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- Alternative sérum biomarkers of bacteraemia for intensive care unit patientsPublication . Araújo, Rúben; Von Rekowski, Cristiana; Bento, Luís; Fonseca, Tiago AH; Calado, CecíliaThe diagnosis of infections in hospital or clinical settings usually involves a series of time-consuming steps, including biological sample collection, culture growth of the organism isolation and subsequent characterization. For this, there are diverse infection biomarkers based on blood analysis, however, these are of limited use in patients presenting confound processes as inflammatory process as occurring at intensive care units. In this preliminary study, the application of serum analysis by FTIR spectroscopy, to predict bacteraemia in 102 critically ill patients in an ICU was evaluated. It was analysed the effect of spectra pre-processing methods and spectral sub-regions on t-distributed stochastic neighbour embedding. By optimizing Support Vector Machine (SVM) models, based on normalised second derivative spectra of a smaller subregion, it was possible to achieve a good bacteraemia predictive model with a sensitivity and specificity of 76%. Since FTIR spectra of serum is acquired in a simple, economic and rapid mode, the technique presents the potential to be a cost-effective methodology of bacteraemia identification, with special relevance in critically ill patients, where a rapid infection diagnostic will allow to avoid the unnecessary use of antibiotics, which ultimately will ease the load on already fragile patients' metabolism.
- Early mortality prediction in intensive care unit patients based on serum metabolomicPublication . Araújo, Rúben; Ramalhete, Luís; Von Rekowski, Cristiana; Fonseca, Tiago AH; Bento, Luís; Calado, CecíliaPredicting mortality in intensive care units (ICUs) is essential for timely interventions and efficient resource use, especially during pandemics like COVID-19, where high mortality persisted even after the state of emergency ended. Current mortality prediction methods remain limited, especially for critically ill ICU patients, due to their dynamic metabolic changes and heterogeneous pathophysiological processes. This study evaluated how the serum metabolomic fingerprint, acquired through Fourier-Transform Infrared (FTIR) spectroscopy, could support mortality prediction models in COVID-19 ICU patients. A preliminary univariate analysis of serum FTIR spectra revealed significant spectral differences between 21 discharged and 23 deceased patients; however, the most significant spectral bands did not yield high-performing predictive models. By applying a Fast Correlation-Based Filter (FCBF) for feature selection of the spectra, a set of spectral bands spanning a broader range of molecular functional groups was identified, which enabled Naïve Bayes models with AUCs of 0.79, 0.97, and 0.98 for the first 48 h of ICU admission, seven days prior, and the day of the outcome, respectively, which are, in turn, defined as either death or discharge from the ICU. These findings suggest FTIR spectroscopy as a rapid, economical, and minimally invasive diagnostic tool, but further validation is needed in larger, more diverse cohorts.
- Comparison of the serum whole molecular composition with the serum metabolome to acquire the pathophysiological statePublication . Correia, Inês; Henrique Fonseca, Tiago Alexandre; Pataco, Jéssica; Oliveira, Mafalda; Caldeira, Viviana; Domingues, N.; Von Rekowski, Cristiana; Araújo, Rúben Alexandre Dinis; Bento, Luís; Calado, Cecília; Domingues, Nuno; Tomar, Rajesh Singh; Mahamud, TosapornOmics Sciences serve as an essential tool to advance precision medicine. Since conventional omics sciences rely on laborious, complex and time-consuming analytical processes, this study evaluated whether the serum molecular fingerprint, captured by FTIR spectroscopy, could predict mortality risk in critically ill patients. Both the whole serum and the serum metabolome (i.e., serum after removal of macromolecules) were analyzed. PCA-LDA models demonstrated strong performance in predicting patients’ pathophysiological state. A significantly more accurate model for predicting the patients’ pathophysiological state was achieved using the serum metabolome (94%) compared to the whole serum (81%). This is consistent with metabolomics, which provides a more direct view of the systems’ functionality. These promising results highlight the importance of FTIR spectroscopy analysis of the serum metabolome, offering a rapid, cost-effective, and high-throughput method for assessing patients' pathophysiological state.
- Early mortality prediction in intensive care unit patients based on serum metabolomic fingerprintPublication . Araújo, Rúben Alexandre Dinis; Ramalhete, Luís; Von Rekowski, Cristiana; Henrique Fonseca, Tiago Alexandre; Bento, Luís; Calado, CecíliaPredicting mortality in intensive care units (ICUs) is essential for timely interventions and efficient resource use, especially during pandemics like COVID-19, where high mortality persisted even after the state of emergency ended. Current mortality prediction methods remain limited, especially for critically ill ICU patients, due to their dynamic metabolic changes and heterogeneous pathophysiological processes. This study evaluated how the serum metabolomic fingerprint, acquired through Fourier-Transform Infrared (FTIR) spectroscopy, could support mortality prediction models in COVID-19 ICU patients. A preliminary univariate analysis of serum FTIR spectra revealed significant spectral differences between 21 discharged and 23 deceased patients; however, the most significant spectral bands did not yield high-performing predictive models. By applying a Fast-Correlation-Based Filter (FCBF) for feature selection of the spectra, a set of spectral bands spanning a broader range of molecular functional groups was identified, which enabled Naïve Bayes models with AUCs of 0.79, 0.97, and 0.98 for the first 48 h of ICU admission, seven days prior, and the day of the outcome, respectively, which are, in turn, defined as either death or discharge from the ICU. These findings suggest FTIR spectroscopy as a rapid, economical, and minimally invasive diagnostic tool, but further validation is needed in larger, more diverse cohorts.
- Discovery of delirium biomarkers through minimally invasive serum molecular fingerprinting.Publication . Viegas, Ana; Araújo, Rúben; Ramalhete, Luís; Von Rekowski, Cristiana; Fonseca, Tiago AH; Bento, Luís; Calado, CecíliaDelirium presents a significant clinical challenge, primarily due to its profound impact on patient outcomes and the limitations of the current diagnostic methods, which are largely subjective. During the COVID-19 pandemic, this challenge was intensified as the frequency of delirium assessments decreased in Intensive Care Units (ICUs), even as the prevalence of delirium among critically ill patients increased. The present study evaluated how the serum molecular fingerprint, as acquired by Fourier-Transform InfraRed (FTIR) spectroscopy, can enable the development of predictive models for delirium. A preliminary univariate analysis of serum FTIR spectra indicated significantly different bands between 26 ICU patients with delirium and 26 patients without, all of whom were admitted with COVID-19. However, these bands resulted in a poorly performing Naïve-Bayes predictive model. Considering the use of a Fast-Correlation-Based Filter for feature selection, it was possible to define a new set of spectral bands with a wider coverage of molecular functional groups. These bands ensured an excellent Naïve-Bayes predictive model, with an AUC, a sensitivity, and a specificity all exceeding 0.92. These spectral bands, acquired through a minimally invasive analysis and obtained rapidly, economically, and in a high-throughput mode, therefore offer significant potential for managing delirium in critically ill patients.