Predictive value of hematocrit, serum albumin level difference, and fibrinogen-to-albumin ratio for COVID-19-associated acute respiratory failure.

Background: Acute respiratory failure is the main clinical manifestation and a major cause of death in patients with COVID-19. However, few reports on its prevention and control have been published because of the need for laboratory predictive indicators. This study aimed to evaluate the predictive value of hematocrit level, serum albumin level difference, and fibrinogen-to-albumin ratio for COVID-19-associated acute respiratory failure. Material and methods: A total of 120 patients with COVID-19 from the First Affiliated Hospital of Anhui Medical University were selected between December 2022 and March 2023. Patients were divided into acute respiratory failure and non-acute respiratory failure groups and compared patient-related indicators between them using univariate and multivariate logistic regression analyses. Receiver operating characteristic analysis was performed to determine the discrimination accuracy. Results: In total, 48 and 72 patients were enrolled in the acute respiratory failure and non-acute respiratory failure groups, respectively. The Quick COVID-19 Severity Index scores, fibrinogen-to-albumin ratio, hematocrit and serum albumin level difference, fibrinogen, and hematocrit levels were significantly higher in the acute respiratory failure group than in the non-acute respiratory failure group. A Quick COVID-19 Severity Index >7, fibrinogen-to-albumin ratio >0.265, and hematocrit and serum albumin level difference >12.792 had a 96.14 % positive predictive rate and a 94.06 % negative predictive rate. Conclusion: Both fibrinogen-to-albumin ratio and hematocrit and serum albumin level difference are risk factors for COVID-19-associated acute respiratory failure. The Quick COVID-19 Severity Index score combined with fibrinogen-to-albumin ratio, and hematocrit and serum albumin level difference predict high and low risks with better efficacy and sensitivity than those of the Quick COVID-19 Severity Index score alone; therefore, these parameters can be used collectively as a risk stratification method for assessing patients with COVID-19.

Incentive-compatible mechanism for manufacturing carbon emission supervision under carbon control policies in China.

Enhance performance in manufacturing carbon emission (MCE) reduction has become a widespread consensus and a necessary part, which cannot be achieved without the joint participation of manufacturing enterprises and supervisory departments. Accordingly, how to coordinate the interests of both sides and design a reasonable incentive-compatible mechanism becomes an urgent task at present. Considering the two subsidy funding channels of peer funds and government finance, this study applies the evolutionary game model to analyze feasible schemes for designing incentive-compatible mechanism of MCE supervision, discusses and simulates the realistic scenarios and influencing factors of incentive-compatible mechanism under the non-subsidized and subsidized schemes. The results show that MCE supervision is in an incentive-incompatible state under the non-subsidized incentive scheme, while in a constrained incentive-compatible state under the subsidized incentive scheme. With the increase of peer funds and penalty coefficient or the decrease of subsidy coefficient, the period of MCE supervision to reach an incentive-compatible state becomes shorter. However, a lower peer fund and penalty coefficient or a higher subsidy coefficient will contribute to a state of incentive-incompatible or a periodic cycle state of "incentive-compatible → incentive-incompatible →incentive-compatible→…" in the MCE supervision.

Predictive Value of Procalcitonin and Neutrophil-to-Lymphocyte Ratio Variations for Bloodstream Infection with Septic Shock.

BACKGROUND Little is known of neutrophil-to-lymphocyte ratio (NLR) variations in septic shock. Hence, the predictive value of procalcitonin (PCT) and NLR variations for septic shock in bloodstream infection were explored. MATERIAL AND METHODS We analyzed 146 patients with bloodstream infection admitted to the Intensive Care Unit (ICU) of the First Affiliated Hospital of Anhui Medical University from October 2016 to May 2020. PCT and NLR were evaluated at 0 and 48 h after admission, and their variations (ΔPCT and DNLR) were calculated. The patients were divided into a shock group (n=80) and a non-shock group (n=66) and a gram-positive cocci group (n=69) and a gram-negative bacilli group (n=77). The predictive value of ΔPCT and DNLR was compared among groups. RESULTS AUROC of NLR0h (0.756) higher than PCT0h (0.743).DPCT (0.561 vs 0.301) and ΔNLR (0.609 vs 0.361) were significantly higher in the shock group than in the non-shock group (P<0.05). No significant difference was seen in DPCT and DNLR in the gram-positive cocci infection group. However, the gram-negative bacilli infection group showed a significant difference in ΔPCT (0.606 vs 0.312) and ΔNLR (0.872 vs 0.508) between the shock and non-shock groups (P<0.05). ΔPCT+ΔNLR showed the best area under the curve (0.937), with a high sensitivity (78.80%) and specificity (90.80%), for predicting septic shock. CONCLUSIONS The prediction efficiency of initial NLR is higher than that of PCT. ΔPCT+ΔNLR best predicted septic shock in patients with bloodstream infections, with better accuracy for gram-negative infections.

Value of CRP, PCT, and NLR in Prediction of Severity and Prognosis of Patients With Bloodstream Infections and Sepsis.

Objective: To investigate the value of C-reactive protein (CRP), procalcitonin (PCT), and neutrophil to lymphocyte ratio (NLR) in assessing the severity of disease in patients with bloodstream infection and sepsis, and to analyze the relationship between the levels of three inflammatory factors and the prognosis of patients. Methods: The clinical data of 146 patients with bloodstream infection and sepsis admitted to our intensive care unit (ICU) from October 2016 to May 2020 were retrospectively analyzed. The differences in the levels of inflammatory indicators such as CRP, PCT, and NLR within 24 h in patients with bloodstream infection sepsis with different conditions (critical group, non-critical group) and the correlation between these factors and the condition (acute physiology and chronic health evaluation II, APACHE II score) were analyzed. In addition, the prognosis of all patients within 28 days was counted, and the patients were divided into death and survival groups according to their mortality, and the risk factors affecting their death were analyzed by logistic regression, and the receiver operating characteristic (ROC) curve was used to analyze the value of the relevant indicators in assessing the prognosis of patients. Results: The levels of NLR, CRP, PCT, total bilirubin (TBIL), glutamic oxaloacetic transaminase (AST), and serum creatinine (Scr) were significantly higher in the critically ill group than in the non-critically ill group, where correlation analysis revealed a positive correlation between CRP, PCT, and NLR and APACHE II scores (P < 0.05). Univariate logistic regression analysis revealed that CRP, PCT, NLR, and APACHE II scores were associated with patient prognosis (P < 0.05). Multi-factor logistic regression analysis found that PCT, NLR, and APACHE II scores were independent risk factors for patient mortality within 28 days (P < 0.05). ROC curve analysis found that PCT and NLR both had an AUC area > 0.7 in predicting patient death within 28 days (P < 0.05). Conclusion: Inflammatory factors such as NLR, CRP, and PCT have important clinical applications in the assessment of the extent of disease and prognosis of patients with bloodstream infection and sepsis.

Rapid asymptomatic transmission of COVID-19 during the incubation period demonstrating strong infectivity in a cluster of youngsters aged 16-23 years outside Wuhan and characteristics of young patients with COVID-19: A prospective contact-tracing study.

BACKGROUND: The outbreak of coronavirus-disease-2019 (COVID-19) has rapidly spread to many places outside Wuhan. Previous studies on COVID-19 mostly included older hospitalized-adults. Little information on infectivity among and characteristics of youngsters with COVID-19 is available. METHODS: A cluster of 22 close-contacts of a 22-year-old male (Patient-Index) including youngsters with laboratory-confirmed COVID-19 and hospitalized close-contacts testing negative for severe-acute-respiratory-syndrome-coronavirus-2 (SARS-CoV-2) in Anhui Province, China was prospectively-traced. RESULTS: Since January 23, 2020, we enrolled a cluster of eight youngsters with COVID-19 (median age [range], 22 [16-23] years; six males) originating from Patient-Index returning from Wuhan to Hefei on January 19. Patient-Index visited his 16-year-old female cousin in the evening on his return, and met 15 previous classmates in a get-together on January 21. He reported being totally asymptomatic and were described by all his contacts as healthy on January 19-21. His very first symptoms were itchy eyes and fever developed at noon and in the afternoon on January 22, respectively. Seven youngsters (his cousin and six classmates) became infected with COVID-19 after a-few-hour-contact with Patient-Index. None of the patients and contacts had visited Wuhan (except Patient-Index), or had any exposure to wet-markets, wild-animals, or medical-institutes within three months. For affected youngsters, the median incubation-period was 2 days (range, 1-4). The median serial-interval was 1 day (range, 0-4). Half or more of the eight COVID-19-infected youngsters had fever, cough, sputum production, nasal congestion, and fatigue on admission. All patients had mild conditions. Six patients developed pneumonia (all mild; one bilateral) on admission. As of February 20, four patients were discharged. CONCLUSIONS: SARS-CoV-2-infection presented strong infectivity during the incubation-period with rapid transmission in this cluster of youngsters outside Wuhan. COVID-19 developed in these youngsters had fast onset and various nonspecific atypical manifestations, and were much milder than in older patients as previously reported.

Risk factors affecting the mortality of HIV-infected patients with pulmonary tuberculosis in the cART era: a retrospective cohort study in China.

BACKGROUND: Tuberculosis infection still places a great burden on HIV-infected individuals in China and other developing countries. Knowledge of the survival of HIV-infected patients with pulmonary tuberculosis (PTB) would provide important insights for the clinical management of this population, which remains to be well described in current China. METHODS: HIV-infected patients with PTB admitted to Shanghai Public Health Clinical Center from January 2011 to December 2015 were retrospectively enrolled. In this cohort, the survival prognosis was estimated by the Kaplan-Meier method, while univariate and multivariate Cox proportional hazards models were used to determine the risk factors affecting mortality. RESULTS: After reviewing 4914 admitted patients with HIV infection, 359 PTB cases were identified. At the time of PTB diagnosis, the patients' median CD4+ T cell count was 51 /mm3 (IQR: 23-116), and 27.30% of patients (98/359) were on combination antiretroviral therapy (cART). For the 333 cases included in the survival analysis, the overall mortality was 15.92% (53/333) during a median 27-month follow-up. The risk factors, including age older than 60 years (HR: 3.18; 95% CI: 1.66-6.10), complication with bacterial pneumonia (HR: 2.64; 95% CI: 1.30-5.35), diagnosis delay (HR: 2.60; 95% CI: 1.42-4.78), CD4+ T cell count less than 50/mm3 (HR: 2.38; 95% CI: 1.27-4.43) and pulmonary atelectasis (HR: 2.20; 95% CI: 1.05-4.60), might independently contribute to poor survival. Among patients without cART before anti-TB treatment, the later initiation of cART (more than 8 weeks after starting anti-TB treatment) was found to increase the mortality rate (OR: 4.33; 95% CI: 1.22-15.36), while the initiation of cART within 4-8 weeks after starting anti-TB treatment was associated with the fewest deaths (0/14). CONCLUSIONS: The subjects in this study conducted in the cART era were still characterized by depressed immunological competence and low rates of cART administration, revealing possible intervention targets for preventing TB reactivation in HIV-infected individuals under current circumstances. Furthermore, our study indicated that the timely diagnosis of PTB, prevention of secondary bacterial pneumonia by prophylactic management and optimization of the timing of cART initiation could have significant impacts on decreasing mortality among HIV/PTB co-infected populations. These findings deserve further prospective investigations to optimize the management of HIV/PTB-co-infected patients. TRIAL REGISTRATION: NCT01344148 , Registered September 14, 2010.

Enhanced Photoelectrochemical Activity of ZnO-Coated TiO2 Nanotubes and Its Dependence on ZnO Coating Thickness.

One-dimensional heterogeneous nanostructures in the form of ZnO-coated TiO2 nanotubes (ZnO/TiO2 NTs) were fabricated by atomic layer deposition of an ultrathin ZnO coating on electrochemical anodization-formed TiO2 nanotubes (NTs) with the thickness of ZnO coating being precisely controlled at atomic scale, and the photoelectrochemical activity of the fabricated ZnO/TiO2 NTs and the influence of ZnO coating and its thickness were studied. The structures of TiO2 NTs and ZnO coatings were characterized by X-ray diffraction, Raman backscattering spectroscopy, and transmission electron microscopy. The photoelectrochemical activity was studied through the measurements of electrochemical impendence, flat-band potential, and transient photocurrent density. The TiO2 NTs exhibit anatase structure, and the ZnO coatings are structured with hexagonal wurtzite. The photoelectrochemical activity of the ZnO/TiO2 NTs is strongly dependent on the thickness of ZnO coating. ZnO/TiO2 NTs with a thinner rather than a thicker ZnO coating exhibit better photoelectrochemical activity with reduced charge transfer resistance, increased negative flat-band potentials, and enhanced photocurrent densities. Under visible illumination, an increase of about 60 % in the photoelectrochemical activity is obtained for ZnO/TiO2 NTs with an about 2-nm-thick ZnO coating.

Determination of carbohydrates in honey and milk by capillary electrophoresis in combination with graphene-cobalt microsphere hybrid paste electrodes.

A graphene-cobalt microsphere (CoMS) hybrid paste electrode was developed for the determination of carbohydrates in honey and milk in combination with capillary electrophoresis (CE). The performance of the electrodes was demonstrated by detecting mannitol, sucrose, lactose, glucose, and fructose after CE separation. The five analytes were well separated within 9 min in a 40 cm long capillary at a separation voltage of 12 kV. The electrodes exhibited pronounced electrocatalytic activity, lower detection potentials, enhanced signal-to-noise characteristics, and higher reproducibility. The relation between peak current and analyte concentration was linear over about three orders of magnitude. The proposed method had been employed to determine lactose in bovine milk and glucose and fructose in honey with satisfactory results. Because only electroactive substances in the samples could be detected on the paste electrode, the electropherograms of both food samples were simplified to some extent.

Extended photo-response of ZnO/CdS core/shell nanorods fabricated by hydrothermal reaction and pulsed laser deposition.

Heterogenous nanostructures shaped with CdS covered ZnO (ZnO/CdS) core/shell nanorods (NRs) are fabricated on indium-tin-oxide by pulsed laser deposition of CdS on hydrothermally grown ZnO NRs and characterized through morphology examination, structure characterization, photoluminescence and optical absorption measurements. Both the ZnO cores and the CdS shells are hexagonal wurtzite in structure. Compared with bare ZnO NRs, the fabricated ZnO/CdS core/shell NRs present an extended photo-response and have optical properties corresponding to the two excitonic band-gaps of ZnO and CdS as well as the effective band-gap formed between the conduction band minimum of ZnO and the valence band maximum of CdS.