Mineralization and microbial utilization of poly(lactic acid) microplastic in soil.

The current carbon dioxide (CO2) evolution-based standard method for determining biodegradable microplastics (MPs) degradation neglects its priming effect on soil organic matter decomposition, which misestimates their biodegradability. Here, a 13C natural abundance method was used to estimate the mineralization of poly(lactic acid) (PLA) MP in various agricultural soils, and to trace its utilization in different microbial groups. In alkaline soils, the PLA-derived CO2 emissions increased with increasing soil carbon/nitrogen (C/N) ratios, and the mineralization of PLA MP concentrations ranged from 3-33 %, whereas the CO2 evolution method probably over- or under-estimated the mineralization of PLA in alkaline soils with different soil C/N ratios. Low PLA mineralization (1-5 %) were found in the acidic soil, and the standard method largely overestimated the mineralization of PLA MP by 1.3- to 3.3-fold. Moreover, the hydrolysate of PLA MP was preferentially assimilated by Gram-negative bacteria, but Gram-positive bacterial decomposition mainly contributed to the release of PLA-derived CO2 at low MP concentrations (≤ 1 %). Overall, the 13C natural abundance method appears to be suitable for tracking the mineralization and microbial utilization of biodegradable PLA in soils, and the PLA-derived C is mainly assimilated and decomposed by bacterial groups.

Colonization ability and uniformity of resources and environmental factors determine biological homogenization of soil protists in human land-use systems.

Humans have substantially transformed the global land surface, resulting in the decline in variation in biotic communities across scales, a phenomenon known as "biological homogenization." However, different biota are affected by biological homogenization to varying degrees, but this variation and the underlying mechanisms remain little studied, particularly in soil systems. To address this topic, we used metabarcoding to investigate the biogeography of soil protists and their prey/hosts (prokaryotes, fungi, and meso- and macrofauna) in three human land-use ecosystem types (farmlands, residential areas, and parks) and natural forest ecosystems across subtropical and temperate regions in China. Our results showed that the degree of community homogenization largely differed between taxa and functional groups of soil protists, and was strongly and positively linked to their colonization ability of human land-use systems. Removal analysis showed that the introduction of widespread, generalist taxa (OTUs, operational taxonomic units) rather than the loss of narrow-ranged, specialist OTUs was the major cause of biological homogenization. This increase in generalist OTUs seemingly alleviated the negative impact of land use on specialist taxa, but carried the risk of losing functional diversity. Finally, homogenization of prey/host biota and environmental conditions were also important drivers of biological homogenization in human land-use systems, with their importance being more pronounced in phagotrophic than parasitic and phototrophic protists. Overall, our study showed that the variation in biological homogenization strongly depends on the colonization ability of taxa in human land-use systems, but is also affected by the homogenization of resources and environmental conditions. Importantly, biological homogenization is not the major cause of the decline in the diversity of soil protists, and conservation and study efforts should target at taxa highly sensitive to local extinction, such as parasites.

Permafrost carbon cycle and its dynamics on the Tibetan Plateau.

Our knowledge on permafrost carbon (C) cycle is crucial for understanding its feedback to climate warming and developing nature-based solutions for mitigating climate change. To understand the characteristics of permafrost C cycle on the Tibetan Plateau, the largest alpine permafrost region around the world, we summarized recent advances including the stocks and fluxes of permafrost C and their responses to thawing, and depicted permafrost C dynamics within this century. We find that this alpine permafrost region stores approximately 14.1 Pg (1 Pg=1015 g) of soil organic C (SOC) in the top 3 m. Both substantial gaseous emissions and lateral C transport occur across this permafrost region. Moreover, the mobilization of frozen C is expedited by permafrost thaw, especially by the formation of thermokarst landscapes, which could release significant amounts of C into the atmosphere and surrounding water bodies. This alpine permafrost region nevertheless remains an important C sink, and its capacity to sequester C will continue to increase by 2100. For future perspectives, we would suggest developing long-term in situ observation networks of C stocks and fluxes with improved temporal and spatial coverage, and exploring the mechanisms underlying the response of ecosystem C cycle to permafrost thaw. In addition, it is essential to improve the projection of permafrost C dynamics through in-depth model-data fusion on the Tibetan Plateau.

Global turnover of soil mineral-associated and particulate organic carbon.

Soil organic carbon (SOC) persistence is predominantly governed by mineral protection, consequently, soil mineral-associated (MAOC) and particulate organic carbon (POC) turnovers have different impacts on the vulnerability of SOC to climate change. Here, we generate the global MAOC and POC maps using 8341 observations and then infer the turnover times of MAOC and POC by a data-model integration approach. Global MAOC and POC storages are 975 964 987 Pg C (mean with 5% and 95% quantiles) and 330 323 337 Pg C, while global mean MAOC and POC turnover times are 129 45 383 yr and 23 5 82 yr in the top meter, respectively. Climate warming-induced acceleration of MAOC and POC decomposition is greater in subsoil than that in topsoil. Overall, the global atlas of MAOC and POC turnover, together with the global distributions of MAOC and POC stocks, provide a benchmark for Earth system models to diagnose SOC-climate change feedback.

Increase in HIV reservoir and T cell immune response after CoronaVac vaccination in people living with HIV.

Introduction: CoronaVac, an inactivated vaccine developed by Sinovac Life Sciences, has been widely used for protection against Coronavirus Disease 2019 (COVID-19). This study investigates its effect on the HIV reservoir and T cell repertoires in people living with HIV (PLWHs). Methods: Blood samples were collected from fifteen PLWHs who were administered at least two doses of CoronaVac between April 2021 and February 2022. The levels of cell-associated HIV RNA (CA HIV RNA) and HIV DNA, as well as the T cell receptor (TCR) repertoire profiles, TCR clustering and TCRß annotation, were studied. Results: A significant increase was observed in CA HIV RNA at 2 weeks (431.5 ± 164.2 copies/106 cells, P = 0.039) and 12 weeks (330.2 ± 105.9 copies/106 cells, P = 0.019) after the second dose, when compared to the baseline (0 weeks) (73.6 ± 23.7 copies/106 cells). Various diversity indices of the TCRß repertoire, including Shannon index, Pielou's evenness index, and Hvj Index, revealed a slight increase (P < 0.05) following CoronaVac vaccination. The proportion of overlapping TCRß clonotypes increased from baseline (31.9 %) to 2 weeks (32.5 %) and 12 weeks (40.4 %) after the second dose. We also found that the breadth and depth of COVID-19-specific T cells increased from baseline (0.003 and 0.0035) to 12 weeks (0.0066 and 0.0058) post the second dose. Conclusions: Our study demonstrated an initial increase in HIV reservoir and TCR repertoire diversity, as well as an expansion in the depth and breadth of COVID-19-specific T-cell clones among CoronaVac-vaccinated PLWHs. These findings provide important insights into the effects of COVID-19 vaccination in PLWHs.

Whole-soil warming leads to substantial soil carbon emission in an alpine grassland.

The sensitivity of soil organic carbon (SOC) decomposition in seasonally frozen soils, such as alpine ecosystems, to climate warming is a major uncertainty in global carbon cycling. Here we measure soil CO2 emission during four years (2018-2021) from the whole-soil warming experiment (4 °C for the top 1 m) in an alpine grassland ecosystem. We find that whole-soil warming stimulates total and SOC-derived CO2 efflux by 26% and 37%, respectively, but has a minor effect on root-derived CO2 efflux. Moreover, experimental warming only promotes total soil CO2 efflux by 7-8% on average in the meta-analysis across all grasslands or alpine grasslands globally (none of these experiments were whole-soil warming). We show that whole-soil warming has a much stronger effect on soil carbon emission in the alpine grassland ecosystem than what was reported in previous warming experiments, most of which only heat surface soils.

Contrasting impacts of fertilization on topsoil and subsoil greenhouse gas fluxes in a thinned Chinese fir plantation.

Globally, forest soils are considered as important sources and sinks of greenhouse gases (GHGs). However, most studies on forest soil GHG fluxes are confined to the topsoils (above 20 cm soil depths), with only very limited information being available regarding these fluxes in the subsoils (below 20 cm soil depths), especially in managed forests. This limits deeper understanding of the relative contributions of different soil depths to GHG fluxes and global warming potential (GWP). Here, we used a concentration gradient-based method to comprehensively investigate the effects of thinning intensity (15% vs. 35%) and nutrient addition (no fertilizer vs. NPK fertilizers) on soil GHG fluxes from the 0-40 cm soil layers at 10 cm depth intervals in a Chinese fir (Cunninghamia lanceolata) plantation. Results showed that forest soils were the sources of CO2 and N2O, but the sinks of CH4. Soil GHG fluxes decreased with increasing soil depth, with the 0-20 cm soil layers identified as the dominant producers of CO2 and N2O and consumers of CH4. Thinning intensity did not significantly affect soil GHG fluxes. However, fertilization significantly increased CO2 and N2O emissions and CH4 uptake at 0-20 cm soil layers, but decreased them at 20-40 cm soil layers. This is because fertilization alleviated microbial N limitation and decreased water filled pore space (WFPS) in topsoils, while it increased WFPS in subsoils, ultimately suggesting that soil WFPS and N availability (especially NH4+-N) were the predominant regulators of GHG fluxes along soil profiles. Generally, there were positive interactive effects of thinning and fertilization on soil GHG fluxes. Moreover, the 35% thinning intensity without fertilization had the lowest GWP among all treatments. Overall, our results suggest that fertilization may not only cause depth-dependent effects on GHG fluxes within soil profiles, but also impede efforts to mitigate climate change by promoting GHG emissions in managed forest plantations.

Identification of an IGHV3-53-Encoded RBD-Targeting Cross-Neutralizing Antibody from an Early COVID-19 Convalescent.

Since November 2021, Omicron has emerged as the dominant severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant, and its sublineages continue to appear one after another, significantly reducing the effectiveness of existing therapeutic neutralizing antibodies (NAbs). It is urgent to develop effective NAbs against circulating Omicron variants. Here, we isolated receptor binding domain (RBD)-specific single memory B cells via flow cytometry from a COVID-19 convalescent. The antibody variable region genes of the heavy chain (VHs) and light chain (VLs) were amplified and cloned into expression vectors. After antibody expression, ELISA screening and neutralizing activity detection, we obtained an IGHV3-53-encoded RBD-targeting cross-neutralizing antibody D6, whose VL originated from the IGKV1-9*01 germlines. D6 could potently neutralize circulating Omicron variants (BA.1, BA.2, BA.4/5 and BF.7), with IC50 values of less than 0.04 µg/mL, and the neutralizing ability against XBB was reduced but still effective. The KD values of D6 binding with RBD of the prototype and BA.1 were both less than 1.0 × 10-12 M. The protein structure of the D6-RBD model indicates that D6 interacts with the RBD external subdomain and belongs to the RBD-1 community. The sufficient contact and deep interaction of D6 HCDR3 and LCDR3 with RBD may be the crucial reason for its cross-neutralizing activity. The sorting and analysis of mAb D6 will provide important information for the development of anti-COVID-19 reagents.

Distinct Lipidomic Profiles between People Living with HIV Treated with E/C/F/TAF or B/F/TAF: An Open-Label Prospective Cohort Study.

INTRODUCTION: Elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/F/TAF) has been increasingly replaced by bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) in the treatment of human immunodeficiency virus (HIV) owing to its more favorable pharmacokinetics and fewer drug-drug interactions. However, the effect of this switch on plasma lipids and lipidomic profiles remains poorly characterized. METHODS: HIV infected patients on an E/C/F/TAF regimen were recruited into the study and followed up every 12 weeks. Participants were divided into E/C/F/TAF and B/F/TAF groups depending on whether they were switched to B/F/TAF during follow-up. Clinical information and blood samples were collected at 0, 12, and 24 weeks, and lipidomic analysis was performed using liquid chromatography mass spectrometry. RESULTS: No significant differences were observed between the groups at baseline. At week 24, patients switched to B/F/TAF had lower triglyceride [mmol/L; 1.23 (0.62) versus 2.03 (0.75), P = 0.001] and very low-density lipoprotein cholesterol [mmol/L; 0.64 (0.26) versus 0.84 (0.32), P = 0.037) compared with patients who continued E/C/F/TAF therapy. Small decrease from baseline in Framingham general cardiovascular risk score (FRS) was observed in the B/F/TAF arm [week (W) 0: 2.59 (1.57) versus W24: 2.18 (1.01), P = 0.043]. Lipidomic analysis indicated that E/C/F/TAF treatment increased the levels of several diglycerides (DGs), triacylglycerols (TAGs), and lyso-phosphatidylcholines (LPCs), whereas switching to B/F/TAF led to increased sphingolipids and glycerophospholipids. After adjusting for demographic and clinical parameters, only DG (16:0/18:2), DG (18:2/22:6), DG (18:3/18:2), DG (20:5/18:2), TAG (18:3/18:2/21:5), TAG (20:5/18:2/22:6), and LPC (22:6) were found to be significantly associated with FRS (regression coefficient of 0.17-6.02, P < 0.05). Most of these FRS associate lipid species were significantly elevated in individuals treated with E/C/F/TAF instead of individuals treated with B/F/TAF. CONCLUSION: E/C/F/TAF promotes the accumulation of lipid species closely associated with cardiovascular disease (CVD) risk among people living with HIV, whereas B/F/TAF has a decreased impact on CVD-related lipid profile and is associated with lower CVD risk. A graphical abstract is available with this article. TRIAL REGISTRATION: ClinicalTrials.gov; identifier, NCT06019273.

Reconciling carbon quality with availability predicts temperature sensitivity of global soil carbon mineralization.

Soil organic carbon (SOC) mineralization is a key component of the global carbon cycle. Its temperature sensitivity Q10 (which is defined as the factor of change in mineralization with a 10 °C temperature increase) is crucial for understanding the carbon cycle-climate change feedback but remains uncertain. Here, we demonstrate the universal control of carbon quality-availability tradeoffs on Q10. When carbon availability is not limited, Q10 is controlled by carbon quality; otherwise, substrate availability controls Q10. A model driven by such quality-availability tradeoffs explains 97% of the spatiotemporal variability of Q10 in incubations of soils across the globe and predicts a global Q10 of 2.1 ± 0.4 (mean ± one SD) with higher Q10 in northern high-latitude regions. We further reveal that global Q10 is predominantly governed by the mineralization of high-quality carbon. The work provides a foundation for predicting SOC dynamics under climate and land use changes which may alter soil carbon quality and availability.

Anti-N-methyl-D-aspartate Receptor Encephalitis in People Living with HIV: Case Report and Literature Review.

With the increase in the number of cases of autoimmune encephalitis (AE), the cerebrospinal fluid (CSF) of people living with HIV (PLWH) showing abnormal behavior, cognitive impairment or abnormal movements should be actively screened for the antibody panel of AE. Early recognition and treatment can prevent severe seizures or coma and markedly improve the prognosis of patients. The first-line immunotherapy for AE includes intravenous methylprednisolone and immunoglobulin. However, whether long-time immunosuppressive maintenance therapy is needed is debated. For PLWH, immunosuppressive therapy and even steroids could be more challenging. Here, we review and summarize the clinical characteristics often reported cases and report one case from our center to improve the diagnosis and treatment of anti-N-methyl-D-aspartate receptor encephalitis in PLWH.

Rhizosphere priming promotes plant nitrogen acquisition by microbial necromass recycling.

Nitrogen availability in the rhizosphere relies on root-microorganism interactions, where root exudates trigger soil organic matter (SOM) decomposition through the rhizosphere priming effect (RPE). Though microbial necromass contribute significantly to organically bound soil nitrogen (N), the role of RPEs in regulating necromass recycling and plant nitrogen acquisition has received limited attention. We used 15N natural abundance as a proxy for necromass-N since necromass is enriched in 15N compared to other soil-N forms. We combined studies using the same experimental design for continuous 13CO2 labelling of various plant species and the same soil type, but considering top- and subsoil. RPE were quantified as difference in SOM-decomposition between planted and unplanted soils. Results showed higher plant N uptake as RPEs increased. The positive relationship between 15N-enrichment of shoots and roots and RPEs indicated an enhanced necromass-N turnover by RPE. Moreover, our data revealed that RPEs were saturated with increasing carbon (C) input via rhizodeposition in topsoil. In subsoil, RPEs increased linearly within a small range of C input indicating a strong effect of root-released C on decomposition rates in deeper soil horizons. Overall, this study confirmed the functional importance of rhizosphere C input for plant N acquisition through enhanced necromass turnover by RPEs.

Improved soil moisture, nutrients, and economic benefits using plastic mulchs in balsa-based agroforestry systems.

The manufacture of wind turbine blades generally uses balsa wood as the base materials, and it is crucial to explore new regions for cultivating balsa trees to achieve carbon neutrality in the future. Xishuangbanna may be China's only area with a tropical climate suitable for the large-scale planting of balsa trees. The present study investigated the key soil elements influencing the growth of balsa plantations and the effects of different cultivation practices on soil environments and economic benefits in Xishuangbanna, China. We found that the height of balsa stems after growing 4 years reached 5.8 m; the increment of diameter at breast height (DBH) reached 27.7 cm and volume of balsa stems reached 196.0 m3 ha-1 in Xishuangbanna of China. It is of the utmost importance to improve the contents of soil exchangeable magnesium (Mg) and available phosphorus (P) for the growth of balsa trees, and exchangeable aluminium (Al) inhibited the growth of balsa trees. The practice of plastic film mulching not only improved soil moisture in the 40‒100-cm soil layer in the dry season and in the 0-60-cm soil layer in the rainy season but also enhanced soil nitrate nitrogen when compared with no plastic-mulching practice in balsa plantations. The comprehensive economic benefits of balsa/coriander/ginger/taro plantations were significantly improved by implementing plastic film mulching, as compared to balsa plantations. We conclude that balsa tree can be cultivated in Xishuangbanna, China, and its successful cultivation provides opportunities for China's wind power development.

Effects of whole-soil warming on CH4 and N2 O fluxes in an alpine grassland.

Global climate warming could affect the methane (CH4 ) and nitrous oxide (N2 O) fluxes between soils and the atmosphere, but how CH4 and N2 O fluxes respond to whole-soil warming is unclear. Here, we for the first time investigated the effects of whole-soil warming on CH4 and N2 O fluxes in an alpine grassland ecosystem on the Tibetan Plateau, and also studied the effects of experimental warming on CH4 and N2 O fluxes across terrestrial ecosystems through a global-scale meta-analysis. The whole-soil warming (0-100 cm, +4°C) significantly elevated soil N2 O emission by 101%, but had a minor effect on soil CH4 uptake. However, the meta-analysis revealed that experimental warming did not significantly alter CH4 and N2 O fluxes, and it may be that most field warming experiments could only heat the surface soils. Moreover, the warming-induced higher plant litter and available N in soils may be the main reason for the higher N2 O emission under whole-soil warming in the alpine grassland. We need to pay more attention to the long-term response of greenhouse gases (including CH4 and N2 O fluxes) from different soil depths to whole-soil warming over year-round, which could help us more accurately assess and predict the ecosystem-climate feedback under realistic warming scenarios in the future.

Primary activation of para-quinone methides by chiral phosphoric acid for enantioselective construction of tetraarylmethanes.

Demonstrated here is an asymmetric nucleophilic addition via primary activation of para-quinone methides (p-QMs) based on a chiral phosphoric acid catalytic system. In sharp contrast to previous CPA-based bifunctional activation processes that all required the nucleophiles to have an effective hydrogen bond donor unit (e.g., OH, NH), here no such unit is required in the nucleophile. N-protected indole nucleophiles were successfully utilized for the synthesis of chiral tetraarylmethanes with high efficiency and enantioselectivity under mild conditions. Therefore, this protocol significantly expanded the scope of asymmetric transformations of p-QMs.

Independent and combined effects of microplastics pollution and drought on soil bacterial community.

Global terrestrial ecosystems are simultaneously threatened by multiple environmental pressures, with microplastics (MPs) pollution and drought possibly being the most pressing, both of which may have unanticipated effects on soil organisms. Here, we investigated the responses of diversity, composition and functions of soil bacterial community to MPs pollution (including two MPs types: polyethylene (PE) and polylactic acid (PLA); two MPs sizes: < 20 µm and <300 µm) and drought in microcosms. We found that only 20 µm PLA MPs significantly decreased soil bacterial diversity by 17.4 % and altered soil bacterial community composition, while PE MPs and 300 µm PLA MPs had no significant effects. The copiotrophic bacteria (i.e., Proteobacteria and Firmicutes) were enriched in the 20 µm PLA MPs pollution soils due to the enhanced dissolved organic carbon contents. Moreover, our results showed that the 20 µm PLA MPs also affected the potential phenotypes and functions of soil bacterial community, increasing the potentially pathogenic, stress-tolerant, containing mobile elements and forming biofilms phenotypes, and promoting membrane transport and signal transduction pathways. These results suggested that the effects of MPs on soil bacterial community varied depending on MPs types and sizes. However, drought significantly increased soil bacterial diversity by 10.3 % and affected soil bacterial community composition in the 20 µm PLA MPs pollution soils. We also found that drought inhibited the levels of potentially pathogenic, containing mobile elements and forming biofilms phenotypes in the 20 µm PLA MPs pollution soils. Taken together, these findings reveal that drought may alleviate the adverse effects of MPs pollution on soil bacterial community, which enhances our understanding of the interactive effects of multiple global change factors on agroecosystem functions.

Copper-Catalyzed Enantioselective Formal [4 + 1] and [3 + 3] Cycloaddition of Ethynylethylene Carbonates.

Herein we employed ethynylethylene carbonates (EECs) to achieve formal [4 + 1] and [3 + 3] cycloaddition with cyclic 1,3-dicarbonyl compounds. On one hand, EECs with styryl substitution could undergo a remotely controlled enantioselective [4 + 1] cycloaddition reaction. This reaction exhibits good chemoselectivity, regioselectivity, and enantioselectivity. In addition, a [3 + 3] cycloaddition reaction of EECs with cyclic 1,3-dicarbonyl compounds was also achieved, leading to a series of 4H-pyrans with impressive chemoselectivity and enantioselectivity.

[Carbon Cycling Processes in Croplands and Their Quantification Methods].

Recent studies have shown that the source of soil carbon(C) includes not only the input of crop C(rhizodeposit- and residue-C) to soil organic C(SOC) but also the contribution of soil autotrophic microorganisms to SOC and the fixation of soil inorganic C(SIC) from the soil inorganic chemical pathway and microbial biomineralization pathway. The level of SOC in croplands is mainly controlled by the balance between the input of crop C and the loss of SOC via decomposition. In the short term, the input of crop C usually promotes the SOC decomposition, showing a positive(rhizosphere) priming effect. We analyzed the literature on the rhizosphere priming effect of major crops and the priming effect of straw additions and found that they were on average 75% and 67%, respectively. The residual straw C in the soil could completely compensate for the SOC loss caused by the priming effect of straw returning. In croplands, rhizodeposit- and residue-C often coexisted, which resulted in at least three C sources(rhizodeposit-, straw-, and soil-C) for soil C input and output. Finally, we proposed a new method to distinguish the contribution of multiple C sources to the CO2 emission and the SOC input in rhizosphere soils, as well as the contribution of inorganic chemistry and microbial pathways to the SIC input in calcareous soils. This review is helpful to improve the understanding of the input and output pathways of SOC and SIC in croplands and to improve the accuracy of soil C assessment in croplands.

Mycobacterium colombiense Pneumonia in HIV-Infected Patients: Three Case Reports and a Literature Review.

Background: Mycobacterium colombiense pneumonia in HIV-infected patients is relatively unusual but is associated with a high mortality rate, as well as high rates of misdiagnosis and delayed diagnosis. Clinical metagenome next-generation sequencing (mNGS) may have potential for its accurate and timely diagnosis. Case Presentation: We retrospectively reviewed the medical records of three HIV-infected patients who presented with M. colombiense pneumonia in Zhejiang Province between January 2019 and December 2020. No specific clinical presentations or radiological manifestations were found in any of the patients. The detection of M. colombiense is 28-55 days earlier using mNGS on bronchoalveolar lavage fluid (BALF) compared to traditional culture methods. A combined treatment of rifabutin, clarithromycin, or azithromycin, and ethambutol did not provide timely relief of symptoms in these three patients. In the early stage of treatment, moxifloxacin and linezolid were used for several weeks. The average course of treatment for all three patients was close to 17 months. Conclusion: We recommend early BALF mNGS for fast and accurate diagnosis of M. colombiense pneumonia in HIV-infected patients with low CD4 counts and long duration of symptoms. Further, moxifloxacin and linezolid may be beneficial in the early stage of treatment.

Prognostic and risk factor analysis of cancer patients after unplanned ICU admission: a real-world multicenter study.

To investigate the occurrence and 90-day mortality of cancer patients following unplanned admission to the intensive care unit (ICU), as well as to develop a risk prediction model for their 90-day prognosis. We prospectively analyzed data from cancer patients who were admitted to the ICU without prior planning within the past 7 days, specifically between May 12, 2021, and July 12, 2021. The patients were grouped based on their 90-day survival status, and the aim was to identify the risk factors influencing their survival status. A total of 1488 cases were included in the study, with an average age of 63.2 ± 12.4 years. The most common reason for ICU admission was sepsis (n = 940, 63.2%). During their ICU stay, 29.7% of patients required vasoactive drug support (n = 442), 39.8% needed invasive mechanical ventilation support (n = 592), and 82 patients (5.5%) received renal replacement therapy. We conducted a multivariate COX proportional hazards model analysis, which revealed that BMI and a history of hypertension were protective factors. On the other hand, antitumor treatment within the 3 months prior to admission, transfer from the emergency department, general ward, or external hospital, high APACHE score, diagnosis of shock and respiratory failure, receiving invasive ventilation, and experiencing acute kidney injury (AKI) were identified as risk factors for poor prognosis within 90 days after ICU admission. The average length of stay in the ICU was 4 days, while the hospital stay duration was 18 days. A total of 415 patients died within 90 days after ICU admission, resulting in a mortality rate of 27.9%. We selected 8 indicators to construct the predictive model, which demonstrated good discrimination and calibration. The prognosis of cancer patients who are unplanned transferred to the ICU is generally poor. Assessing the risk factors and developing a risk prediction model for these patients can play a significant role in evaluating their prognosis.