Day 1 :
Keynote Forum
Thomas R McCune
EVMS, USA
Keynote: High dose vitamin C associated with acute kidney injury and mortality
Biography:
Thomas McCune is the Chair of the Division of Nephrology Department of Internal Medicine at Eastern Virginia Medical School. His current areas of research include SARS-CoV-2 vaccination in transplant patients, APOL-1and other congenital kidney diseases, and technics to decrease AKI in healthcare settings.
Abstract:
Background: The effects of vitamin C on clinical outcomes in critically ill patients remain controversial due to inconclusive studies. Oxalic acid and oxalate toxicity have been shown to occur in myocardial tissue of patients with hereditary and possibly secondary hyperoxaluria. This retrospective observational cohort study evaluated the effects of vitamin C therapy on acute kidney injury (AKI) and mortality among septic patients.
Methods: Electronic medical records of 1390 patients from an academic hospital who were categorized as Treatment (received at least one dose of 1.5g IV vitamin C, n=212) or Comparison (received no, or less than 1.5g IV vitamin C, n=1178) were reviewed. Propensity score matching was conducted to balance several covariates between groups. Multivariate logistic regressions were conducted predicting AKI and in-hospital mortality among the full sample and a sub-sample of patients seen in the ICU.
Results: Data revealed that vitamin C therapy was associated with increases in AKI (OR=2.07 95% CI [1.46-2.93]) and in-hospital mortality (OR= 1.67 95% CI [1.003-2.78]) after adjusting for demographic and clinical covariates. When stratified to examine ICU patients, vitamin C therapy remained a significant risk factor of AKI (OR=1.61 95% CI [1.09-2.39]) and provided no protective benefit against mortality (OR= 0.79 95% CI [0.48-1.31]). The authors recommend ongoing use of high dose vitamin C in sepsis should be appraised due to observed associations with AKI and death.
Further Research: The authors are reviewing this data base to evaluate if there is a dose of vitamin C that is associated with toxicity. The authors are reviewing the NIH National COVID Cohort Collaborative (N3C) data base to assess if high dose vitamin C when used to treat COVID-19 was associated with AKI and mortality. If the association persists in this data base additional studies of toxicity of vitamin C will be undertaken.
Multiple Logistic Regression Models Predicting Acute Kidney Injury and Mortality in the Total Population Performed
after Propensity Score Matching (3:1) (n=848).
Keynote Forum
Guoli Dai
Indiana University-Purdue University Indianapolis, USA
Keynote: Activin B promotes the initiation and progression of liver fibrosis
Biography:
Guoli Dai is an associate professor in the Department of Biology, School of Science, Center for Developmental and Regenerative Biology, in Indiana University-Purdue University Indianapolis (IUPUI). His research interest focuses on molecular and cellular mechanisms controlling liver growth and regeneration.
Abstract:
Background & Aims: Liver fibrosis is a pivotal pathology in multiple hepatic disease indications, profoundly characterizing disease severity and outcomes. The role of activin B, a TGFβ superfamily cytokine, in liver health and disease is largely unknown. We aimed to investigate whether activin B modulates liver fibrogenesis.
Methods: Liver and serum activin B, along with its analog activin A, were analyzed in patients with liver fibrosis from different etiologies and in mouse acute and chronic liver injury models. Activin B, activin A, or both was immunologically neutralized in mice with progressive or established carbon tetrachloride (CCl4)-induced liver fibrosis. The direct effects of activin B and A on hepatocytes and
hepatic stellate cells (HSCs) were evaluated in vitro.
Results: As a result, hepatic and circulating activin B was increased in human patients with liver fibrosis caused by several liver diseases. In mice, hepatic and circulating activin B exhibited persistent elevation following the onset of several types of liver injury, whereas activin A displayed transient increases. The results revealed a close correlation of activin B with liver injury regardless of etiology and species. We found that neutralizing activin B largely prevented, as well as remarkably regressed, CCl4-induced liver fibrosis, which was augmented by co-neutralizing activin A. Mechanistically, activin B directly promotes hepatocyte death, induces a profibrotic expression profile in HSCs, and stimulates HSCs to form a septa structure. In addition, activin B and A interdependently upregulated the transcription of profibrotic factors including connective tissue growth factor and TGFβ1 in injured livers.
Conclusions: We demonstrate that activin B, cooperating with activin A, directly acts on multiple liver cell populations, and drives the initiation and progression of liver fibrosis. Our finding inspires the development of a novel therapy of chronic liver diseases.
- General Surgery | Pediatric Surgery | Oral and Maxillofacial medical procedure Nursing care | Neurosurgery | Anesthesiology |Orthopedic Surgery | Surgical Oncology | Robotic Surgery | Acute Care Surgery |Ocular Surgery
Location: Barcelona
Session Introduction
Aashish Kaushal
Sr. operational Head, Aarogyapath, India
Title: AarogyaPath: National health care supply chain management
Biography:
Aashish Kaushal is a Sr. operational Head in Aarogyapath, India.
Abstract:
Aarogyapath, a web-based solution for the healthcare supply chain that provides real-time availability of critical supplies launched. This public platform will help healthcare users like hospitals, pathology laboratories, research institutes, medical colleges and patients. This national healthcare supply chain portal will remove supply chain bottlenecks during the Covid-19 pandemic. The vision of this initiative is to set up an information management and forecasting database platform at national level. It will capture demand and supply scenarios for key healthcare needs items. This public platform can help customers in tackling a number of routinely experienced issues like dependence on limited suppliers, time-consuming processes to identify good quality products, limited access to suppliers etc. It also helps to reduce the Black Marketing of medical equipment & products, Unstandardized Medical product prices. It’s the single platform of all medical suppliers & buyers for any announcement/feedback etc. It will also help the manufacturers and suppliers to
reach customers efficiently like nearby pathological laboratories, medical stores, hospitals, etc. It will also create opportunities for business expansion due to an expanded slate of buyers and visibility of new requirements for products. It also helps to fill a critical gap in last-mile delivery of patient care within India through improved availability and affordability of healthcare supplies.
Biography:
Najmeh Askarynejad Amiri is affiliated from MBA Carleton University, Ottawa, Canada and she has done her Healthcare & Hospital Management in Tehran Medical University, Iran. She is Entrepreneur, CEO of Herald Group Georgia & HIRAD Co, Iran. Her interest in Business & Management Consulting, Investment and technology transfer consultation, Business setup and development plan consultation, strategic management and marketing plan analysis and consultation.
Abstract:
Customer Problem: Lack of on time and to the needs medical services and low security of data transfer, low interoperability of related health organizations through a well- formed system. Loss of time, energy and money to receive favourable care services considering patient’s background and medical history in emergency cases. Lack of enough trained professional HR especially during pandemic because of overload in responsibilities. Product / Services: Meta Med Chain will be a decentralized system of block chain that improves efficiency
and interoperability of related departments through its own chain and improves the financial management by using its own coin. There would be a web application and cloud network as Back office and front office for this project. In our long-term objectives, we plan to develop required interfaces to connect medical organization and last but not least assist them to design a compatible EHS or HIS system for their own. Target Market: We are currently targeting younger generation of ages 24-50 in Ontario. This market would be our focus during the first 5 years, but it doesn’t mean that we will limit ourselves to them. Through updated marketing campaigns we would cover potential future markets as well.
Business Model: The income for Meta med chain comes from the payment patients make to healthcare providers by our own coin, Medical organization receives the payment and pays the commission agreed to Meta med chain, and this will be our income. This model is for our 24 months plan as first step Customers: Our target markets of customers are young generation that have internet access and knowledge and cultural accordance to use the application in a correct way. We decided to target 24-50 years generation of Ontario population that might change in the future to include more clients from other ages.
Sales and Marketing Strategy: The main marketing emphasis would be on both face to face and digital marketing through the below marketing plan model
Competitors: We currently have few competitors that have exactly the same product and services, but there are growing number of research and development plans going on to develop similar products. Other competitors
are focusing on different products but focusing on our potential clients.
Competitive Advantage: Design and implement our own block chain and coin is the most important competitive advantage that we have, it’s very professional, time consuming and needs high maintenance, but this will lead us to make a big change over other competitors, cause they are copying or using available block chains that definitely might have their own bugs and problems. We also design smart contracts directly between care receiver and provider; this will increase the security much higher than normal.