ARDS Mortality Prediction Model Using Evolving Clinical Data and Chest Radiograph Analysis.

INTRODUCTION: Within primary ARDS, SARS-CoV-2-associated ARDS (C-ARDS) emerged in late 2019, reaching its peak during the subsequent two years. Recent efforts in ARDS research have concentrated on phenotyping this heterogeneous syndrome to enhance comprehension of its pathophysiology. METHODS AND RESULTS: A retrospective study was conducted on C-ARDS patients from April 2020 to February 2021, encompassing 110 participants with a mean age of 63.2 ± 11.92 (26-83 years). Of these, 61.2% (68) were male, and 25% (17) experienced severe ARDS, resulting in a mortality rate of 47.3% (52). Ventilation settings, arterial blood gases, and chest X-ray (CXR) were evaluated on the first day of invasive mechanical ventilation and between days two and three. CXR images were scrutinized using a convolutional neural network (CNN). A binary logistic regression model for predicting C-ARDS mortality was developed based on the most influential variables: age, PaO2/FiO2 ratio (P/F) on days one and three, CNN-extracted CXR features, and age. Initial performance assessment on test data (23 patients out of the 110) revealed an area under the receiver operating characteristic (ROC) curve of 0.862 with a 95% confidence interval (0.654-0.969). CONCLUSION: Integrating data available in all intensive care units enables the prediction of C-ARDS mortality by utilizing evolving P/F ratios and CXR. This approach can assist in tailoring treatment plans and initiating early discussions to escalate care and extracorporeal life support. Machine learning algorithms for imaging classification can uncover otherwise inaccessible patterns, potentially evolving into another form of ARDS phenotyping. The combined features of these algorithms and clinical variables demonstrate superior performance compared to either element alone.

Metals quantification in e-cigarettes liquids by Total Reflection X-ray Spectrometry.

Electronic cigarettes (e-cig) have gained popularity around the world and its health risks demands more research. This study aims at characterizing e-cig liquids (e-liquids) and its constituents by Total Reflection X-ray Spectrometry (TXRF). The internal standard method was the quantification procedure employed. The spectrometer's performance was evaluated with one certified reference material and spiked samples. It was possible to quantify K, Ca, Ti, Cr, Mn, Fe, Ni, Cu, Zn, Br, and Pb in the e-liquids. Concentrations above the limit for potable water were found in 10 out of 38 samples. Principal component analysis was useful for identifying toxic samples. TXRF is a promising technique for e-liquids evaluation due to its simplicity and performance.

Layered double hydroxides for corrosion-related applications-Main developments from 20 years of research at CICECO.

This work describes the main advances carried out in the field of corrosion protection using layered double hydroxides (LDH), both as additive/pigment-based systems in organic coatings and as conversion films/pre-treatments. In the context of the research topic "Celebrating 20 years of CICECO", the main works reported herein are based on SECOP's group (CICECO) main advances over the years. More specifically, this review describes structure and properties of LDH, delving into the corrosion field with description of pioneering works, use of LDH as additives to organic coatings, conversion layers, application in reinforced concrete and corrosion detection, and environmental impact of these materials. Moreover, the use of computational tools for the design of LDH materials and understanding of ion-exchange reactions is also presented. The review ends with a critical analysis of the field and future perspectives on the use of LDH for corrosion protection. From the work carried out LDH seem very tenable, versatile, and advantageous for corrosion protection applications, although several obstacles will have to be overcome before their use become commonplace.

Molecular Dynamics Model to Explore the Initial Stages of Anion Exchange involving Layered Double Hydroxide Particles.

A classical molecular dynamics (MD) model of fully unconstrained layered double hydroxide (LDH) particles in aqueous NaCl solution was developed to explore the initial stages of the anion exchange process, a key feature of LDHs for their application in different fields. In particular, this study focuses on the active corrosion protection mechanism, where LDHs are able to entrap aggressive species from the solution while releasing fewer corrosive species or even corrosion inhibitors. With this purpose in mind, it was explored the release kinetics of the delivery of nitrate and 2-mercaptobenzothiazole (MBT, a typical corrosion inhibitor) from layered double hydroxide particles triggered by the presence of aggressive chloride anions in solution. It was shown that the delamination of the cationic layers occurs during the anion exchange process, which is especially evident in the case of MBT-.

Total Reflection X-ray Fluorescence spectrometry determination of titanium dioxide released from UV-protective textiles during wash.

The aim of this study is to determine the release of TiO2 from six sport garments into the wash water after 1, 2 and 10 washes. For such, Total Reflection X-ray Fluorescence (TXRF) spectrometry was employed for the study of the wash water and Scanning Electron Microscopy - Energy Dispersive Spectrometry (SEM-EDS) was used for the analysis of the textiles. Results showed that the six sport garments released between 0.106 mg/L and 0.352 mg/L after the first two washes and between 0.028 mg/L and 0.337 mg/L of Ti after ten washes. The values found for the Ti amount released in wash water, and consequently into the environment, is much less than other common sources. These results showed the potential of TXRF spectrometry in quantifying Ti in wash water, which is a hard task even for well-established methods. SEM images show that all six samples were weft knitted fabrics, with yarns of approximately 250 µm of width and fibers' width between 9 and 13 µm.

Reactive oxygen species and other biochemical and morphological biomarkers in the gills and kidneys of the Neotropical freshwater fish, Prochilodus lineatus, exposed to titanium dioxide (TiO2) nanoparticles.

This study investigated the action of titanium dioxide nanoparticles (TiO2-NPs), on the gills and kidneys of Neotropical freshwater fish, Prochilodus lineatus, with emphasis on reactive oxygen species (ROS) production, antioxidant responses, and morphological changes. Fish were exposed to 1, 5, 10, and 50 mg L-1 nominal TiO2-NPs suspended into water for 2 or 14 days. In gills, ROS decreased and glutathione (GSH) increased after 2 days, while ROS and GSH increased and superoxide dismutase activity decreased after 14 days. In kidneys, GSH and lipoperoxidation increased after 2 days and catalase activity decreased after 14 days. Common histopathologies in gills were epithelium hyperplasia, cellular hypertrophy, proliferation of mitochondria-rich cells (MRC), and lamellar stasis; in kidneys, there were cellular and nuclear hypertrophy, focal tubule degeneration, necrosis, and melanomacrophage (MM) proliferation. Although environmentally unlikely, high-dose exposures clarified biological effects of TiO2-NPs, such as ROS formation and MRC responses in the gills, which may impair ionic balance. It was also found that MM are likely responsible for eliminating NPs in the kidney. These findings will help to regulate TiO2-NP disposal, but longer-term studies are still needed.

Mitochondria-rich cells adjustments and ionic balance in the Neotropical fish Prochilodus lineatus exposed to titanium dioxide nanoparticles.

Manufactured titanium dioxide nanoparticles (TiO2-NP) have been intensely applied in numerous industrial products and may be a risk for aquatic systems as they are not completely removed from domestic and industrial wastes after water treatment. This study evaluated the osmo- and ionic balance, Na+/K+-ATPase, H+-ATPase and carbonic anhydrase activities and the mitochondria-rich cells (MRC) in the gills and kidney of the Neotropical fish Prochilodus lineatus after 2 (acute) and 14 (subchronic) days of exposure to nominal 0, 1, 5, 10 and 50 mg L-1 TiO2-NP. The nominal concentrations corresponded to 0.0, 0.6, 1.6, 2.7 and 18.1 mg L-1 suspended TiO2-NP, respectively, in the water column one hour after NP introduction and were maintained for at least 24 h. Acute exposure to TiO2-NP decreased plasma osmolality and Ca2+ levels. Na+/K+-ATPase, H+-ATPase and carbonic anhydrase activities were inhibited in the gills, but not in the kidney. Total MRC density did not change in gills and kidneys. At gill surface, total MRC density decreased in fish exposed to 50 mg L-1 TiO2-NP and the total MRC fractional surface area unchanged although, there were some changes in the fractional area of MRC with apical microvilli (MRCm) and MRC with apical sponge-like structure (MRCs). MRCm was more abundant than MRCs. After subchronic exposure, there was no change in plasma osmolality, ionic balance and enzyme activities. Total gill MRC density increased in the filament epithelium and renal tubules. In the gills, MRC contacting water exhibited some adjustments. Total MRC and fractional surface area unchanged, but there was an increase of MRCs contacting water at gill surface after exposure to10 and 50 mg L-1 TiO2-NP. MRC proliferation in filament epithelium and in renal tubules as well as the increasing MRCs at gill surface may have contributed to avoid change in plasma osmolality, ionic balance and enzyme activities and suggested a cellular physiological and morphological response to restore and maintain osmotic and ionic homeostasis after subchronic exposure.

Gold nanorods induce early embryonic developmental delay and lethality in zebrafish (Danio rerio).

Due to their unique electronic and optical features, gold nanoparticles (AuNP) have received a great deal of attention for application in different fields such as catalysis, electronics, and biomedicine. The large-volume manufacturing predicted for future decades and the inevitable release of these substances into the environment necessitated an assessment of potential adverse human and ecological risks due to exposure to AuNP. Accordingly, this study aimed to examine the acute and developmental toxicity attributed to a commercial suspension of Au nanorods stabilized with cetyltrimethylammonium bromide (CTAB-AuNR) using early embryonic stages of zebrafish (Danio rerio), a well-established model in ecotoxicology. Zebrafish embryos were exposed to CTAB-AuNR (0-150 µg/L) to determine for developmental assessment until 96 hr post fertilization (hpf) and lethality. Uptake of CTAB-AuNR by embryos and nanoparticles potential to induce DNA damage was also measured at 48 and 96 hpf. Analysis of the concentration-response curves with cumulative mortality at 96 hpf revealed a median lethal concentration (LC50,96h) of 110.2 µg/L. At sublethal concentrations, CTAB-AuNR suspensions were found to produce developmental abnormalities such as tail deformities, pericardial edema, decreased body length, and delayed eye, head, and tail elongation development. Further, less than 1% of the initial concentration of CTAB-AuNR present in the exposure media was internalized by zebrafish embryos prior to (48 hpf) and after hatching (96 hpf). In addition, no marked DNA damage was detected in embryos after exposure to CTAB-AuNR. Overall, CTAB-AuNR suspensions produced lethal and sublethal effects on zebrafish embryos with possible repercussions in fitness of adult stages. However, these results foresee a low risk for fish since the observed effects occurred at concentrations above the levels expected to find in the aquatic environment.

Corrosion inhibition of copper in aqueous chloride solution by 1H-1,2,3-triazole and 1,2,4-triazole and their combinations: electrochemical, Raman and theoretical studies.

Triazoles are well-known organic corrosion inhibitors of copper. 1H-1,2,3-Triazole and 1,2,4-triazole, two very simple molecules with the only difference being the positions of the nitrogen atoms in the triazole ring, were studied in this work as corrosion inhibitors of copper in 50 mM NaCl solution using a set of electrochemical and analytical techniques. The results of electrochemical tests indicate that 1H-1,2,3-triazole exhibited superior inhibitor properties but could not suppress anodic copper dissolution at moderate anodic potentials (>+300 mV SCE), while 1,2,4-triazole, although it exhibited higher anodic currents, suppressed anodic copper dissolution at very anodic potentials. Density functional theory calculations were also performed to interpret the measured data and trends observed in the electrochemical studies. The computational studies considered either the inhibitors isolated in the gaseous phase or adsorbed onto Cu(111) surface models. From the calculations, the mechanisms of the inhibitive effects of both triazoles were established and plausible mechanisms of formation of the protective films on the Cu surface were proposed. The results of this study hold positive implications for research in the areas of catalysis, and copper content control in water purification systems.

Control of crystallite and particle size in the synthesis of layered double hydroxides: Macromolecular insights and a complementary modeling tool.

Zinc-aluminum layered double hydroxides with nitrate intercalated (Zn(n)Al-NO3, n=Zn/Al) is an intermediate material for the intercalation of different functional molecules used in a wide range of industrial applications. The synthesis of Zn(2)Al-NO3 was investigated considering the time and temperature of hydrothermal treatment. By examining the crystallite size in two different directions, hydrodynamic particle size, morphology, crystal structure and chemical species in solution, it was possible to understand the crystallization and dissolution processes involved in the mechanisms of crystallite and particle growth. In addition, hydrogeochemical modeling rendered insights on the speciation of different metal cations in solution. Therefore, this tool can be a promising solution to model and optimize the synthesis of layered double hydroxide-based materials for industrial applications.

Self-association of oligothiophenes in isotropic systems.

The self-association equilibrium constants, Kass, for the dimerization of some small oligothiophenes in acetone, acetonitrile and chloroform were measured by (1)H NMR spectroscopy. The gas phase interaction energies for some oligothiophene dimers were determined by computational quantum chemistry. The (1)H NMR results indicate that Kass generally increases with the chain length (the number of thienyl rings, n) and solvent polarity; however, Kass for thiophene (n = 1) was found to be higher than for the bithiophenes (n = 2). The linear oligothiophenes 2,2'-bithiophene and 2,2',5',2''-terthiophene were found to self-associate less than their corresponding nonlinear isomers 3,3'-bithiophene and 3,2',5',3''-terthiophene in solution and in the gas phase. For α-quaterthiophene (n = 4) Kass in solution was found to be smaller than expected. The non-linear dependence of the standard molar Gibbs energy of self-association, ΔassG, on the chain length in solution could be nicely reproduced and related to the conformational entropy change of dimerization. It was observed that the melting properties of oligothiophenes correlate well with their tendency to self-associate, with more self-association leading to increased liquid stability, and thus lower melting temperatures. These results highlight the relevance of self-association in isotropic systems for the correct molecular interpretation of phase equilibria.

From 2,4-dimethoxypyrimidine to 1,3-dimethyluracil: isomerization and hydrogenation enthalpies and noncovalent interactions.

An enthalpic value for the N-methyllactam/O-methyllactim isomerization, in the gaseous phase, is reported in this work for the conversion between 2,4-dimethoxypyrimidine and 1,3-dimethyluracil. For this purpose, the enthalpy of formation of 2,4-dimethoxypyrimidine, in the gaseous phase, was obtained experimentally combining results from combustion calorimetry and Calvet microcalorimetry, and the enthalpy of formation of 1,3-dimethyluracil, in the gaseous phase, reported previously in the literature, is also discussed. The enthalpy of hydrogenation of 1,3-dimethyluracil is compared with the enthalpy of hydrogenation of uracil and interpreted in terms of aromaticity, considering the influence of the hyperconjugation and the hindrance of the solvation of the ring by the methyl groups. The enthalpy of sublimation of 2,4-dimethoxypyrimidine was obtained combining Calvet microcalorimetry and differential scanning calorimetry results. This enthalpy is compared with the enthalpy of sublimation of 1,3-dimethyluracil previously reported in the literature and analyzed herein. From the interplay between the experimental results and the theoretical simulation of dimers of these molecules, the influence of stereochemical hindrance on the in-plane intermolecular contacts and aromaticity on the π···π interactions is analyzed.

Energetic study of 4(3H)-pyrimidinone: aromaticity of reactions, hydrogen bond rules, and support for an anomeric effect.

4(3H)-Pyrimidinone is observed in nature in equilibrium with other tautomeric forms, mimicking the tautomeric equilibrium in pyrimidine nucleobases. In this work, the enthalpy of formation in the gaseous phase of 4(3H)-pyrimidinone was derived from the combination of the enthalpy of formation in the crystalline phase, obtained by static bomb combustion calorimetry, and the enthalpy of sublimation, obtained by Knudsen effusion. The gaseous phase enthalpy of formation of 4(3H)-pyrimidinone was interpreted in terms of isodesmic reactions that consider the enthalpic effects of hydroxypyridines and pyrimidine. After comparison of the experimental and computational results, the same type of isodesmic reactions was used to study the substituent effects of the hydroxyl functional group of 2-, 4-, and 5-hydroxypyrimidines. The influence of aromaticity on the energetics of hydroxypyrimidines was evaluated using the variation of nucleus-independent chemical shifts for several reactions. The influence of intramolecular hydrogen bonds was investigated using the quantum theory of atoms in molecules and the geometric rule of Baker and Hubbard to identify hydrogen bonds. The energetic results obtained were also interpreted in terms of an in plane anomeric effect in the pyrimidine ring.

Thermodynamic study of chlorobenzonitrile isomers: a survey on the polymorphism, pseudosymmetry, and the chloro···cyano interaction.

The relationships among structural and thermodynamic properties of 2-, 3-, and 4-chlorobenzonitrile were investigated, in the present work, using several experimental techniques (Knudsen effusion, differential scanning calorimetry, and combustion calorimetry) and computational studies. The CN···Cl intermolecular interactions are weaker in 2-chlorobenzonitrile, reflecting a lower enthalpy of sublimation. The two polymorphic forms of 4-chlorobenzonitrile were observed by differential scanning calorimetry and interpreted in terms of the strength of CN···Cl intermolecular interactions. The entropic differentiation due to the pseudosymmetry observed in the crystalline packing of 2-chlorobenzonitrile was evaluated. Using adequate working reactions and the respective standard molar enthalpies of formation, in the gaseous phase, the halogen-cyano intramolecular interaction was also evaluated. The theoretically estimated gas-phase enthalpies of formation were calculated using high-level ab initio molecular orbital calculations at the G3MP2B3 and MP2/cc-pVTZ levels of theory. The computed values support very well the experimental results obtained in this work.

From 2-hydroxypyridine to 4(3H)-pyrimidinone: computational study on the control of the tautomeric equilibrium.

In this work is investigated why the entrance of a nitrogen atom in the ring of cis-2-hydroxypyridine and 2-pyridinone, resulting in cis-4-hydroxypyrimidine and 4(3H)-pyrimidinone, respectively, shifts the tautomeric equilibrium from the hydroxyl form, in the pyridine derivative, to the ketonic form, in the pyrimidine derivative. The conclusions obtained for these model systems allow us to understand how to control the gaseous-phase keto-enol tautomeric equilibrium in nitrogen heterocyclic rings and justify the tautomeric preference in pyrimidine nucleobases. The experimental and computational energetics of tautomeric equilibrium were interpreted in terms of the aromaticity, intramolecular hydrogen bonds, and electronic delocalization, evaluated using nucleus independent chemical shifts, quantum theory of atoms in molecules, natural bond orbital analysis, and the thermodynamic changes of appropriate reactions.

Is uracil aromatic? The enthalpies of hydrogenation in the gaseous and crystalline phases, and in aqueous solution, as tools to obtain an answer.

The enthalpy of hydrogenation of uracil was derived from the experimental enthalpies of formation, in the gaseous phase, of uracil and 5,6-dihydrouracil, in order to analyze its aromaticity. The enthalpy of formation of 5,6-dihydrouracil was obtained from combustion calorimetry, Knudsen effusion technique and Calvet microcalorimetry results. High-level computational methods were tested for the enthalpy of hydrogenation of uracil, but only with G3 was possible to obtain results in agreement with the experimental ones. It was found that uracil possesses 30.0% of aromatic character in the gaseous phase. Using both implicit, explicit, and hybrid solvation methods, it was possible to obtain a reference value for the enthalpy of hydrogenation of uracil in the aqueous solution and the effect of polarity and hydrogen bonds on the aromaticity of uracil was analyzed. The value of the hydrogenation enthalpy of uracil in aqueous solution was compared with the experimental value in the crystal phase, also dominated by polarity and hydrogen bonds, derived from combustion calorimetry results. The supramolecular effects on the crystal lattice were explored by the computational simulation of π-π staking dimers and hydrogen bonded dimers.

Tratamento periodontal de pacientes imunossuprimidos / Periodontal treatment of immunosuppressed patient

O número de pacientes periodontais com deficiências do sistema imune tem aumentado. A imunodeficiência pode afetar não apenas a integridade do periodonto, mas também ter profundos efeitos no hospedeiro. Conseqüentemente, o tratamento periodontal de imunodeficientes requer o entendimento do status médico do paciente e o conhecimento de possíveis complicações bucais e sistêmicas. Cuidados com a saúde bucal desempenham um importante papel, contribuindo para diminuir a morbidade e promover uma qualidade de vida para pacientes imunocomprometidos. Este trabalho tem como objetivo descrever sobre o tratamento periodontal de pacientes transplantados, com leucemia e portadores de HIV, reconhecendo as modificações dos tecidos periodontais causados pela imunossupressão.

The number of periodontal patients with deficiencies of the immune system is growing. Immunodeficiency may not only affect the integrity of the periodontum but has a profound effect on the host. Consequently, the periodontal treatment of the immunodeficient patient relies on an understanding of the patient's medical status and knowledge of possible oral and systemic complications. Oral health care play an important role in contributing to decreased morbidity and in improving the quality of life of immunodeficient patient. The aim of this study is to describe about the periodontal treatment of the transplantation patients, with leukemia and HIV-infected individuals, identifying the modifications of the periodontal tissues caused by immunosuppression.