Keberkesanan program pemulihan tingkah laku di Taman Sri Puteri, Batu Gajah dan Kompleks Dar-As-Saadah

Taman Seri Puteri Batu Gajah, Perak dan Kompleks Dar-Assa’dah, Kuala Lumpur. Di institusi ini, delikuen wanita akan menjalani program pemulihan yang bertujuan untuk memberi bimbingan dan pendedahan kepada mereka sebagai persediaan untuk diterima semula oleh masyarakat. Instrument kajian ialah soal selidik yang digunakan ini diubahsuai daripada kajian Azizi(1990) dan Azizi ( 2004). Darjah kebolehpercayaan soal selidik diuji dengan menggunakan Cronbach Alpha di mana nilai keseluruhannya ialah 0.961. Seramai 79 orang pelatih terdiri penghuni yang telah menjalani sekurang-kurangnya 6 bulan program pemulihan tingkah laku di kedua-dua institusi dipilih sebagai responden. Pemboleh ubah yang digunakan dalam kajian ialah Kemudahan dan Kelengkapan yang sedia ada, Program Vokasional, Program Kokurikulum, Program Keagamaan dan Program Bimbingan serta Kaunseling. Dapatan kajian menunjukkan Kemudahan dan Kelengkapan yang tersedia berada di tahap sederhana. Begitu juga Program Vokasional, Program Kokurikulum dan Program Bimbingan dan Kaunseling kurang berkesan. Program Keagamaan adalah berkesan. Tidak terdapat perbezaan yang signifikan antara Kemudahan dan Kelengkapan yang sedia ada, Program Vokasional dan Program Kokurikulum di Taman Seri Puteri Batu Gajah, Perak dan Kompleks Dar-Assa’dah, Kuala Lumpur. Terdapat perbezaan yang signifikan di antara Program Keagamaan dan Program Bimbingan dan Kaunseling di Taman Seri Puteri Batu Gajah, Perak dan Kompleks Dar-Assa’dah, Kuala Lumpur. (katakunci: pusat pemulihan, delikuen wanita, kemudahan dan kelengkapan, program vokasional, program kokurikulum, program keagamaan, program bimbingan dan kaunseling) Abstract: The purpose of this study is to evalute the effectiveness of the programmes conducted by two rehabilitation centres for female delinquents. In these centres, the delinquents undergo programmes which aimed to give guidance and help the delinquents change their unwanted behaviour. The data were collected using questionnaires which was adapted from the research done by Azizi (1999) and Azizi (2004). Alpha Cronbach is used to test the reliability of this research. It showed that the overall Alpha value for the programmes is 0.93. A total of 79 respondents were chosen at simplified random to be the respondents of the research. The variables used in the research are the facilities, Vocational Programme, Co-curriculum Programme, Religious Programme and Counseling Programme. The overall findings of the research indicates that facilities and Counseling programme to be less effective compared to Vocational Programme, Co-curriculum Programme, Religious Programme. The results of the research showed that there is no significant difference in the way the facilities, Vocational Programme and Co-curriculum Programme was carried out in these two institution, namely Taman Seri Puteri Batu Gajah, Perak and Kompleks Dar-Assa’dah, Kuala Lumpur. There are significant differences between the Religious Programme and Counseling Programme in these two institutions

Comparative Analysis of Data Mining Classification Algorithms in Type-2 Diabetes Prediction Data Using WEKA Approach

The goal of this paper discusses about different types of data mining classification algorithms accuracies that are widely used to extract significant knowledge from huge amounts of data. Here illustrate 20 classifications of supervised data mining algorithms base on type-2 diabetes disease dataset perspective to Bangladeshi populations. In this paper we compare 20 classification algorithms by measuring accuracies, speed and robustness of those algorithms using WEKA toolkit version 3.6.5. Accuracies of classification algorithms are measured in 3 cases like Total Training data set, 10 fold Cross Validation and Percentage Split (66% taken). Speed (CPU Execution Time) and error rate also measured as like as accuracy. Firstly checked top perform algorithms that have best outcome for different cases and then ranked top outcomes algorithms. Finally ranked best 5 algorithms among 20 algorithms based on their accuracies

Keberkesanan Program-Program Pemulihan Tingkah laku Di Taman Seri Putri Batu Gajah Dan Kompleks Dar-Assa’adah

Kajian ini bertujuan melihat keberkesanan pelaksanaan program yang dijalankan di Taman Seri Puteri Batu Gajah, Perak dan Kompleks Dar-Assa’dah, Kuala Lumpur. Di institusi ini, delikuen wanita akan menjalani program pemulihan yang bertujuan untuk memberi bimbingan dan pendedahan kepada mereka sebagai persediaan untuk diterima semula oleh masyarakat. Instrument kajian ialah soal selidik yang digunakan ini diubahsuai daripada kajian Azizi(1990) dan Azizi ( 2004). Darjah kebolehpercayaan soal selidik diuji dengan menggunakan Cronbach Alpha di mana nilai keseluruhannya ialah 0.961. Seramai 79 orang pelatih terdiri penghuni yang telah menjalani sekurang-kurangnya 6 bulan program pemulihan tingkah laku di kedua-dua institusi dipilih sebagai responden. Pemboleh ubah yang digunakan dalam kajian ialah Kemudahan dan Kelengkapan yang sedia ada, Program Vokasional, Program Kokurikulum, Program Keagamaan dan Program Bimbingan serta Kaunseling. Dapatan kajian menunjukkan Kemudahan dan Kelengkapan yang tersedia berada di tahap sederhana. Begitu juga Program Vokasional, Program Kokurikulum dan Program Bimbingan dan Kaunseling kurang berkesan. Program Keagamaan adalah berkesan. Tidak terdapat perbezaan yang signifikan antara Kemudahan dan Kelengkapan yang sedia ada, Program Vokasional dan Program Kokurikulum di Taman Seri Puteri Batu Gajah, Perak dan Kompleks Dar-Assa’dah, Kuala Lumpur. Terdapat perbezaan yang signifikan di antara Program Keagamaan dan Program Bimbingan dan Kaunseling di Taman Seri Puteri Batu Gajah, Perak dan Kompleks Dar-Assa’dah, Kuala Lumpur. (katakunci: pusat pemulihan, delikuen wanita, kemudahan dan kelengkapan, program vokasional, program kokurikulum, program keagamaan, program bimbingan dan kaunseling

A systematic review of cost-effectiveness analyses of complex wound interventions reveals optimal treatments for specific wound types.

BackgroundComplex wounds present a substantial economic burden on healthcare systems, costing billions of dollars annually in North America alone. The prevalence of complex wounds is a significant patient and societal healthcare concern and cost-effective wound care management remains unclear. This article summarizes the cost-effectiveness of interventions for complex wound care through a systematic review of the evidence base.MethodsWe searched multiple databases (MEDLINE, EMBASE, Cochrane Library) for cost-effectiveness studies that examined adults treated for complex wounds. Two reviewers independently screened the literature, abstracted data from full-text articles, and assessed methodological quality using the Drummond 10-item methodological quality tool. Incremental cost-effectiveness ratios were reported, or, if not reported, calculated and converted to United States Dollars for the year 2013.ResultsOverall, 59 cost-effectiveness analyses were included; 71% (42 out of 59) of the included studies scored 8 or more points on the Drummond 10-item checklist tool. Based on these, 22 interventions were found to be more effective and less costly (i.e., dominant) compared to the study comparators: 9 for diabetic ulcers, 8 for venous ulcers, 3 for pressure ulcers, 1 for mixed venous and venous/arterial ulcers, and 1 for mixed complex wound types.ConclusionsOur results can be used by decision-makers in maximizing the deployment of clinically effective and resource efficient wound care interventions. Our analysis also highlights specific treatments that are not cost-effective, thereby indicating areas of resource savings. Please see related article: http://dx.doi.org/10.1186/s12916-015-0288-5

Hyper-hippocampal glycogen induced by glycogen loading with exhaustive exercise

Glycogen loading (GL), a well-known type of sports conditioning, in combination with exercise and a high carbohydrate diet (HCD) for 1 week enhances individual endurance capacity through muscle glycogen supercompensation. This exercise-diet combination is necessary for successful GL. Glycogen in the brain contributes to hippocampus-related memory functions and endurance capacity. Although the effect of HCD on the brain remains unknown, brain supercompensation occurs following exhaustive exercise (EE), a component of GL. We thus employed a rat model of GL and examined whether GL increases glycogen levels in the brain as well as in muscle, and found that GL increased glycogen levels in the hippocampus and hypothalamus, as well as in muscle. We further explored the essential components of GL (exercise and/or diet conditions) to establish a minimal model of GL focusing on the brain. Exercise, rather than a HCD, was found to be crucial for GL-induced hyper-glycogen in muscle, the hippocampus and the hypothalamus. Moreover, EE was essential for hyper-glycogen only in the hippocampus even without HCD. Here we propose the EE component of GL without HCD as a condition that enhances brain glycogen stores especially in the hippocampus, implicating a physiological strategy to enhance hippocampal functions

Targeted client communication to improve timely antenatal care utilization : Assessment, development and evaluation

Bakgrunn Rettidige svangerskapskontroller reduserer sykelighet og dødelighet hos mor og nyfødt ved at gravide med økt risiko for svangerskapsrelaterte komplikasjoner kan identifiseres i tide, sikres adekvat behandling og oppfølging og kan henvises videre til riktig omsorgsnivå ved behov. I Bangladesh er både kvaliteten på svangerskapsomsorgen, og andelen gravide som benytter seg av helsetjenesten, svært lav. Verdens helseorganisasjon (WHO) publiserte i 2019 anbefalinger for digitale helseintervensjoner (DHIs) som kan komplementere og forbedre helsesystemfunksjoner ved å styrke informasjonsutvekslingen. Målrettet klientkommunikasjon (targeted client communication, TCC) har vist seg å gi økt oppmøte i svangerskapsomsorgen i lav- og mellominntektsland. En nylig publisert systematisk Cochrane-gjennomgang fra 2020 konkluderte imidlertid med lav sannsynlighet for at TCC har positiv effekt på rettidigheten av svangerskapskontroller. eRegistry-studien i Matlab gav en unik mulighet til å utvikle teoribasert TCC, og til å evaluere effekten av intervensjonen implementert i helsetjenesten i en lavressurs-setting. Mål Det overordnede målet med denne doktoravhandlingen er å produsere kunnskapsbasert bevis for TCC som en effektiv, digital helseintervensjon. I tre artikler i denne avhandlingen beskrives; 1) dekning av rettidige svangerskapskontroller, faktorer som assosieres med rettidige svangerskapskontroller og hvilke typer klinikker kvinner benytter seg av i svangerskapsomsorgen (Artikkel I); 2) hvordan teorier om atferdsendring benyttes for vurdering av kvinners oppfatninger om svangerskapsomsorg og svangerskapskomplikasjoner, for deretter å utvikle SMS-basert TCC for å adressere deres respektive oppfatninger (Artikkel II); og 3) evaluering av effekten av SMS-basert TCC i et digitalt helseregister, på rettidig oppmøte ved første svangerskapskontroll, påfølgende svangerskapskontroller, andel fødsler i helseinstitusjon, perinatal dødelighet og alvorlig, perinatal sykelighet i Matlab, Bangladesh (Artikkel III). Metoder Avhandlingen er en del av et større prosjekt i en klyngerandomisert, kontrollert studie (eRegMat). eRegMat-studien evaluerte effekten av å innføre et longitudinelt klientsporingssystem med DHIs (eRegistry) på dekning av svangerskapsomsorg i primærhelsetjenesten, andel fødsler i helseinstitusjon, høy risiko-henvisninger, perinatal dødelighet og alvorlig, perinatal sykelighet. Effekten ble vurdert i en to-armet klyngerandomisert, kontrollert studie (eRegMat) i primærhelsetjenesten. I intervensjonsarmen ble det innført et eRegistry med tre digitale helseintervensjoner; beslutningsstøtte til helsepersonell, tilbakemeldingspanel med handlingspunkter, og målrettet klientkommunikasjon ved bruk av SMS. De digitale pasientjournalene til kvinnene i intervensjonsarmen var tilgjengelige for ulike helsepersonell. I kontrollarmen var pasientjournalene ikke tilgjengelige for andre helsepersonell og definert som ikke-kommuniserbare, digitale pasientjournaler uten digitale helseintervensjoner. Utfallsdata ble hentet fra eRegistry og fra en husholdningsundersøkelse som ble foretatt blant mødrene postpartum. I doktorgradsprosjektet brukte vi et blandet studiedesign for å vurdere status for benyttelse av svangerskapstilbudet, utvikle en intervensjon for TCC ved bruk av SMS, og for å evaluere TCC. For å vurdere den nåværende dekningen av rettidige svangerskapskontroller, andelen fødsler i helseinstitusjon, - og faktorer som påvirket utfallet, benyttet vi en tverrsnittsundersøkelse med data fra husholdningsundersøkelsen (Artikkel I). Vi gjennomførte univariat og multivariat logistisk regresjonsanalyse for å vurdere avgjørende faktorer for svangerskapsomsorg og helseinstitusjonsfødsler. Deretter benyttet vi kvalitative metoder for å utvikle TCC-intervensjonen (Artikkel II). Vi brukte en formålsbestemt utvalgsstrategi for utvelgelse av deltakere. Vi gjennomførte dybdeintervjuer med 24 studiedeltakere for å utforske deres erfaringer med svangerskapsomsorg og oppfatninger om svangerskapskomplikasjoner, og benyttet co-design metoder for å utvikle TCC. Til slutt evaluerte vi effekten av digital TCC på rettidige svangerskapskontroller, andelen fødsler i helseinstitusjon, perinatal dødelighet og alvorlig, perinatal sykelighet i en toarmet klyngerandomisert, kontrollert studie (Artikkel III). Vi inkluderte data fra eRegistry og postpartum-undersøkelsen av gravide kvinner som ble inkludert i studien mellom oktober 2018 og juni 2020. Vi utførte en intensjon-til-å-behandle-analyse, og vi brukte generaliserte, lineære modeller med blandede effekter for å estimere relativ risiko for dekning av svangerskapsomsorg, andelen fødsler i helseinstitusjon, perinatal dødelighet og alvorlig, perinatal sykelighet. Resultater Artikkel I: Vi inkluderte data fra 3293 kvinner i studien. Mer enn halvparten av kvinnene oppsøkte første svangerskapskontroll til rett tid, mens færre enn fem prosent hadde fire rettidige svangerskapskontroller gjennom svangerskapet. Tre fjerdedeler av kvinnene fødte på helseinstitusjon. Kvinner som oppsøkte offentlig helsetjeneste for sin første svangerskapskontroll, flyttet gradvis over til privat helsetjeneste for sine påfølgende svangerskapskontroller og for fødsel. Rettidig første svangerskapskontroll og fødsel i helseinstitusjon var assosiert med kvinners alder, paritet, ektefelles utdanning og husholdningsformue. Ingen av disse sosioøkonomiske faktorene var imidlertid assosiert med fire rettidige svangerskapskontroller. Artikkel II: Vi utførte en tematisk analyse i henhold til Helseoppfatningsmodellen (the Health Belief Model (HBM)). TCC ble utviklet basert på HBM og en teoribasert taksonomi om teknikker for atferdsendring. Et utvalg tekstmeldinger ble utviklet på engelsk og oversatt til bengali. Vi opprettet algoritmer i eRegistry-databasen for å tilpasse individ-basert TCC til de gravide kvinnene, basert på spesifikke kriterier. Artikkel III: 5769 kvinner (intervensjon: n=3023 og kontroll: n=2746) ble inkludert i studien. Det ble ikke observert statistiske forskjeller mellom intervensjons- og kontrollarmen for rettidig oppmøte i svangerskapsomsorgen (aRR 0.96, CI: 0.89-1.05), rettidig oppmøte for første svangerskapskontroll (aRR 0.97, CI: 0.84-1.11) og fødsel i helseinstitusjon (aRR 0.95, CI: 0.82-1.11). Vi observerte en statistisk signifikant reduksjon i det sammensatte sekundærutfallet perinatal dødelighet og alvorlig, perinatal sykelighet (aRR 0.73, CI: 0.58-0.96). Studien hadde flere implementeringsutfordringer, og resultatene hadde ikke tilstrekkelig statistisk presisjon til å gjøre konkluderende tolkninger av effekt. Konklusjon Studien observerte lav dekning av rettidige svangerskapskontroller i rurale Matlab, Bangladesh, ved oppstart av studien. Co-design av TCC ved bruk av SMS ble gjort i samråd med klienter, med mål om å implementere en intervensjon som var tilpasset målgruppen. Teoribasert TCC ved bruk av SMS ble evaluert i en klyngerandomisert, kontrollert studie. TCC hadde ingen effekt på rettidig oppmøte til svangerskapskontroller eller til fødsel i helseinstitusjon, men vi observerte, med lav tillit i dokumentasjonen, en effekt på perinatal dødelighet og alvorlig, perinatal sykelighet. Artikkel I: Studien observerte variasjon i dekning i svangerskapsomsorgen og andelen fødsler i helseinstitusjon for utvalgte sosiodemografiske variabler. Mødrehelseprogrammer bør prioritere kvinner med ektefeller med lav utdanning. Lav sosio-økonomisk status og ung alder for å øke bruken av helsetjenester i svangerskap og fødsel. Artikkel II: Studien representerer et eksempel på utvikling av teoribaserte TCC-meldinger gjennom behovsanalyse av kunnskap om svangerskapsomsorg og svangerskapskomplikasjoner, for å øke opptak og bruk av helsetjenester i svangerskapsomsorgen. Artikkel III: TCC ved bruk av SMS påvirket ikke rettidigheten av svangerskapskontroller eller andelen fødsler i helseinstitusjon. Studien ble forstyrret av COVID-19 pandemien, og vi fant ikke effekter av intervensjonen på primære utfall.Background Timely attendance at antenatal care (ANC) reduces maternal and neonatal illnesses and deaths by providing an opportunity to identify women at increased risk of developing pregnancy-related complications, ensuring referral to an appropriate level of care, and treating complications. In Bangladesh, timely ANC utilization is very low. The WHO published a set of recommendations for digital health interventions (DHIs) in 2019 that can complement and augment health system functions through the enhanced exchange of information, although these are not replacements for a functioning health system. Targeted client communication (TCC) has been shown to increase ANC attendance in low-resource settings. However, a recent Cochrane systematic review from 2020 reported low certainty evidence for TCC to increase timely ANC attendance. The eRegistry study at Matlab provided a unique opportunity to develop theory-based TCC and evaluate the effectiveness of this intervention in a health system in a low-resource setting. Aims The overall aim of this dissertation is to generate evidence for TCC as a digital health intervention. In the three papers of this PhD dissertation, we describe 1) coverage of timely uptake of ANC, factors associated with timely ANC visits, and which type of facilities women utilized for their ANC services (Paper I); 2) how we used behavior change theories to assess women's perceptions of ANC services and pregnancy complications, and subsequently develop SMS-based TCC addressing their perceptions (Paper II); and 3) evaluation of the effectiveness of the SMS-based TCC in a digital health registry on timely attendance at first ANC visit, timely attendance at eligible ANC visits, facility delivery, perinatal mortality, and severe perinatal morbidities in Matlab, Bangladesh (Paper III).   Materials and methods The dissertation is a part of a larger project undertaking a cluster-randomized controlled trial (eRegMat). The eRegMat trial implemented and evaluated the effect of a longitudinal client tracking system with DHIs (eRegistry) on ANC attendance, facility delivery, high-risk referrals, perinatal mortality, and severe perinatal morbidities. The effectiveness was assessed in the two-arm trial in primary health care facilities. The intervention arm received an eRegistry with three DHIs: health worker clinical decision support, feedback dashboards with action items, and targeted client communication via short message service (SMS). The digital client records of women in the intervention arm were accessible to different care providers. In the control arm, records were not accessible by other health care providers, defined as an unshared digital client record without any more DHIs. Outcome data were derived from the eRegistry and a postpartum household survey. In the PhD project, we used a mixed methods study design to assess the status of ANC utilization, develop an intervention using TCC via SMS, and evaluate TCC. To assess the current situation of timely utilization of ANC services, facility delivery, and their determinants, we used a cross-sectional study design using post-partum survey data (Paper I). We conducted univariate and multivariate logistic regression to assess ANC and facility delivery determinants. Then, we used qualitative methods to develop the TCC intervention (Paper II). A purposive sampling approach was used for the selection of participants. We conducted in-depth interviews with 24 study participants to explore their experiences of pregnancy care and perceptions regarding pregnancy complications and used co-design methods to develop TCC. Finally, we evaluated the effectiveness of digital TCC on timely attendance at eligible ANC visits, timely first ANC visit, facility delivery, and perinatal mortality and severe perinatal morbidities in a two-arm cluster-randomized controlled trial (Paper III). We included data from the eRegistry and the post-partum survey of pregnant women enrolled in the trial between October 2018 and June 2020. We performed an intention-to-treat analysis. We used mixed-effects generalized linear models to estimate the relative risk of ANC attendance, facility delivery, perinatal mortality, and severe perinatal morbidities. Results Paper I: We included data on 3293 women in this study. More than half of the women attended their first ANC in a timely manner, but less than five percent presented themselves for four timely ANC visits. Three-quarters of the women gave birth in a health facility. Women who started attending ANC in public health facilities gradually moved to private health facilities during their follow-up visits and for delivery. Timely first ANC attendance and facility delivery were associated with the woman's age, parity, husband's education, and household wealth index. None of these socio-economic factors were associated with four timely ANC visits. Paper II: We performed a thematic analysis according to the constructs of the Health Belief Model (HBM). TCC was developed based on the HBM and a theory-linked taxonomy of behavior change techniques. A library of text messages was developed first in English and then translated into Bangla. We created algorithms in the eRegistry database to tailor TCC to individual pregnant women based on specific criteria. Paper III: A total of 5769 women (intervention: n=3023 and control: n=2746) were enrolled in the trial. No statistical differences were observed between the intervention and control arms for timely attendance at eligible ANC visits (aRR 0.96, CI: 0.89-1.05), timely first ANC visit (aRR 0.97, CI: 0.84-1.11) and facility delivery (aRR 0.95, CI: 0.82-1.11). We observed a statistically significant reduction in the secondary composite outcome of perinatal mortality and severe perinatal morbidities (aRR 0.73, CI: 0.58-0.96). The trial had several implementation challenges and the results did not have adequate statistical precision to make conclusive interpretations of effect. Conclusion The study observed low levels of timely ANC utilization at baseline in rural Matlab Bangladesh. Co-design of TCC via SMS was done with clients, with the goal of implementing an intervention that was more acceptable to users. The theory-based TCC via SMS was evaluated in this cluster-randomized controlled trial. The TCC had no effect on timely ANC attendance or facility delivery, but we observed low certainty evidence of an impact on perinatal mortality and severe perinatal morbidities. Paper I: The study observed the variation of ANC and delivery care utilization by selected socio-demographic characteristics. Maternal health care programs should prioritize women with husbands with low education, low socio-economic status, and younger age to increase the use of health services for ANC and delivery. Paper II: The study represents an example of theory-driven TCC message development through gap analysis on knowledge of ANC and pregnancy complications to improve ANC service utilization. Paper III: TCC via SMS did not affect timely ANC or facility delivery. This trial was interrupted by the COVID-19 pandemic, and we were unable to observe effects of our intervention on the primary outcomes.  Doktorgradsavhandlin

Angiogenic factors and their soluble receptors predict organ dysfunction and mortality in post-cardiac arrest syndrome

INTRODUCTION: Post-cardiac arrest syndrome (PCAS) often leads to multiple organ dysfunction syndrome (MODS) with a poor prognosis. Endothelial and leukocyte activation after whole-body ischemia/reperfusion following resuscitation from cardiac arrest is a critical step in endothelial injury and related organ damage. Angiogenic factors, including vascular endothelial growth factor (VEGF) and angiopoietin (Ang), and their receptors play crucial roles in endothelial growth, survival signals, pathological angiogenesis and microvascular permeability. The aim of this study was to confirm the efficacy of angiogenic factors and their soluble receptors in predicting organ dysfunction and mortality in patients with PCAS. METHODS: A total of 52 resuscitated patients were divided into two subgroups: 23 survivors and 29 non-survivors. The serum levels of VEGF, soluble VEGF receptor (sVEGFR)1, sVEGFR2, Ang1, Ang2 and soluble Tie2 (sTie2) were measured at the time of admission (Day 1) and on Day 3 and Day 5. The ratio of Ang2 to Ang1 (Ang2/Ang1) was also calculated. This study compared the levels of angiogenic factors and their soluble receptors between survivors and non-survivors, and evaluated the predictive value of these factors for organ dysfunction and 28-day mortality. RESULTS: The non-survivors demonstrated more severe degrees of organ dysfunction and a higher prevalence of MODS. Non-survivors showed significant increases in the Ang2 levels and the Ang2/Ang1 ratios compared to survivors. A stepwise logistic regression analysis demonstrated that the Ang2 levels or the Ang2/Ang1 ratios on Day 1 independently predicted the 28-day mortality. The receiver operating characteristic curves of the Ang2 levels, and the Ang2/Ang1 ratios on Day 1 were good predictors of 28-day mortality. The Ang2 levels also independently predicted increases in the Sequential Organ Failure Assessment (SOFA) scores. CONCLUSIONS: We observed a marked imbalance between Ang1 and Ang2 in favor of Ang2 in PCAS patients, and the effect was more prominent in non-survivors. Angiogenic factors and their soluble receptors, particularly Ang2 and Ang2/Ang1, are considered to be valuable predictive biomarkers in the development of organ dysfunction and poor outcomes in PCAS patients