Added value of chest CT images to a personalized prognostic model in acute respiratory distress syndrome: a retrospective study.

Background: Acute respiratory distress syndrome (ARDS) is a critical disease in the intensive care unit (ICU) with high morbidity and mortality. The accuracy for predicting ARDS patients' outcome with mechanical ventilation is limited, and most based on clinical information. Methods: The patients diagnosed with ARDS between January 2014 and June 2019 were retrospectively recruited. Radiomics features were extracted from the upper, middle, and lower levels of the lung, and were further analyzed with the primary outcome (28-day mortality after ARDS onset). The univariate and multivariate logistic regression analyses were applied to figure out risk factors. Various predictive models were constructed and compared. Results: Of 366 ARDS patients recruited in this study, 276 (median age, 64 years [interquartile range, 54-75 years]; 208 male) survive on the Day 28. Among all factors, the APACHE II Score (OR 2.607, 95% CI 1.896-3.584, P < 0.001), the Radiomics_Score of the middle lung (OR 2.230, 95% CI 1.387-3.583, P = 0.01), the Radiomics_Score of the lower lung (OR 1.633, 95% CI 1.143-2.333, P = 0.01) were associated with the 28-day mortality. The clinical_radiomics predictive model (AUC 0.813, 95% CI 0.767-0.850) show the best performance compared with the clinical model (AUC 0.758, 95% CI 0.710-0.802), the radiomics model (AUC 0.692, 95% CI 0.641-0.739) and the various ventilator parameter-based models (highest AUC 0.773, 95% CI 0.726-0.815). Conclusions: The radiomics features of chest CT images have incremental values in predicting the 28-day mortality in ARDS patients with mechanical ventilation. Supplementary Information: The online version contains supplementary material available at 10.1007/s42058-023-00116-x.

Macromolecular pullulan produced by Aureobasidium melanogenum 13-2 isolated from the Taklimakan desert and its crucial roles in resistance to the stress treatments.

A novel yeast strain Aureobasidium melanogenum 13-2 isolated from the Taklimakan desert was found to be able to produce a high level of extracellular polysaccharide (EPS). Under the optimal conditions, the yeast strain could yield 73.25 ±â€¯2.3 g/L of EPS within 5 days at a flask level. During a 10-liter fermentation, the yeast strain could produce 78.05 ±â€¯3.5 g/L of EPS within 120 h. The FT-IR spectra of the standard pullulan from Sigma and the purified EPS produced by A. melanogenum 13-2 were almost identical and the purified EPS could be actively hydrolyzed by a pullulanase, demonstrating that the purified EPS was pullulan. The molecular weight (Mw) of the purified pullulan was estimated to be 7.703 × 105 g/moL. Disruption of a pullulan synthase gene (PUL1) made a mutant DAG27 lose the ability to synthesize any pullulan. The mutant DAG27 was more sensitive to radiation of UV light, high NaCl concentration, heat treatment, strong oxidation of H2O2 and desiccation than its wild type strain 13-2, suggesting that the produced pullulan could play an important role in resistance of the yeast cells to various stresses. This was the first time to show that the yeast strain obtained from the desert could produce such high level pullulan and the produced pullulan had an obviously protective effect on its producer.