Ventilator-Associated Pneumonia Prediction Models Based on AI: Scoping Review.

Background: Ventilator-associated pneumonia (VAP) is a serious complication of mechanical ventilation therapy that affects patients' treatments and prognoses. Owing to its excellent data mining capabilities, artificial intelligence (AI) has been increasingly used to predict VAP. Objective: This paper reviews VAP prediction models that are based on AI, providing a reference for the early identification of high-risk groups in future clinical practice. Methods: A scoping review was conducted in accordance with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. The Wanfang database, the Chinese Biomedical Literature Database, Cochrane Library, Web of Science, PubMed, MEDLINE, and Embase were searched to identify relevant articles. Study selection and data extraction were independently conducted by 2 reviewers. The data extracted from the included studies were synthesized narratively. Results: Of the 137 publications retrieved, 11 were included in this scoping review. The included studies reported the use of AI for predicting VAP. All 11 studies predicted VAP occurrence, and studies on VAP prognosis were excluded. Further, these studies used text data, and none of them involved imaging data. Public databases were the primary sources of data for model building (studies: 6/11, 55%), and 5 studies had sample sizes of <1000. Machine learning was the primary algorithm for studying the VAP prediction models. However, deep learning and large language models were not used to construct VAP prediction models. The random forest model was the most commonly used model (studies: 5/11, 45%). All studies only performed internal validations, and none of them addressed how to implement and apply the final model in real-life clinical settings. Conclusions: This review presents an overview of studies that used AI to predict and diagnose VAP. AI models have better predictive performance than traditional methods and are expected to provide indispensable tools for VAP risk prediction in the future. However, the current research is in the model construction and validation stage, and the implementation of and guidance for clinical VAP prediction require further research.

Nitric oxide-releasing poly(ionic liquid)-based microneedle for subcutaneous fungal infection treatment.

Poor permeation of therapeutic agents and similar eukaryotic cell metabolic and physiological properties of fungi and human cells are two major challenges that lead to the failure of current therapy for fungi-induced skin and soft tissue infections. Herein, a nitric oxide (NO)-releasing poly(ionic liquid)-based microneedle (PILMN-NO) with the capacity of deep persistent NO toward subcutaneous fungal bed is presented as a synergistic antifungal treatment strategy to treat subcutaneous fungal infection. Upon the insertion of PILMN-NO into skin, the contact fungicidal activities induced by electrostatic and hydrophobic effects of poly(ionic liquid) and the released NO sterilization resulting from the peroxidation and nitrification effect of NO achieved enhanced antifungal efficacy against fungi (Candida albicans) both in vitro and in vivo. Simultaneously, PILMN-NO showed biofilm ablation ability and efficiently eliminated mature biofilms. In vivo fungal-induced subcutaneous abscess studies revealed that PILMN-NO could effectively sterilize fungi while suppressing the inflammatory reaction, facilitating collagen deposition and angiogenesis, and promoting wound healing. This work provides a new strategy to overcome the difficulties in deep skin fungal infection treatment and has potential for further exploitation of NO-releasing microbicidal therapy.

The relationship between quality of life and health promotion behavior in patients with type B aortic dissection: a cross-sectional study.

BACKGROUND: To understand the current situation of health promotion behavior and quality of life among aortic dissection survivors and the correlation between them. METHODS: Sociodemographic characteristics were collected. T-test and variance analysis were applied for univariate analysis. Quality of life was measured using the SF-36 Questionnaire, and health-promoting behaviors were measured using the aortic dissection health promotion behavior questionnaire. The association between type B aortic dissection survivors' health promotion behavior and health status questionnaire (SF-36) scores was determined through Pearson's correlation coefficients. This association was analyzed through multivariable regression analysis. RESULTS: A total of 131 type B aortic dissection survivors were evaluated through the self-developed aortic dissection patient health promotion behavior scale and health status questionnaire (SF-36). Results showed that the health promotion behavior of Stanford B aortic dissection survivors (85.05 ± 11.28) correlated with their Mental Component Summary (MCS) (55.23 ± 30.72; r = 0.359, P < 0.01). The model showed 39.00% variance shared between behavior motivation and MCS (R2 = 0.390, F = 13.189, P < 0.01). CONCLUSION: Type B aortic dissection survivors in Zunyi, China had a lower quality of life. Medical staff can formulate intervention measures from behavioral motivation to improve the quality of life of aortic dissection survivors.

Antimicrobial poly(ionic liquid)-induced bacterial nanotube formation and drug-resistance spread.

Bacterial nanotubes are tubular membranous structures bulging from the cell surface that can connect neighboring bacteria for the exchange of intercellular substances. However, little is known about the formation and function of bacterial nanotubes under the stress of antimicrobial materials. Herein, an imidazolium-type cationic poly(ionic liquid) (PIL) and corresponding PIL membranes with antimicrobial properties were synthesized. The effects of these cationic polymers on the formation of bacterial nanotubes between Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) or Vibrio fischeri (V. fischeri), followed by intraspecies and interspecies exchange of antibiotic resistance genes (ARGs) were investigated. The results showed that bacteria tend to produce more nanotubes accompanied by drug-resistance trade, which can even make the ARGs of pathogens spread to the environmental microbes of V. fischeri. Given the unique antimicrobial sustainability toward bacteria after they acquire ARGs via bacterial nanotubes, antimicrobial PILs demonstrate bright prospects in the battle against resistant bacteria.

Oxygen-supplied mesoporous carbon nanoparticles for enhanced photothermal/photodynamic synergetic therapy against antibiotic-resistant bacterial infections.

Pandemic and epidemic spread of antibiotic-resistant bacterial infections would result in a huge number of fatalities globally. To combat antibiotic-resistant pathogens, new antimicrobial strategies should be explored and developed to confront bacteria without acquiring or increasing drug-resistance. Here, oxygen saturated perfluorohexane (PFH)-loaded mesoporous carbon nanoparticles (CIL@ICG/PFH@O2) with photothermal therapy (PTT) and enhanced photodynamic therapy (PDT) utility are developed for antibacterial applications. Ionic liquid groups are grafted onto the surface of mesoporous carbon nanoparticles, followed by anion-exchange with the anionic photosensitizer indocyanine green (ICG) and loading oxygen saturated PFH to prepare CIL@ICG/PFH@O2. These CIL@ICG/PFH@O2 nanoparticles exhibit effective PTT and enhanced PDT properties simultaneously upon 808 nm light irradiation. In vitro assays demonstrate that CIL@ICG/PFH@O2 shows a synergistic antibacterial action against antibiotic-resistant pathogens (methicillin-resistant Staphylococcus aureus and kanamycin-resistant Escherichia coli). Moreover, CIL@ICG/PFH@O2 could effectively kill drug-resistant bacteria in vivo to relieve inflammation and eliminate methicillin-resistant Staphylococcus aureus-wound infection under NIR irradiation, and the released oxygen can increase collagen deposition, epithelial tissue formation and blood vessel formation to promote wound healing while enhancing the PDT effect. This study proposes a platform with enhanced PTT/PDT effects for effective, controlled, and precise treatment of topical drug-resistant bacterial infections.

[Tetrahydropalmatine alleviated diabetic neuropathic pain by inhibiting activation of microglia via p38 MAPK signaling pathway].

Neuropathic pain is one of the common complications of diabetes. Tetrahydropalmatine(THP) is a main active component of Corydalis Rhizoma with excellent anti-inflammatory and pain-alleviating properties. This study aims to investigate the therapeutic effect of THP on diabetic neuropathic pain(DNP) and the underlying mechanism. High-fat and high-sugar diet(4 weeks) and streptozotocin(STZ, 35 mg·kg~(-1), single intraperitoneal injection) were employed to induce type-2 DNP in rats. Moreover, lipopolysaccharide(LPS) was used to induce the activation of BV2 microglia in vitro to establish an inflammatory cellular model. Fasting blood glucose(FBG) was measured by a blood glucose meter. Mechanical withdrawal threshold(MWT) was assessed with von Frey filaments, and thermal withdrawal latency(TWL) with hot plate apparatus. The protein expression levels of OX42, inducible nitric oxide synthase(iNOS), CD206, p38, and p-p38 were determined by Western blot, the fluorescence expression levels of OX42 and p-p38 in the dorsal horn of the rat spinal cord by immunofluorescence, the mRNA content of p38 and OX42 in rat spinal cord tissue by qRT-PCR, and levels of nitric oxide(NO), interleukin-1ß(IL-1ß), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α), interleukin-10(IL-10), and serum fasting insulin(FINS) by enzyme-linked immunosorbent assay(ELISA). RESULTS:: showed that the mo-del group demonstrated significant decrease in MWT and TWL, with pain symptoms. THP significantly improved the MWT and TWL of DNP rats, inhibited the activation of microglia and p38 MAPK signaling pathway in rat spinal cord, and ameliorated its inflammatory response. Meanwhile, THP promoted the change of LPS-induced BV2 microglia from the pro-inflammatory M1 phenotype to the anti-inflammatory M2 phenotype, suppressed the activation of the p38 MAPK signaling pathway, decreased the expression levels of inflammatory factors NO, IL-1ß, IL-6, and TNF-α, and increased the expression level of anti-inflammatory factor IL-10. The findings suggested that THP can significantly ameliorate the pain symptoms of DNP rats possibly by inhibiting the inflammatory response caused by M1 polarization of microglia via the p38 MAPK pathway.

Enhanced photocatalytic and antibacterial activity of acridinium-grafted g-C3N4 with broad-spectrum light absorption for antimicrobial photocatalytic therapy.

As a metal-free polymeric photocatalyst, graphitic carbon nitride (g-C3N4) has attracted great attention owing to its high stability and low toxicity. However, g-C3N4 suffers from low light harvesting ability which limits its applications in antimicrobial photocatalytic therapy (APCT). Herein, acridinium (ADN)-grafted g-C3N4 (ADN@g-C3N4) nanosheets are prepared via covalent grafting of ADN to g-C3N4. The obtained ADN@g-C3N4 exhibits a narrow optical band gap (2.12 eV) and a wide optical absorption spectrum (intensity a.u. > 0.30) ranging from ultraviolet to near-infrared region. Moreover, ADN@g-C3N4 would produce reactive oxygen species (ROS) under light irradiation to exert effective sterilization and biofilm elimination activities against both gram-negative and gram-positive bacteria. Molecular dynamics simulation reveals that the ADN@g-C3N4 may move toward, tile and insert the bacterial lipid bilayer membrane through strong van der Waals and electrostatic interaction, decreasing the order parameter of the lipid while increasing the conducive of ROS migration, inducing ADN@g-C3N4 with improved antimicrobial and antibiofilm performance. Moreover, ADN@g-C3N4 could efficiently eradicate oral biofilm on artificial teeth surfaces. This work may provide a broad-spectrum light-induced photocatalytic therapy for preventing and treating dental plaque diseases and artificial teeth-related infections, showing potential applications for intractable biofilm treatment applications. An acridinium-grafted g-C3N4 (ADN@g-C3N4) with a narrow band gap and broad-spectrum light absorption was synthesized. The narrow optical band gap and improved electrostatic interaction with bacterial lipid bilayer membrane of ADN@g-C3N4 strengthened the ROS generation and facilitated the diffusion of ROS to bacteria surface, leading to enhanced photocatalytic and antibacterial activity against bacteria and corresponding biofilm under light irradiation. STATEMENT OF SIGNIFICANCE: An acridinium-grafted g-C3N4 (ADN@g-C3N4) with a narrow band gap and broad-spectrum light absorption was developed as an antimicrobial photocatalytic therapy agent. The ADN@g-C3N4 exhibited enhanced photocatalytic and antibacterial activity against bacteria and corresponding biofilm under light irradiation, showing potential applications for intractable biofilm treatment.

Genome-wide association studies for growth traits in broilers.

BACKGROUND: The identification of markers and genes for growth traits may not only benefit for marker assist selection /genomic selection but also provide important information for understanding the genetic foundation of growth traits in broilers. RESULTS: In the current study, we estimated the genetic parameters of eight growth traits in broilers and carried out the genome-wide association studies for these growth traits. A total of 113 QTNs discovered by multiple methods together, and some genes, including ACTA1, IGF2BP1, TAPT1, LDB2, PRKCA, TGFBR2, GLI3, SLC16A7, INHBA, BAMBI, APCDD1, GPR39, and GATA4, were identified as important candidate genes for rapid growth in broilers. CONCLUSIONS: The results of this study will provide important information for understanding the genetic foundation of growth traits in broilers.

Nurses reports of actual work hours and preferred work hours per shift among frontline nurses during coronavirus disease 2019 (COVID-19) epidemic: A cross-sectional survey.

BACKGROUND: The Coronavirus disease (COVID-19) pandemic is an ongoing pandemic all over the world, leading to 126, 372, 442 people diagnosed and 2, 769, 696 deaths globally as of March 28, 2021. Nurses are providing care to patients with COVID-19 who require hospitalization. To ensure adequate response capacity and to maintain the health of nurses, it is important to analyse the actual work hours and the nurses reported preferred work hours per shift among frontline nurses. OBJECTIVE: To analyse the actual work hours and preferred work hours per shift of nurses reports among frontline nurses fighting the COVID-19 epidemic and to explore the influencing factors on the nurses reported preferred work hours. DESIGN: Cross-sectional survey. SETTINGS: This study was conducted in 10 designated hospitals providing treatments to patients with COVID-19 in China. PARTICIPANTS: Nurses providing care to patients with COVID-19 in designated hospitals in China. METHODS: A questionnaire with open-ended questions was used to assess frontline nurses caring for COVID-19 cases in 10 designated hospitals. Quantitative and qualitative methods were used to analyse the actual work hours, the nurses reported preferred work hours and factors influencing nurses reported preferred work hours among the frontline nurses. RESULTS: A total of 109 nurses responded to the survey. The shift length exceeded the nurses' preferred work hours [Median (interquartile range): 5.00 (2.00) h vs 4.00 (2.00) h; Minimum-Maximum: 4-12 h vs 4-8 h], and 60.55% (66/109) of the nurses regarded 4 h as the preferred number of work hours per shift. Five key themes associated with the influencing factors emerged, including circumstances; personal preventable equipment; the nurses' physical and emotional needs of nurse; and the nurses' safety needs and work intensity. CONCLUSIONS: These findings suggest that there is a gap between the actual work hours and the nurses preferred work hours among frontline nurses in different units and different posts. The main influencing factors were circumstances, personal protective equipment, the nurses' physical and emotional needs, and the nurses' safety needs and work intensity.

Intrathoracic infusion therapy with Lentinan and chemical irritants for malignant pleural effusion: a systematic review and meta-analysis of 65 randomized controlled trials.

BACKGROUND: Aderivative of Shiitake mushrooms, Lentinan is used to control malignant pleural effusion (MPE) through intrathoracic infusion. PURPOSE: To determine the clinical response, survival and safety of Lentinan plus chemical irritants, and the optimal combinations with chemical irritants, indication, threshold and optimal regimen for achieving the desired responses. STUDY DESIGN: We performed a new systematic review and meta-analysis following the PRISMA guidelines. METHODS: We collected all randomized controlled trials (RCTs) regarding Lentinan plus chemical irritants from Chinese and English electronic databases (from inception until March 2019). We evaluated their bias risk, synthesized data using meta-analysis, and summarized evidence quality following the Grades of Recommendation Assessment, Development and Evaluation approach. RESULTS: We included 65 RCTs involving 4,080 patients and nine chemical irritants. Most trials had unclear bias risk. Lentinan with cisplatin significantly improved complete response [Risk ratio (RR) = 1.68, 95% confidence intervals (CI) (1.51 to 1.87), p < 0.00001, Fig.3a] and quality of life [RR = 1.51 95% CI (1.41 to 1.62), p < 0.00001, Fig.4], and decreased the risk of treatment failure, myelosuppression, gastrointestinal reaction, and chest pain. For patients with moderate to large volume of the pleural effusion, primary treatment, KPS score ≥ 50-60, or anticipated survival time ≥ 3months, Lentinan (3-4 mg/time, once a week for three to four times) withcisplatin (30-40 mg/m2 or 50-60 mg/m2) significantly improved complete response and decreased failure. Most results were robust and moderate quality. CONCLUSION: The results suggest that Lentinan with chemical irritants, especially cisplatin is beneficial to the patient with MPE, and provide evidence for the indication, threshold, and optimal regimen that may achieve success and decrease failure.

WITHDRAWN: Nurses reports of actual work hours and preferred work hours per shift among frontline nurses during coronavirus disease 2019 (COVID-19) epidemic: A cross-sectional survey.

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Association of PCSK1 gene polymorphisms with abdominal fat content in broilers.

Protein proteolytic enzymes (Proprotein Convertase, PC) is a Ca2+ -dependent serine protease family, whose main function is to cleave precursors of biologically inactive proteins or peptide chains into active functional molecules. Proprotein convertase subtilisin/kexin type 1 (PCSK1) gene is mainly expressed in nerve and endocrine tissues. In this study, PCSK1 was selected as an important candidate gene for abdominal fat content in broilers. We cloned the exon region of chicken PCSK1 gene and found six single-nucleotide polymorphisms (SNPs). Association analysis was carried out and we found that the polymorphisms of these six SNPs were significantly associated with abdominal fat content in G19 and G20 populations. Five of these SNPs were significantly associated with abdominal fat content in G19 and G20 combined population. The polymorphism of these five SNPs was significantly correlated with the abdominal fat content of AA broilers. Together, our study demonstrated that c.927T>C, c.1880C>T, c.*900G>A, and c.*1164C>T were significantly associated with abdominal fat content in populations used in this study, which means that these SNPs in PCSK1 gene could be used as candidate markers to select lean broiler lines.

New insight from using spatiotemporal image correlation in prenatal screening of fetal conotruncal defects.

BACKGROUND: : To establish the reference range of the angle between ascending aorta and main pulmonary artery of fetus in the second and third trimester using spatiotemporal image correlation (STIC), and to investigate the value of this angle in prenatal screening of conotruncal defects (CTDs). MATERIALS AND METHODS: Volume images of 311 normal fetuses along with 20 fetuses with congenital heart diseases were recruited in this cross-sectional study. An offline analysis of acquired volume datasets was carried out with multiplanar mode. The angle between aorta and pulmonary artery was measured by navigating the pivot point and rotating axes and the reference range was established. The images of ascending aorta and main pulmonary artery in fetuses with congenital heart diseases were observed by rotating the axes within the normal angle reference range. RESULTS: THE ANGLE BETWEEN ASCENDING AORTA AND MAIN PULMONARY ARTERY OF THE NORMAL FETUS (RANGE: 59.1˚~97.0˚, mean ± SD: 78.0˚ ± 9.7˚) was negatively correlated with gestational age (r = -0.52; p<0.01). By rotating the normal angle range corresponding to gestational age, the fetuses with CTD could not display views of their left ventricular long axis and main pulmonary trunk correctly. CONCLUSION: The left ventricular long axis and main pulmonary trunk views can be displayed using STIC so that the echocardiographic protocol of the cardiovascular joint could be standardized. The reference range of the angle between ascending aorta and main pulmonary artery is clinically useful in prenatal screening of CTD and provides a reliable quantitative standard to estimate the spatial relationship of the large arteries of fetus.

[Analysis of prognostic factors of severe jaundice patients using HB-H-6 resin plasma perfusion].

OBJECTIVE: To investigate the influencing factors of efficacy of plasma perfusion in patients with severe jaundice. METHODS: The clinical data of 78 patients with severe jaundice due to different causes receiving HB-H-6 resin plasma perfusion therapy admitted to Tianjin Third Central Hospital from October 2006 to July 2010 were retrospectively analyzed. Patients were divided into improved group (n = 51) and ineffective group (n = 27) according to outcomes. The effecting factors of prognosis, including age, sex, hospital stay days, number of perfusion therapy received, Child-Pugh scores before perfusion, total bilirubin (TBil) levels before perfusion, and mean TBil rebound rate were studied by univariate and multivariate logistic regression analysis. RESULTS: All 78 patients received (3.31 ± 1.36) times of HB-H-6 resin plasma perfusion treatment. Child-Pugh score before perfusion, TBil (µmol/L) before perfusion and mean TBil rebound rate in improved group were significantly lower than those in ineffective group [Child-Pugh score before perfusion: 8.06 ± 1.01 vs. 9.44 ± 1.19; TBil before perfusion: 384.29 ± 170.41 vs. 504.93 ± 206.88; mean TBil rebound rate: -(7.35 ± 20.76)% vs. (37.32 ± 23.22)%]. They were also significantly different in gender between two groups (improved group: 30 males, 21 females; ineffective group: 24 males, 3 females, P < 0.05 or P < 0.01). Gender and mean TBil bounce rate were defined as independent significant factors influencing the clinical results by multivariate logistic regression analysis. Regression coefficient ß were 5.35 and -2.82 for gender and mean TBil bounce rate respectively [χ (2) = 64.42, P = 0.000]. Receive operating characteristic curve (ROC curve) analysis showed that the area under the curve (AUC) was 0.90 (0.82, 0.97), and mean TBil bounce rate higher than 29.5% indicated poor prognosis. No obvious side effects were observed after plasma perfusion. CONCLUSIONS: Gender and mean TBil bounce rate were independent risk factors in treatment of severe jaundice with HB-H-6 resin plasma perfusion. Mean TBil bounce rate higher than 29.5% indicated a poor prognosis.