Hypertension is a rather common comorbidity among critically ill patients and hospital mortality might be higher among critically ill patients with hypertension (SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg). ...This study aimed to explore the association between ACEI/ARB medication during ICU stay and all-cause in-hospital mortality in these patients.
A retrospective cohort study was conducted based on data from Medical Information Mart for Intensive Care IV (MIMIC-IV) database, which consisted of more than 40,000 patients in ICU between 2008 and 2019 at Beth Israel Deaconess Medical Center. Adults diagnosed with hypertension on admission and those had high blood pressure (SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg) during ICU stay were included. The primary outcome was all-cause in-hospital mortality. Patients were divided into ACEI/ARB treated and non-treated group during ICU stay. Propensity score matching (PSM) was used to adjust potential confounders. Nine machine learning models were developed and validated based on 37 clinical and laboratory features of all patients. The model with the best performance was selected based on area under the receiver operating characteristic curve (AUC) followed by 5-fold cross-validation. After hyperparameter optimization using Grid and random hyperparameter search, a final LightGBM model was developed, and Shapley Additive exPlanations (SHAP) values were calculated to evaluate feature importance of each feature. The features closely associated with hospital mortality were presented as significant features.
A total of 15,352 patients were enrolled in this study, among whom 5,193 (33.8%) patients were treated with ACEI/ARB. A significantly lower all-cause in-hospital mortality was observed among patients treated with ACEI/ARB (3.9 vs. 12.7%) as well as a lower 28-day mortality (3.6 vs. 12.2%). The outcome remained consistent after propensity score matching. Among nine machine learning models, the LightGBM model had the highest AUC = 0.9935. The SHAP plot was employed to make the model interpretable based on LightGBM model after hyperparameter optimization, showing that ACEI/ARB use was among the top five significant features, which were associated with hospital mortality.
The use of ACEI/ARB in critically ill patients with hypertension during ICU stay is related to lower all-cause in-hospital mortality, which was independently associated with increased survival in a large and heterogeneous cohort of critically ill hypertensive patients with or without kidney dysfunction.
Realizing ultrafast control of magnetization switching is of crucial importance for information processing and recording technology. Here, we explore the laser-induced spin electron excitation and ...relaxation dynamics processes of CrCl3/CrBr3 heterostructures with antiparallel (AP) and parallel (P) systems. Although an ultrafast demagnetization of CrCl3 and CrBr3 layers occurs in both AP and P systems, the overall magnetic order of the heterostructure remains unchanged due to the laser-induced equivalent interlayer spin electron excitation. More crucially, the interlayer magnetic order switches from antiferromagnetic (AFM) to ferrimagnetic (FiM) in the AP system once the laser pulse disappears. The microscopic mechanism underpinning this magnetization switching is dominated by the asymmetrical interlayer charge transfer combined with a spin-flip, which breaks the interlayer AFM symmetry and ultimately results in an inequivalent shift in the moment between two FM layers. Our study opens up a new idea for ultrafast laser control of magnetization switching in two-dimensional opto-spintronic devices.
Lung adenocarcinoma (LUAD) is a prevalent subtype of lung cancer, yet the contribution of purine metabolism (PM) to its pathogenesis remains poorly elucidated. PM, a critical component of ...intracellular nucleotide synthesis and energy metabolism, is hypothesized to exert a significant influence on LUAD development. Herein, we employed single‐cell analysis to investigate the role of PM within the tumour microenvironment (TME) of LUAD. PM scoring (PMS) across distinct cell types was determined using AUCell, UCell, singscore and AddModuleScore algorithms. Subsequently, we explored communication networks among cells within high‐ and low‐PMS groups, establishing a robust PM‐associated signature (PAS) utilizing a comprehensive dataset comprising LUAD samples from TCGA and five GEO datasets. Our findings revealed that the high‐PMS group exhibited intensified cell interactions, while the PAS, constructed using PM‐related genes, demonstrated precise prognostic predictive capability. Notably, analysis across the TCGA dataset and five GEO datasets indicated that low‐PAS patients exhibited a superior prognosis. Furthermore, the low‐PAS group displayed increased immune cell infiltration and elevated CD8A expression, coupled with reduced PD‐L1 expression. Moreover, data from eight publicly available immunotherapy cohorts suggested enhanced immunotherapy outcomes in the low‐PAS group. These results underscore a close association between PAS and tumour immunity, offering predictive insights into genomic alterations, chemotherapy drug sensitivity and immunotherapy responses in LUAD. The newly established PAS holds promise as a valuable tool for selecting LUAD populations likely to benefit from future clinical stratification efforts.
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•Special synthetic routes for Dual-Porosity Mn2O3 Cubes.•Mn2O3 Cubes contain both macropores and mesopores.•Dual-porosity Mn2O3 Cubes show great adsorption capacity for Congo Red.
...Dual-porosity materials containing both macropores and mesopores are highly desired in many fields. In this work, we prepared dual-porosity Mn2O3 cube materials with large-pore mesopores, in which, macropores are made by using carbon spheres as the hard templates, while the mesopores are produced via a template-free route. The attained dual-porosity Mn2O3 materials have 24nm of large-pore mesopores and 700nm of macropores. Besides, the achieved materials own cubic morphologies with particle sizes as large as 6.0μm, making them separable in the solution by a facile natural sedimentation. Dye adsorption measurements reveal that the dual-porosity materials possess a very high maximum adsorption capacity of 125.6mg/g, much larger than many reported materials. Particularly, the adsorbents can be recycled and the dye removal efficiency can be well maintained at 98% after four cycles. Adsorption isotherm and kinetics show that the Langmuir model and the pseudo-second-order kinetics model can well describe the adsorption process of Congo Red on the dual-porosity Mn2O3 cube materials. In brief, the reported dual-porosity Mn2O3 demonstrates a good example for controlled preparation of dual-porosity materials with large-pore mesopores, and the macropore-mesopore dual-porosity distribution is good for mass transfer in dye adsorption application.
A magnetic field induced hydrothermal method is applied to synthesize precursors, followed by annealing to prepare mesoporous MnO microchains. Different morphologies of the ultimate products can be ...dominated by changing the magnetic field strength to acquire good electrochemical performances. The initial high reversible capacity of MnO microchains is 948 mA h g−1. After 250 cycles, the reversible capacity retains about 769 mA h g−1 at 2 C, even after 2000 cycles, the reversible capacity maintains around 198 mA h g−1 at 8 C. The superb electrochemical properties could originate from the mesoporosity of aggregated nanoparticles of the MnO 1D-microchain structure induced by applied magnetic field of 8 T, which is beneficial for the fast transport of Li+ and electron, and can adapt to the dramatic volume change during the Li+ deintercalation.
•MnO microchains are prepared by magnetic-field-induced hydrothermal method followed by calcinating.•MnO microchains show superb stable cyclability and high rate capability.•This paper offers a facile method to prepare other metal oxide anode materials for LIBs.
The relationship between DNA damage repair (DDR) and cancer is intricately intertwined; however, its specific role in esophageal squamous cell carcinoma (ESCC) remains enigmatic.
Employing ...single-cell analysis, we delineated the functionality of DDR-related genes within the tumor microenvironment (TME). A diverse array of scoring mechanisms, including AUCell, UCell, singscore, ssgsea, and AddModuleScore, were harnessed to scrutinize the activity of DDR-related genes across different cell types. Differential pathway alterations between high-and low-DDR activity cell clusters were compared. Furthermore, leveraging multiple RNA-seq datasets, we constructed a robust DDR-associated signature (DAS), and through integrative multiomics analysis, we explored differences in prognosis, pathways, mutational landscapes, and immunotherapy predictions among distinct DAS groups.
Notably, high-DDR activity cell subpopulations exhibited markedly enhanced cellular communication. The DAS demonstrated uniformity across multiple datasets. The low-DAS group exhibited improved prognoses, accompanied by heightened immune infiltration and elevated immune checkpoint expression. SubMap analysis of multiple immunotherapy datasets suggested that low-DAS group may experience enhanced immunotherapy responses. The "oncopredict" R package analyzed and screened sensitive drugs for different DAS groups.
Through the integration of single-cell and bulk RNA-seq data, we have developed a DAS associated with prognosis and immunotherapy response. This signature holds promise for the future stratification and personalized treatment of ESCC patients in clinical settings.
Background To investigate the prognostic significance of station 4R lymph node (LN) dissection in patients who underwent operations for right primary non-small cell lung cancer (NSCLC). Methods We ...performed a retrospective study involving patients with right primary NSCLC who received lobotomy or pneumonectomy with mediastinal LN dissection between January 2011 and December 2017. Propensity score matching was performed. Disease-free survival (DFS) and overall survival (OS) were compared between patients with and without station 4R dissection. Results Our study included 2070 patients, with 207 patients having no station 4R dissection (S4RD- group) and 1863 patients having station 4R dissection (S4RD+ group). The 4R LN metastasis rate was 13.4% (142/1748), higher than that for other mediastinal LN metastases. Compared with the S4RD- group, the S4RD+ group had higher 5-year DFS (48.1% vs. 39.1%, P = 0.009) and OS (54.4% vs. 42.8%, P = 0.025). Station 4R dissection was an independent risk factor for DFS (odds ratio, OR, 1.28, 95% confidence interval, CI, 1.08-1.64, P = 0.007) and OS (OR 1.31, 95% CI 1.04-1.63, P = 0.018). Patients with adjuvant chemotherapy had a better prognosis after station 4R dissection than those without adjuvant chemotherapy (57.4% vs. 52.3%, P = 0.006). The 5-year OS in the station 4R metastasis group was lower than that in the station 4R non-metastasis group (26.9% vs. 44.3%, P = 0.006) among N2 patients. The 5-year OS of the single-station 4R metastasis group was lower than that of the single-station 7 metastasis group (15.7% vs. 51.6%, P = 0.002). Conclusions Station 4R metastasis was the highest among all the mediastinal station metastases in right primary NSCLC patients. Station 4R dissection can improve the prognosis and should be recommended as a routine procedure for these patients. Keywords: Non-small cell lung cancer, Right primary lung cancer, Station 4R lymph nodes
Omnidirectional wireless power transfer (WPT) can simultaneously power multiple loads. The power or voltage needed by various loads inevitably differ at diverse stages. It is difficult or impossible ...to meet the power requirements of all loads only by the adjustment of transmission power. A reconfigurable receiver that can actively adjust the receiving power is proposed in this paper. The reconfigurable receiving coil is divided into multiple segments. The mutual inductance of coupler is adjusted adaptively by the number of segments selected for power receiving to ensure that the voltage and power are stable within a certain range, or meet the various requirements of different loads and stages. Simulations and experiments were carried out. The adaptive adjustment of reconfigurable receiver on the output voltage and power is verified. It provides a new idea for the output regulation of WPT.
The role of amyloid-β (Aβ) and tau in reversion and conversion in patients with mild cognitive impairment (MCI) remains unclear. This study aimed to investigate the influence of cerebrospinal fluid ...(CSF) Aβ and tau on reversion and conversion and the temporal sequence of their pathogenicity in MCI patients.
179 MCI patients were recruited from the Alzheimer's Disease Neuroimaging Initiative database and classified into two groups based on cognitive changes after follow-up: reversal group (MCI to cognitively normal) and conversion group (MCI to Alzheimer's disease). CSF biomarkers and cognitive function were measured at baseline and 2-year follow-up. Partial correlation was used to analyze the association between CSF biomarkers and cognitive function, and multivariable logistic regression to identify independent risk factors for cognitive changes at baseline and 2-year follow-up. Receiver operating characteristic (ROC) curves were utilized to evaluate the predictive ability of these risk factors for cognitive changes.
The differences in cognitive function and CSF biomarkers between the two groups remained consistent with baseline after 2-year follow-up. After controlling for confounding variables, there was still a correlation between CSF biomarkers and cognitive function at baseline and 2-year follow-up. Multivariable regression analysis found that at baseline, only Aβ level was independently associated with cognitive changes, while Aβ and tau were both predictive factors after 2-year follow-up. ROC curve analysis revealed that the combination of Aβ and tau area under the curve (AUC) 0.91, sensitivity 84%, specificity 86% in predicting cognitive changes after 2-year follow-up had better efficacy than baseline Aβ alone (AUC 0.81).
Aβ may precede Tau in causing cognitive changes, and the interaction between the two mediates cognitive changes in patients. This study provides new clinical evidence to support the view that Aβ pathology precedes tau pathology, which together contribute to the changes in cognitive function.
We used parallel sunshine duration datasets obtained with a Jordan sunshine recorder and three automatic sunshine duration sensors to investigate the differences between these instruments. We used ...measurements obtained at Shangdianzi (SDZ) regional Global Atmosphere Watch (GAW) station with a Jordan sunshine recorder, a DFC2 photoelectric sunshine meter, a CHP1 pyrheliometer, and two CMP11 pyranometers from 1 January to 5 July 2019 and from 3 November 2020 to 28 February 2021. The results showed that the daily sunshine duration measurements obtained from the Jordan sunshine recorder were comparable with those from the DFC2 meter and the CMP11 pyranometers under all-sky conditions, but were considerably different from those observed by the CHP1 pyrheliometer. An analysis of potential influencing factors showed that the solar zenith angle, the spectral range of the automatic sensors, the relative humidity, and the sky conditions were the main factors affecting the measurements of sunshine duration between the Jordan sunshine recorder and three automatic sensors. We proposed a simple linear regression function—the DFC2-equivalent sunshine duration estimation (DFCESD) model—to guarantee the consistency of the long-term sunshine duration series observed by the Jordan sunshine recorder at SDZ and the measurements from the DFC2 meter. Validation of the DFCESD model showed that the mean absolute difference (MAD) between the daily sunshine duration observed by the Jordan sunshine recorder and those from the DFC2 meter improved from −0.7 to −0.2 h day
−1
, the relative deviation (RD) improved from −9.3% to −2.3%, and the root-mean-square deviation (RMSD) decreased from 1.0 to 0.8 h day
−1
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