Electronegativity- induced cobalt-doped platinum hollow nanospheres with high CO tolerance for efficient methanol oxidation reaction

Although Platinum (Pt)-based alloys have garnered significant interest within the realm of direct methanol fuel cells (DMFCs), there still exists a notable dearth in the exploration of the catalytic behavior of the liquid fuels on well-defined active sites and unavoidable Pt poisoning because of the adsorbed CO species (COads). Here, we propose an electronegativity-induced electronic redistribution strategy to optimize the adsorption of crucial intermediates for the methanol oxidation reaction (MOR) by introducing the Co element to form the PtCo alloys. The optimal PtCo hollow nanospheres (HNSs) exhibit excellent high-quality activity of 3.27 A mgPt-1, which is 11.6 times and 13.1 times higher than that of Pt/C and pure Pt, respectively. The in-situ Fourier transform infrared reflection spectroscopy validates that electron redistribution could weak CO adsorption, and subsequently decrease the CO poisoning adjacent the Pt active sites. Theoretical simulations result show that the introduction of Co optimize surface electronic structure and reduce the d-band center of Pt, thus optimized the adsorption behavior of COads. This study not only employs a straightforward method for the preparation of Pt-based alloys but also delineates a pathway toward designing advanced active sites for MOR via electronegativity-induced electronic redistribution.

Flt3 ligand augments immune responses to soluble PD1-based DNA vaccine via expansion of type 1 conventional DCs

DNA vaccines are prospective for their efficient manufacturing process, but their immunogenicity is limited as they cannot efficiently induce CD8+ T cell responses. A promising approach is to induce cross-presentation by targeting antigens to DCs. Flt3L can expand the number of type 1 conventional DCs and thereby improve cross-presentation. In this study, we first constructed a DNA vaccine expressing soluble PD1 and found that the therapeutic effect of targeting DCs with only the sPD1 vaccine was limited. When combined the vaccine with Flt3L, the anti-tumor effect was significantly enhanced. Considering the complexity of tumors and that a single method may not be able to activate a large number of effective CD8+ T cells, we combined different drugs and the vaccine with Flt3L based on the characteristics of different tumors. In 4T1 model, we reduced Tregs through cyclophosphamide. In Panc02 model, we increased activated DCs by using aCD40. Both strategies triggered strong CD8+ T cell responses and significantly improved the therapeutic effect. Our study provides important support for the clinical exploration of DC-targeted DNA vaccines in combination with Flt3L.

Just a number? Donor age and (lack of) associated reasons for heart offer refusal

The use of 50+ year-old donors for heart transplant (HT) is rare in the United States. We assessed reasons for this-and whether it reflects concern about age itself or associated risk factors-using a survey of US HT centers. The Donor Heart Study enrolled US adult potential heart donors from 2015 to 2020. A total of 6,814 surveys across 2,197 donors cited, on average, 2.4 reasons (per donor) for offer refusal. Age was cited often (by ≥50% of centers surveyed) for 715 donors (33%). In this subgroup, accompanying donor-related reasons for refusal were infrequent, with no cardiac abnormality cited in most cases. Donor age showed associations with (1) age as a reason for refusal and (2) discard. Both abruptly increased at age 50: 55% of 50 to 51-year-old donors were refused often due to age (vs 38% of 48-49-year-olds), and 72% were discarded (vs 55% of 48-49-year-olds), despite no evidence of a threshold effect of age on outcomes.

Insights into the molecular mechanisms of lipid transformation in sturgeon fillets: Interplay between specific spoilage and dominant bacteria

This study investigates spoilage bacteria's impact on lipid metabolism in sturgeon fillets using UHPLC-Q-Orbitrap-MS/MS-based untargeted lipidomic analysis. A total of 4041 lipid molecules across five classes and 42 subclasses were identified, including glycerophospholipids (GPs, 50.88%), glycerolipids (GLs, 36.08%), sphingolipids (SPs, 10.47%), fatty acyls (FAs, 2.45%), and sterol lipids (STs, 0.12%). Aeromonas sobria, a specific spoilage bacterium, reduced GPs and FAs while increasing GLs, SPs, and STs via extracellular lipases and esterases. Acinetobacter albensis, the dominant bacterium, mainly elevated SPs and FAs. Their interaction promoted lipid metabolism and oxidation while producing volatile organic compounds (VOCs). Ethyl isobutyrate, ethyl propionate, isobutyl formate, pentan-2-one, propan-2-one, 2-butanone, 3-methyl-3-buten-1-ol, and dimethyl sulfide were mainly associated with Acinetobacter albensis, while 1-hexanol, 1-pentanol, 1-penten-3-ol, 1-hydroxypropan-2-one, 3-methyl-1-butanol, 2-methylbutanal, 3-hydroxy-2-butanone, and propionaldehyde were mainly related to Aeromonas sobria. This work unveils the mechanism of lipid transformation in sturgeon fillets during refrigerated storage, offering insights for aquatic products quality control.

Unveiling the slow digestion and peptide profiles of polymerised whey gel via heat and TGase crosslinking: An in vitro/vivo perspective

Polymerised whey is widely used in dairy products and can affect digestibility when its high-molecular-weight aggregates and gel structure are modified. This study investigated the digestibility, peptide profiles and satiety of modified whey protein isolate (MWPI) pre-heated with transglutaminase. Results showed that 43.06 % of MWPI was digested during the 4-h in vitro digestion, indicating a slow digestion rate. Compared with whey protein isolate (WPI), MWPI yielded 103 peptides with higher abundance following in vitro digestion, including 17 angiotensin-converting enzyme inhibitors and 1 dipeptidyl peptidase-4 inhibitor. Visual analytics indicated differential peptides located at distinct α-helix and β-sheet of β-lactoglobulin, α-lactalbumin and bovine serum albumin. MWPI gavage extended stomach retention time, decreased intestinal propulsion rate from 75.60 % (WPI group) to 33.72 % in 30 min and enhanced satiety within 120 min compared with WPI. Overall, whey polymerisation modulates protein-enzyme interactions, releasing different peptides and enhancing satiety.

Growth Modulation of High-Entropy Alloys for Electrocatalytic Methanol Oxidation Reaction

High-entropy alloy (HEA) electrocatalysts have exhibited remarkable catalytic performance because of their synergistic interactions among multiple metals. However, the growth mechanism of HEAs remains elusive, primarily due to the constraints imposed by the current synthesis methodologies for HEAs. In this work, an innovative electrodeposition method was developed to fabricate Pt-based nanocomposites (Pt1Bi2Co1Cu1Ni1/CC), comprising HEA nanosheets and carbon cloths (CCs). The reaction system could be effectively monitored by taking samples out from the system during the reaction process, facilitating in-depth insight into the growth mechanism underlying the material formation. In particular, Pt1Bi2Co1Cu1Ni1/CC nanocomposites show superior methanol oxidation reaction (MOR) performance (mass activity up to 5.02 A mgPt-1). Upon structural analysis, the d-band center of Pt1Bi2Co1Cu1Ni1/CC is lower in comparison with that of Pt1Bi2/CC and Pt/CC, demonstrating the formation of a rich-electron structure. Both the uniformity of HEAs and the carbon-supported effect could provide additional active sites. These findings suggest that the strong electronic interaction within HEAs and additional active sites can effectively modulate the catalytic structure of Pt, which benefits the enhanced CO tolerance and MOR performance.

Precise Construction of the Triple-Phase Boundary and Its Antiphosphate Poisoning Effect in the Confined Region

As a critical component for the oxygen reduction reaction (ORR), platinum (Pt) catalysts exhibit promising catalytic performance in High-temperature-proton exchange membrane fuel cells (HT-PEMFCs). Despite their success, HT-PEMFCs primarily utilize phosphoric acid-doped polybenzimidazole (PA-PBI) as the proton exchange membrane, and the phosphoric acid within the PBI matrix tends to leach onto the Pt-based layers, easily causing toxicity. Herein, we first propose UiO-66@Pt3Co1-T composites with precisely engineered interfacial structures. The UiO-66@Pt3Co1-T exhibits an octahedral porous framework with uniform structural dimensions and even distribution of surface nanoparticles, which demonstrate superior ORR performance compared to commercial Pt/C. The unique structure and morphology of the composites also exhibit a favorable half-wave potential in different concentrations of phosphoric acid electrolyte, regulated by the phosphoric acid adsorption site and intensity.This finding suggests that the incorporation of Co could effectively modulate the Pt d-band center, thereby enhancing the ORR performance. Furthermore, the selective adsorption of phosphoric acid by ZrO2 enables precise control over the phosphoric acid distribution. Notably, the retention of the octahedral framework post high-temperature treatment facilitates the establishment of dual transport pathways for gases and protons, leading to a stable and efficient triple-phase boundary.

Search for Light Long-Lived Particles in pp Collisions at sqrt[s]=13 TeV Using Displaced Vertices in the ATLAS Inner Detector

A search for long-lived particles (LLPs) using 140  fb^{-1} of pp collision data with sqrt[s]=13  TeV recorded by the ATLAS experiment at the LHC is presented. The search targets LLPs with masses between 5 and 55 GeV that decay hadronically in the ATLAS inner detector. Benchmark models with LLP pair production from exotic decays of the Higgs boson and models featuring long-lived axionlike particles (ALPs) are considered. No significant excess above the expected background is observed. Upper limits are placed on the branching ratio of the Higgs boson to pairs of LLPs, the cross section for ALPs produced in association with a vector boson, and, for the first time, on the branching ratio of the top quark to an ALP and a u/c quark.

R-loops' m6A modification and its roles in cancers

R-loops are three-stranded nucleic acid structures composed of an RNA-DNA hybrid and a displaced DNA strand. They are widespread and play crucial roles in regulating gene expression, DNA replication, and DNA and histone modifications. However, their regulatory mechanisms remain unclear. As R-loop detection technology advances, changes in R-loop levels have been observed in cancer models, often associated with transcription-replication conflicts and genomic instability. N6-methyladenosine (m6A) is an RNA epigenetic modification that regulates gene expression by affecting RNA localization, splicing, translation, and degradation. Upon reviewing the literature, we found that R-loops with m6A modifications are implicated in tumor development and progression. This article summarizes the molecular mechanisms and detection methods of R-loops and m6A modifications in gene regulation, and reviews recent research on m6A-modified R-loops in oncology. Our goal is to provide new insights into the origins of genomic instability in cancer and potential strategies for targeted therapy.

Search for the Exclusive W Boson Hadronic Decays W^{±}→π^{±}γ, W^{±}→K^{±}γ and W^{±}→ρ^{±}γ with the ATLAS Detector

A search for the exclusive hadronic decays W^{±}→π^{±}γ, W^{±}→K^{±}γ, and W^{±}→ρ^{±}γ is performed using up to 140  fb^{-1} of proton-proton collisions recorded with the ATLAS detector at a center-of-mass energy of sqrt[s]=13  TeV. If observed, these rare processes would provide a unique test bench for the quantum chromodynamics factorization formalism used to calculate cross sections at colliders. Additionally, at future colliders, these decays could offer a new way to measure the W boson mass through fully reconstructed decay products. The search results in the most stringent upper limits to date on the branching fractions B(W^{±}→π^{±}γ)<1.9×10^{-6}, B(W^{±}→K^{±}γ)<1.7×10^{-6}, B(W^{±}→ρ^{±}γ)<5.2×10^{-6} at 95% confidence level.

Recent progress of gas sensors based on perovskites

Gas sensors convert gas-related information into usable data by monitoring changes in conductivity and chemical reactions resulting from the adsorption of gas molecules. Recently, perovskites have emerged as promising candidate materials for gas sensors, owing to their polar reactivity, chemical responsiveness, and sensitivity. These characteristics enable the detection of the presence and concentration of various gases. This article provides a concise review of recent advancements in perovskite-based gas sensors. First, the chemical composition, structure, and preparation methods of perovskites, as well as the effects of their structure on gas sensing performance, are examined. The key performance parameters of the sensor and the sensing mechanism of the perovskite-based gas sensor are discussed. Then the development of gas sensors based on different structural types of perovskites, including single-component perovskites, mixed-component perovskites, and metal-oxide perovskites, is discussed. Finally, the challenges and opportunities for gas sensors based on perovskites are summarized and prospected.

Domestic violence and depression among Chinese adolescents: The role of self-evaluation

BACKGROUND

Depression of adolescents seriously affects their mental health as well as the formation and development of sound personality. According to Family Systems Theory, individuals' mental health is closely related with external (e.g. domestic violence) and internal factor (e.g. self-evaluation). The formation mechanism of depression needs deep investigation in order to provide better educational intervention for students and promote their healthy development.

AIM

The study examined the relationship among domestic violence, depression, and self-evaluation.

METHODS

The data were collected from 1,011 Chinese adolescents (Mage = 12.04 ± 1.71) by the questionnaire of Family Violence Scale, Depression Questionnaire, and Rosenberg Self Esteem Scale.

RESULTS

We found domestic violence and depression were significantly positively correlated (r = .25, p < .001); self-evaluation was significantly negatively correlated with domestic violence (r = -.26, p < .001) and depression (r = -.50, p < .001). Moreover, domestic violence could directly and positively predict depressed psychology, and could also indirectly predict depressed psychology through the mediating effect of self-evaluation.

CONCLUSION

The level of depression of adolescents was closely related with domestic violence and self-evaluation. And self-evaluation played a mediating role between domestic violence and self-evaluation.

Association between blood phosphorus level and adverse outcomes in patients with coronary artery disease: A meta-analysis

Objective

The prognostic implication of phosphorus level in patients with coronary artery disease (CAD) remains controversial. We aimed to conduct a meta-analysis to evaluate the prognostic role of blood phosphorus level in CAD patients.

Methods

We searched the PubMed, Web of Science, Scopus, and Embase databases until December 28, 2023, to identify prospective or retrospective longitudinal observational studies that examined the prognostic value of blood phosphorus level in CAD patients. Outcome measures included all-cause or cardiovascular mortality, heart failure, stroke, and major adverse cardiac events (MACEs). The prognostic value of blood phosphorus level was expressed by pooling the fully adjusted hazard ratios (HR) with 95 % confidence intervals (CI) for the hypophosphatemia or hyperphosphatemia compared to the reference normal phosphorus level.

Results

Six studies involving 19,553 CAD patients were included. Meta-analysis showed that the hyperphosphatemia was significantly associated with higher risk of all-cause mortality (HR 1.39; 95 % CI 1.20-1.61), cardiovascular mortality (HR 1.37; 95 % CI 1.22-1.53), heart failure (HR 1.64; 95 % CI 1.44-1.87), and MACEs (HR 1.39; 95 % CI 1.03-1.88) but not stroke (HR 1.23; 95 % CI 0.79-1.92). However, non-significant association was found between hypophosphatemia and all-cause mortality (HR 1.21; 95 % CI 0.98-1.51), cardiovascular mortality (HR 1.07; 95 % CI 0.78-1.45), heart failure (HR 0.87; 95 % CI 0.72-1.05), stroke (HR 1.12; 95 % CI 0.76-1.67), and MACEs (HR 1.16; 95 % CI 0.99-1.36).

Conclusions

Hyperphosphatemia, but not hypophosphatemia independently predicts all-cause mortality, cardiovascular mortality, heart failure, and MACEs in CAD patients.

Combination and summary of ATLAS dark matter searches interpreted in a 2HDM with a pseudo-scalar mediator using 139 fb-1 of s=13 TeV pp collision data

Results from a wide range of searches targeting different experimental signatures with and without missing transverse momentum (ETmiss) are used to constrain a Two-Higgs-Doublet Model (2HDM) with an additional pseudo-scalar mediating the interaction between ordinary and dark matter (2HDM+a). The analyses use up to 139 fb-1 of proton-proton collision data at a centre-of-mass energy s=13 TeV recorded with the ATLAS detector at the Large Hadron Collider during 2015-2018. The results from three of the most sensitive searches are combined statistically. These searches target signatures with large ETmiss and a leptonically decaying Z boson; large ETmiss and a Higgs boson decaying to bottom quarks; and production of charged Higgs bosons in final states with top and bottom quarks, respectively. Constraints are derived for several common and new benchmark scenarios in the 2HDM+a.

The Complex Immune Cell Composition and Cellular Interaction in the Alveolar Compartment of Patients with Acute Respiratory Distress Syndrome

Acute respiratory distress syndrome (ARDS) is characterized by protein rich edema due to alveolar-capillary barrier dysfunction caused by inflammatory processes. Currently, our understanding of the inflammatory response in patients with ARDS is mainly based on assessment of the systemic compartment and preclinical studies. Investigations into the intricate network of immune cells and their critical functions in the alveolar compartment remain limited. However, with recent improvements in single cell analyses, our comprehensive understanding of the interactions between immune cells in the lungs has improved. In this review, we summarize the current knowledge about the cellular composition and interactions of different immune cell types within the alveolar space of patients with ARDS. Neutrophils and macrophages are the predominant immune cells in the alveolar space of ARDS patients. Yet, all immune cells present, including lymphocytes, participate in complex interactions, coordinate recruitment, modulate the lifespan and control apoptosis through various signaling pathways. Moreover, the cellular composition of alveolar immune cells is associated with clinical outcomes of ARDS patients. In conclusion, this synthesis advances our understanding of ARDS immunology, emphasizing the crucial role of immune cells within the alveolar space. Associations between cellular composition and clinical outcomes highlight the significance of exploring distinct alveolar immune cell subsets. Such exploration holds promise for uncovering novel therapeutic targets in ARDS pathophysiology, presenting avenues for enhancing clinical management and treatment strategies for ARDS patients. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Imputing spatial transcriptomics through gene network constructed from protein language model

Image-based spatial transcriptomic sequencing technologies have enabled the measurement of gene expression at single-cell resolution, but with a limited number of genes. Current computational approaches attempt to overcome these limitations by imputing missing genes, but face challenges regarding prediction accuracy and identification of cell populations due to the neglect of gene-gene relationships. In this context, we present stImpute, a method to impute spatial transcriptomics according to reference scRNA-seq data based on the gene network constructed from the protein language model ESM-2. Specifically, stImpute employs an autoencoder to create gene expression embeddings for both spatial transcriptomics and scRNA-seq data, which are used to identify the nearest neighboring cells between scRNA-seq and spatial transcriptomics datasets. According to the neighbored cells, the gene expressions of spatial transcriptomics cells are imputed through a graph neural network, where nodes are genes, and edges are based on cosine similarity between the ESM-2 embeddings of the gene-encoding proteins. The gene prediction uncertainty is further measured through a deep learning model. stImpute was shown to consistently outperform state-of-the-art methods across multiple datasets concerning imputation and clustering. stImpute also demonstrates robustness in producing consistent results that are insensitive to model parameters.

Determination of the Relative Sign of the Higgs Boson Couplings to W and Z Bosons Using WH Production via Vector-Boson Fusion with the ATLAS Detector

The associated production of Higgs and W bosons via vector-boson fusion is highly sensitive to the relative sign of the Higgs boson couplings to W and Z bosons. In this Letter, two searches for this process are presented, using 140  fb^{-1} of proton-proton collision data at sqrt[s]=13  TeV recorded by the ATLAS detector at the LHC. The first search targets scenarios with opposite-sign couplings of the W and Z bosons to the Higgs boson, while the second targets standard model-like scenarios with same-sign couplings. Both analyses consider Higgs boson decays into a pair of b quarks and W boson decays with an electron or muon. The data exclude the opposite-sign coupling hypothesis with a significance beyond 5σ, and the observed (expected) upper limit set on the cross section for vector-boson fusion WH production is 9.0 (8.7) times the standard model value at 95% confidence level.

Identification and functional analysis of GmPasL regulating pod color in vegetable soybean

BACKGROUND

Vegetable soybean is rich in nutrients and has a unique flavor. It is highly preferred by people because of its pharmacological activities, including those that regulate the intestines and lower blood pressure. The pod color of vegetable soybeans is an important quality that indicates their freshness and has a significant impact on their commercialization.

RESULTS

In this study, pod color was evaluated in 301 vegetable soybean accessions collected from various regions. Genome-wide association analysis was carried out using the Mixed linear model (MLM), a total of 18 quantitative trait loci including 117 SNPs were detected. Two significant QTLs located on chromosomes 6 (qGPCL4 /qGPCa1/qGPCb2) and 18 (qGPCL10/qGPCb3) were consistently detected across different variables. Based on gene functional annotation, 30 candidate genes were identified in these two candidate intervals. Combined with transcriptome analysis, Glyma.18g241700 has been identified as a candidate gene for regulating pod color in vegetable soybeans. Glyma.18g241700 encodes a chlorophyll photosystem I subunit XI. which localizes to the chloroplast named GmPsaL, qRT-PCR analysis showed that GmPsaL was specifically highly expressed in developing pods. Furthermore, overexpression of GmPsaL in transgenetic Arabidopsis plants produced dark green pods.

CONCLUSIONS

These findings may be useful for clarifying the genetic basis of the pod color of vegetable soybeans. The identified candidate genes may be useful for the genetic improvement of the appearance quality of vegetable soybeans.

Fully Integrated Biosensing System for Dynamic Monitoring of Sweat Glucose and Real-Time pH Adjustment Based on 3D Graphene MXene Aerogel

The development of noninvasive glucose sensors capable of continuous monitoring without restricting user mobility is crucial, particularly for managing diabetes, which demands consistent and long-term observation. Traditional sensors often face challenges with accuracy and stability that curtail their practical applications. To address these issues, we have innovatively applied a three-dimensional porous aerogel composed of Ti3C2Tx MXene and reduced graphene oxide (MX-rGO) in electrochemical sensing. It significantly reduces the electron-transfer distance between the enzyme's redox center and the electrode surface while firmly anchoring the enzyme layer to effectively prevent any leakage. Another pivotal advancement in our study is the integration of the sensor with a real-time adaptive calibration mechanism tailored specifically for analyzing sweat glucose. This sensor not only measures glucose levels but also dynamically monitors and adjusts to pH fluctuations in sweat. Such capabilities ensure the precise delivery of physiological data during physical activities, providing strong support for personalized health management.

Construction and validation of a prediction model for preoperative prediction of Ki-67 expression in endometrial cancer patients by apparent diffusion coefficient

AIM

Ki-67 is a marker of cell proliferation and is increasingly being used as a primary outcome measure in preoperative window studies of endometrial cancer (EC). This study explored the feasibility of using apparent diffusion coefficient (ADC) values in noninvasive prediction of Ki-67 expression levels in EC patients before surgery, and constructs a nomogram by combining clinical data.

MATERIAL AND METHODS

This study retrospectively analyzed 280 EC patients who underwent preoperative magnetic resonance imaging (MRI) diffusion-weighted imaging (DWI) in our hospital from January 2017 to February 2023. Evaluate the potential nonlinear relationship between ADC values and Ki-67 expression using the nomogram. The included patients were randomized into a training set (n = 186) and a validation set (n = 84). Using a combination of logistic regression and LASSO regression results, from which the four best predictors were identified for the construction of the nomogram. The accuracy and clinical applicability of the nomogram were assessed using the receiver operating characteristic curve (ROC), calibration curve, and decision curve analysis (DCA).

RESULTS

The results of this study showed a nonlinear correlation between ADCmin and Ki-67 expression (nonlinear P = 0.019), and the nonlinear correlation between ADCmean and Ki-67 expression (nonlinear P = 0.019). In addition, this study constructed the nomogram by incorporating ADCmax, International Federation of Gynecology and Obstetrics (FIGO), and chemotherapy. The area under the curve (AUC) values of the ROC for nomogram, ADCmax, FIGO, chemotherapy and grade in the training set were 0.783, 0.718, 0.579, 0.636, and 0.654, respectively. In the validation set, the AUC values for nomogram, ADCmax, FIGO, chemotherapy, and grade were 0.820, 0.746, 0.558, 0.542, and 0.738, respectively. In addition, the calibration curves and the DCA curves suggested a better predictive efficacy of the model.

CONCLUSION

A nomogram prediction model constructed on the basis of ADCmax values combined with clinical data can be used as an effective method to noninvasively assess Ki-67 expression in EC patients before surgery.

Prediction of Donor Heart Acceptance for Transplant and Its Clinical Implications: Results From The Donor Heart Study

BACKGROUND

Despite a shortage of potential donors for heart transplant in the United States, most potential donor hearts are discarded. We evaluated predictors of donor heart acceptance in the United States and applied machine learning methods to improve prediction.

METHODS

We included a nationwide (2005-2020) cohort of potential heart donors in the United States (n=73 948) from the Scientific Registry of Transplant Recipients and a more recent (2015-2020) rigorously phenotyped cohort of potential donors from DHS (Donor Heart Study; n=4130). We identified predictors of acceptance for heart transplant in both cohorts using multivariate logistic regression, incorporating time-interaction terms to characterize their varying effects over time. We fit models predicting acceptance for transplant in a 50% training subset of DHS using logistic regression, least absolute shrinkage and selection operator, and random forest algorithms and compared their performance in the remaining 50% (test) of the subset.

RESULTS

Predictors of donor heart acceptance were similar in the nationwide and DHS cohorts. Among these, older age (P value for time interaction, 0.0001) has become increasingly predictive of discard over time while other factors, including those related to drug use, infection, and mild cardiac diagnostic abnormalities, have become less influential (P value for time interaction, <0.05 for all). A random forest model (area under the curve, 0.908; accuracy, 0.831) outperformed other prediction algorithms in the test subset and was used as the basis of a novel web-based prediction tool.

CONCLUSIONS

Predictors of donor heart acceptance for transplantation have changed significantly over the last 2 decades, likely reflecting evolving evidence regarding their impact on posttransplant outcomes. Real-time prediction of donor heart acceptance, using our web-based tool, may improve efficiency during donor management and heart allocation.

[Clinical application of inferior pancreaticoduodenal artery management in laparoscopic pancreaticoduodenectomy]

Objective: To investigate the clinical effect of proper management of inferior pancreaticoduodenal artery (IPDA) in laparoscopic pancreaticoduodenectomy (LPD). Methods: This is a retrospective case series study. The clinical and pathological data of 70 patients who received LPD due to pancreatic head tumors, periampullary tumors, or distal common bile duct tumors in the Pancreatic Center of the Second Clinical College of Guangzhou University of Chinese Medicine from January to December 2022 were retrospectively collected. There were 47 males(67.1%) and 23 females(32.9%),aged (59.9±12.8)years(range:13 to 87 years).The procedure of IPDA exposure was as follows:a middle approach was utilized to expose the right half of superior mesenteric artery(SMA) and its right branches between the SMA and superior mesenteric vein(SMV) in superior colonic region. In the subcolonic region,SMA trunk exposure via dissection along the jejunal artery from feet to head and identification the association between IPDA and jejunal artery were prior to IPDA root ligation and dissection. The safety and efficacy of intraoperative IPDA handling were assessed based on surgical videos. Follow-up was carried out in outpatient clinic or by telephone, and outpatient follow-up was conducted once every 1 to 3 months after surgery. Results: The percentage of total LPD was 98.6%(69/70),with all patients achieving R0 resection. Nine cases(12.9%) were involved in combined vascular resection and reconstruction,with 1 case (1.4%) requiring additional upper abdominal incision for vascular and gastrointestinal reconstruction,while the remaining eight cases (11.4%) were completed laparoscopically. The operative time was (432.7±115.4)minutes(range:282 to 727 minutes), and the blood loss was (140.0±125.7)ml(range:20 to 800 ml). Only two patients(2.9%) received fresh frozen plasma transfusion,with an average volume of 650 ml. Reliable ligation and safe handling of the IPDA were achieved in 91.4%(64/70) of cases, with 8.6%(6/70) suffering from IPDA injury-related bleeding. No one was converted to opened surgery. Pathologically,the mean tumor size was (3.3±1.6)cm (range:1 to 7 cm),and the mean number of harvested lymph nodes was 17.0±7.3(range:0 to 46). Lymph node metastasis was observed in 13 cases (18.6%). Five cases (13.2%) developed grade B pancreatic fistula,while no grade C pancreatic fistula occurred. Other complications included bile leakage in one case(1.4%),delayed gastric emptying in two cases(2.9%), lymphatic leakage in 2 cases(2.9%),intra-abdominal infection in 9 cases(12.9%),and fat liquefaction of surgical incision in 1 case(1.4%). Two cases(2.9%) experienced postoperative intra-abdominal bleeding,one due to mesangial bleeding of lesser curvature of the stomach and the other due to oozing from the hepatic arterial sheath. These bleeding events were not concerned with IPDA. The average length of postoperative hospital stay was (15.2±4.6)days(range:9 to 28 days). Conclusion: Proper intraoperative management of IPDA in LPD might reduce IPDA-related bleeding during and after surgery and improve the safety of LPD.

The 'D-M-C' strategy for conventional ameloblastoma of the mandible: a retrospective study

The purpose of this multicentre study was to evaluate the efficacy of the 'dredging-marsupialization-curettage' (D-M-C) strategy in the treatment of conventional intraosseous ameloblastoma of the mandible. A total of 31 patients from three institutions, who had a pathological diagnosis of conventional ameloblastoma of the mandible, were treated with the D-M-C strategy. The surgical protocol comprised a dredging and marsupialization (D-M) step, with additional D-M steps as required. The patients then underwent curettage (C) once an obvious effect of the D-M step had been achieved during follow-up. Eight patients were followed up for ≥36 months but <60 months, while 23 were followed up for ≥60 months. Nineteen of the 23 patients followed up for ≥60 months were disease-free at the last follow-up, with no evidence of recurrence. The D-M step is effective for reducing the tumour size and preserving vital structures. The D-M-C surgical strategy may be a feasible treatment option for conventional ameloblastoma of the mandible.