Nowadays, a large number of consumers have a strong preference for the "functional foods" for the improvement of their eating diet and maintenance of their health (Jeffery, 2005;Shashirekha et al., 2015).Accordingly, fruits and vegetables are important parts of the healthy diet with the capacity of preventing several diseases (Jeffery, 2005;Shashirekha et al., 2015). In recent years, the beetroot (Beta vulgaris L.) has become popular as a potential "functional food" within this context (Frank et al., 2005). In spite of the fact that the beetroot has long been used as a traditional cuisines in Europe, the understanding of the applied value is very limited. Today, with the development of preclinical trials, consumers have increased knowledge about the biological activity of beetroot. The beetroot is now widely cultivated to meet the increase in demand (Maity et al., 2016). In addition to being known as fresh vegetables, or as food additives in cattle products, beverages, candies, and dairy products (Georgiev et al., 2010;Vieira Teixeira da Silva et al., 2019), beetroot has also been found to possess the potential of treating and preventing multiple diseases. According to the database displays in the US Department of Agriculture Agricultural Research Service, beetroot is not only rich in proteins (1.68 g), carbohydrates (9.96 g), fat (0.18 g), amino acids (1.216 g), fatty acids (0.119 g), phytosterols (0.025 g), minerals (0.483 g), and fibers (2 g) per 100 g of wet weight, but also contains

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BackgroundPatients with heart failure (HF) with diabetes may face a poorer prognosis and higher mortality than patients with either disease alone, especially for those in intensive care unit. So far, there is no precise mortality risk prediction indicator for this kind of patient.MethodTwo high-quality critically ill databases, the Medical Information Mart for Intensive Care IV (MIMIC-IV) database and the Telehealth Intensive Care Unit (eICU) Collaborative Research Database (eICU-CRD) Collaborative Research Database, were used for study participants’ screening as well as internal and external validation. Nine machine learning models were compared, and the best one was selected to define indicators associated with hospital mortality for patients with HF with diabetes. Existing attributes most related to hospital mortality were identified using a visualization method developed for machine learning, namely, Shapley Additive Explanations (SHAP) method. A new composite indicator ASL was established using logistics regression for patients with HF with diabetes based on major existing indicators. Then, the new index was compared with existing indicators to confirm its discrimination ability and clinical value using the receiver operating characteristic (ROC) curve, decision curve, and calibration curve.ResultsThe random forest model outperformed among nine models with the area under the ROC curve (AUC) = 0.92 after hyper-parameter optimization. By using this model, the top 20 attributes associated with hospital mortality in these patients were identified among all the attributes based on SHAP method. Acute Physiology Score (APS) III, Sepsis-related Organ Failure Assessment (SOFA), and Max lactate were selected as major attributes related to mortality risk, and a new composite indicator was developed by combining these three indicators, which was named as ASL. Both in the initial and external cohort, the new indicator, ASL, had greater risk discrimination ability with AUC higher than 0.80 in both low- and high-risk groups compared with existing attributes. The decision curve and calibration curve indicated that this indicator also had a respectable clinical value compared with APS III and SOFA. In addition, this indicator had a good risk stratification ability when the patients were divided into three risk levels.ConclusionA new composite indicator for predicting mortality risk in patients with HF with diabetes admitted to intensive care unit was developed on the basis of attributes identified by the random forest model. Compared with existing attributes such as APS III and SOFA, the new indicator had better discrimination ability and clinical value, which had potential value in reducing the mortality risk of these patients.

Background: Vitamin D, as a common micronutrient, has been widely used in critically ill patients. However, whether supplementation of vitamin D in adult patients with sepsis can improve their prognosis remains controversial. Methods: Data from the Mart for Intensive Care IV database was used in this retrospective cohort study, and adult patients with sepsis were enrolled. Critically ill patients, admitted to intensive care units (ICUs) between 2008 and 2019 at the Beth Israel Deaconess Medical Center (BIDMC), were divided into the vitamin D supplementation group and non-vitamin D supplementation group. The primary outcomes were defined as all-cause in-hospital, 28-day, and 90-day mortality rates after admission to the ICU. A 1:1 propensity score matching (PSM), inverse probability of treatment weighting (IPTW), and overlap weighting (OW) analyses were used to minimize selection bias and balance the baseline demographic characteristics. Regression and survival analyses were performed to assess the association between vitamin D supplementation and clinical outcomes in patients with sepsis. Results: In total, 3539 patients with sepsis were enrolled as study participants; of these, 315 were supplemented with vitamin D during their ICU stay. In-hospital, 28-day, and 90-day mortality rates were significantly lower in patients with sepsis supplemented with vitamin D. Multivariate regression analysis showed vitamin D supplementation as a potential protective factor for in-hospital mortality with an odds ratio (OR) = 0.70 (0.51–0.96) after adjusting for all confounders. The hazard ratios (HRs) for 28-day and 90-day mortality were 0.65 (0.50–0.85) and 0.70 (0.55–0.90), respectively. The survival analysis showed that the vitamin D supplementation group had a higher survival probability within 28 and 90 days (p-value < 0.05). These results remained relatively stable post PSM, IPTW, and OW. However, we found no evidence that vitamin D supplementation could shorten the length of stay in the ICU or hospital. Conclusions: Vitamin D supplementation during an ICU stay was associated with improved prognosis in patients with sepsis, as evidenced by lower in-hospital, 28-day, and 90-day mortality rates and lower disease severity-related scores, but showed no influence on the length of stay in the hospital or ICU.

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