to their sport commitment, and these relationships were mediated by teammate prosocial behavior. In contrast, antisocial behavior did not affect their relationship. The findings suggest that teammate trust could facilitate sport commitment in athletes, which could occur via prosocial behavior.

Background Peripheral gangrene is a clinical condition characterized with digital ischemia of extremities usually seen in patients with sepsis or shock that resulted in a hypoperfusion state. It is not common but often complicated with high mortality rate. Currently, there is no definite treatment for peripheral gangrene which often result in amputation. Methods We reported a 74-year-old female case of shock-related peripheral gangrene of both feet who was partially and successfully treated by oral sildenafil with a dose of 50mg twice daily. We also reviewed present evidences regarding effectiveness of sildenafil in managing distal ischemia caused by different clinical conditions. Results Except for limited regions which had already shown evident dark discoloration (i.e., the 4 th and 5 th toe on the right foot) at the time of treatment initiation, all other region of peripheral ischemia significantly improved after systemic oral sildenafil treatment for 7 days. The 4 th and 5 th toe of the right foot eventually turned into a darker area of necrosis with an obvious margin, in contrast to recovered regions. Literature showed relief of pain and reversal of other ischemic symptoms after a few days to months sildenafil therapy. Conclusions In accordance with the reported case and current literature, systemic sildenafil shows great potential in ameliorating peripheral ischemia and gangrene as an off-label drug of choice.

In modern embedded processor systems, energy efficiency is a critical issue. Unfortunately, to avoid cache memory (SRAM) faults from dynamic variations, caches generally operate at an elevated voltage to build a safety guardband that decreases energy efficiency. To address this issue, tolerating SRAM faults to eliminate the safety of a guardband without frequency scaling may be a viable solution. This study investigates the characteristics of low-voltage 8 T SRAM faults and demonstrates that most SRAM faults are typically caused by insufficient access times with variation effects and significantly reduced voltages. Thus, we propose an access-time fault-tolerant cache design based on a type of 8 T SRAM known as zero-counting and adaptive-latency cache (ZCAL cache), which can tolerate numerous access-time faults. ZCAL caches detect access-time faults dynamically using a lightweight error detection code (“0” counting) because access-time faults occur only when reading “0” bits on the 8 T SRAM; the cache then adapts its access time to tolerate the access-time faults with new cache management processes. With the ZCAL cache, the experimental results from the MiBench benchmarks indicate that the energy efficiency is improved by 17% on average and that the energy consumption is reduced by 22% from 0.76 to 0.63 V.

Contemporary cache is known for consuming a large part of total power in microprocessors. Voltage scaling had been used to reduce the power consumption of the cache. However, due to the impact of variations, SRAM cells of the cache could potentially fail when voltage dropping. To against variations, we need to increase the supply voltage for the safety margin, thus the cache costs large energy consumption. For eliminating the voltage safety margin, some prior works for SRAM failure tolerance designs were proposed. These schemes will result in worse energy consumption and cannot deal with dynamic variations. They still have a safety margin to resist dynamic variations. With the supply voltage scaling down, we find out that the major reason of failures is that some slow cells have longer latency. We call these cell faults as “latency fault”. If each cache line can be accessed in an appropriate access time, the slower cells could be reused but not disable them. We propose a VAL-Cache adapting the access time to tolerate latency faults and which is able to scale down the voltage. And we also propose the latency-fault detector to detect latency faults at run-time so as to tolerate both static and dynamic variations. Our experimental results on Mibench and 0xbench benchmarks demonstrate that the energy consumption can be reduced 10%~18% in average at a cost of acceptable performance loss.

Escherichia coli remains one of the most common etiologies of secondary peritonitis. CMY-2 is the most prevalent AmpC enzyme identified in nosocomial E. coli isolates causing bacteremia in Taiwan. This report is of a patient who underwent surgery for intestinal perforations due to blunt abdominal trauma and developed unexpected CMY-2-producing E. coli septicemia in the early postoperative period. The AmpC-type CMY-2 enzyme might partially contribute to the poor response to antimicrobial therapy of amoxicillin-clavulanic acid or flomoxef. Late changes in antibiotic therapy to an appropriate regimen of cefpirome based on the culture results did not result in a positive outcome and the patient died. Whether selection of an anti-AmpC regimen is appropriate as first-line treatment for traumatic abdomen-associated septicemia should be an area of further investigation in Taiwan.

To investigate the characteristics and outcomes of surgical patients who were readmitted to the intensive care unit (ICU).The data were collected for all readmissions to the surgical ICUs in a tertiary hospital in the year 2003.Of all the 945 ICU discharges, 110 patients (11.6%) were readmitted. They had a longer initial ICU stay (8.05 +/- 7.17 vs 5.22 +/- 4.95, P0.001) and were older and in a more severe condition than those not readmitted, but with a longer hospital stay and higher mortality rate (40% vs 3.6%, P0.001). A total of 26.4% of the readmission patients had an early readmission (48 h), with a lower mortality rate than those with a late readmission (24.1% vs 45.7%, P = 0.049). A total of 46.4% of the patients were readmitted with the same diagnosis while the rest were readmitted with a new complication. Respiratory disease was the most common diagnosis for patients readmitted with a new complication (66.1%). The nonsurvivors had a significantly higher second Acute Physiology and Chronic Health Evaluation (APACHE II) score (22.1 +/- 8.8 vs.14.6 +/- 7.4, P0.001) and second Therapeutic Intervention Scoring System (TISS) score (30.1 +/- 8.7 vs 24.7 +/- 7.6, P = 0.001) and a longer stay in the first ICU admission (10.4 +/- 9 days vs 6.4 +/- 5 days, P = 0.010). A multivariate analysis showed that the first ICU length of stay and the APACHE II score at the time of readmission were the two risk factors for mortality.The mortality of surgical patients with ICU readmission was high with respiratory complications being the most important issue.

Background The increased incidence of pyogenic liver abscess caused by Klebsiella pneumoniae (K.pneumoniae) was reported in the recent literature. This study was conducted retrospectively to investigate the clinical characteristics and outcomes of these patients. Methods Microbiological and medical databases of a medical center were searched from January 2000 to June 2003. Eighty-four patients with liver abscess caused by K.pneumoniae were analyzed. Results In the 84 patients, 52 men and 32 women aged (58.2 +/- 13.3) years on average, 64.4% had concomitant diabetes mellitus and 23.8% had biliary disease. The most common clinical symptoms were fever (98.8%), chills (69.0%) and abdominal pain (58.3%). 85.7% of the 84 patients received catheter drainage for the abscess. The length of hospital stay was (17.4 +/- 8.7) days. The mortality rate was 7.1%. Older age and presence of biliary disease were associated with mortality. Conclusions The low mortality of our patients was probably related to the high proportion of patients who received catheter drainage. Older age and presence of biliary disease were associated with the mortality.

28-year-old man presented with syncope after passing ark-red stool several times in 24 hours. He had no ematemesis, nausea, vomiting, or epigastralgia. The abomen was soft without tenderness. His hemoglobin as 7.2 g/dL and hematocrit was 20.5%. Panendosopy did not reveal any abnormality. Colonoscopy failed ecause of a large amount of blood in the rectum. Aniography showed active extravasation of contrast media rom a distal branch of an ileal artery (A, black arrow). mergent laparotomy was performed because of persisent bleeding with unstable hemodynamics. Under light ranslumination, the entire colon and ileum were filled ith blood. A 0.4 0.5 0.8-cm mass over the ileum as palpated, with a marginal artery feeding this mass B). The rest of the bowel was unremarkable. Limited esection of the ileal lesion with primary end-to-end nastomosis was performed. The patient had a rapid and neventful recovery. The lesion looked crater-like on the mucosal side (C). icroscopically, a large-caliber artery was located within he submucosa. There was erosion on the mucosal surace without surrounding ulceration. A thrombus was resent in the vascular lumen (D). It was a typical picure of Dieulafoy’s lesion. Dieulafoy’s lesion is an important cause of gastrointestial hemorrhage and is potentially life-threatening. It can A