The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

1D Supergravity FLRW Model of Starobinsky

We study two homogeneous supersymmetric extensions for the f(R) modified gravity model of Starobinsky with the FLRW metric. The actions are defined in terms of a superfield R that contains the FLRW scalar curvature. One model has N = 1 local supersymmetry, and its bosonic sector is the Starobinsky action; the other action has N = 2, its bosonic sector contains, in additional to Starobinsky, a massive scalar field without self-interaction. As expected, the bosonic sectors of these models are consistent with cosmic inflation, as we show by solving numerically the classical dynamics. Inflation is driven by the R2 term during the large curvature regime. In the N = 2 case, the additional scalar field remains in a low energy state during inflation. Further, by means of an additional superfield, we write equivalent tensor-scalar-like actions from which we can give the Hamiltonian formulation

1D Supergravity FLRW Model of Starobinsky

We study two homogeneous supersymmetric extensions for the f(R) modified gravity model of Starobinsky with the FLRW metric. The actions are defined in terms of a superfield R that contains the FLRW scalar curvature. One model has N = 1 local supersymmetry, and its bosonic sector is the Starobinsky action; the other action has N = 2, its bosonic sector contains, in additional to Starobinsky, a massive scalar field without self-interaction. As expected, the bosonic sectors of these models are consistent with cosmic inflation, as we show by solving numerically the classical dynamics. Inflation is driven by the R2 term during the large curvature regime. In the N = 2 case, the additional scalar field remains in a low energy state during inflation. Further, by means of an additional superfield, we write equivalent tensor-scalar-like actions from which we can give the Hamiltonian formulation

Modeling the Groundwater Dynamics of the Celaya Valley Aquifer

We propose a hydrodynamic simulation model to understand the piezometric operation of the Celaya Valley aquifer. The aquifer is located at the east of Guanajuato State in México. Our proposed model reproduces, under transitory conditions, the performance of the aquifer during the dry season from year 2015 to 2019 and the rainy season from year 2010 to 2015. The simulation was projected for the two seasons up to eleven years ahead and considering only three simulation scenarios (one should bear in mind that there are a number of different and interesting scenarios): trend, pump reduction and pump increase. In general terms, the model accurately reproduces the natural conditions of the aquifer. It is necessary to continue taking measures for the preservation of water; similarly, it is suggested to continue monitoring the aquifer piezometric levels to update the model based on data availability

Structural Stability and Electronic Properties of Boron Phosphide Nanotubes: A Density Functional Theory Perspective

Based on the Density Functional Theory (DFT) calculations, we analyze the structural and electronic properties of boron phosphide nanotubes (BPNTs) as functions of chirality. The DFT calculations are performed using the M06-2X method in conjunction with the 6-31G(d) divided valence basis set. All nanostructures, (n,0) BPNT (n = 5&ndash;8, 10, 12, 14) and (n,n) BPNT (n = 3&ndash;11), were optimized minimizing the total energy, assuming a non-magnetic nature and a total charge neutrality. Results show that the BPNT diameter size increases linearly with the chiral index &ldquo;n&rdquo; for both chiralities. According to the global molecular descriptors, the (3,3) BPNT is the most stable structure provided that it shows the largest global hardness value. The low chirality (5,0) BPNT has a strong electrophilic character, and it is the most conductive system due to the small |HOMO-LUMO| energy gap. The chemical potential and electrophilicity index in the zigzag-type BPNTs show remarkable chirality-dependent behavior. The increase in diameter/chirality causes a gradual decrease in the |HOMO-LUMO| energy gap for the zigzag BPNTs; however, in the armchair-type BPNTs, a phase transition is generated from a semiconductor to a conductor system. Therefore, the nanostructures investigated in this work may be suggested for both electrical and biophysical applications

Structural Stability and Electronic Properties of Boron Phosphide Nanotubes: A Density Functional Theory Perspective

Based on the Density Functional Theory (DFT) calculations, we analyze the structural and electronic properties of boron phosphide nanotubes (BPNTs) as functions of chirality. The DFT calculations are performed using the M06-2X method in conjunction with the 6-31G(d) divided valence basis set. All nanostructures, (n,0) BPNT (n = 5–8, 10, 12, 14) and (n,n) BPNT (n = 3–11), were optimized minimizing the total energy, assuming a non-magnetic nature and a total charge neutrality. Results show that the BPNT diameter size increases linearly with the chiral index “n” for both chiralities. According to the global molecular descriptors, the (3,3) BPNT is the most stable structure provided that it shows the largest global hardness value. The low chirality (5,0) BPNT has a strong electrophilic character, and it is the most conductive system due to the small |HOMO-LUMO| energy gap. The chemical potential and electrophilicity index in the zigzag-type BPNTs show remarkable chirality-dependent behavior. The increase in diameter/chirality causes a gradual decrease in the |HOMO-LUMO| energy gap for the zigzag BPNTs; however, in the armchair-type BPNTs, a phase transition is generated from a semiconductor to a conductor system. Therefore, the nanostructures investigated in this work may be suggested for both electrical and biophysical applications