Development and validation of a model for predicting the early occurrence of RF in ICU-admitted AECOPD patients: a retrospective analysis based on the MIMIC-IV database.

BACKGROUND: This study aims to construct a model predicting the probability of RF in AECOPD patients upon hospital admission. METHODS: This study retrospectively extracted data from MIMIC-IV database, ultimately including 3776 AECOPD patients. The patients were randomly divided into a training set (n = 2643) and a validation set (n = 1133) in a 7:3 ratio. First, LASSO regression analysis was used to optimize variable selection by running a tenfold k-cyclic coordinate descent. Subsequently, a multifactorial Cox regression analysis was employed to establish a predictive model. Thirdly, the model was validated using ROC curves, Harrell's C-index, calibration plots, DCA, and K-M curve. RESULT: Eight predictive indicators were selected, including blood urea nitrogen, prothrombin time, white blood cell count, heart rate, the presence of comorbid interstitial lung disease, heart failure, and the use of antibiotics and bronchodilators. The model constructed with these 8 predictors demonstrated good predictive capabilities, with ROC curve areas under the curve (AUC) of 0.858 (0.836-0.881), 0.773 (0.746-0.799), 0.736 (0.701-0.771) within 3, 7, and 14 days in the training set, respectively and the C-index was 0.743 (0.723-0.763). Additionally, calibration plots indicated strong consistency between predicted and observed values. DCA analysis demonstrated favorable clinical utility. The K-M curve indicated the model's good reliability, revealed a significantly higher RF occurrence probability in the high-risk group than that in the low-risk group (P < 0.0001). CONCLUSION: The nomogram can provide valuable guidance for clinical practitioners to early predict the probability of RF occurrence in AECOPD patients, take relevant measures, prevent RF, and improve patient outcomes.

Efficient Planar Perovskite Solar Cells with Improved Fill Factor via Interface Engineering with Graphene.

Organic-inorganic hybrid lead halide perovskites have been widely investigated in optoelectronics both experimentally and theoretically. The present work incorporates chemically modified graphene into nanocrystal SnO2 as the electron transporting layer (ETL) for highly efficient planar perovskite solar cells. The modification of SnO2 with highly conductive two-dimensional naphthalene diimide-graphene can increase surface hydrophobicity and form van der Waals interaction between the surfactant and the organic-inorganic hybrid lead halide perovskite compounds. As a result, highly efficient perovskite solar cells with power conversion efficiency of 20.2% can be achieved with an improved fill factor of 82%, which could be mainly attributed to the augmented charge extraction and transport.

Efficacy and safety of casirivimab and imdevimab for preventing and treating COVID-19: a systematic review and meta-analysis.

Background: The ongoing global epidemic of coronavirus disease 2019 (COVID-19) has created a serious public health problem. The selection of safe and effective therapeutic agents is of paramount importance. This systematic review aims to evaluate the efficacy and safety of the combination of casirivimab and imdevimab in the treatment of global cases of COVID-19. Methods: To identify randomized controlled trials (RCTs) investigating the combined administration of casirivimab and imdevimab for COVID-19 management, a comprehensive search was conducted across multiple databases including PubMed, Web of Science, Embase, and the Cochrane Library from their inception to September 10, 2022. Data on the efficacy and safety of casirivimab and imdevimab were extracted. Subgroup analyses and sensitivity analyses were performed. Results: A total of 851 articles were searched. Twelve studies were finally included in the meta-analysis, with 27,179 participants. Dichotomous and continuous variables were presented as odds ratios (ORs) and weighted mean differences (WMDs) with their 95% confidence intervals (CIs), respectively. Compared to placebo or alternative medications, the combination of casirivimab and imdevimab reduced viral load (WMD: -0.73, 95% CI: -1.09 to -0.38, P<0.01), all-cause mortality (OR =0.90, 95% CI: 0.82-0.99, P=0.03), the incidence of any serious adverse events (OR =0.80, 95% CI: 0.67-0.95, P=0.01), the incidence of Grade 3 or more severe adverse events (OR =0.76, 95% CI: 0.62-0.92, P=0.01), the likelihood of contracting COVID-19, the incidence of hospitalization, emergency room visits, and mortality (OR =0.54, 95% CI: 0.32-0.93, P=0.03). Conclusions: The monoclonal antibody combination of casirivimab and imdevimab is effective in treating patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), as they can reduce viral load, all-cause mortality, infection rates, and the incidence of clinical outcomes of special interest after treatment, while maintaining a favorable safety profile.

Relationship Between Systemic Immune-Inflammation Index and Risk of Respiratory Failure and Death in COPD: A Retrospective Cohort Study Based on the MIMIC-IV Database.

Purpose: Chronic obstructive pulmonary disease (COPD) concurrent with respiratory failure (RF) is devastating, and may result in death and disability. Systemic immune-inflammation index (SII) is a new prognostic biomarker linked to unfavorable outcomes of acute coronary syndrome, ischemic stroke, and heart failure. Nonetheless, its role in COPD is rarely investigated. Consequently, this study intends to assess the accuracy of SII in predicting the prognosis of COPD. Patients and Methods: The clinical information was retrospectively acquired from the Medical Information Mart for Intensive Care-IV database. The outcomes encompassed the incidence of RF and mortality. The relationship between different SII and outcomes was examined utilizing the Cox proportional-hazards model and restricted cubic splines. Kaplan-Meier analysis was employed for all-cause mortality. Results: The present study incorporated 1653 patients. During hospitalization, 697 patients (42.2%) developed RF, and 169 patients (10.2%) died. And 637 patients (38.5%) died during long-term follow-up. Higher SII increased the risk of RF (RF: HR: 1.19, 95% CI 1.12-1.28, P<0.001), in-hospital mortality (HR: 1.22, 95% CI 1.07-1.39, P=0.003), and long-term follow-up mortality (HR: 1.12, 95% CI 1.05-1.19, P<0.001). Kaplan-Meier analysis suggested a significantly elevated risk of all-cause death (log-rank P<0.001) in patients with higher SII, especially during the short-term follow-up period of 21 days. Conclusion: SII is closely linked to an elevated risk of RF and death in COPD patients. It appears to be a potential predictor of the prognosis of COPD patients, which is helpful for the risk stratification of this population. However, more prospective studies are warranted to consolidate our conclusion.

Life cycle assessment for evaluation of novel solvents and technologies: A case study of flavonoids extraction from Ginkgo biloba leaves.

Innovative solvents such as deep eutectic solvents (DESs) and process intensification technologies assisted by ultrasound have been demonstrated to be promising pathways for enhancing solid-liquid extraction. Nevertheless, quantitative and systematic knowledge of their environmental impact is still limited. In this work, a case study of flavonoids extraction from Ginkgo biloba leaves was evaluated by using life cycle assessment (LCA) for comparison of three extraction scenarios. The first used DES as extractant (DESE), and the other two adopted ethanol, including heat reflux extraction (HRE), and ultrasound-assisted extraction (UAE). Among eight key midpoints investigated, all these from UAE were 10.0 %-80.0 % lower than from DESE and HRE except water consumption. The UAE was the eco-friendliest option due to its higher extraction yield, shorter duration and lower solvent consumption. The DESE exhibited the lowest water consumption, the highest freshwater ecotoxicity and human carcinogenic toxicity, while HRE had the highest impacts for the other 6 midpoints. Moreover, solvent production was the key contributor for all the categories. The standardized sensitivity analysis showed that the overall environmental footprint can be further decreased by 15.4 % for DESE pathways via substituting choline chloride/glycerine with choline chloride/ethylene glycol. Furthermore, all pathways using DESs had higher standardized impacts than those employing ethanol from sugarcane or wood. Replacing ethanol from maize with other feedstocks can significantly lessen the overall impacts, among which the UAE using ethanol from sugarcane demonstrated the least environmental impacts. The promotion of DESs as "green and sustainable" alternative to traditional solvents requires careful consideration.

Case report: Bronchoscopic intervention for rare benign airway tumors: a report of 4 cases and literature review.

Due to their unique location, airway tumors have a significant impact on patient quality of life and survival. Current research has focused extensively on malignant airway tumors; however, benign airway tumors, especially rare ones, are less understood due to their low incidence. These tumors are often misdiagnosed and mistreated due to diagnostic challenges. Therefore, there is still a lack of consensus on the treatment of some rare benign airway tumors. Our center summarizes the diagnosis and treatment of four rare cases of benign airway stenosis in recent years, highlighting the bronchoscopic manifestations and therapeutic approaches to improve the understanding of these diseases.

The efficacy of telemedicine for pain management in patients with cancer: a systematic review and meta-analysis.

Background: Pain is the most common cancer-related symptom, but it is often undertreated. Telemedicine is widely used in cancer treatment, but its effectiveness is uncertain. Objective: We aimed to evaluate the impact of telemedicine intervention on pain in patients with cancer. Design: Methodological quality and risk-of-bias evaluation were conducted, and the sources of heterogeneity were explored through subgroup analysis and sensitivity analysis. Data Sources and Methods: PubMed, Embase, Web of Science, Cochrane Library, and clinical trial databases were searched up to 16 August 2022. Randomized controlled trials of the impact of telemedicine intervention regarding pain in patients with cancer were included, and the results related to pain were extracted. Results: Twenty-one randomized controlled trials were selected from 1810 articles. A total of 1454 patients received telemedicine interventions, and 2213 received conventional medical services. Telemedical intervention had a positive effect on improving pain intensity [standard mean deviation (SMD) = -0.28, 95% confidence interval (CI): -0.49 to -0.06, p = 0.01] and pain interference (SMD = -0.41, 95% CI: -0.54 to -0.28, p < 0.00001), with statistical difference between the two groups. The subgroup analysis results showed that the telemedicine subgroup based on an application (SMD = -0.54, 95% CI: -0.91 to -0.18, p = 0.004) and the subgroup with intervention time ⩾ 6 months (SMD = -0.33, 95% CI: -0.52 to -0.13, p = 0.001), both demonstrated significant improvement regarding pain intensity, with significant statistical difference between the two groups. When the follow-up time was ⩾ 6 months, there was no significant difference (SMD = -0.24, 95% CI: -0.55 to 0.07, p = 0.13). Conclusion: Compared with conventional medical services, telemedicine intervention can improve the pain of patients with cancer and is effective and acceptable regarding symptom monitoring. Integrating telemedicine interventions into cancer pain management may be a feasible option. But its long-term effects still need to be confirmed with more high-quality randomized controlled trials in the future. Registration: https://www.crd.york.ac.uk/PROSPERO/; CRD42022361990.

Comparison of alkaline- and fungi-assisted wet-storage of corn stover.

Storage of lignocellulosic biomass is critical for a year-round supply of feedstock for a biorefinery. Compared with dry storage, wet storage is a promising alternative technology, providing several advantages including reduced dry matter loss and fire risk and improved feedstock digestibility after storage. This study investigated the concurrent pretreatment and wet-storage of corn stover with the assistance of NaOH or a lignin-degrading fungus, Ceriporiopsis subvermispora, during a 90-d period. Compared with ensilage, adding NaOH or inoculation with C. subvermispora significantly enhanced the enzymatic degradability of corn stover by 2-3-fold after 90-d wet storage. Lignin and xylan removal during NaOH pretreatment and wet-storage were influenced by NaOH loading and moisture. NaOH pretreatment retarded the production of organic acids during storage and the acetate release correlated with lignin and xylan removal. Further study is needed to reduce cellulose degradation during the late stage of fungal treatment.

Solid-state anaerobic digestion of spent wheat straw from horse stall.

The spent wheat straw from horse stall bedding has lower cellulose and hemicellulose contents, but higher volatile fatty acid content than raw wheat straw. Biogas production from solid-state anaerobic digestion (SS-AD) of spent wheat straw and raw wheat straw was compared in this study. The SS-AD tests were conducted at 22% total solids (TS) content using inoculum from a liquid AD system at three feedstock-to-inoculum (F/I) ratios of 2.0, 4.0, and 6.0. Daily methane yields of spent wheat straw peaked 8 and 3 days earlier than those of raw wheat straw at F/I ratios of 2.0 and 4.0, respectively. The highest methane yield of 150.0 L/kg volatile solids (VS) was obtained from spent wheat straw at an F/I ratio of 4.0, which was 56.2% higher than that of raw wheat straw. The corresponding cellulose and hemicellulose degradation of spent wheat straw was 24.1% and 49.4% higher than those of raw wheat straw, respectively.