Automated profiling of gene function during embryonic development.

Systematic functional profiling of the gene set that directs embryonic development is an important challenge. To tackle this challenge, we used 4D imaging of C. elegans embryogenesis to capture the effects of 500 gene knockdowns and developed an automated approach to compare developmental phenotypes. The automated approach quantifies features-including germ layer cell numbers, tissue position, and tissue shape-to generate temporal curves whose parameterization yields numerical phenotypic signatures. In conjunction with a new similarity metric that operates across phenotypic space, these signatures enabled the generation of ranked lists of genes predicted to have similar functions, accessible in the PhenoBank web portal, for ∼25% of essential development genes. The approach identified new gene and pathway relationships in cell fate specification and morphogenesis and highlighted the utilization of specialized energy generation pathways during embryogenesis. Collectively, the effort establishes the foundation for comprehensive analysis of the gene set that builds a multicellular organism.

Characteristics and prognostic implications of peripheral blood lymphocyte subsets in patients with anti-MDA5 antibody positive dermatomyositis-interstitial lung disease.

OBJECTIVES: To examine the characteristics of blood lymphocyte subsets in dermatomyositis-interstitial lung disease (DM-ILD) inflicted patients with positive anti-melanoma differentiation-associated gene 5 (anti-MDA5), as well as its prognosis value in this set of patients. METHODS: Data were retrospectively collected from 253 DM-ILD patients from three hospitals in China between January 2016 to January 2021. Patients were grouped into anti-MDA5 antibody positive group (MDA5+ DM-ILD) and anti-MDA5 antibody negative group (MDA5- DM-ILD) based on myositis-specific autoantibody test results. Demographic characteristics, lymphocyte subsets patterns and other clinical features were compared between the two groups. The association of lymphocyte subsets with 180-day mortality was investigated using survival analysis in MDA5+ DM-ILD. RESULTS: Out of 253 eligible patients with DM-ILD, 59 patients were anti-MDA5+ and 194 were anti-MDA5-. Peripheral blood lymphocyte count, CD3+ count, percentage of CD3+, CD3+CD4+ count, and CD3+CD8+ count was lower in MDA5+ DM-ILD than in MDA5- DM-ILD- (all P < 0.001) as well as CD3-CD19+ count (P = 0.04). In MDA5+ DM-ILD, CD3+CD8+ count ≤ 49.22 cell/µL (HR = 3.81, 95%CI [1.20,12.14]) and CD3-CD19+ count ≤ 137.64 cell/µL (HR = 3.43, 95%CI [1.15,10.24]) were independent predictors of mortality. CD3+CD8+ count ≤ 31.38 cell/µL was associated with a higher mortality risk in all DM-ILD patients (HR = 8.6, 95%CI [2.12,31.44]) after adjusting for anti-MDA5 and other clinical characteristics. CONCLUSION: Significant lymphocytes decrease was observed in MDA5+ DM-ILD patients. CD3+CD8+ cell count was associated with worse prognosis in both MDA5+ DM-ILD and all DM-ILD patients.

A high-content imaging approach to profile C. elegans embryonic development.

The Caenorhabditis elegans embryo is an important model for analyzing mechanisms of cell fate specification and tissue morphogenesis. Sophisticated lineage-tracing approaches for analyzing embryogenesis have been developed but are labor intensive and do not naturally integrate morphogenetic readouts. To enable the rapid classification of developmental phenotypes, we developed a high-content method that employs two custom strains: a Germ Layer strain that expresses nuclear markers in the ectoderm, mesoderm and endoderm/pharynx; and a Morphogenesis strain that expresses markers labeling epidermal cell junctions and the neuronal cell surface. We describe a procedure that allows simultaneous live imaging of development in 80-100 embryos and provide a custom program that generates cropped, oriented image stacks of individual embryos to facilitate analysis. We demonstrate the utility of our method by perturbing 40 previously characterized developmental genes in variants of the two strains containing RNAi-sensitizing mutations. The resulting datasets yielded distinct, reproducible signature phenotypes for a broad spectrum of genes that are involved in cell fate specification and morphogenesis. In addition, our analysis provides new in vivo evidence for MBK-2 function in mesoderm fate specification and LET-381 function in elongation.

Single Step Assembly of Janus Porous Biomaterial by Sub-Ambient Temperature Electrodeposition.

Janus porous biomaterials are gaining increasing attention and there are considerable efforts to develop simple, rapid, and scalable methods capable of tuning micro- and macro-structures. Here, a single-step electro-fabrication method to create a Janus porous film by the electrodeposition of the amino-polysaccharide chitosan is reported. Specifically, a Janus structure emerges spontaneously when electrodeposition is performed at sub-ambient temperature (0-5 °C). Sub-ambient temperature electrodeposition experiments show that: a Janus microstructure emerges (potentially as the result of a subtle alteration of the intermolecular interactions responsible for self-assembly); important microstructural features (pore size, porosity, and thicknesses) can be tuned by conditions; and this method is readily scalable (vs serial printing) and can yield complex tubular structures with Janus faces. In vitro studies demonstrate anisotropic cell guidance, and in vivo studies using a rat calvarial defect model further confirm the beneficial features of such Janus porous film for guided bone regeneration. In summary, these results further demonstrate that electro-fabrication provides a simple and scalable platform technology for the controlled functional structures of soft matter for applications in regenerative medicine.

Development of a noncompetitive magnetic-phage anti-immunocomplex assay for detecting of organophosphorus pesticides with a thiophosphate group.

Organophosphorus pesticides (OPs) are widely used in agriculture and the monitoring of their residues is very important to protect human health. Immunoassays are important tools for the analysis of small molecules. Generally, noncompetitive mode of immunoassay is considered to be more sensitive than competitive mode. In this study, peptides that can identify immunocomplex of OPs were screened from a phage display library. Subsequently, a second-generation peptide library was constructed and peptides with better performance were isolated. Then, a rapid and sensitive noncompetitive magnetic-phage anti-immunocomplex assay (MPHAIA) for OPs was developed based on the best phage-peptide and single chain antibody immunomagnetic beads. The MPHAIA showed broad specificity for OPs with a thiophosphate group. The half-saturated concentration (SC50) values and limits of detection (LODs) of MPHAIA to 12 OPs were ranged from 15.04 to 105.48 ng/mL and 4.07-14.19 ng/mL, respectively. The accuracy and reliability of MPHAIA were verified by gas chromatography-tandem mass spectrometry (GC-MS/MS) parallel analysis of six kinds of OPs in spiked cucumber samples. The recovery rates were in range of 81.2-116.3% with coefficient of variation from 4.1% to 14.1%, which were consistent with the results of GC-MS/MS.

Subclinical left ventricular myocardial dysfunction in patients with obstructive sleep apnea syndrome: insights from noninvasive left ventricular myocardial work analysis.

BACKGROUND: Obstructive sleep apnea syndrome (OSAS) is associated with various cardiovascular diseases and has aroused public concern. Early detection for declining myocardial function is of great significance. This study was aimed at noninvasively evaluating the subclinical left ventricular (LV) myocardial dysfunction with LV pressure-strain loop (PSL) in patients with OSAS having normal LV ejection fraction. METHODS: We enrolled 200 patients with OSAS who visited the Beijing Chaoyang Hospital between February 2021 and December 2021. According to the apnea-hypopnea index (AHI), patients were divided into mild, moderate, and severe groups. The global longitudinal strain (GLS) of the left ventricle was analyzed by two-dimensional speckle tracking echocardiography. The LV PSL was used to assess global work index (GWI), global constructive work (GCW), global waste work (GWW), and global work efficiency (GWE), and comparisons were made among groups. RESULTS: GLS was significantly lower in the severe group than in mild and moderate group. GWI, GCW, and GWE were lower in the severe group than in mild and moderate groups. GWW was significantly higher in the severe group than in the mild group. GLS, GWI, and GWE were moderately correlated with AHI (Spearman's ρ = -0.468, -0.321, and -0.319, respectively; P < 0.001), whereas GCW and GWW showed a weak correlation with AHI (Spearman's ρ = -0.226 and 0.255 respectively; P < 0.001). Multiple regression analyses revealed AHI was independently associated with GWI after adjusting for SBP, GLS, e', etc. AHI was independently associated with GCW after adjusting for SBP, GLS, etc. CONCLUSIONS: The LV PSL is a new technique to noninvasively detect myocardial function deterioration in patients with OSAS and preserved LV ejection fraction. Increased severity of OSAS was independent associated with both decreased GWI and GCW.

Anxiety and depression in patients with chronic obstructive pulmonary disease and obstructive sleep apnea: the overlap syndrome.

PURPOSE: Psychological symptoms are increasingly being noted in patients with chronic diseases. Currently, little evidence is available on the mental health of patients with overlap syndrome (OVS, chronic obstructive pulmonary disease plus obstructive sleep apnea). This study aimed to describe the prevalence and identify influencing factors of anxiety and depression in patients with OVS. METHODS: We recruited patients admitted for chronic obstructive pulmonary disease (COPD) from July 2018 to July 2019 who also underwent polysomnography tests to assess obstructive sleep apnea (OSA). COPD patients who had an apnea-hypopnea index (AHI) ≥ 5/h were defined as OVS. COPD patients who had an AHI < 5/h were identified as pure COPD. Questionnaires were administered to evaluate depression and anxiety in all subjects. We compared the differences in scores between patients with OVS and pure COPD. RESULTS: Two hundred and fifty-two patients were included, 180 (71%) patients had OVS, while only 72 patients had pure COPD. In the OVS group, 54% of the patients had depression, and 77% of the patients had anxiety. We found that patients with OVS had higher anxiety (8.00 (4.00, 10.00) vs. 6.00 (3.00, 9.00), p = 0.018) and depression (8.00 (4.00, 10.00) vs. 5.50 (2.25, 10.00), p = 0.022) scores than patients with pure COPD. A higher proportion of patients with hypertension (41% vs. 21%) and coronary heart disease (14% vs. 4%) were found in the OVS group. Chest pain, COPD Assessment Test (CAT) score, and OVS were independent risk factors for depression (P<0.05). A positive correlation was shown between anxiety and depression (r=0.638, p < 0.001). CONCLUSIONS: Anxiety and depression were more severe in patients with OVS than in patients with pure COPD. More attention should be paid to the mental health of OVS patients. TRIAL REGISTRATION: ClinicalTrials.gov; URL: www. CLINICALTRIALS: gov . NO.: NCT03182309. Registered on June 9, 2017; https://clinicaltrials.gov/ct2/show/NCT03182309?term=NCT+03182309&draw=2&rank=1.

Highly Soluble Imidazolium Ferrocene Bis(sulfonate) Salts for Redox Flow Battery Applications.

Redox flow batteries (RFBs) are scalable devices that employ solution-based redox active components for scalable energy storage. To maximize energy density, new highly soluble catholytes and anolytes need to be synthesized and evaluated for their electrochemical performance. To that end, we synthesized a series of imidazolium ferrocene bis(sulfonate) salts as highly soluble catholytes for RFB applications. Six salts with differing alkyl chain lengths on the imidazolium cation were synthesized, characterized, and electrochemically analyzed. While aqueous solubility was significantly improved, the reactivity of the imidazolium cation and the increased viscosities of the salt solutions in water (which increase with increasing imidazolium chain length) limit the applicability of these materials to RFB design.

Effect and mechanism of reduced membrane bioreactor fouling by powdered activated carbon.

Powered Activated Carbon - Membrane Bioreactors (PAC-MBRs) have been used with good results for slightly polluted water treatment. Our batch experiments showed that the transmembrane pressure of a PAC-MBR was 25% less than that of a MBR in one period of test, which indicated that PAC did help control the fouling in MBRs. Based on this observation, several mechanisms of membrane fouling of MBRs and PAC-MBRs were investigated to have some insight into how PAC brought a positive impact. The total resistances decreased by 60% and different resistances were redistributed after adding PAC. The dominant one changed from filtration resistance to cake resistance. These smaller cake resistances resulted from the PAC because, showing in the scanning electron microscopy pictures, it made the cake layer looser and rougher than that on a normal membrane. Meanwhile, the analysis of the membrane eluent showed that the addition of PAC changed the microbial species and its metabolites on the membrane and effectively reduced the adsorption of hydrophilic organic molecules on the membrane surface. Additionally, PAC prevented polypeptide compounds from being trapped inside the pores of membranes, so the cake on the PAC-MBR contaminated membrane surface was easier to scrape off. In the test of cleaning methods, alkaline cleaning removed the most organics from contaminated membranes to restore membrane performance.

A toolkit for GFP-mediated tissue-specific protein degradation in C. elegans.

Proteins that are essential for embryo production, cell division and early embryonic events are frequently reused later in embryogenesis, during organismal development or in the adult. Examining protein function across these different biological contexts requires tissue-specific perturbation. Here, we describe a method that uses expression of a fusion between a GFP-targeting nanobody and a SOCS-box containing ubiquitin ligase adaptor to target GFP-tagged proteins for degradation. When combined with endogenous locus GFP tagging by CRISPR-Cas9 or with rescue of a null mutant with a GFP fusion, this approach enables routine and efficient tissue-specific protein ablation. We show that this approach works in multiple tissues - the epidermis, intestine, body wall muscle, ciliated sensory neurons and touch receptor neurons - where it recapitulates expected loss-of-function mutant phenotypes. The transgene toolkit and the strain set described here will complement existing approaches to enable routine analysis of the tissue-specific roles of C. elegans proteins.

Effect of lung function on the apnea-hypopnea index in patients with overlap syndrome: a multicenter cross-sectional study.

PURPOSE: Patients with chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) are referred to as having overlap syndrome (OVS). However, the relationship of lung function with the apnea-hypopnea index (AHI) in patients with OVS has not been evaluated. This multicenter study aimed to evaluate the relationship. METHODS: COPD patients diagnosed by spirometry were recruited from four Chinese tertiary hospitals. Those patients were requested to attend an overnight polysomnography (PSG). The relationships between parameters of lung function and sleep respiration in patients with OVS were assessed using multiple regression analyses. RESULTS: A total of 520 OVS patients and 246 patients with COPD only finally met inclusion criteria for study. After adjustment for age, sex, body mass index, neck circumference, economic status, smoking status, alcohol consumption, and hypertension, the forced expiratory volume in the first second (FEV1) had a positive correlation with the AHI in patients with OVS (ß, 0.17; 95% CI, 0.06-0.28; P < 0.01). However, when the severity of lung function of patients with OVS was stratified, the correlation with the FEV1 of each grade and the AHI was absent (P > 0.05). Additionally, The FEV1 was positively correlated with the nadir oxygen saturation (SaO2) (ß, 0.18; 95% CI, 0.08-0.27; P < 0.01) and was negatively correlated with the percentage of time spent with an SaO2 below 90% (TS90%) (ß,- 0.41; 95% CI,- 0.61-0.21; P < 0.01) in patients with OVS using multiple regression analyses. CONCLUSION: Lung function was associated with the AHI in patients with OVS. The lower FEV1 may play some protective role in the severity of AHI in OVS patients. Trial registry ClinicalTrials.gov , No.: NCT03182309, URL: www.clinicaltrials.gov .

Obstructive Sleep Apnea Increases the Prevalence of Hypertension in Patients with Chronic Obstructive Disease.

Whether there are increased rates of chronic diseases associated with the combination of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) overlap syndrome (OVS) has not been determined. The purpose of this study was to assess the prevalence of five comorbidities in COPD and OVS patients. A total of 968 patients with confirmed COPD were included in this study. Participants were requested to fill out a questionnaire involving their basic information and medical history. All subjects underwent one overnight polysomnography and were then divided into an OVS group or a COPD only group according to their apnea-hypopnea index. The prevalence of hypertension, diabetes, cardiovascular disease, arrhythmia and cerebrovascular disease were compared and risk factors for comorbidities in COPD patients were identified. Compared with the COPD only group, the prevalence of hypertension was significantly higher in the OVS group, however, the prevalence rates of the other four kinds of diseases were not statistically different between the two groups. In COPD patients, the prevalence of hypertension increased with the severity of OSA and the prevalence of arrhythmia increased with airflow limitation severity. Risk factors for OSA in patients with COPD included BMI, FEV1%, Epworth Sleepiness Scale score and the Sleep Apnea Clinical Score. OSA was an independent risk factor for hypertension. The other risk factors for hypertension in COPD patients included age, BMI, CAT score and alcohol consumption. Age, lower FEV1% may be risk factors for arrhythmia. OVS patients were associated with a high prevalence rate of hypertension, while OSA was an independent risk factor for hypertension.

Hot-Tip Scanning Electrochemical Microscopy: Theory and Experiments Under Positive and Negative Feedback Conditions.

Hot-tip scanning electrochemical microscopy (HT-SECM) is a novel surface characterization technique utilizing an alternating current (ac) polarized disk microelectrode as a probe. A high-frequency (∼100 MHz) ac waveform applied between the tip and a counter electrode causes the resistive heating of the surrounding electrolyte solution that leads also to the electrothermal fluid flow (ETF). The effects of the temperature and the convection driven by the ETF result in the increased rate of mass transfer of the redox species. In this paper, HT-SECM was studied in positive and negative feedback modes, for which approach curves and cyclic voltammograms were recorded. The experimental data showed that the use of a hot tip leads to a more pronounced feedback compared to that at room temperature. Numerical simulations performed in COMSOL Multiphysics supported the experimental findings. Additional analytical approximations were developed that could be used to predict the faradaic response in HT-SECM experiments. Finally, a possible contribution to the current from the Soret effect was studied theoretically. A good understanding of HT-SECM was achieved, both experimentally and theoretically, suggesting that this methodology could be applied to investigate electrode kinetics under the conditions of elevated temperature and increased rate of mass transfer.

Pregnancy-Related ICU Admissions From 2008 to 2016 in China: A First Multicenter Report.

OBJECTIVES: To identify the key points for improving severe maternal morbidity by analyzing pregnancy-related ICU admissions in Beijing. DESIGN: This was a retrospective, multicenter cohort study. SETTING: Three ICUs in tertiary hospitals in Beijing. PATIENTS: A total of 491 severe maternal cases in any trimester of pregnancy or within 42 days of delivery were reviewed between January 1, 2008, and December 31, 2016. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among 491 obstetric ICU admissions (median Sequential Organ Failure Assessment score, 2) out of 87,850 hospital deliveries (a frequency of 5.6 admissions per 1,000 deliveries), the leading diagnoses were postpartum hemorrhage (170; 34.62%), hypertensive disorders of pregnancy (156; 31.77%), and cardio-cerebrovascular diseases (78; 15.9%). Comparing 2008-2011 to 2012-2016, the rates of maternal mortality (2.5% vs 1.9%; p = 0.991) and fetal loss (8.5% vs 8.6%; p = 0.977) did not decrease significantly, whereas the rates of ICU admission (3.05% vs 7.85%; p trends < 0.001) and postpartum hemorrhage (23% vs 38.5%; p = 0.002) increased. Hypertensive disorder (150/156; 96.2% transferred to the ICU postpartum, 24/28 women with fetal loss transferred from lower-level hospitals) was an independent maternal factor associated with fetal loss, and infections were the leading cause of maternal death (6/10) in the ICU. CONCLUSIONS: Our study highlights the increasing rate of intensive care admissions for postpartum hemorrhage. Improving prenatal care quality for pregnancy-induced hypertension and sepsis at lower-level hospitals may improve maternal and fetal outcomes. Specifically, providing more effective regional cooperation before transfer and shifting patients who require continuous surveillance but not necessarily intensive care to a transitional ward in a tertiary hospital would provide more ICU beds for more prenatal intensive care for the most complex medical conditions.

Risk stratification and prediction value of procalcitonin and clinical severity scores for community-acquired pneumonia in ED.

OBJECTIVE: Community-acquired pneumonia (CAP) is a common presentation to the emergency department (ED) and has high mortality rates. The aim of our study is to investigate the risk stratification and prognostic prediction value of precalcitonin (PCT) and clinical severity scores on patients with CAP in ED. METHODS: 226 consecutive adult patients with CAP admitted in ED of a tertiary teaching hospital were enrolled. Demographic information and clinical parameters including PCT levels were analyzed. CURB65, PSI, SOFA and qSOFA scores were calculated and compared between the severe CAP (SCAP) and non-severe CAP (NSCAP) group or the death and survival group. Receiver-operating characteristic (ROC) curves for 28-day mortality were calculated for each predictor using cut-off values. Logistic regression models and area under the curve (AUC) analysis were performed to compare the performance of predictors. RESULTS: Fifty-one patients were classified as SCAP and forty-nine patients died within 28days. There was significant difference between either SCAP and NSCAP group or death and survival group in PCT level and CURB65, PSI, SOFA, qSOFA scores (p < 0.001). The AUCs of the PCT and CURB65, PSI, SOFA and qSOFA in predicting SCAP were 0.875, 0.805, 0.810, 0.852 and 0.724, respectively. PCT is superior in predicting SCAP and the models combining PCT and SOFA demonstrated superior performance to those of PCT or the CAP severity score alone. The AUCs of the PCT and CURB65, PSI, SOFA and qSOFA in predicting 28-day mortality were 0.822, 0.829, 0.813, 0.913 and 0.717, respectively. SOFA achieved the highest AUC and the combination of PCT and SOFA had the highest superiority over other combinations in predicting 28-day mortality. CONCLUSION: Serum PCT is a valuable single predictor for SCAP. SOFA is superior in prediction of 28-day mortality. Combination of PCT and SOFA could improve the performance of single predictors. More further studies with larger sample size are warranted to validate our results.

[The community structure and diversity of the endophytes in American ginseng].

OBJECTIVE: To clarify the composition of endophytes community in American ginseng, to know the differences of the endophytes community structure of different producing area and colonization part, and to grasp the resource situation of endophytes in American ginseng of Jilin Province. METHODS: Endophytes were separated with tissue explant and identified with 165 rDNA and ITS sequence analysis, by combining the cultivation forms. Moreover, ecological index analysis was conducted for the endophytes separated. RESULTS: Endophytes in American ginseng root obtained included 13 genera and 26 species, endophytes of the stem obtained included 10 genera and 18 species, whereas endophytes of the leaves obtained included 9 genera and 16 species. Bacillus and Pseudomonas were advantageous genera in the endophytes in American ginseng, and the species contained occupied 17.6% and 14.7% of the total endophytes respectively. According to the diversity index (H'), Hunchun > Jingyu > Fusong > Ji' an > Changbai; according to the evenness index (J), Hunchun > Ji'an > Jingyu > Fusong > Changbai; according to the dominance index(D), Jingyu > Hunchun > Fusong > hi' an > Changbai. CONCLUSIONS: Endophytes in American ginseng were characterized by abundant genetic diversity. The structure of the endophytes community in American ginseng was complicated, there were differences of the endophytes community structure of different producing area and colonization part, the community diversity of producing area with high altitude was decreased.

[Research on genetic stability to American ginseng introduced into China for 30 years].

To study the genetic stability of Panax quinquefolium after introduced into China for 30 years, the samples of P. quinquefolium from 14 regions of China were studied. RAPD molecular marker technology was applied in this research, and POPGEN32 data analysis and NTSYS2. 10 cluster diagram were used to analyze the data. The results showed that there are abundant genetic diversity in the ginseng samples. There were 81 polymorphic bands based on the 13 random primers. The polymorphism was 83.51%, the effective number of alleles (N(e)) was 1.456 7; Nei's gene diversity index (H) was 0.274 8; Shannon's diversity index (H(o)) was 0.419 4. The clustering analyses indicated that P. quinquefolium and P. ginseng were classified into two obvious groups, especially, it was also found that the P. quinquefolium could be divided into two obvious groups based on whether the P. ginseng was cultivated in the same region or not, but it was thought that there was not genetically a qualitative difference. Thus it suggests that a good breeding field should be established in Jilin Province of China for the germplasm purification.

[Meta analysis of the predictive efficacy of various derived indicators of sequential organ failure assessment in outcomes of patients with sepsis].

OBJECTIVE: To systematically review and evaluate the predictive efficacy of various derived indicators of sequential organ failure assessment (SOFA) in mortality rate of sepsis patients. METHODS: Literature on sepsis and SOFA scores were searched in PubMed, Embase and Cochrane Library. The retrieval time will be set to the time of database-building to February, 2023. The main outcome measures included 28-day mortality, 30-day mortality, in-hospital mortality, intensive care unit (ICU) mortality and long-term mortality. Literature screening, data extraction and quality evaluation were carried out independently by 2 researchers. Data were analyzed by Revman 5.3.5, Meta-disc and Stata software. Deek funnel plots were used to assess publication bias in the included studies. RESULTS: A total of 40 articles including 51 trials were included. Of these, 32 were in English and 8 in Chinese, 17 were in prospective trials and 34 were in retrospective trials, 38 were in initial SOFA-related trials and 9 were in the change of SOFA score (ΔSOFA)-related studies, a total of 59 962 patients were enrolled. (1) The area under the receiver operator characteristic curve (AUC) of initial SOFA and ΔSOFA for predicting outcome in sepsis was 0.773 and 0.787 (Z = 0.115, P > 0.05), respectively. There was no significant difference between the two indexes in predicting the outcome of patients with sepsis. (2) In subgroup analysis, due to limitations in the number of literature articles, the 28-day mortality rate and 30-day mortality rate were merged for discussion. The predictive power of ΔSOFA for 28-day or 30-day mortality was significantly higher than that of initial SOFA (AUC was 0.854, 0.787, Z = 2.603, P ≤ 0.01). (3) There were few studies on ΔSOFA in predicting in-hospital mortality, ICU mortality and long-term mortality of sepsis patients. The AUC of the initial SOFA for predicting the study endpoints described above was: ICU mortality (0.814) > 28-day or 30-day mortality (0.787) > in-hospital mortality (0.697) > long-term mortality (0.646). (4) Initial SOFA and ΔSOFA in patients with sepsis of non-Han original had good predictive performance and there was no significant difference between them (AUC was 0.766, 0.811, respectively). However, the pooled sensitivity of ΔSOFA was higher (92%). (5) In prospective studies, initial SOFA was better at predicting outcomes in patients with sepsis (AUC was 0.804, pooled sensitivity 64%). The sensitivity of ΔSOFA indicators in predicting the outcome of sepsis patients was significantly higher than the initial SOFA (78% vs. 64%). The funnel plot showed that there was no significant publication bias in the included literature. CONCLUSIONS: ΔSOFA has a relatively high diagnostic efficacy in predicting short-term (28-day or 30-day) mortality in patients with sepsis.

A generalizable and easy-to-use COVID-19 stratification model for the next pandemic via immune-phenotyping and machine learning.

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has affected billions of people worldwide, and the lessons learned need to be concluded to get better prepared for the next pandemic. Early identification of high-risk patients is important for appropriate treatment and distribution of medical resources. A generalizable and easy-to-use COVID-19 severity stratification model is vital and may provide references for clinicians. Methods: Three COVID-19 cohorts (one discovery cohort and two validation cohorts) were included. Longitudinal peripheral blood mononuclear cells were collected from the discovery cohort (n = 39, mild = 15, critical = 24). The immune characteristics of COVID-19 and critical COVID-19 were analyzed by comparison with those of healthy volunteers (n = 16) and patients with mild COVID-19 using mass cytometry by time of flight (CyTOF). Subsequently, machine learning models were developed based on immune signatures and the most valuable laboratory parameters that performed well in distinguishing mild from critical cases. Finally, single-cell RNA sequencing data from a published study (n = 43) and electronic health records from a prospective cohort study (n = 840) were used to verify the role of crucial clinical laboratory and immune signature parameters in the stratification of COVID-19 severity. Results: Patients with COVID-19 were determined with disturbed glucose and tryptophan metabolism in two major innate immune clusters. Critical patients were further characterized by significant depletion of classical dendritic cells (cDCs), regulatory T cells (Tregs), and CD4+ central memory T cells (Tcm), along with increased systemic interleukin-6 (IL-6), interleukin-12 (IL-12), and lactate dehydrogenase (LDH). The machine learning models based on the level of cDCs and LDH showed great potential for predicting critical cases. The model performances in severity stratification were validated in two cohorts (AUC = 0.77 and 0.88, respectively) infected with different strains in different periods. The reference limits of cDCs and LDH as biomarkers for predicting critical COVID-19 were 1.2% and 270.5 U/L, respectively. Conclusion: Overall, we developed and validated a generalizable and easy-to-use COVID-19 severity stratification model using machine learning algorithms. The level of cDCs and LDH will assist clinicians in making quick decisions during future pandemics.

Redox-mediated Biomolecular information transfer in single electrogenetic biological cells.

Electronic communication in natural systems makes use, inter alia, of molecular transmission, where electron transfer occurs within networks of redox reactions, which play a vital role in many physiological systems. In view of the limited understanding of redox signaling, we developed an approach and an electrochemical-optical lab-on-a-chip to observe cellular responses in localized redox environments. The developed fluidic micro-system uses electrogenetic bacteria in which a cellular response is activated to electrically and chemically induced stimulations. Specifically, controlled environments for the cells are created by using microelectrodes to generate spatiotemporal redox gradients. The in-situ cellular responses at both single-cell and population levels are monitored by optical microscopy. The elicited electrogenetic fluorescence intensities after 210 min in response to electrochemical and chemical activation were 1.3 × 108±0.30 × 108 arbitrary units (A.U.) and 1.2 × 108±0.30 × 108 A.U. per cell population, respectively, and 1.05 ± 0.01 A.U. and 1.05 ± 0.01 A.U. per-cell, respectively. We demonstrated that redox molecules' mass transfer between the electrode and cells - and not the applied electrical field - activated the electrogenetic cells. Specifically, we found an oriented amplified electrogenetic response on the charged electrodes' downstream side, which was determined by the location of the stimulating electrodes and the flow profile. We then focused on the cellular responses and observed distinct subpopulations that were attributed to electrochemical rather than chemical stimulation, with the distance between the cells and the stimulating electrode being the main determinant. These observations provide a comprehensive understanding of the mechanisms by which diffusible redox mediators serve as electron shuttles, imposing context and activating electrogenetic responses.