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ABSTRACT: Objective: To achieve a better prediction of in-hospital mortality, the Sequential Organ Failure Assessment (SOFA) score needs to be adjusted and combined with comorbidities. This study aims to enhance the prediction of SOFA score for in-hospital mortality in patients with Sepsis-3. Methods: This study adjusted the maximum SOFA score within the first 3 days (Max Day3 SOFA) in relation to in-hospital mortality using logistic regression and incorporated the age-adjusted Charlson Comorbidity Index (aCCI) as a continuous variable to build the age-adjusted Charlson Comorbidity Index-Sequential Organ Failure Assessment (aCCI-SOFA) model. The outcome was in-hospital mortality. We developed, internally validated, and externally validated the aCCI-SOFA model using cohorts of Sepsis-3 patients from the MIMIC-IV, MIMIC-III (CareVue), and the FAHWMU cohort. The predictive performance of the model was assessed through discrimination and calibration, which was assessed using the area under the receiver operating characteristic and calibration curves, respectively. The overall predictive effect was evaluated using the Brier score. Measurements and main results: Compared with the Max Day3 SOFA, the aCCI-SOFA model showed significant improvement in area under the receiver operating characteristic with all cohorts: development cohort (0.81 vs 0.75, P < 0.001), internal validation cohort (0.81 vs 0.76, P < 0.001), MIMIC-III (CareVue) cohort (0.75 vs 0.68, P < 0.001), and FAHWMU cohort (0.72 vs 0.67, P = 0.001). In sensitivity analysis, it was suggested that the application of aCCI-SOFA in early nonseptic shock patients had greater clinical value, with significant differences compared with the original SOFA scores in all cohorts ( P < 0.05). Conclusion: For septic patients in intensive care unit, the aCCI-SOFA model exhibited superior predictive performance. The application of aCCI-SOFA in early nonseptic shock patients had greater clinical value.
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Sepse , Humanos , Mortalidade Hospitalar , Estudos Retrospectivos , Prognóstico , Unidades de Terapia Intensiva , Curva ROCRESUMO
BACKGROUND: The relationship between fibrosis-4 (FIB-4) index and all-cause mortality in critically ill patients with alcohol use disorder (AUD) is unclear. The present study aimed to investigate the predictive ability of FIB-4 for all-cause mortality in critically ill AUD patients and the association between them. METHODS: A total of 2528 AUD patients were included using the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. FIB-4 was calculated for each patient using the existing formula. The patients were equally divided into four groups based on the quartiles of FIB-4. Multivariate logistic regression and Cox proportional hazard model were used to evaluate the association of FIB-4 with in-hospital mortality, 28-day mortality and 1-year mortality. Kaplan-Meier curves were used to analyse the incidence of 28-day mortality among four groups. RESULTS: FIB-4 was positively associated with 28-day mortality of AUD patients with hazard ratio (HR) of 1.354 [95% confidence interval (CI) 1.192-1.538]. There were similar trends in the in-hospital mortality [odds ratio (OR): 1.440, 95% CI (1.239-1.674)] and 1-year mortality [HR: 1.325, 95% CI (1.178-1.490)]. CONCLUSION: Increased FIB-4 is associated with greater in-hospital mortality, 28-day mortality and 1-year mortality in critically ill AUD patients.
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Alcoolismo , Humanos , Estado Terminal , Cuidados Críticos , Razão de ChancesRESUMO
The nitrogen removal efficiency of heterotrophic nitrification and aerobic denitrification (HN-AD) bacteria can be seriously inhibited at low temperatures (< 15 °C). A novel psychrotolerant bacterium, Pseudomonas peli NR-5 (P. peli NR-5), with efficient HN-AD capability was isolated and screened from river sediments in cold areas. When P. peli NR-5 was aerobically cultivated for 60 h at 10 °C with NH4+-N, NO3--N, and NO2--N as the sole nitrogen sources (N 105 mg/L), the nitrogen removal efficiencies were 97.3, 95.3, and 87.8%, respectively, without nitrite accumulation, and the corresponding average nitrogen removal rates were 1.71, 1.67, and 1.55 mg/L/h, respectively. Meanwhile, P. peli NR-5 exhibited excellent simultaneous nitrification and denitrification capabilities at 10 °C. Sodium succinate was the most favorable carbon substrate for bacterial growth and ammonia removal by strain NR-5. The optimal culture conditions determined by the response surface methodology model were a carbon to nitrogen ratio of 5.9, temperature of 11.5 °C, pH of 7.0, and shaking speed of 144 rpm. Under these conditions, 99.1% of the total nitrogen was removed in the verification experiments, which was not significantly different from the predicted maximum removal in the model (99.6%). Six functional genes participating in the HN-AD process were successfully obtained by polymerase chain reaction amplification, which further confirmed the HN-AD capability of P. peli NR-5 and proposed the metabolic pathway of HN-AD. The above results provide a theoretical background of psychrotolerant HN-AD bacteria in wastewater purification under low-temperature conditions.
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Desnitrificação , Nitrificação , Temperatura , Aerobiose , Nitritos , Processos Heterotróficos , Nitrogênio/metabolismo , CarbonoRESUMO
Background: Alcohol use disorder (AUD) is common in critically ill patients. Plasma anion gap (AG) was known as a feasible parameter and was associated with outcomes of various diseases. This study is intended to explore whether AG is related to 28-day inhospital mortality and 1-year mortality of critically ill patients with AUD. Method: We extracted data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. The association of plasma AG with 28-day inhospital mortality and 1-year mortality of critically ill AUD patients was assessed using Cox proportional hazard regression models and stratification analyses, allowing AG as a time-varying covariate in the models. To evaluate the accuracy of AG in predicting different endpoints, receiver operator characteristic (ROC) curves were used. Result: Among the 3993 critically ill patients with AUD, AG was positively associated with 28-day inhospital mortality and 1-year mortality after adjusting confounders (p < 0.001 for all). Compared with lower AG (<12 mmol/L), patients in different groups (12 ≤ AG < 14 mmol/L, 14 ≤ AG < 17 mmol/L, 17 ≤ AG < 20 mmol/L, and AG ≥ 20 mmol/L) had different HRs (95% CIs) for 28-day inhospital mortality (1.105, (0.906, 1.347); 1.171, (0.981, 1.398); 1.320, (1.108, 1.573); and 1.487, (1.254, 1.763), respectively) and 1-year mortality (1.037 (0.898, 1.196); 1.091 (0.955, 1.246); 1.201 (1.052, 1.371); and 1.3093 (1.149, 1.492), respectively). Conclusion: Increased AG is associated with greater 28-day inhospital mortality and 1-year mortality. The effect of AG on all-cause mortality is linear in critically ill AUD patients.
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Equilíbrio Ácido-Base , Alcoolismo , Estado Terminal , Mortalidade Hospitalar , Humanos , Unidades de Terapia Intensiva , Estudos RetrospectivosRESUMO
The long start-up period is a major challenging issue for the widespread application of aerobic granular sludge (AGS). In this study, a novel rapid start-up strategy was developed by inoculating Phanerochaete chrysosporium (P. chrysosporium) pellets as the induced nucleus in a sequencing batch airlift reactor (SBAR) to enhance activated sludge granulation. The results demonstrated that P. chrysosporium pellets could effectively shorten the aerobic granulation time from 32 to 20 days. The AGS promoted by P. chrysosporium pellets had a larger average diameter (2.60-2.74 mm) than that without P. chrysosporium pellets (1.78-1.88 mm) and had better biomass retention capacity and sedimentation properties; its mixed liquor suspended solids (MLSS) and sludge volume index (SVI30) reached approximately 5.2 g/L and 45 mL/g, respectively. The addition of P. chrysosporium pellets promoted the secretion of extracellular polymeric substances (EPS), especially protein (PN). The removal efficiencies of chemical oxygen demand (COD), ammonia nitrogen (NH4+-N), total nitrogen (TN), and total phosphorus (TP) in P. chrysosporium pellets reactor were 98.91%, 89.17%, 64.73%, and 94.42%, respectively, which were higher than those in the reactor without P. chrysosporium pellets (88.73%, 82.09%, 55.75%, and 88.92%). High throughput sequencing analysis indicated that several functional genera that were responsible for the formation of aerobic granules and the removal of pollutants, such as Acinetobacter, Pseudomonas, Janthinobacterium, and Enterobacter, were found to be predominant in the mature sludge granules promoted by P. chrysosporium pellets.
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Phanerochaete , Esgotos , Aerobiose , Reatores Biológicos , Nitrogênio/metabolismo , Phanerochaete/metabolismo , Esgotos/química , Eliminação de Resíduos Líquidos/métodosRESUMO
Libanotis buchtormensis (Fisch.) DC. is one of the traditional Chinese herbal medicines in the Qinling District, while the genetic information is limited. In the study, we reported the complete chloroplast genome of L. buchtormensis using BGISEQ-500 sequencing data. The complete chloroplast genome was 147,036 bp in length with a GC content of 37.6%, consisting of four parts, namely LSC (91,969 bp), SSC (17,469 bp), and two IRs (18,799 bp in each). The cp genome contained 127 genes, including 83 CDS genes, 36 tRNA genes, and 8 rRNA genes. The phylogenetic analysis showed that L. buchtormensis was sister to Ledebouriella seseloides.
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BACKGROUND: Elevated red cell distribution width (RDW) has been reported to be associated with mortality in some critically ill patient populations. The aim of this article is to investigate the relationship between RDW and in-hospital mortality and short- and long-term mortality of patients with cholecystitis. METHOD: We conducted a retrospective cohort study in which data from all 702 patients extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) database were used. Receiver operating characteristic (ROC) curves were constructed to evaluate the prognostic predictive value of RDW for in-hospital mortality and short- (i.e., 30-day and 90-day) and long-term (i.e., 180-day, 1-year, 3-year, and 5-year) mortality. We converted RDW into a categorical variable according to quintiles as less than or equal to 13.9%, 14.0-14.8%, 14.9-15.8%, and 15.9-17.2% and more than 17.2%. The Kaplan-Meier (K-M) methods and log-rank tests were used to compare survival differences among different groups. The relationships between RDW levels and in-hospital mortality were evaluated by univariate and multivariate binary logistic regression models. Multivariable Cox regression models were built to investigate the association of RDW on the short-term and long-term mortality. RESULT: After adjusting for potential confounders, RDW was positively associated with in-hospital mortality (OR: 1.187, 95% CI [1.049, 1.343]) and short- (i.e., 30-day: HR: 1.183, 95% CI [1.080, 1.295], 90-day: HR: 1.175, 95% CI [1.089, 1.268]) and long-term (i.e., 1-year: HR:1.162, 95% CI [1.089, 1.240]) mortality in critically ill patients with cholecystitis. Similar results were also shown in the secondary outcomes of 180-day, 3-year, and 5-year mortality. RDW had a significant accurate prognostic effect on different endpoints and could improve the prognostic effect of scoring systems. CONCLUSION: High level of RDW is associated with an increased risk of in-hospital mortality and short- and long-term mortality in critically ill patients with cholecystitis. RDW can independently predict the prognosis of patients with cholecystitis.
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Colecistite/sangue , Colecistite/mortalidade , Índices de Eritrócitos , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Estado Terminal , Feminino , Mortalidade Hospitalar , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Prognóstico , Modelos de Riscos Proporcionais , Curva ROC , Estudos RetrospectivosRESUMO
Determining the target genes that interact with drugs-drug-target interactions-plays an important role in drug discovery. Identification of drug-target interactions through biological experiments is time consuming, laborious, and costly. Therefore, using computational approaches to predict candidate targets is a good way to reduce the cost of wet-lab experiments. However, the known interactions (positive samples) and the unknown interactions (negative samples) display a serious class imbalance, which has an adverse effect on the accuracy of the prediction results. To mitigate the impact of class imbalance and completely exploit the negative samples, we proposed a new method, named DTIGBDT, based on gradient boosting decision trees, for predicting candidate drug-target interactions. We constructed a drug-target heterogeneous network that contains the drug similarities based on the chemical structures of drugs, the target similarities based on target sequences, and the known drug-target interactions. The topological information of the network was captured by random walks to update the similarities between drugs or targets. The paths between drugs and targets could be divided into multiple categories, and the features of each category of paths were extracted. We constructed a prediction model based on gradient boosting decision trees. The model establishes multiple decision trees with the extracted features and obtains the interaction scores between drugs and targets. DTIGBDT is a method of ensemble learning, and it effectively reduces the impact of class imbalance. The experimental results indicate that DTIGBDT outperforms several state-of-the-art methods for drug-target interaction prediction. In addition, case studies on Quetiapine, Clozapine, Olanzapine, Aripiprazole, and Ziprasidone demonstrate the ability of DTIGBDT to discover potential drug-target interactions.
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Identification of disease-related microRNAs (disease miRNAs) is helpful for understanding and exploring the etiology and pathogenesis of diseases. Most of recent methods predict disease miRNAs by integrating the similarities and associations of miRNAs and diseases. However, these methods fail to learn the deep features of the miRNA similarities, the disease similarities, and the miRNAâ»disease associations. We propose a dual convolutional neural network-based method for predicting candidate disease miRNAs and refer to it as CNNDMP. CNNDMP not only exploits the similarities and associations of miRNAs and diseases, but also captures the topology structures of the miRNA and disease networks. An embedding layer is constructed by combining the biological premises about the miRNAâ»disease associations. A new framework based on the dual convolutional neural network is presented for extracting the deep feature representation of associations. The left part of the framework focuses on integrating the original similarities and associations of miRNAs and diseases. The novel miRNA and disease similarities which contain the topology structures are obtained by random walks on the miRNA and disease networks, and their deep features are learned by the right part of the framework. CNNDMP achieves the superior prediction performance than several state-of-the-art methods during the cross-validation process. Case studies on breast cancer, colorectal cancer and lung cancer further demonstrate CNNDMP's powerful ability of discovering potential disease miRNAs.
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Redes Reguladoras de Genes , Estudos de Associação Genética , Predisposição Genética para Doença , MicroRNAs/genética , Redes Neurais de Computação , Algoritmos , Bases de Dados Genéticas , Suscetibilidade a Doenças , Estudos de Associação Genética/métodos , Humanos , Curva ROC , Reprodutibilidade dos TestesRESUMO
A pair of Fe-C electrodes was installed in a traditional submerged membrane bioreactor (MBR, Rc), and a novel asynchronous periodic reversal bio-electrocoagulation system (Re) was developed. The simultaneous nitrification and denitrification (SND) performance was discussed under limited dissolved oxygen (DO). Results showed that electrocoagulation enhanced total nitrogen (TN) removal from 59.48% to 75.09% at 1.2â¯mg/L DO. Additionally, Fe electrode could increase sludge concentration, particle size, and enzyme activities related to nitrogen removal. The enzyme activities of Hydroxylamine oxidoreductase (HAO), Nitrate Reductase (NAR), nitric oxide reductase NOR and nitrous oxide reductase (N2OR) in Re were 38.35%, 21.59%, 89.96% and 38.64% higher than Rc, respectively. Moreover, electrocoagulation was advantageous for nitrite accumulation, indicating partial nitrification and denitrification were more easily achieved in Re. Besides, results from high throughput sequencing analysis revealed that electrocoagulation increased the relative abundance of most genera related to nitrogen removal, including Nitrosomonas, Comamonadaceae_unclassified, Haliangium and Denitratisoma.
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Reatores Biológicos , Desnitrificação , Eletrocoagulação , Nitrificação , Nitrogênio , Oxigênio , Eliminação de Resíduos LíquidosRESUMO
A method to determine soil exchangeable calcium (Ca), magnesium (Mg), potassium (K), and sodium (Na) by using atomic absorption spectrophotometer (AAS) and extraction with ammonium acetate was developed. Results showed that the accuracy of exchangeable base cation data with AAS method fits well with the national standard referential soil data. The relative errors for parallel samples of exchangeable Ca and Mg with 66 pair samples ranged from 0.02%-3.14% and 0.06%-4.06%, and averaged to be 1.22% and 1.25%, respectively. The relative errors for exchangeable K and Na with AAS and flame photometer (FP) ranged from 0.06%-8.39% and 0.06-1.54, and averaged to be 3.72% and 0.56%, respectively. A case study showed that the determination method for exchangeable base cations by using AAS was proven to be reliable and trustable, which could reflect the real situation of soil cation exchange properties in farmlands.
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Photosynthetic bacterial strain PSB-1D cannot utilize o-chlorophenol (2-CP) as the sole carbon source for energy. In this paper, different carbon sources (malic acid, sodium propionate, sodium acetate, sodium citrate, phenol, glucose, and soluble starch) were taken as the co-metabolism substrates to study their effects on PSB-1D growth and 2-CP degradation under the condition of aerobic culture in darkness. Among the substrates, glucose was most efficient, which promoted the reproduction of PSB-1D, enhanced the 2-CP degradation efficiency, and shortened the degradation period. The optimization experiment of added concentration of glucose showed that when the added glucose concentration was 3 g x L(-1), the PSB-1D cell concentration deltaD560 after 168 h culture was 1.749, the half-time of 2-CP was shortened to 3.9 d, and the degradation rate constant was increased to 0.00864 h(-1). The SDS-PAGE analysis on the total microbial cellular protein showed that taking glucose as the co-metabolism substrate, PSB-1D could induce a specific 2-CP-degrading enzyme.