Mortality predictors in patients with COVID-19 pneumonia: a machine learning approach using eXtreme Gradient Boosting model

Recently, global health has seen an increase in demand for assistance as a result of the COVID-19 pandemic. This has prompted many researchers to conduct different studies looking for variables that are associated with increased clinical risk, and find effective and safe treatments. Many of these studies have been limited by presenting small samples and a large data set. Using machine learning (ML) techniques we can detect parameters that help us to improve clinical diagnosis, since they are a system for the detection, prediction and treatment of complex data. ML techniques can be valuable for the study of COVID-19, especially because they can uncover complex patterns in large data sets. This retrospective study of 150 hospitalized adult COVID-19 patients, of which we established two groups, those who died were called Case group (n = 53) while the survivors were Control group (n = 98). For analysis, a supervised learning algorithm eXtreme Gradient Boosting (XGBoost) has been used due to its good response compared to other methods because it is highly efficient, flexible and portable. In this study, the response to different treatments has been evaluated and has made it possible to accurately predict which patients have higher mortality using artificial intelligence, obtaining better results compared to other ML methods.

Determination of the direct bandgap value in In4Se3thin films

The value and the nature of the bandgap of In₄Se₃are still not well defined, with a large spread of the experimental data between 0.42 and 1.68 eV and an uncertain nature, predicted to be indirect byab initioband structure calculations. Here we report on the optical transmission and photoluminescence (PL) performed in In₄Se₃thin films grown by coevaporation on (0001)-oriented sapphire wafers. The quality of the polycrystalline layers allows the first detection of the excitonic-like transition in the optical absorption of this compound at low temperature. The PL detected under weak laser excitation shows a bound exciton emission at 0.75 eV. Strong laser irradiation reveals a quadratic dependence of the PL intensity on the optical excitation, which demonstrates a stimulated emission at 0.79 eV in relation with an exciton-exciton scattering process. On the basis of a reasonable estimate of the exciton energy, equal to10-15meV, we evaluate the direct bandgap of In₄Se₃to0.82±0.01eV at low temperature.

InSe as a case between 3D and 2D layered crystals for excitons

InSe is a promising material in many aspects where the role of excitons is decisive. Here we report the sequential appearance in its luminescence of the exciton, the biexciton, and the P-band of the exciton-exciton scattering while the excitation power increases. The strict energy and momentum conservation rules of the P-band are used to reexamine the exciton binding energy. The new value ≥20 meV is markedly higher than the currently accepted one (14 meV), being however well consistent with the robustness of the excitons up to room temperature. A peak controlled by the Sommerfeld factor is found near the bandgap (~1.36 eV). Our findings supported by theoretical calculations taking into account the anisotropic material parameters question the pure three-dimensional character of the exciton in InSe, assumed up to now. The refined character and parameters of the exciton are of paramount importance for the successful application of InSe in nanophotonics.

Epitaxy of oligothiophenes on alkali metal hydrogen phthalates: Simulations and experiments

Three alkali metal hydrogen phthalate salts (denoted as XAP, X = K⁺, Rb⁺, and Cs⁺) are chosen as substrates for the growth of quaterthiophene (4T) and hexathiophene (6T) thin films by organic molecular beam epitaxy to study the influence of gradual changes of surface unit cell parameters on the epitaxialgrowth. The increment of substrate lattice parameters increases the distance between the planes that define the furrows where oligothiophene molecules lie, while keeping unmodified the interactions between the overlayer and the substrate. Atom-atom potential simulations predict the preferential azimuthal orientations of the overlayer, which are compared with those experimentally observed. The agreement between simulations and experiments about contact planes and orientation of the crystalline domains in the films is satisfactory for both 4T/XAP and 6T/XAP. The increasing width of the surface furrows existing on moving from KAP to RbAP and CsAP does not cause any significant variation of the orientation and density of the overlayer domains, demonstrating that the interaction between overlayer and substrate is the key factor guiding organic epitaxialgrowth.

[Internal medicine in the hospital setting]

Management of all pathologies, and in particular that of the most frequent ones, should whenever possible be based on robust evidence and arguments. New studies published this year enable rationalizing of screening in certain clinical situations, more adequate treatment of others, and open the way for novel and apparently very effective treatments. Whether it be the screening of carotid stenosis, the treatment of pericarditis, of heart failure, of chronic obstructive lung disease or spontaneous bacterial peritonitis, paradigm changes are conceivable. This selective review of the literature summarizes certain studies published this year.

["Mobile" ECMO]

ECMO (extracorporeal membrane oxygenation) is a cardiac or respiratory support which uses the principle of extracorporeal circulation (ECC). It consists of a pump generating an output as well as a membrane oxygenating blood and removing CO2. Thanks to an ECMO mobile team, expert caregivers can now perform the circulatory support in primary centers and then transfer patients under assistance to the referral center. After a brief summary of the two different anatomical approaches (veno-arterial and veno-venous) as well as their indications, the authors will share their experience of two transferred patients under ECMO to Geneva. Referral center and ECMO mobile team concepts will then be detailed focusing on the present situation in Switzerland.

Ultrafast gaseous "half-wave plate"

We demonstrate that filaments generated by ultrashort laser pulses can induce a remarkably large birefringence in Argon over its whole length, resulting in an ultrafast "half-wave plate" for a copropagating probe beam. This birefringence originates from the difference between the nonlinear refractive indices induced by the filament on the axes parallel and orthogonal to its polarization. An angle of 45 degrees between the filament and the probe polarizations allows the realization of ultrafast Kerr-gates, with a switching time ultimately limited by the duration of the filamenting pulse.

Magnetically Driven Growth of Anthracene Thin Films by Organic Molecular Beam Deposition

The possible use of a static magnetic field during organic molecular beam deposition of thin molecular films for inducing some preferential growth is discussed and the magnetic properties of diamagnetic molecules and molecular crystals are recalled. Considering prototypical materials, namely anthracene molecules and potassium phthalate substrates, which interact and may give rise to polycrystalline films with specific orientations, we show that in the presence of a magnetic field the films display a macroscopic preferential orientation as a result of minimization of the magnetic energy contribution. A very good agreement between the results of optical spectroscopy, atomic force microscopy, and predictions made on the basis of the anisotropic magnetic susceptibility of anthracene is found.

Directional dispersion in absorbance spectra of oligothiophene crystals

Due to the large oscillator strength of the first molecular transition in oligothiophenes, a strong directional dispersion of the b(u) exciton transition is expected originating from the macroscopic polarization field. Examining such dispersion unambiguously usually requires different faces to be accessible for the optical measurements. Alternatively, measurements carried out at different angles of incidence are met with intrinsic limits due to the peculiarities of wave propagation in such anisotropic systems. In order to demonstrate these limits along with the experimental difficulties involved, we examine refraction and absorption of light in these crystals and discuss the effects of directional dispersion on the absorbance spectra of quaterthiophene crystals.

Haemocompatibility evaluation of DLC- and SiC-coated surfaces

Diamond-like carbon (DLC) and silicon carbide (SiC) coatings are attractive because of low friction coefficient, high hardness, chemical inertness and smooth finish, which they provide to biomedical devices. Silicon wafers (Si(waf)) and silicone rubber (Si(rub)) plates were coated using plasma-enhanced chemical vapour deposition (PE-CVD) techniques. This article describes: 1- the characterization of modified surfaces using attenuated total reflection-Fourier transform infrared spectroscopy (ATR/FTIR) and contact angle measurements, 2- the results of three in-vitro haemocompatibility assays. Coated surfaces were compared to uncoated materials and various substrates such as polymethylmethacrylate (PMMA), polyethylene (LDPE), polydimethylsiloxane (PDMS) and medical steel (MS). Thrombin generation, blood platelet adhesion and complement convertase activity tests revealed the following classification, from the most to the least heamocompatible surface: Si(rub)/ DLC-Si(rub)/ DLC-Si(waf)/ LDPE/ PDMS/ SiC-Si(waf)/ Si(waf)/ PMMA/ MS. The DLC coating surfaces delayed the clotting time, tended to inhibit the platelet and complement convertase activation, whereas SiC-coated silicon wafer can be considered as thrombogenic. This study has taken into account three events of the blood activation: coagulation, platelet activation and inflammation. The response to those events is an indicator of the in vitro haemocompatibility of the different surfaces and it allows us to select biomaterials for further in vivo blood contacting investigations.

Equation of state data for iron at pressures beyond 10 Mbar

We present equation of state points for iron, in the pressure range 10-45 Mbar, the first obtained with laser-driven shock waves. The experiment has been performed with the high energy laser Phebus, optically smoothed with Kinoform phase plates. Our results double the set of existing experimental data at very high pressures showing good agreement with the predictions of the quotidian equation of state model and with previous results.

[Re]

A chair conformation comparable to that observed for six-membered rings composed of tetrahedral carbon atoms is found for the cluster anion [Re(6)(µ-H)(5)(CO)(24)](-) (see picture; black spheres: Re, white spheres: µ-H; CO ligands omitted for clarity) in spite of the octahedral coordination at the Re centers. This is the first example of a carbonyl cluster exhibiting a cyclohexane-like geometry of the metallic framework.

In vitro metabolism of bladder carcinogenic nitrosamines by rat liver and urothelial cells

In order to establish the importance of the target organ in the activation of bladder carcinogens, we compared rat liver and urothelial cell alpha-hydroxylation activities using as substrates N-nitrosobutyl(4-hydroxybutyl)amine and its metabolite N-nitrosobutyl(3-carboxypropyl)amine, two potent urinary bladder carcinogens in animals. Previous studies have shown that the production of molecular nitrogen can serve as an indicator of nitrosamine alpha-hydroxylation. The use of doubly 15N-labelled nitrosamines and the gas chromatography-mass spectrometric detection of 15N2 formed gives a measurement of the extent of this metabolic step. Various amounts of 15N-labelled substrates were incubated for 60 min at 37 degrees C with rat liver S9 preparations or urothelial cell homogenates in the presence of a NADPH generating system. Both enzyme sources metabolized 15N-labelled N-nitrosobutyl(4-hydroxybutyl)amine and N-nitrosobutyl(3-carboxypropyl)amine through the alpha-hydroxylation pathway. Using hepatic S9 fractions, 15N2 production from 15N-labelled N-nitrosobutyl(4-hydroxybutyl)amine increased from 1.69 +/- 0.02 nmol/h per mg protein (mean +/- S.E.) to 5.78 +/- 0.5 with substrate concentrations ranging between 0.55 and 5.55 mM. 15N2 produced by urothelial cell homogenates was about 40-50% that of the liver S9. 15N-labelled N-nitrosobutyl(3-carboxypropyl)amine was also metabolized through the alpha-hydroxylation pathway both by hepatic S9 and urothelial cell homogenates, though to a lesser extent. 15N2 production was about 10-times less than from 15N-labelled N-nitrosobutyl(4-hydroxybutyl)amine, but again urothelial cell 15N2 production was about 40-50% that of the liver. Treatment with phenobarbital resulted in a 2.7-fold increase in the 15N2 produced from 15N-labelled N-nitrosobutyl(4-hydroxybutyl)amine by hepatic S9. No effect was observed with urothelial cell homogenates. Acetone treatment had no effect on 15N2 production from 15N-labelled N-nitrosobutyl(4-hydroxybutyl)amine by hepatic S9, but raised 15N2 production by urothelial cell homogenates 1.8 times. Although the liver has a greater capacity than the bladder for activating the 15N-labelled nitrosamines studied, the target organ can metabolize bladder carcinogens, thus increasing the possibility of a local toxic effect. Moreover, the distribution of P-450 isozymes might be different in the bladder and this could affect the metabolism of nitrosamines reportedly formed in the human bladder in some pathological conditions.

Renal and urinary lipid changes associated with an acutely induced renal papillary necrosis in rats

A single dose of 2-bromoethanamine hydrobromide (BEA; 100 mg/kg body weight) given ip to male Wistar rats causes an acute renal papillary necrosis in 24 hr. Oil Red O (ORO) lipid staining is normally confined to the polyunsaturated lipid droplets of the medullary interstitial cells, but ORO-positive material was present in the endothelial cells of the vasa recta 7 hr after BEA treatment. At 24 hr (by which time papillary necrosis had developed), there were also markedly increased quantities of lipid in the cells of the collecting ducts and covering epithelia. At 48 hr totally necrosed areas stained heavily with ORO, and lipid deposits were particularly numerous in the hyperplastic urothelia adjacent to the necrosed region. Epithelial and endothelial accumulation of lipid material also extended into areas of the juxtamedulla and cortex, which appeared normal by routine haematoxylin and eosin staining. Lipid staining is more selective and sensitive for identifying papillary necrosis than routine histology, because neither hexachlorobutadiene-, aminoglycoside-, cis-platin- nor polybrene-induced lesions produce similar histochemical changes. This suggests that the capillary and epithelial deposits of lipid material are pathognomonic for the development of renal papillary necrosis. An increase in urinary triglycerides following BEA treatment supports the biochemical basis of these ORO changes as a neutral lipid accumulation.

Determination of O6-butylguanine in DNA by immunoaffinity extraction/gas chromatography-mass spectrometry

A sensitive, specific, and rapid method for quantitating the minor adduct O6-butylguanine (O6BuG) in hydrolyzed DNA has been developed by combining immunoaffinity chromatography and high resolution gas chromatography-negative ion chemical ionization-mass spectrometry. Polyclonal antibodies raised against O6BuG were coupled to CNBr-activated Sepharose 4B and used for sample clean-up and extraction of the specific O6-alkylguanine. After addition of O6BuG and its deuterium labeled analogue (O6BuG-D7), used as internal standard, hydrolyzed DNA was applied on the immunoaffinity column and washed with water, and the immunoadsorbed butylated guanines were eluted with acetone/water cetome/water (95/5) before gas chromatographic derivatization. O6BuG and O6BuG-D7 were analyzed and quantitated by high resolution gas chromatography-negative ion chemical ionization-mass spectrometry as their pentafluorobenzyl-trimethylsilyl derivatives. Immunoaffinity column capacity and O6BuG recovery from this column were 1.53 nmol O6BuG/column and 62 +/- 5%, respectively. The method was applied to evaluate O6BuG levels in DNA butylated in vitro with 10 mM N-nitroso-Nr-butylurea or isolated from rats given an i.p. dose of 185 mg/kg N-nitroso-N-butylurea or N-nitrosodibutylamine. In the first case the level of modifications present in calf thymus DNA was 104 mumol O6BuG/mol guanine, and in the second case O6BuG in liver DNA was about 6 times higher after N-nitroso-N-butylurea (2.11 mumol O6BuG/mol guanine) than after N-nitrosodibutylamine (0.34 mumol O6BuG/mol guanine) treatment. These results indicate that O6BuG formed in vivo can be isolated and quantitated by this method, which may also be useful for studying DNA damage and repair mechanisms.

Cytogenetic analysis of malignant mesothelioma

Cytogenetic analyses of 40 confirmed malignant mesotheliomas (MMs) are reported. Pleural effusion cells were studied in 90% of the cases by direct method or after culture or both. Biopsy and ascites fluid were also analyzed in some patients. A normal karyotype was found in nine cases, and complex karyotypic abnormalities were observed in 30 cases. In one case, analyzable metaphases were not obtained. The chromosomal changes were all complex and heterogeneous; no consistent presumably specific abnormality was detected. Nevertheless, two main patterns of nonrandom abnormalities were observed: 1) loss of chromosomes 4 and 22, 9p, and 3p in the most of the abnormal cases and corresponding to a hypodiploid and/or hypotetraploid modal chromosome number; and 2) gain of chromosomes 7, 5, and 20 with deletion or rearrangement of 3p as well in the hyperdiploid cases, which were a minority in our series. These findings are discussed in view of other reported cytogenetic studies of MM, asbestos exposure, and possible mechanisms of malignant transformation.

A novel variant of the bcr-abl fusion product in Philadelphia chromosome-positive acute lymphoblastic leukemia

Two patients with Philadelphia chromosome-positive acute lymphoblastic leukemia showed novel variants of the chimeric bcr-abl mRNA. The bcr-abl breakpoint region on cDNA derived from the chimeric mRNA was amplified using the polymerase chain reaction (PCR). Sequence analysis of the breakpoint-containing fragment showed that in both patients exon a2 of the abl gene was deleted, giving rise to an in-frame joining at the mRNA level of 5' bcr sequences to the abl exon a3. These findings were confirmed by Southern blot analysis and cloning of chromosomal DNA. Protein studies showed a bcr-abl protein with heightened tyrosine kinase activity in blast cells of both patients: one of the P190 type, the other of the P210 type. The significance of these findings and the role of this new type of translocation in the disregulation of the abl gene are discussed.