\documentclass[10pt]{article}

\usepackage{fullpage}
\usepackage{setspace}
\usepackage{parskip}
\usepackage{titlesec}
\usepackage[section]{placeins}
\usepackage{xcolor}
\usepackage{breakcites}
\usepackage{lineno}
\usepackage{hyphenat}





\PassOptionsToPackage{hyphens}{url}
\usepackage[colorlinks = true,
            linkcolor = blue,
            urlcolor  = blue,
            citecolor = blue,
            anchorcolor = blue]{hyperref}
\usepackage{etoolbox}
\makeatletter
\patchcmd\@combinedblfloats{\box\@outputbox}{\unvbox\@outputbox}{}{%
  \errmessage{\noexpand\@combinedblfloats could not be patched}%
}%
\makeatother


\usepackage{natbib}




\renewenvironment{abstract}
  {{\bfseries\noindent{\abstractname}\par\nobreak}\footnotesize}
  {\bigskip}

\titlespacing{\section}{0pt}{*3}{*1}
\titlespacing{\subsection}{0pt}{*2}{*0.5}
\titlespacing{\subsubsection}{0pt}{*1.5}{0pt}


\usepackage{authblk}


\usepackage{graphicx}
\usepackage[space]{grffile}
\usepackage{latexsym}
\usepackage{textcomp}
\usepackage{longtable}
\usepackage{tabulary}
\usepackage{booktabs,array,multirow}
\usepackage{amsfonts,amsmath,amssymb}
\providecommand\citet{\cite}
\providecommand\citep{\cite}
\providecommand\citealt{\cite}
% You can conditionalize code for latexml or normal latex using this.
\newif\iflatexml\latexmlfalse
\providecommand{\tightlist}{\setlength{\itemsep}{0pt}\setlength{\parskip}{0pt}}%

\AtBeginDocument{\DeclareGraphicsExtensions{.pdf,.PDF,.eps,.EPS,.png,.PNG,.tif,.TIF,.jpg,.JPG,.jpeg,.JPEG}}

\usepackage[utf8]{inputenc}
\usepackage[greek,ngerman,english]{babel}



\usepackage{float}








\begin{document}

\title{Role of AScorbic acid Infusion in critically ill patients with
Transfusion Related Acute Lung Injury (ASTRALI)}



\author[1]{Amira kassem}%
\author[1]{Islam Ahmed}%
\author[1]{Gamal Omran}%
\author[2]{Mohamed Megahed}%
\author[2]{Tamer Habib}%
\affil[1]{Damanhour University Faculty of Pharmacy}%
\affil[2]{Alexandria University Faculty of Medicine}%


\vspace{-1em}



  
  \date{May 21, 2024}


\begingroup
\let\center\flushleft
\let\endcenter\endflushleft
\maketitle
\endgroup





\selectlanguage{english}
\begin{abstract}
Introduction: In critically ill patients, Transfusion Related Acute Lung
Injury (TRALI) remains the leading cause of transfusion-related
fatalities in critical care setting and associated with inflammation and
oxidative stress state. Recent research raised the potential efficacy of
high dose intravenous ascorbic acid in critically ill patients.
Objective: The aim of this trial was to investigate the effect of high
dose intravenous ascorbic acid (VC) as a targeted therapy for TRALI in
terms of serum proinflammatory (interleukin-8, interleukin-1\selectlanguage{greek}β,
\selectlanguage{english}C-reactive protein), anti-inflammatory (interleukin-10), oxidative
stress (superoxide dismutase, malondialdehyde) markers, and plasma VC
levels. Secondary outcomes were oxygenation (PaO2/FiO2 ratio),
vasopressor use, duration of mechanical ventilation, ICU length of stay,
7-days mortality and 28-days mortality. Methods: Eighty critically ill
patients with TRALI (n=80) were randomized to receive 2.5gm/6hr
intravenous vitamin C for 96 hours (ASTRALI group) or placebo. Patients
were followed-up to measure the outcomes initially (T0) and at the end
of treatment (T96). Results: When compared to control group, ASTRALI
group at T96, showed significantly higher median of interleukin-10 (31.6
\selectlanguage{ngerman}± 25.8 Vs. 17.7 ± 12.0 pg/mL, p\textless{}0.0001) levels and superoxide
dismutase (12876 ± 4627 U/L Vs. 5895 ± 6632 U/L, p\textless{}0.0001)
activities, lower median C-reactive protein (76 ± 50 Vs. 89 ± 56 mg/L,
p=0.033), interleukin-8 (11.8 ± 7.3, 35.5 ± 19.8 pg/mL,
p\textless{}0.0001), and malondialdehyde (0.197 ± 0.034 Vs. 0.234 ±
0.074 \selectlanguage{greek}µ\selectlanguage{english}M/L, p=0.002) levels. Conclusion: High dose ascorbic acid was
associated with significantly reduced oxidative stress, reduced
pro-inflammatory markers except IL-1\selectlanguage{greek}β, \selectlanguage{english}elevated anti-inflammatory
marker, and elevated plasma VC levels%
\end{abstract}%



\sloppy


\textbf{}\selectlanguage{english}
\begin{figure}[H]
\begin{center}
\includegraphics[width=0.70\columnwidth]{figures/Figure-4/Figure-4}

\end{center}
\end{figure}

\selectlanguage{english}
\FloatBarrier
\end{document}

