A Prediction Model for Clinical Outcomes of COVID-19 Hospitalized Patients: Construction and Accuracy Assessment.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic spread rapidly with considerable morbidity nationwide since China's liberalization in December 2022. Our work has focused on identifying different predictive factors from the laboratory examination of critically ill patients, and forecasting the unfavorable outcome of critically ill patients with COVID-19 through a combined diagnosis of biological markers. METHODS: We conducted a retrospective study at the Department of First Affiliated Hospital of Wenzhou Medical University, China, from December 24, 2022, to January 10, 2023, where 434 critically ill patients who met the inclusion criteria were involved. Machine analysis was employed to search for the parameters with the highest predictive value to calculate COVID-19 mortality by exploiting 66 typical laboratory results. RESULTS: Combined diagnosis of serum albumin (ALB), lactate dehydrogenase (LDH), direct bilirubin (Dbil), ferritin, pulse oxygen saturation (SpO2), and neutrophil count (NEUT#) was evaluated, and the result with the highest predictive value (NEUT#) was selected as the predictor for COVID-19 mortality with a sensitivity of 89.2% and a specificity of 77.4%. CONCLUSIONS: The increased levels of LDH, Dbil, ferritin, and NEUT#, along with lowered ALB and SpO2 levels are the most decisive variables for forecasting the mortality for COVID-19 according to our machine-learning-based model. The combined diagnosis could be used to improve further diagnostic performance.

Combined treatment with ultrasound-targeted microbubble destruction technique and NM-aFGF-loaded PEG-nanoliposomes protects against diabetic cardiomyopathy-induced oxidative stress by activating the AKT/GSK-3ß1/Nrf-2 pathway.

The present study sought to investigate the effect of non-mitogenic acidic fibroblast growth factor (NM-aFGF) loaded PEGylated nanoliposomes (NM-aFGF-PEG-lips) combined with the ultrasound-targeted microbubble destruction (UTMD) technique on modulating diabetic cardiomyopathy (DCM)and the mechanism involved. Animal studies showed that the diabetes mellitus (DM) group exhibited typical myocardial structural and functional changes of DCM. The indexes from the transthoracic echocardiography showed that the left ventricular function in the NM-aFGF-PEG-lips + UTMD group was significantly improved compared with the DM group. Histopathological observation further confirmed that the cardiomyocyte structural abnormalities and mitochondria ultrastructural changes were also significantly improved in the NM-aFGF-PEG-lips + UTMD group compared with DM group. The cardiac volume fraction (CVF) and apoptosis index in the NM-aFGF-PEG-lips + UTMD group decreased to 10.31 ± 0.76% and 2.16 ± 0.34, respectively, compared with those in the DM group (CVF = 21.4 ± 2.32, apoptosis index = 11.51 ± 1.24%). Moreover, we also found significantly increased superoxide dismutase (SOD) activity and glutathione peroxidase (GSH-Px) activity as well as clearly decreased lipid hydroperoxide levels and malondialdehyde (MDA) activity in the NM-aFGF-PEG-lips + UTMD group compared with those in the DM group (p < .05). Western blot analysis further revealed the highest level of NM-aFGF, p-AKT, p-GSK-3ß1, Nrf-2, SOD2 and NQO1 in the NM-aFGF-PEG-lips + UTMD group. This study confirmed using PEGylated nanoliposomes combined with the UTMD technique can effectively deliver NM-aFGF to the cardiac tissue of diabetic rats. The NM-aFGF can then inhibit myocardial oxidative stress damage due to DM by activating the AKT/GSK/Nrf-2 signaling pathway, which ultimately improved the myocardial structural and functional lesions in diabetic rats.

Streptomyces albogriseolus SY67903 Produces Eunicellin Diterpenoids Structurally Similar to Terpenes of the Gorgonian Muricella sibogae, the Bacterial Source.

Microeunicellols A (1) and B (2), two undescribed eunicellin diterpenoids, were isolated from the culture of a bacterial symbiont, Streptomyces albogriseolus SY67903. Their structures, including absolute configurations revealed by spectroscopic data and single-crystal X-ray diffraction analysis, are closely related with the diterpenoids from its host, a South China Sea gorgonian, Muricella sibogae. This is the first report of eunicellin diterpenoids, commonly coral-derived, from a bacterial symbiont of coral. The chemical metabolic relationship between the bacterium and its host is discussed. Biological evaluation revealed that compound 1 possessed cytotoxicities against several human cancer cell lines.

Efficient decomposition of perfluorooctanic acid by persulfate with iron-modified activated carbon.

Using persulfate (PS) oxidation to remove the persistent perfluorooctanoic acid (PFOA) in water typically requires an elevated temperature or an extended reaction time. Under relatively ambient temperatures (15-45 °C), feasibility of employing PS with iron-modified activated carbon (AC) for PFOA oxidation was evaluated. With presence of Fe/AC in PS oxidation, 61.7% of PFOA was decomposed to fluoride ions and intermediates of short-chain perfluorinated carboxylic acids (PFCAs) with a 41.9% defluorination efficiency at 25 °C after 10 h. Adsorption of PFOA onto Fe/AC can be regarded as a pre-concentration step prior to subsequent oxidation of PFOA. Fe/AC not only removes PFOA through adsorption, but also activates PS to form sulfate radicals that accelerate the decomposition and mineralization of PFOA. With Fe/AC in the PS system, activation energies (Ea) of PFOA removal and defluorination were significantly reduced from 66.8 to 13.2 and 97.3 to 14.5 kJ/mol, respectively. It implies that PFOA degradation and defluorination could proceed at a lower reaction temperature within a shorter reaction time. Besides, the surface characteristics of AC and Fe/AC before and after PS oxidation were evaluated by XPS and SEM. A quenching test used MeOH as an inhibitor and EPR spectra of free radicals were conducted to develop the proposed reaction mechanisms for PFOA oxidation.

Autocatalytic degradation of perfluorooctanoic acid in a permanganate-ultrasonic system.

An autocatalytic system, permanganate-ultrasonic (PM-US) system, was applied to degrade perfluorooctanoic acid (PFOA) in aqueous solutions. After a 120-min ultrasonication, a PM dosage of 6 mM increased the pseudo first-order rate constant (k1) for PFOA decomposition from 3.5 × 10-3 to 13.0 × 10-3 min-1 and increased the pseudo zeroth-order rate constant (k2) for PFOA defluorination from 1.5 × 10-3 to 7.9 × 10-3 mM·min-1, respectively. The PFOA degradation rates increased proportionally with the enhanced production rates of MnO2 particles. An initial pH 4 condition was optimal for the PFOA degradation compared to highly acidic and neutral conditions. PFOA degradation could be significantly facilitated by increasing power density of ultrasonication from 60 to 180 W·L-1. While increasing solution temperature to 50 °C only slightly promoted the PFOA decomposition and defluorination to 1.15 and 1.07 times of that at 30 °C, respectively. The solution saturated with argon was more favorable for the PFOA degradation in the PM-US system than that saturated with air and oxygen. Co-dissolved Cu(II), Fe(II) and Fe(III) ions inhibited the PFOA degradation by forming metal-PFOA complexes. Based on the experimental results and intermediates analysis, mechanisms and pathways of PFOA decomposition and defluorination in the PM-US system were proposed.

Reductive defluorination of perfluorooctanoic acid by titanium(III) citrate with vitamin B12 and copper nanoparticles.

Perfluorooctanoic acid (PFOA) is widespread in the environment, which causes serious health and safety concerns. A mechanistic study on reductive defluorination of PFOA by titanium(III) citrate in the presence of catalysts was conducted. Vitamin B12 was used to catalyze reduction reactions by shuttling electrons from a reducing agent (electron donor) to PFOA to produce a Co-carbon bond intermediates. In the presence of copper nanoparticles, a precursor complex, B12-C7F14COOH, adsorbed on the metal surface, followed by a hydrogenolytic reaction to form less-fluorinated products. The synergistic effect between vitamin B12 and copper nanoparticles enhances the reductive activities by electron-transfer reactions and hydrogenolysis. The efficient reduction of PFOA to less-noxious compounds was demonstrated with a copper dose of 2gL-1, titanium(III) citrate (45mM), and vitamin B12 (0.2mM) with an initial pH of 9.0 and 70°C. In this anoxic aqueous solution, the biomimetic reductive system effectively removed 65% of PFOA. The mass balance on fluoride matched the observed degradation of PFOA, while no short-chain intermediates were detected.

Efficient sonochemical degradation of perfluorooctanoic acid using periodate.

A rapid and efficient treatment method, using periodate (PI) for sonochemical oxidation of persistent and bioaccumulative perfluorooctanoic acid (PFOA) was developed. With an addition of 45 mM PI, 96.5% of PFOA was decomposed with a defluorination efficiency of 95.7% after 120 min of ultrasound (US). The removals of PFOA were augmented with an increase in PI doses. In all the PI+US experimental runs, decomposition efficiencies were essentially similar to those of defluorination, indicating that PFOA was decomposed and mineralized into fluoride ions. Lower solution pHs resulted in an increase in decomposition and defluorination efficiencies of PFOA due to acid-catalyzation. Dissolved oxygen increased the amount of IO4 radicals produced, which consumed the more effective IO3 radicals. Consequently, presence of oxygen inhibited the destruction of PFOA. The PFOA degradation rates with different gases sparging are in the following order: nitrogen>air>oxygen. Effects of anions follow the Hofmeister effects on PFOA degradation (i.e., Br(-)>none ⩾ Cl(-)>SO4(2)(-)). Br(-) could react with OH to yield radical anion Br2(-) that enhances the PFOA degradation. A reaction pathway was also proposed to describe the PI oxidation of PFOA under US irradiation.

Decomposition of perfluorooctanoic acid by ultraviolet light irradiation with Pb-modified titanium dioxide.

Perfluorooctanoic acid (PFOA, C7H15COOH) is widely used in industrial and commercial applications. It has become a global concern due to its widespread occurrence in water bodies and adverse environmental impact. PFOA could not be effectively removed by the conventional UV/TiO2 system. This study synthesized Pb-modified TiO2 catalyst and used it as a catalyst with light irradiation for PFOA decomposition. It was found that the Pb-TiO2 catalyst could produce traps to capture photo-induced electrons or holes that lead to better photocatalytic efficiencies. Rate constant values for PFOA decomposition by the UV/TiO2 and UV/Pb-TiO2 systems were determined to be 0.0158 and 0.5136 h(-1), respectively. The PFOA decomposition in the UV/Pb-TiO2 system is 32.5 times faster than that in the UV/TiO2 system. The UV/Pb-TiO2 system yielded a better performance than those of the UV/Fe-TiO2 and UV/Cu-TiO2 systems. During the reaction, PFOA decomposed stepwisely into shorter-chain perfluorocarboxylic acids and F(-).

Photocatalytic decomposition of perfluorooctanoic acid by transition-metal modified titanium dioxide.

Transition-metal modified TiO2 was used in a UV reactor to assist in decomposition of perfluorooctanoic acid (PFOA) in aqueous solutions. Comparing TiO2 and two types of metal-modified TiO2 (Fe-TiO2 and Cu-TiO2), Cu-TiO2 exhibited the highest catalytic activity during PFOA decomposition and defluorination. After 12 h of reaction, the PFOA decomposition and defluorination efficiencies by the UV/Cu-TiO2 system reached 91% and 19%, respectively. PFOA was decomposed into fluoride ions (F(-)) and shorter perfluorinated carboxylic acids (PFCAs) such as C6 F13COOH, C5F11COOH, C4F9COOH, C3F7COOH, C2F5COOH and CF3COOH. The pseudo-first-order and pseudo-zero-order kinetics were used to model the decomposition and defluorination of PFOA, respectively. Rate constant values of PFOA decomposition for the UV/TiO2, UV/Fe-TiO2, and UV/Cu-TiO2 systems were 0.0001, 0.0015, and 0.0031 min(-1), respectively, while rate constant values of PFOA defluorination for the UV/Fe-TiO2, and UV/Cu-TiO2 systems were 0.0048 and 0.0077 mg/L·min(-1), respectively. The photocatalysts were prepared by a photodeposition synthesis method and were characterized by scanning electron microscopy with energy-dispersive X-ray, X-ray diffraction and UV-vis spectrophotometry. The Fe-TiO2 and Cu-TiO2 catalysts exhibited considerably higher activities than that of TiO2. The experimental results have demonstrated that the UV/Fe-TiO2 and UV/Cu-TiO2 systems could produce traps to capture photo-induced electrons, thereby reduce electron-hole recombination during photocatalytic reactions and consequently enhance the PFOA decomposition.