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Background: Acute respiratory failure is a type of sepsis complicated by severe organ failure. We have developed a new nomogram for predicting the 30-day risk of death in patients through a retrospective study., Method: Data was collected and extracted from MIMICIV, with 768 eligible cases randomly assigned to the primary cohort (540) and the validation cohort (228). The final six factors were included by Cox regression analysis to create the Nomogram, the accuracy of the Nomogram was assessed using the C-index and calibration curve, and finally, the clinical usefulness of the Nomogram was evaluated using DCA in., Results: Multivariate Cox regression analysis showed that age, DBP, lactate, PaO2, platelet, mechanical ventilation were independent factors for 30-day mortality of SA-ARF. The nomogram established based on the six factors. The C-index of nomogram in the primary cohort is 0.731 (95% CI 0.657-0.724) and 0.722 (95%CI 0.622-0.759) in the validation cohort. Besides, the decision curve analysis (DCA) confirmed the clinical usefulness of the nomogram., Conclusion: The study developed and validated a risk prediction model for SA-ARF patients that can help clinicians reasonably determine disease risk and further confirm its clinical utility using internal validation., (© 2023. The Author(s).)

Beams with optical vortices are widely used in various fields, including optical communication, optical manipulation and trapping, and, especially in recent years, in the processing of nanoscale structures. However, circular vortex beams are difficult to use for the processing of chiral micro and nanostructures. This paper introduces a multiramp helical-conical beam that can produce a three-dimensional spiral light field in a tightly focused system. Using this spiral light beam and the two-photon direct writing technique, micro-nano structures with chiral characteristics in space can be directly written under a single exposure. The fabrication efficiency is more than 20 times higher than the conventional point-by-point writing strategy. The tightly focused properties of the light field were utilized to analyze the field-dependent properties of the micro-nano structure, such as the number of multiramp mixed screw-edge dislocations. Our results enrich the means of two-photon polymerization technology and provide a simple and stable way for the micromachining of chiral microstructures, which may have a wide range of applications in optical tweezers, optical communications, and metasurfaces.

As a common cardiovascular disease, acute myocardial infarction seriously affects the health and life of patients. miRNAs play an important role in acute myocardial infarction. Based on miRNA obtained from the previous sequencing, this study investigated whether miRNA (miR)-124-3p-loaded nanoparticles (NPs) affect the phenotype of the acute myocardial infarction (AMI) rat. Nano-miR-124-3p decreased the myocardial infarction area, improved the myocardial tissue structure, and increased the degree of fibrosis. Nano-miR-124-3p decreased apoptosis and the expression of cleaved caspase 3, indicating its role in protecting and repairing the myocardium. To further verify the action mechanism of miRNA, a potential target gene of miR-124-3p, PTEN was identified by STARBASE and further confirmed using double luciferase assays. Following cotransfection of nano-miR-124-3p and PTEN, the areas of tissue structure damage, myocardial infarction, and fibrosis were substantially elevated. The expression of cleaved caspase 3 and the apoptosis rate in the nano-miR-124-3p and PTEN cotransfection group was also significantly increased. Bioinformatics analysis revealed that miRNA-124-3 may regulate oxidative stress injury by targeting PTEN. Taken together, miR-124-3p could protect and repair myocardial tissues through targeting PTEN., Competing Interests: The authors declare no competing interest., (Copyright © 2022 Yuan Cheng et al.)

Objective: In an era of increasingly expensive intensive care costs, it is essential to evaluate early whether the length of stay (LOS) in the intensive care unit (ICU) of obesity patients with sepsis will be prolonged. On the one hand, it can reduce costs; on the other hand, it can reduce nosocomial infection. Therefore, this study aimed to verify whether ICU prolonged LOS was significantly associated with poor prognosis poor in obesity patients with sepsis and develop a simple prediction model to personalize the risk of ICU prolonged LOS for obesity patients with sepsis., Method: In total, 14,483 patients from the eICU Collaborative Research Database were randomized to the training set (3,606 patients) and validation set (1,600 patients). The potential predictors of ICU prolonged LOS among various factors were identified using logistic regression analysis. For internal and external validation, a nomogram was developed and performed., Results: ICU prolonged LOS was defined as the third quartile of ICU LOS or more for all sepsis patients and demonstrated to be significantly associated with the mortality in ICU by logistic regression analysis. When entering the ICU, seven independent risk factors were identified: maximum white blood cell, minimum white blood cell, use of ventilation, Glasgow Coma Scale, minimum albumin, maximum respiratory rate, and minimum red blood cell distribution width. In the internal validation set, the area under the curve was 0.73, while in the external validation set, it was 0.78. The calibration curves showed that this model predicted probability due to actually observed probability. Furthermore, the decision curve analysis and clinical impact curve showed that the nomogram had a high clinical net benefit., Conclusion: In obesity patients with sepsis, we created a novel nomogram to predict the risk of ICU prolonged LOS. This prediction model is accurate and reliable, and it can assist patients and clinicians in determining prognosis and making clinical decisions., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Chen, Luo, Cheng, Huang and He.)

This research sought to ascertain the relationship between hematocrit (HCT) and mortality in patients with sepsis., Methods: A retrospective analysis was conducted on the clinical data of septic patients who were hospitalized between 2008 and 2019 in an advanced academic medical center in Boston, Massachusetts, registered in the Medical Information Mart for Intensive Care IV (MIMIC-IV) database, We analyzed basic information including gender, age, race, and types of the first admission, laboratory indicators including HCT, platelets, white blood cells, albumin, bilirubin, hemoglobin, and serum creatinine, and 30-day mortality. A Cox proportional hazards regression model was utilized to analyze the relationship between HCT and 30-day mortality in patients with sepsis., Results: This research recruited 2057 patients who met the research requirements from 2008 to 2019. According to the HCT level, it was classified into the low HCT level, the regular HCT level, and the high HCT level. The 30-day mortality rate was 62.6%, 27.5%, and 9.9% for patients with the low HCT level, the regular HCT level, and the high HCT level, respectively (p < 0.05). The multivariate Cox proportional hazard regression model analysis displayed that compared with patients with the regular HCT level, the 30-day mortality of patients with the low HCT level increased by 58.9% (hazard ratio = 1.589, 95% confidence interval (CI) = 1.009-2.979, p < 0.05)., Conclusion: The low HCT level is an independent risk factor for the increase of the 30-day mortality in patients with sepsis and can be used as a significant predictor of the clinical outcome of sepsis., Competing Interests: No

Objectives: This research aims to explore the impact of serum phosphate on the mortality of critically ill patients., Design: A retrospective large cohort study., Setting: Our data were extracted from a publicly accessible database named 'Multiparameter Intelligent Monitoring in Intensive Care Database III'., Participants: 27 131 patients were included by clear definitions of selection and exclusion criteria., Interventions: We used initial phosphate at admission as a design variable. Patients were divided into six groups with different serum phosphate levels and five groups at different intensive care unit (ICU) departments., Primary and Secondary Outcomes: 28-day and 90-day mortality were primary outcomes. All-cause mortality and length of stay ICU were secondary outcomes., Results: Patients with very-high-normal serum phosphate, hypophosphataemia and hyperphosphataemia had worse outcomes. And the relationship between serum phosphate and the probability of 28-day or 90-day mortality had a linear relationship. After adjustment for potential confounders, hypophosphataemia and hyperphosphataemia were not significantly associated with 28-day or 90-day mortality. Nevertheless, at the medical ICU, hyperphosphataemia was associated with increased 28-day or 90-day mortality (HR=0.64, 95% CI 0.48 to 0.84, p=0.0017; HR=0.72, 95% CI 0.57 to 0.91, p=0.0067, respectively), using group 2 (≥2.5 mg/dL and <3.0 mg/dL) as the reference group., Conclusions: Patients with very-high-normal serum phosphate also had worse outcomes, it might be necessary to re-evaluate the definitions of the normal reference range for serum phosphate. Hypophosphataemia and hyperphosphataemia are not the independent risk factors of 28-day or 90-day ICU mortality, which leads us to consider whether phosphate monitoring is not a necessary measure in critically ill patients. But hyperphosphataemia was associated with increased 28-day or 90-day mortality at the medical ICU, which emphasises the potential importance of early diagnosis and treatment of hyperphosphataemia for the patients who were admitted to the medical ICU., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

The angular momentum (AM) of light has important implications for many fields of optics research, such as optics communication, quantum information and laser-scan microscopy. Thus, in this paper, we intend to investigate the average AM of the vortex ultrashort pulsed beam (VUPB), which is generated and widely applied in the field of high-intensity and ultrafast regimes. According to the vector potential, we firstly derive the electromagnetic field of the VUPB, then analyze the spatial intensity, the phase profile and the polarization state of the beam. We explore that the total AM per photon of VUPB is not n ℏ value when the beam waist w 0 is of wavelength or sub-wavelength order, since the polarization of VUPB is changed from linear to circular polarization with the decrease of beam waist, which introduces the conversion of the orbital AM to the spin AM. Moreover, based on the conservation of the total AM, the minimum waist of VUPB can be obtained, which is dependent on the pulse duration time α and topological charge n. Finally, the average AM of the fractional VUPB expressed by the superposition of the integer VUPB with different weights, is analyzed, which is not equal to the AM of fractional CW beam μ - sin (2μπ)/2π (μ is the fractional topological charge), but is associated with the beam waist w 0 and α. Therefore, we think that the AM of VUPB can be controlled by adjusting the α and w 0 .

In most papers about the fractional vortex continuous beams (FVCBs), the relationship between the total vortex strength S α and the propagation distance is not analyzed since the vortex structure is not stable in the near field. In this paper, we theoretically study the fractional vortex ultrashort pulsed beams (FVUPBs) possessing non-integer topological charges α at arbitrary plane and find that the vortex structure is propagation-distance-dependent. Both the intensity and phase distributions are calculated to analyze the vortex structure. To evaluate the propagation properties of FVUPBs, we focus on the total vortex strength (TVS) of FVUPBs to investigate the number of vortex, and demonstrate that the birth of a vortex is at α = m + ɛ, where m is an integer, ɛ is a changing fraction depending on the pulse durations, peak wavelengths and propagation distances. Furthermore, we discover that the FVUPBs carry decreasing TVS along the propagation axis in free space. This special vortex structure for FVUPBs appears due to the mixture weight of vortex pulsed beam with different integer topological charges (TCs) n. However, the total orbital angular momentum is invariant during propagation. The above phenomenon presented in our paper are totally particular and intriguing compared with the FVCBs.