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Relationship between anion gap and 28-day all-cause mortality in patients with acute pulmonary edema: A retrospective analysis of the MIMIC-IV database

Background Acute pulmonary edema is a severe clinical condition with high mortality. The anion gap, reflecting metabolic acid-base disturbances, is often elevated in critically ill patients. However, its relationship with outcomes in acute pulmonary edema remains unclear. Objective To explore the association between admission anion gap levels and 28-day all-cause mortality in patients with acute pulmonary edema. Methods This retrospective cohort study utilized data from the MIMIC-IV database (2008–2019) and included adult patients with acute pulmonary edema. Patients were categorized into quartiles based on anion gap levels. Cox regression models analyzed the relationship between anion gap and mortality, with restricted cubic spline (RCS) curves, Kaplan-Meier analysis, and subgroup analyses. Results A total of 1094 patients were included. Univariate Cox regression showed a positive correlation between anion gap levels and 28-day mortality (HR = 1.13, 95%CI: 1.09–1.17, P < 0.001). Multivariate analysis confirmed anion gap as an independent predictor (HR = 1.11, 95%CI: 1.07–1.15, P < 0.001). The RCS curve indicated a nonlinear relationship, and Kaplan-Meier analysis showed lower survival in higher anion gap groups (P < 0.001). Subgroup analysis revealed significant interactions between age and renal disease status, indicating that anion gap levels had a stronger association with mortality in younger patients and those without renal disease. Conclusion Admission anion gap levels predict 28-day all-cause mortality in acute pulmonary edema patients, particularly in younger patients and those without renal disease. Clinically, anion gap monitoring should be emphasized, and individualized prognostic and treatment strategies should be developed with factors like age and renal status to improve outcomes.

Recombinant ROP6 protein expressed in Saccharomyces cerevisiae INVSc1 cells induced strong immune response and provided significant protection against toxoplasmosis

Frem2 knockout mice exhibit Fraser syndrome phenotypes and neonatal lethality due to bilateral renal agenesis

The persuasiveness of different sources of information on the decision to vaccinate. A cross-sectional study in Germany during the pandemic at the turn of the year 2021/2022

Health information about vaccinations is communicated via various sources of information and is crucial for vaccination decisions. Information sources such as interpersonal sources, traditional print and digital media as well as social media offer information about the risks and benefits of vaccination. During health crises such as the COVID-19 pandemic was, some information sources provide hanging or contradictory information, alongside with misinformation and disinformation. Little is known about the relationship between the reported persuasiveness of different sources of information for individual vaccination decisions and differences in this between the vaccinated and unvaccinated. Utilizing data from 10,284 participants in the “Corona-Monitoring Nationwide” survey in Germany from winter 2021/22, this study explored the relationship between the persuasiveness of information sources and vaccination decisions, considering socio-demographic and pandemic-related factors. For more than half of respondents, talks with family, friends, and acquaintances were the most convincing. Traditional media like television and radio were reported by 44%. Newspapers/magazines (online or print) and talks with physicians were each found the most convincing by around one third. About one fifth were persuaded by public authority’s flyers or websites. Less than a tenth each was convinced by social media/messenger services, brochures from pharmacies and health insurances, talks with pharmacy staff or online health portals. Significant differences emerged between vaccinated and unvaccinated individuals. Unvaccinated people were four times more likely to report social media and messenger services as convincing compared to vaccinated people. Reporting talks with doctors and flyers/websites from public authorities as very persuasive significantly reduced the likelihood of being unvaccinated. The findings suggest that in future health crises, information should be disseminated through diverse sources, using both traditional and digital media, as well as interpersonal communication. Proactive science communication on social media and messenger services is crucial to counteract misinformation and disinformation.

Artistic and literary evidence of eruptive activity at Mt. Vesuvius during the apparent long quiescence period before the 1631 eruption

Proof-of-concept for an alternative prion detection method utilizing nanoparticle-enhanced, aptamer-template loop-mediated isothermal amplification

The value of combined thromboelastography test for the early prediction of disease severity in patients with haemorrhagic fever of renal syndrome and the construction of a critical model

Background Thromboelostograms (TEG) are indicators that reflect the dynamic changes in blood coagulation objectively. Compared with traditional coagulation tests, TEG are easy to perform; imparting a head start in determining patients’coagulation status. The aim of this study was to explore the role of thromboelastography as an early predictor of disease severity and as a prognostic factor in patients with haemorrhagic fever of renal syndrome (HFRS). Methods This was a retrospective study in which we collected clinical data from 342 patients with HFRS who were hospitalized from January 2017 to January 2021. The predictive value of laboratory parameters for HFRS criticalization was assessed via receiver operating characteristic (ROC) curves. After that, a model of criticalization was developed using stepwise analysis, subsequently, the model was evaluated and validated internally as well as externally. This study was approved by the Ethics Committee of the Hospital. Results The study population was categorized into critical and noncritical groups according to their condition during hospitalization, with a median age of 52.00 (39.00–61.50) years for the critical group and 39.00 (16.00–53.25) years for the noncritical group. Both groups had a large proportion of male patients (65.3% and 72.3%, respectively). The median duration of hospitalization was 15.00 (3.50–25.00) days in the critical group and 13.00 (10.00–17.25) days in noncritical group. In the critical group 40.8% of patients died. The incidence of bleeding was greater in critical patients (51.0%) than in noncritical patients (15.1%). The coagulation indices: CI, K, MA, R and angle were significantly different between the two groups (p < 0.05). Critical patients had higher levels of K and R and lower levels of CI, MA and angle. Multivariate analysis revealed that K, ALB, CK, SCR, angle, WBC and LYM were independently associated with disease severity in patients with HFRS. ROC curve analysis revealed that the criticality model equation had an AUC of 0.9058, a sensitivity of 88.9% and a specificity of 80.2%, which were better than that of any single parameter in predicting the patient’s outcome. The internal validation C index was 0.866, the GOF P value was 0.825, and the external validation AUC was 0.762, with a sensitivity of 71.4% and a specificity of 74.2%. The results of the calibration plots indicated that there was some agreement between the model-estimated HFRS critical illness rates and the final observed critical illness rates in the study population. Decision curve analysis indicated that the model had significant clinical utility and comparable net benefit over a range of threshold probabilities. Conclusion Critical HFRS have significantly abnormal coagulation function and high incidence of bleeding associated with poor outcome. A criticalization prediction model constructed on the basis of thromboelastography indices in early stages of the disease has a good predictive ability and may be helpful in the early identification of critically ill patients for timely clinical intervention and treatment.

In silico approaches unveil the mechanism of action of Eclipta prostrata against acute myeloid leukemia

Bifurcation and synchronization analysis in a stall-flutter aeroelastic system under varying preset angles and frequency ratios

Clinical, laboratory and genetic factors associated with smoking in a Brazilian Sickle Cell Disease (SCD) cohort

Background Smoking is associated with increased morbidity among individuals with sickle cell disease (SCD). While genetic factors influencing smoking behavior have been identified in other populations, they have not been studied in individuals with SCD. This study aimed to assess the impact of smoking on clinical and laboratory parameters in a large SCD cohort and to identify genetic variants potentially associated with smoking behavior in this population. Methods The Recipient Epidemiology and Donor Evaluation Study-III (REDS-III) Brazil SCD cohort was established across six Brazilian cities to investigate clinical outcomes in individuals with SCD. Adult participants were interviewed and asked whether they had ever smoked more than 100 cigarettes in their lifetime. Those who responded “yes” were classified as ever smokers, while those who responded “no” were classified as never smokers. Clinical and laboratory data were compared between the two groups. All participants were genotyped using a customized array, and a genome-wide association study (GWAS) was conducted to identify single nucleotide variants (SNVs) associated with smoking status. Results Of the 1,231 adults with available smoking data, 332 (27%) were classified as ‘ever smokers’ and 899 (73%) as ‘never smokers’. ‘Ever smoker’ status was associated with male sex, age ≥ 40 years, lower educational attainment, and hemoglobin levels above the 75th percentile. In the GWAS, no SNVs reached genome-wide significance (p < 5 × 10 ⁻ ⁸). However, several SNVs demonstrated nominal significance (p < 1 × 10 ⁻ ⁷), including rs11087854 and a variant at position 1059991 on chromosome 20 within the gene AL110114.1, as well as rs701023 in the NCOR2 gene, suggesting a potential association with smoking behavior. Conclusion Biological sex, age, and educational level are associated with smoking status among adults with SCD, and tobacco use appears to correlate with elevated hemoglobin levels in this population. Although no genome-wide significant associations were identified, our findings highlight potential genetic loci—particularly within AL110114.1 and NCOR2—that warrant further investigation in relation to smoking behavior in individuals with SCD.

Natural frequency and modal analysis of tractor vibration system

Computer-aided design of piezoelectric systems operating as machine assemblies or subassemblies

Factors associated with cerebral palsy among children in Hawassa University comprehensive specialized hospital: Case-control study

Background Cerebral palsy is a frequent physical disability of childhood, causing motor impairment, sensory impairment, cognitive and behavioral issues, and secondary musculoskeletal deformities, with a global incidence of 1–4 per 1,000 children. It significantly impacts children’s quality of life and imposes an economic burden on families and healthcare systems. There is limited evidence of the risk factors of cerebral palsy in Ethiopia, including in the study setting. We investigated factors associated with cerebral palsy among children attending Hawassa University Comprehensive Specialized Hospital. Methods An institution-based, unmatched case-control study was conducted among children who visited Hawassa University Comprehensive Specialized Hospital from January 2019 to December 2023. Consecutive cases were recruited until the required sample size was reached, and controls were randomly selected. Data were extracted from 80 cases and 160 control charts. Binary logistic regression analysis was used to identify risk factors for cerebral palsy. An adjusted odds ratio with a 95% confidence interval was reported to show the strength of the association. The significance of the association was declared at a p-value < 0.05. The goodness-of-fit model was checked by the Hosmer and Lemeshow test. Results A total of 240 participants (80 cases and 160 controls) were enrolled in the study. Maternal infection during pregnancy [AOR:4.1; 95%; 1.39, 12.1], low birth weight [AOR:4.1; 95%; 1.49, 11.2], prolonged labor [AOR:3.2; 95%;1.47, 7.00], history of perinatal asphyxia [AOR: 2.65; 95%;1.06, 6.65], and central nervous system infection during infancy [AOR:3.4; 95%; 1.21, 9.64] were risk factors for cerebral palsy. Conclusion Perinatal asphyxia, maternal infection, low birth weight, prolonged labor, and CNS infection during infancy are significantly associated with cerebral palsy. Public health education should promote awareness about cerebral palsy, encourage antenatal care, and educate healthcare professionals on emergency obstetrics and newborn care. Appropriate measures should be taken to reduce the incidence of CNS infections during infancy.

Microglia reactivity is brain region and sex specific in the context of chronic stress

Robust inference and errors in studies of wildlife control

Abstract Randomized, controlled trials (RCT) are seen as the strongest basis for causal inference, but their strengths of inference and error rates relative to other study designs have never been quantified for interventions designed to prevent wildlife damage to property and game. We simulate common study designs from simple correlation to RCT with crossover design. We report rates of false positive, false negative, and over-estimation of treatment effects for five common study designs under various confounding interactions and effect sizes. We find non-randomized study designs mostly unreliable and that randomized designs with suitable safeguards against biases have much lower error rates. One implication is that virtually all studies of lethal interventions against predatory wildlife appear unreliable. Generally, applied fields can benefit from more robust designs against the common confounding effects we simulated.

Evaluation of urban green space plant landscape quality in Zhengzhou city using the AHP-SBE method

Urban green space plays a key role in urban ecosystems, and the quality of the landscape directly affects its ecological, aesthetic, and social functions. On the basis of field survey data from 349 sample sites in Zhengzhou City, this study constructed a comprehensive evaluation index system for plantscape and systematically evaluated 40 representative plantscape units using the hierarchical analysis method (AHP) and the scenic beauty estimation method (SBE). The results indicated that: (1) In the analysis of plant diversity, the diversity indices for trees, shrubs, and herbs in park green spaces were higher than those observed in other types of green spaces, with overall species richness reaching its highest level. (2) The results of the AHP comprehensive evaluation revealed that 10% of the samples were classified as high-quality (CEI ≥ 8 points), 57.5% as medium-to-high quality (6 ≤ CEI < 8 points), and 32.5% as medium or below (CEI < 6 points). The mean comprehensive scores across different green space types were ranked as follows: park green space> ancillary green space> protective green space> regional green space> plaza land. (3) The SBE evaluation results showed that only 40% of the samples achieved standardized scores above zero, while 60% scored below zero, indicating that the overall aesthetic quality of the planted landscapes was low and required optimization and improvement. (4) Spearman’s correlation analysis revealed that the AHP and SBE methods were highly consistent in terms of the ranking of the plant landscape units, and there was a significant positive correlation. This study combines quantitative evaluation and perceptual analysis methods to systematically reveal the characteristics and differences of plant escape among different types of green space in Zhengzhou City, which provides a theoretical basis and practical reference for the optimal design of plant escape in urban green spaces and the high-quality development of these spaces.

Correction: The effect of compositional fluctuations in a liquid Fe–O alloy on the nucleation of Earth’s inner core

A simple and low-cost strategy to develop antibacterial composite film of nanocellulose and stilbite zeolite particles

The fate of pollutants in the co-composting of natural mineral biochar and animal manures in an intermittent aeration and mixing bioreactor (IAMB)

Kink strengthening and rank-1 connection of crustal rocks

Abstract Kink bands are localized folds or bends formed in layered materials, such as millefeuille. They are common in rocks within the earth’s crust that have undergone compression deformation. While the formation of kinks has been studied extensively, their effects on material strength remain unclear in geologic materials. This study investigates the relationship between kink formation and compressive strength through experiments on crustal-material biotite. In our results, kink bands are observed pervasively in samples and show hardening behavior. The observed kinks have symmetric tilt boundaries, satisfying the rank-1 connection condition, a key condition for material strengthening. Therefore, the hardening behavior observed in this study is due to “kink strengthening”. Furthermore, we reviewed whether kink bands of various scales in geologic materials satisfy the rank-1 connection and discussed its effect on the strength. Notably, it is indicated that the formation of mega kinks (km-scale kinks) strengthens the crust and influences earthquake rupture.