Single-Port One Anastomosis Sleeve Gastrectomy with Transit Bipartition: Initial Experience and Technique

BACKGROUND

Sleeve gastrectomy with transit bipartition (SG-TB) procedure has been gaining traction recently. While being a relatively novel procedure, it shows potentials to improve the standalone SG outcomes, such as diabetes remission and reflux. This article aims to show insights on performing SG-TB in one anastomosis fashion (SG-OATB) and single-port approach.

METHODS

Three patients who underwent laparoscopic single-port SG-OATB at our hospital were included. The parameters included in this study comprised of age, gender, height, weight, body mass index (BMI), type 2 diabetes mellitus (T2DM) assessment, gastroesophageal reflux disease (GERD) assessment, length of the small bowel, the duration of the procedure, and 30-day readmission rate.

RESULTS

The mean preoperative assessments for the three patients were as follows: two females vs. one male; age 38.7 ± 5.5 years old; weight 105.7 ± 5.4 kg; height 1.64 ± 0.11 m; BMI 39.3 ± 4.7 kg/m2; fasting blood glucose 6.7 ± 1.2 mmol/L; glycosylated hemoglobin level 7.1 ± 1.3%; GERD-Questionnaire score 6.3 ± 1.5; two patients with esophagitis grade A and B following endoscopy. The total duration of the procedure was 170.0 ± 26.5 min; there was no need for conversion to multiple-port in all patients. The 30-day readmission rate for all patients was 0%.

CONCLUSION

In our small cases of patients, single-port SG-OATB is feasible and safe. We found the closure of the anastomosis defect to be most technically demanding. To understand better the outcome of single-port SG-OATB, studies with larger sample and longer follow-up will be needed in the future.

Research on Laser Cleaning Technology for Aircraft Skin Surface Paint Layer

In this study, a pulsed laser operating at a wavelength of 1064 nm and with a pulse width of 100 ns was utilized for the removal of paint from the surface of a 2024 aluminum alloy. The experimental investigation was conducted to analyze the influence of laser parameters on the efficacy of paint layer removal from the aircraft skin's surface and the subsequent evolution in the microstructure of the laser-treated aluminum alloy substrate. The mechanism underlying laser cleaning was explored through simulation. The findings revealed that power density and scanning speed significantly affected the quality of cleaning. Notably, there were discernible damage thresholds and optimal cleaning parameters in repetitive frequency, with a power density of 178.25 MW/cm2, scanning speed of 500 mm/s, and repetitive frequency of 40 kHz identified as the primary optimal settings for achieving the desired cleaning effect. Thermal ablation and thermal vibration were identified as the principal mechanisms of cleaning. Moreover, laser processing induced surface dislocations and concentrated stress, accompanied by grain refinement, on the aluminum substrate.

Evaluation of China's live streaming e-commerce industry policies based on a three-dimensional analysis framework

As an emerging business modality and Internet format, live streaming e-commerce has developed rapidly since its emergence in 2016, especially since the outbreak of the COVID-19 epidemic in late 2019, when an increasing number of businesses from other industries attracted participation. However, with the development of the live streaming e-commerce industry, the industry's market environment is becoming increasingly chaotic. Therefore, during this period, government departments continuously formulate and implement relevant industry policies. In order to exploring the cooperation network structure, policy content distribution, and implementation effectiveness characteristics among publishers, this paper constructs a three-dimensional analysis framework of policy from the perspective of policy tools, policy effectiveness evaluation and policy publishers. The results show that in terms of policy tools, the overall structure of policy tools in the live streaming e-commerce industry is unreasonable, and different types of policy tools are significantly diverse. The proportion of environmental policy tools is greater than that of demand-based and supply-based policy tools, accounting for 62.97%, and among them, the tools related to industry regulation and management account for the largest proportion of the total, which greatly suppresses the enthusiasm of various entities in the industry for development. In terms of policy effectiveness evaluation, most of the policies do not formulate detailed long-, medium-, or short-term goals, nor are the policy priorities, incentive measures, or action modes perfect, indicating that the government's pushing and pulling forces for the live streaming e-commerce industry are insufficient. Finally, in the subject dimension of policy release, the synergy of relevant subjects is constantly improving, but there is also a phenomenon of over-concentration in the synergistic departments.

Identifying autism spectrum disorder from multi-modal data with privacy-preserving

The application of deep learning models to precision medical diagnosis often requires the aggregation of large amounts of medical data to effectively train high-quality models. However, data privacy protection mechanisms make it difficult to perform medical data collection from different medical institutions. In autism spectrum disorder (ASD) diagnosis, automatic diagnosis using multimodal information from heterogeneous data has not yet achieved satisfactory performance. To address the privacy preservation issue as well as to improve ASD diagnosis, we propose a deep learning framework using multimodal feature fusion and hypergraph neural networks for disease prediction in federated learning (FedHNN). By introducing the federated learning strategy, each local model is trained and computed independently in a distributed manner without data sharing, allowing rapid scaling of medical datasets to achieve robust and scalable deep learning predictive models. To further improve the performance with privacy preservation, we improve the hypergraph model for multimodal fusion to make it suitable for autism spectrum disorder (ASD) diagnosis tasks by capturing the complementarity and correlation between modalities through a hypergraph fusion strategy. The results demonstrate that our proposed federated learning-based prediction model is superior to all local models and outperforms other deep learning models. Overall, our proposed FedHNN has good results in the work of using multi-site data to improve the performance of ASD identification.

Causal relationship of obesity and adiposity distribution on risk of ventral hernia

PURPOSE

Ventral hernia (VH) is a common surgical disease. Previous studies suggested that obesity is an important risk factor for VH. However, the causal relationship between fat distribution and the risk of VH is still unclear. This study used Mendelian randomization (MR) to evaluate their causal relationship.

METHODS

We used the body mass index (BMI), body fat percentage, and body fat mass to represent general obesity and utilized the volume of abdominal subcutaneous adiposity tissue, visceral adiposity tissue, waist circumference, hip circumference, and waist-to-hip ratio to represent abdominal adiposity. The data were extracted from the large-scale genome-wide association study of European ancestry. We used two-sample MR to infer causality, using multivariate MR to correct the effects of confounding factors.

RESULTS

Increased BMI, body fat percentage, body fat mass, visceral adiposity tissue, waist circumference, and hip circumference rather than subcutaneous adiposity tissue or waist-to-hip ratio, were causally associated with a higher risk of VH. The results of multivariate MR suggested that body fat percentage was causally associated with a higher risk of VH after adjusting for body mass index, diabetes, and smoking.

CONCLUSION

General obesity, increased visceral adiposity tissue, waist circumference, and hip circumference rather than subcutaneous adiposity tissue or the waist-to-hip ratio were causally associated with a higher risk of VH. These findings provided a deeper understanding of the role that the distribution of adiposity plays in the mechanism of VH.

Supermolecule Polymer Derived Porous Carbon Nitride Microspheres with Controllable Energy Band Structure for Photocatalytic Hydrogen Evolution Reaction

Porous graphitic carbon nitride microsphere with large specific surface area and controllable energy band structure is synthesized via a simple method with the supermolecule polymer of melamine-cyanuric acid (MCA) as the intermediates. The energy band structure and morphology of carbon nitride are closely correlative to the calcination time. And the CN-20 catalyst fabricated by calcination for 20 h exhibit superior photocatalytic activity of hydrogen evolution reaction (HER) under visible-light (λ ≥ 420 nm) irradiation. The photocatalytic and photoelectrochemical test results indicate that Pt is the optimum cocatalyst candidate compared with Pd, Ru, and Ag. Meanwhile, the time-dependent process of the intermediate pyrolysis to carbon nitride and the internal mechanism of photogenerated charge transfer between semiconductors and cocatalyst is investigated and supplemented by theoretical calculations. This work provides a novel and energy band structure controllable manufacture strategy for porous carbon nitride semiconductor with satisfying visible-light photocatalytic reduction performance.

Evaluation of the efficacy and safety of ramucirumab combined with nab-paclitaxel, lobaplatin, and S-1 in neoadjuvant and conversion therapy for advanced gastric cancer: A study protocol of prospective single-center, randomized controlled and open label clinical trial (RNPLS-01)

Objective

Ramucirumab is a VEGFR2 antagonist. The aim of this trial is to evaluate the efficacy and safety of ramucirumab combined with nab-paclitaxel, lobaplatin and S-1 in neoadjuvant and conversion therapy for advanced gastric cancer.

Methods

and analysis: This study is a prospective single-center, randomized controlled and open label clinical study, enrolling a total of 140 patients with advanced gastric cancer distributed across two distinct cohorts (Cohort A n = 70; Cohort B n = 70). The central focus of the study lies in evaluating the pathological complete response (pCR) of the cancer post-neoadjuvant or conversion therapy. Secondary endpoints encompass the assessment of the R0 resection rate subsequent to the aforementioned therapies, the occurrence of adverse events (AE), progression-free survival (PFS), overall survival (OS), the objective response rate (ORR), the total response rate and its duration, the disease control rate (DCR), and the duration of overall response (DOR).

Ethics

Ethics approval has been obtained from the Ethics Committee at the First Affiliated Hospital (Xijing Hospital) of Air force Military Medical University (KY20232220-F-1).

Trial registration

This trial has been registered at the ClinicalTrials.gov: NCT06169410 (registration date: December 5, 2023).

Protaetia brevitarsis larvae produce frass that can be used as an additive to immobilize Cd and improve fertility in alkaline soils

Bioconversion of agricultural waste by Protaetia brevitarsis larvae (PBL) holds significant promise for producing high-quality frass organic amendments. However, the effects and mechanisms of PBL frass on Cd immobilization in an alkaline environment remain poorly understood. In this study, three types of frass, namely maize straw frass (MF), rice straw frass (RF), and sawdust frass (SF), were produced by feeding PBL. The Cd immobilization efficiencies of three frass in alkaline solutions and soils were investigated through batch sorption and incubation experiments, and spectroscopic techniques were employed to elucidate the sorption mechanisms of Cd onto different frass at the molecular level. The results showed that MF proved to be an efficient sorbent for Cd in alkaline solutions (176.67-227.27 mg g-1). X-ray absorption near-edge structure (XANES) spectroscopy indicated that Cd immobilization in frass is primarily attributed to the association with organic matter (OM-Cd, 78-90%). And MF had more oxygen-containing functional groups than the other frass. In weakly alkaline soils, MF application (0.5-1.5%) significantly decreased Cd bioavailability (5.65-18.48%) and concurrently improved soil nutrients (2.21-56.79%). Redundancy analysis (RDA) unveiled that pH, CEC, and available P were important factors controlling Cd fractions. Path analysis demonstrated that MF application affected Cd bioavailability directly and indirectly by influencing soil chemical properties and nutrients. In summary, MF, the product of PBL-mediated conversion maize straw, demonstrated promise as an effective organic amendment for Cd immobilization and fertility improvement in alkaline soils.

The regional disparities in liver disease comorbidity among elderly Chinese based on a health ecological model: the China Health and Retirement Longitudinal Study

PURPOSE

This study aimed to investigate the risk factors for liver disease comorbidity among older adults in eastern, central, and western China, and explored binary, ternary and quaternary co-morbid co-causal patterns of liver disease within a health ecological model.

METHOD

Basic information from 9,763 older adults was analyzed using data from the China Health and Retirement Longitudinal Study (CHARLS). LASSO regression was employed to identify significant predictors in eastern, central, and western China. Patterns of liver disease comorbidity were studied using association rules, and spatial distribution was analyzed using a geographic information system. Furthermore, binary, ternary, and quaternary network diagrams were constructed to illustrate the relationships between liver disease comorbidity and co-causes.

RESULTS

Among the 9,763 elderly adults studied, 536 were found to have liver disease comorbidity, with binary or ternary comorbidity being the most prevalent. Provinces with a high prevalence of liver disease comorbidity were primarily concentrated in Inner Mongolia, Sichuan, and Henan. The most common comorbidity patterns identified were "liver-heart-metabolic", "liver-kidney", "liver-lung", and "liver-stomach-arthritic". In the eastern region, important combination patterns included "liver disease-metabolic disease", "liver disease-stomach disease", and "liver disease-arthritis", with the main influencing factors being sleep duration of less than 6 h, frequent drinking, female, and daily activity capability. In the central region, common combination patterns included "liver disease-heart disease", "liver disease-metabolic disease", and "liver disease-kidney disease", with the main influencing factors being an education level of primary school or below, marriage, having medical insurance, exercise, and no disabilities. In the western region, the main comorbidity patterns were "liver disease-chronic lung disease", "liver disease-stomach disease", "liver disease-heart disease", and "liver disease-arthritis", with the main influencing factors being general or poor health satisfaction, general or poor health condition, severe pain, and no disabilities.

CONCLUSION

The comorbidities associated with liver disease exhibit specific clustering patterns at both the overall and local levels. By analyzing the comorbidity patterns of liver diseases in different regions and establishing co-morbid co-causal patterns, this study offers a new perspective and scientific basis for the prevention and treatment of liver diseases.

Dense Amorphous Passivation Layer Formed on Aluminum Alloy Surfaces by Femtosecond Laser-Assisted Oxygen-Rich Doping

Aluminum (Al) alloy surfaces are prone to serious corrosion in humid and salt-laden environments, which promotes the development of numerous protective approaches. Although the amorphous state is more conducive to improve corrosion resistance compared with the crystalline state, it still faces coating design problems like insufficient adhesive strength and flaking-off tendency. Here, we propose a strategy of femtosecond laser-assisted oxygen-rich doping to in situ create a dense high-quality passivation layer on Al alloy surfaces. With respect to the femtosecond laser processing in traditional air ambience, the material surface modifications within the oxygen-rich environment demonstrate some distinctiveness. For the ridge area of the laser ablation grooves, the oxidation surface is separated into two layers: the outer region presents a loose and porous appearance similar to the observations in the air ambience, while the inner region exhibits complete and homogeneous oxidation, especially associated with the continuous distribution of the amorphous substance, in sharp contrast to the nanoscale discrete amorphous formation in the air case. Simultaneously, the high degree of material oxidization with the amorphous phase is also developed on the wallside area of the groove valleys, which is much different from the incomplete oxidation in the air ambience. As a result, the measured corrosion current decreases by 49 times to a value of Icorr = 1.19 × 10-10 A/cm2 relative to the laser treatment in the air environment. Such a method offers the prospect for elevating the anticorrosion performance of metal surfaces.

The immobilization of cadmium by rape straw derived biochar in alkaline conditions: Sorption isotherm, molecular binding mechanism, and in-situ remediation of Cd-contaminated soil

The issue of cadmium (Cd) contamination in alkaline soils is escalating, necessitating the prompt implementation of effective passivation strategies. Biochar has gained significant attention for its potential in immobilizing heavy metals; however, the suitability of biochar as a remediation material and its micro-scale interaction mechanisms with Cd under alkaline conditions remain unclear. Rape straw (RS) were pyrolyzed at 400 °C (RB400) and 700 °C (RB700) to produce biochar. Adsorption and soil incubation experiments were carried out to assess the feasibility of using rape straw derived biochar pyrolyze at different temperatures and understanding their remediation mechanisms in alkaline environments. The sorption capacity for Cd immobilization was evaluated using sorption isotherms, revealing that RB700 exhibited enhanced Cd sorption performance with a maximum sorption capacity of 119.33 mg g-1 calculated from the Langmuir isotherm equation at pH 8. Cd L3-edge X-ray absorption near-edge structure (XANES) spectroscopy analysis confirmed that the dominant sorption species of Cd were organic Cd in RB400, with CdCO3 precipitation increased to 73.9% in RB700. Solid-state 13C nuclear magnetic resonance (13C-NMR) spectroscopy demonstrated that aromatic and carboxyl C functional groups are involved in the organic sorption of Cd through complexation and Cd2+-π interactions in alkaline solutions. The precipitation of CdCO3 in RB700 may resulted in a more effective passivation effect compared to RB400, leading to a significant 15.54% reduction in the DTPA-Cd content in Cd-contaminated soil. These findings highlight the effective Cd passivation Cd in alkaline environments by rape straw derived biochar, providing new molecular insights into the Cd retention mechanism of biochar. Furthermore, it presents novel ideas for improving remediation approaches for alkaline Cd-contaminated soils.

The Genome of Bifidobacterium longum subsp. infantis YLGB-1496 Provides Insights into Its Carbohydrate Utilization and Genetic Stability

Bifidobacterium longum subsp. infantis YLGB-1496 (YLGB-1496) is a probiotic strain isolated from human breast milk. The application of YLGB-1496 is influenced by carbohydrate utilization and genetic stability. This study used genome sequencing and morphology during continuous subculture to determine the carbohydrate utilization characteristics and genetic stability of YLGB-1496. The complete genome sequence of YLGB-1496 consists of 2,758,242 base pairs, 2442 coding sequences, and a GC content of 59.87%. A comparison of carbohydrate transport and metabolism genes of Bifidobacterium longum subsp. infantis (B. infantis) showed that YLGB-1496 was rich in glycosyl hydrolase 13, 20, 25, and 109 gene families. During continuous subculture, the growth characteristics and fermentation activity of the strain were highly stable. The bacterial cell surface and edges of the 1000th-generation strains were progressively smoother and well-defined, with no perforations or breaks in the cell wall. There were 20 SNP loci at the 1000th generation, fulfilling the requirement of belonging to the same strain. The presence of genes associated with cell adhesion and the absence of resistance genes supported the probiotic characteristics of the strain. The data obtained in this study provide insights into broad-spectrum carbohydrate utilization, genomic stability, and probiotic properties of YLGB-1496, which provide theoretical support to promote the use of YLGB-1496.

Exploring the Median Effective Dose of Ciprofol for Anesthesia Induction in Elderly Patients: Impact of Frailty on ED50

Purpose

Explore the median effective dose of ciprofol for inducing loss of consciousness in elderly patients and investigate how frailty influences the ED50 of ciprofol in elderly patients.

Patients and Methods

A total of 26 non-frail patients and 28 frail patients aged 65-78 years, with BMI ranging from 15 to 28 kg/m2, and classified as ASA grade II or III were selected. Patients were divided into two groups according to frailty: non-frail patients (CFS<4), frail patients (CFS≥4). With an initial dose of 0.3 mg/kg for elderly non-frail patients and 0.25 mg/kg for elderly frail patients, using the up-and-down Dixon method, and the next patient's dose was dependent on the previous patient's response. Demographic information, heart rate (HR), oxygen saturation (SpO2), mean blood pressure (MBP), and bispectral index (BIS) were recorded every 30 seconds, starting from the initiation of drug administration and continuing up to 3 minutes post-administration. Additionally, the total ciprofol dosage during induction, occurrences of hypotension, bradycardia, respiratory depression, and injection pain were recorded.

Results

The calculated ED50 (95% confidence interval [CI]) and ED95 (95% CI) values for ciprofol-induced loss of consciousness were as follows: 0.267 mg/kg (95% CI 0.250-0.284) and 0.301 mg/kg (95% CI 0.284-0.397) for elderly non-frail patients; and 0.263 mg/kg (95% CI 0.244-0.281) and 0.302 mg/kg (95% CI 0.283-0.412) for elderly frail patients. Importantly, no patients reported intravenous injection pain, required treatment for hypotension, or experienced significant bradycardia.

Conclusion

Frailty among elderly patients does not exert a notable impact on the median effective dose of ciprofol for anesthesia induction. Our findings suggest that anesthesiologists may forego the necessity of dosage adjustments when administering ciprofol for anesthesia induction in elderly frail patients.

The effect of glycopyrrolate vs. atropine in combination with neostigmine on cardiovascular system for reversal of residual neuromuscular blockade in the elderly: a randomized controlled trial

BACKGROUND

Glycopyrrolate-neostigmine (G/N) for reversing neuromuscular blockade (NMB) causes fewer changes in heart rate (HR) than atropine-neostigmine (A/N). This advantage may be especially beneficial for elderly patients. Therefore, this study aimed to compare the cardiovascular effects of G/N and A/N for the reversal of NMB in elderly patients.

METHODS

Elderly patients aged 65-80 years who were scheduled for elective non-cardiac surgery under general anesthesia were randomly assigned to the glycopyrrolate group (group G) or the atropine group (group A). Following the last administration of muscle relaxants for more than 30 min, group G received 4 ug/kg glycopyrrolate and 20 ug/kg neostigmine, while group A received 10 ug/kg atropine and 20 ug/kg neostigmine. HR, mean arterial pressure (MAP), and ST segment in lead II (ST-II) were measured 1 min before administration and 1-15 min after administration.

RESULTS

HR was significantly lower in group G compared to group A at 2-8 min after administration (P < 0.05). MAP was significantly lower in group G compared to group A at 1-4 min after administration (P < 0.05). ST-II was significantly depressed in group A compared to group G at 2, 3, 4, 5, 6, 7, 8, 9, 11, 13, 14, and 15 min after administration (P < 0.05).

CONCLUSIONS

In comparison to A/N, G/N for reversing residual NMB in the elderly has a more stable HR, MAP, and ST-II within 15 min after administration.

Sympathetic innervation induces exosomal miR-125 transfer from osteoarthritic chondrocytes, disrupting subchondral bone homeostasis and aggravating cartilage damage in aging mice

INTRODUCTION

Osteoarthritis (OA) is a progressive disease that poses a significant threat to human health, particularly in aging individuals: Although sympathetic activation has been implicated in bone metabolism, its role in the development of OA related to aging remains poorly understood. Therefore, this study aimed to investigate how sympathetic regulation impacts aging-related OA through experiments conducted both in vivo and in vitro.

METHODS

To analyze the effect of sympathetic regulation on aging-related OA, we conducted experiments using various mouse models. These models included a natural aging model, a medial meniscus instability model, and a load-induced model, which were used to examine the involvement of sympathetic nerves. In order to evaluate the expression levels of β1-adrenergic receptor (Adrβ1) and sirtuin-6 (Sirt6) in chondrocytes of naturally aging OA mouse models, we performed assessments. Additionally, we investigated the influence of β1-adrenergic receptor knockout or treatment with a β1-adrenergic receptor blocker on the progression of OA in aging mice and detected exosome release and detected downstream signaling expression by inhibiting exosome release. Furthermore, we explored the impact of sympathetic depletion through tyrosine hydroxylase (TH) on OA progression in aging mice. Moreover, we studied the effects of norepinephrine(NE)-induced activation of the β1-adrenergic receptor signaling pathway on the release of exosomes and miR-125 from chondrocytes, subsequently affecting osteoblast differentiation in subchondral bone.

RESULTS

Our findings demonstrated a significant increase in sympathetic activity, such as NE levels, in various mouse models of OA including natural aging, medial meniscus instability, and load-induced models. Notably, we observed alterations in the expression levels of β1-adrenergic receptor and Sirt6 in chondrocytes in OA mouse models associated with natural aging, leading to an improvement in the progression of OA. Critically, we found that the knockout of β1-adrenergic receptor or treatment with a β1-adrenergic receptor blocker attenuated OA progression in aging mice and the degraded cartilage explants produced more exosome than the nondegraded ones, Moreover, sympathetic depletion through TH was shown to ameliorate OA progression in aging mice. Additionally, we discovered that NE-induced activation of the β1-adrenergic receptor signaling pathway facilitated the release of exosomes and miR-125 from chondrocytes, promoting osteoblast differentiation in subchondral bone.

CONCLUSION

In conclusion, our study highlights the role of sympathetic innervation in facilitating the transfer of exosomal miR-125 from osteoarthritic chondrocytes, ultimately disrupting subchondral bone homeostasis and exacerbating cartilage damage in aging mice. These findings provide valuable insights into the potential contribution of sympathetic regulation to the pathogenesis of aging-related OA.

Correlation between essential and toxic elements in maternal blood during early pregnancy and atrial septal defects/ventricular septal defects/patent ductus arteriosus in offspring

BACKGROUND

Congenital heart defects (CHDs) are the most common congenital malformation in the world. Recent studies have found that essential and toxic trace element levels may play a crucial role in the risk of neonatal malformation. However, the relationships between element levels in early pregnancy and CHD risk among humans remain unclear. This study investigates the association between maternal essential element (copper [Cu], zinc [Zn], calcium [Ca], manganese [Mg] and iron [Fe]) and toxic element (lead [Pb] and cadmium [Cd]) levels during early pregnancy and CHDs.

METHODS

A hospital-based case-control study was conducted, including 181 cases and 218 controls. Eligible participants underwent antenatal examination during gestational weeks 11-14 and trace element levels were detected by the atomic absorption method. Multi-variable logistic regression was used to examine the associations between the level of maternal trace elements and CHD risks.

RESULTS

Higher levels of Ca in early pregnancy were associated with lower risk of ASD/VSD risks. Moreover, higher Fe, Pb, and Cd levels in the first trimester were associated with higher risks of all CHD and the subtypes risks, and the tests for trend were significant (all p < .05). The restricted cubic spline analysis showed that there was a nonlinear inverted u-shaped dose-response relationship between levels of Zn, Pb, and Cd in the first trimester and risk of CHDs (non-linearity test p < .05).

CONCLUSIONS

A moderate increase in Zn and Ca levels and a decrease in Pb and Cd levels during early pregnancy are needed to reduce the incidence of CHDs in the Chinese population.

Increased A1 astrocyte activation-driven hippocampal neural network abnormality mediates delirium-like behavior in aged mice undergoing cardiac surgery

Delirium is the most common neurological complication after cardiac surgery with adverse impacts on surgical outcomes. Advanced age is an independent risk factor for delirium occurrence but its underlying mechanisms are not fully understood. Although increased A1 astrocytes and abnormal hippocampal networks are involved in neurodegenerative diseases, whether A1 astrocytes and hippocampal network changes are involved in the delirium-like behavior of aged mice remains unknown. In the present study, a mice model of myocardial ischemia-reperfusion mimicking cardiac surgery and various assessments were used to investigate the different susceptibility of the occurrence of delirium-like behavior between young and aged mice and the underlying mechanisms. The results showed that surgery significantly increased hippocampal A1 astrocyte activation in aged compared to young mice. The high neuroinflammatory state induced by surgery resulted in glutamate accumulation in the extrasynaptic space, which subsequently decreased the excitability of pyramidal neurons and increased the PV interneurons inhibition through enhancing N-methyl-D-aspartate receptors' tonic currents in the hippocampus. These further induced the abnormal activities of the hippocampal neural networks and consequently contributed to delirium-like behavior in aged mice. Notably, the intraperitoneal administration of exendin-4, a glucagon-like peptide-1 receptor agonist, downregulated A1 astrocyte activation and alleviated delirium-like behavior in aged mice, while IL-1α, TNF-α, and C1q in combination administered intracerebroventricularly upregulated A1 astrocyte activation and induced delirium-like behavior in young mice. Therefore, our study suggested that cardiac surgery increased A1 astrocyte activation which subsequently impaired the hippocampal neural networks and triggered delirium development.

Larixyl acetate, a TRPC6 inhibitor, attenuates pressure overload‑induced heart failure in mice

Heart failure is a primary cause of global mortality. In the present study, whether larixyl acetate, an inhibitor of transient receptor potential cation channel subfamily C member 6, attenuates pressure overload‑induced heart failure in mice was investigated. To test this hypothesis, a transverse aortic constriction (TAC) animal model and an angiotensin II (Ang II)‑treated H9c2 cell model were used. Cardiac and cellular structure, function and the expression levels of hypertrophy, endoplasmic reticulum (ER) stress, apoptosis, autophagy and pmTOR/mTOR related mRNAs or proteins were assessed to explore the underlying molecular mechanisms. The results indicated that treatment with TAC or Ang II leads to significant hypertrophy and dysfunction of the heart or H9c2 cells, accompanied by an increase in ER stress, apoptosis and activation of the mTOR signaling pathway, and a decrease in autophagy. The administration of larixyl acetate attenuated these impairments, which can be reversed by inhibiting autophagy through the activation of the mTOR signaling pathway. These findings suggested that larixyl acetate can effectively protect against pressure overload‑induced heart failure by enhancing autophagy and limiting ER stress and apoptosis through inhibition of the mTOR pathway.

Arsenic(III) sorption on organo-ferrihydrite coprecipitates: Insights from maize and rape straw-derived DOM

The mobility of arsenic (As) specie in agricultural soils is significantly impacted by the interaction between ferrihydrite (Fh) and dissolved organic material (DOM) from returning crop straw. However, additional research is necessary to provide molecular evidence for the interaction of toxic and mobile As (As(III)) specie and crop straw-based organo- Fh coprecipitates (OFCs). This study investigated the As(III) sorption behaviours of OFCs synthesized with maize or rape derived-DOM under various environmental conditions and the primary molecular sorption mechanisms using As K-edge X-ray absorption near edge structure (XANES) spectroscopy. According to our findings, pure Fh adsorbed more As(III) relative to the other two OFCs, and the presence of natural organic matter in the OFCs induced more As(III) adsorption at pH 5.0. Findings from this study indicated a maximum As(III) sorption on Ma (53.71 mg g⁻1) and Ra OFC (52.46 mg g⁻1) at pH 5.0, with a sharp decrease as the pH increased from 5.0 to 8.0. Additionally, As K-edge XANES spectroscopy indicated that ∼30% of adsorbed As(III) on the OFCs undergoes transformation to As(V) at pH 7-8. Functional groups from the DOM, such as O-H, COOH, and CO, contributed to As(III) desorption and its oxidation to As(V), whereas ionic strength analysis revealed inner complexation as the dominant As(III) sorption mechanism on the OFCs. Overall, the results indicate that the interaction of natural organic matter (NOM) with As(III) at higher pH promotes As(III) mobility, which is crucial when evaluating As migration and bioavailability in alkaline agricultural soils.

Risk factors of liver abscess and biloma formation after drug-eluting bead transarterial chemoembolization for unresectable intrahepatic cholangiocarcinoma

BACKGROUND AND STUDY AIMS

Drug-eluting bead transarterial chemoembolization (DEB-TACE) causes serious complications, including liver abscess and biloma formation. This study aimed to investigate the frequency and risk factors of liver abscess and biloma formation after dug-eluting bead transarterial chemoembolization for unresectable intrahepatic cholangiocarcinoma (ICC).

PATIENTS AND METHODS

152 unresectable ICC patients received 241 DEB-TACE procedures from February 2018 to November 2022 were studied retrospectively. Patients were evaluated for the presence of liver abscess and biloma formation after DEB-TACE. The medical records, including baseline demographic data, preoperative imaging data, DEB-TACE details, and postoperative management, were reviewed to search for risk factors of liver abscess and biloma formation.

RESULTS

Liver abscesses developed in 11 cases, with an incidence rate of 7.2 % (11/152) per patient and 4.6 % (11/241) per procedure. In the 11 patients with abscesses, the incidence of biloma formation was 36.4 % (n = 4). The binary logistic regression analysis showed that diabetes mellitus (OR 7.967, 95 % CI 1.491-42.571, p = 0.015), bilioenterostomy or biliary stent implantation (OR 18.716, 95 % CI 1.006-348.049, p = 0.049) and grade 1 arterial occlusion (OR 9.712, 95 % CI 1.054-89.484, p = 0.045) were independent risk factors for liver abscess and biloma formation.

CONCLUSION

Liver abscesses and biloma formation induced by DEB-TACE are associated with various factors. Diabetes mellitus, bilioenterostomy or biliary stent implantation, and grade 1 artery occlusion were all associated with liver abscess and biloma formation after DEB-TACE for unresectable ICC. In patients with these risk factors, the DEB-TACE procedure should be finely designed and manipulated with more caution.

Development and validation of serological dynamic risk score to predict outcome in gastric cancer with adjuvant chemotherapy: a multicentre, longitudinal, cohort study

Background

Baseline serological biomarkers have the potential to predict the benefits of adjuvant chemotherapy in patients with gastric cancer. However, the fluctuating nature of postoperative recurrence risk makes precise treatment challenging. We aimed to develop a risk score in real-time predicting outcomes for postoperative GC patients using blood chemistry tests.

Materials and methods

This was a retrospective, multicentre, longitudinal cohort study from three cancer centres in China, with a total of 2737 GC patients in the pTNM stage Ib to III. Among them, 1651 patients with at least two serological records were assigned to the training cohort. Model validation was carried out using separate testing data with area under curve (AUC). The least absolute shrinkage and selection operator (LASSO) and random forest-recursive feature elimination (RF-RFE) algorithm were used to select the parameters.

Results

The Cox regression model derived six risk factors to construct a composite score (low-risk: 0-2 score; high risk: 3-6 score), including CEA, CA125, CA199, haemoglobin, albumin, and neutrophil to lymphocyte ratio. The risk score accurately predicted mortality in 1000-time bootstrap (AUROCs:0.658; 95% CI: 0.645, 0.670), with the highest AUROC (0.767; 95% CI: 0.743, 0.791) after 1 year since the gastrectomy. In validation dataset, the risk score had an AUROC of 0.586 (95% CI 0.544, 0.628). Furthermore, patients with high risk at 1 month derived significant clinical benefits from adjuvant chemotherapy (P for interaction <0.0001). Compared with the low-low-low risk group, the low-low-high risk group of the long-term state chain (risk state at baseline, 6 months, 1 year) had the worse OS (HR, 6.91; 95%CI: 4.27, 11.19) and DFS (HR, 7.27; 95%CI: 4.55, 11.63).

Conclusion

The dynamic risk score is an accurate and user-friendly serological risk assessment tool for predicting outcomes and assisting clinical decisions after gastrectomy.

Effectiveness of perioperative low-dose esketamine infusion for postoperative pain management in pediatric urological surgery: a prospective clinical trial

BACKGROUND

Postoperative pain is common in pediatric urological surgery. The study assess the impact of perioperative intravenous infusion of low-dose esketamine on postoperative pain in pediatric urological surgery.

METHODS

Pediatric patients (n = 80) undergoing urological surgery were randomized into four groups. Patients in the control group were administered an analgesic pump containing only hydromorphone at a dose of 0.1 mg/kg (Hydromorphone Group 1, H1) or 0.15 mg/kg (Hydromorphone Group 2, H2). Patients in the experimental group were injected intravenously with 0.3 mg/kg of esketamine (Esketamine group 1, ES1) or equal volume of saline (Esketamine Group 2, ES2) during anesthesia induction. Esketamine 1.0 mg/kg and hydromorphone 0.1 mg/kg were added to the analgesic pump. Face, Leg, Activity, Crying, and Comfort (FLACC) scale or the Numerical Rating Scale (NRS) and adverse effects were recorded at 2, 6, 24, and 48 h postoperatively. Additionally, total and effective PCA button presses were recorded.

RESULTS

In comparison to the H1 group, the pain scores were notably reduced at all postoperative time points in both the ES1 and H2 groups. The ES2 group exhibited lower pain scores only at 24 and 48 h postoperatively. When compared to the H2 group, there were no significant differences in pain scores at various postoperative time points in the ES2 group. However, the ES1 group demonstrated significantly lower pain scores at 6, 24 and 48 h postoperatively, and these scores were also significantly lower than those observed in the ES2 group. The total and effective number of PCA button presses in the ES1, ES2 and H2 group were lower than that in the H1 group (P < 0.001). The incidence of adverse effects within 48 h after surgery was 15% in ES1, 22% in ES2, 58% in H1, and 42% in H2, respectively (P = 0.021).

CONCLUSIONS

The use of low-dose esketamine infusion in analgesia pump can effectively alleviates postoperative pain in pediatric urological patients, leading to a significant reduction in the number of analgesic pump button press. The combined approach of perioperative anesthesia induction and analgesia pump administration is recommended for optimal pain management in these patients.

TRIAL REGISTRATION

Chinese Clinical Trial Registry- ChiCTR2300073879 (24/07/2023).

Esketamine pretreatment during cesarean section reduced the incidence of postpartum depression: a randomized controlled trail

BACKGROUND

Postpartum depression (PPD) is a common mental disease in postpartum women, which has received more and more attention in society. Ketamine has been confirmed for its rapid antidepressant effect in women with PPD. We speculate that esketamine, an enantiomer of ketamine, pretreatment during cesarean can also reduce the incidence of PPD.

METHODS

All the parturients enrolled in the study were randomly assigned to two groups: the esktamine group (0.2 mg/kg esketamine) and the control group (a same volume of saline). All the drugs were pumped for 40 min started from the beginning of the surgery. The Amsterdam Anxiety and Information Scale (APAIS) scores before the surgery, the Edinburgh postnatal depression scale (EPDS) scores at 4 d and 42 d after surgery, the Pain Numerical Rating Scale (NRS) scores at 6 h, 12 h, 24 h and 48 h post-operation were evaluated, as well as the adverse reactions were recorded.

RESULTS

A total of 319 parturients were analyzed in the study. The incidence of PPD (EPDS score > 9) in the esketamine group was lower than the control group at 4 days after surgery (13.8% vs 23.1%, P = 0.0430) but not 42 days after surgery (P = 0.0987). Esketamine 0.2 mg/kg could reduce the NRS score at 6 h,12 h and 24 h after surgery, as well as the use of vasoactive drugs during surgery (P < 0.05). The incidences of maternal dizziness (17.0%), blurred vision (5%), illusion (3.8%) and drowsiness (3.8%) in the esketamine group were higher than those of control group (P < 0.05).

CONCLUSIONS

Intraoperative injection of esketamine (0.2 mg/kg) prevented the occurrence of depression (EPDS score > 9) at 4 days after delivery but not 42 days. Esketamine reduced the NRS scores at 6 h, 12 h and 24 h after surgery, but the occurrence of maternal side effects such as dizziness, blurred vision, drowsiness and hallucination were increased.

TRIAL REGISTRATION

Registered in the Chinese Clinical Trial Registry (ChiCTR2100053422) on 20/11/2021.

Ciprofol is primarily glucuronidated by UGT1A9 and predicted not to cause drug-drug interactions with typical substrates of CYP1A2, CYP2B6, and CYP2C19

Ciprofol is a novel intravenous anesthetic agent. Its major glucuronide metabolite, M4, is found in plasma and urine. However, the specific isoforms of UDP-glucuronosyltransferases (UGTs) that metabolize ciprofol to M4 remain unknown. This study systematically characterized UGTs that contribute to the formation of M4 using human liver microsomes (HLM), human intestinal microsomes (HIM), and human recombinant UGTs. The inhibitory potential of ciprofol and M4 against major human UGTs and cytochrome P450 enzymes (P450s) was also explored. In vitro-in vivo extrapolation (IVIVE) and physiologically-based pharmacokinetic (PBPK) simulations were performed to predict potential in vivo drug-drug interactions (DDIs) caused by ciprofol. Glucuronidation of ciprofol followed Michaelis-Menten kinetics in both HLM and HIM with apparent Km values of 345 and 412 μM, Vmax values of 2214 and 444 nmol min-1·mg protein-1, respectively. The in vitro intrinsic clearances (CLint = Vmax/Km) for ciprofol glucuronidation by HLM and HIM were 6.4 and 1.1 μL min-1·mg protein-1, respectively. Human recombinant UGT studies revealed that UGT1A9 is the predominant isoform mediating M4 formation, followed by UGT1A7, with UGT1A8 playing a minor role. Ciprofol competitively inhibited CYP1A2 (Ki = 12 μM) and CYP2B6 (Ki = 4.7 μM), and noncompetitively inhibited CYP2C19 (Ki = 29 μM). No time-dependent inhibition by ciprofol was noted for CYP1A2, CYP2B6, or CYP2C19. In contrast, M4 showed limited or no inhibitory effects against selected P450s. Neither ciprofol nor M4 inhibited UGTs significantly. Initial IVIVE suggested potential ciprofol-mediated inhibition of CYP1A2, CYP2B6, and CYP2C19 inhibition in vivo. However, PBPK simulations showed no significant effect on phenacetin, bupropion, and S-mephenytoin exposure or peak plasma concentration. Our findings are pertinent for future DDI studies of ciprofol as either a perpetrator or victim drug.

Exploring low-carbon mulching strategies for maize and wheat on-farm: Spatial responses, factors and mitigation potential

Mulching strategies - including plastic film mulching (FM) and straw mulching (SM) - can enhance crop yields while affecting multiple greenhouse gas (GHG) fluxes. However, most of currently published site-based studies only focus on a certain gas, resulting in an inability to spatially integrated understanding of changes in agricultural global warming potential (GWP) and greenhouse gas intensity (GHGI) caused by mulching across China. Thus, we developed an optimal model considering crop type, meteorology, soil and management variables by four machine learning methods, namely support vector machine, multilayer perceptron, random forest, and gradient boosting machine (GBM). Then we mapped the relative changes in yield and GHG fluxes caused by mulching strategies. The GBM model had the best simulation capability for yield and GHGs in China. Our result showed that FM increased yield in maize (25 %) and wheat (19 %), while SM respectively increased by 14 % and 11 %. Among the relative changes due to mulching strategies, yield and N2O emissions were mainly influenced by soil fertility and soil properties, CH4 uptakes and CO2 emissions were more affected by environmental factors. GWP in maize and wheat average increased by 40 % under FM, while SM decreased GWP by 14 % and 2 %, respectively. Besides, FM average increased GHGI in maize and wheat by 17 % and 9 %, and SM decreased GHGI by 22 % and 12 %, respectively. Spatially, FM reduced maize GWP on 19 % of cropland, while SM reduced maize and wheat GWP on 71 % and 64 % of cropland, respectively. Soil pH was significantly correlated with ΔGHGI in maize and wheat. Our analysis not only estimated for the first time the spatial effects of mulching strategies across China, but also systematically analyzes the agricultural carbon emission mitigation potential of mulching strategies, which promote the development of low-carbon agriculture based on locally appropriate mulching strategies.

Clinical variables and genetic variants associated with perioperative anaphylaxis in Chinese Han population: A pilot study

Background

Perioperative anaphylaxis (POA) can lead to severe consequences. Identifying clinical risk factors and genetic loci associated with POA through pre-prescription screening may help reduce its incidence.

Methods

Using univariate regression and covariate-adjusted multivariate regression, we retrospectively analyzed the association between clinical characteristics and POA in 72 POA patients and 72 non-POA individuals. The discovery study of whole-exome association relied on whole-exome sequencing of 73 POA cases and 1339 healthy individuals. A replication study involving an independent set of 16 POA cases and 1339 healthy individuals confirmed this association. The accurate typing of human leucocyte antigen through exome sequencing (ATHLATES) algorithm and the whole-exome sequencing data were used for genotyping the human leucocyte antigen G (HLA-G) of 73 POA patients. The HLA-G of 16 POA cases and 122 non-POA patients were genotyped through Sanger sequencing. We used Fisher's exact probability method to compare the allele and carrier frequencies between POA patients and healthy individuals or non-POA patients. A Pc (P/Bonferroni correction coefficient) < 0.05 represents statistical significance.

Results

Regression analysis identified female sex, an unconfirmed food allergy label, and a history of prior surgery as clinical variables associated with POA. The whole-exome association discovery study identified a strong signal in the major histocompatibility complex region on chromosome 6, with the rs1130356 being the most significant locus (P = 1.5E-10, OR = 3.4, 95% CI = 2.4-4.9). The replication study verified the association between the rs1130356-T allele and POA cases (P = 1.0E-6, OR = 6.3, 95% CI = 3.1-12.7). Compared with non-POA patients, HLA-G∗01:01 (Pc = 2.4E-4, OR = 2.4, 95% CI = 1.6-3.6) was significantly enriched, while HLA-G∗01:04 (Pc = 1.2E-6, OR = 0.3, 95% CI = 0.2-0.5) was lessened in POA patients.

Conclusion

Our study suggested an association between POA and the risk factors of female sex, an unconfirmed food allergy label, and prior surgery. HLA-G, located in the human leucocyte antigen (HLA) region, may act as a surrogate genetic marker for POA. This suggests a causal relationship between this specific genomic region and POA. Our findings shed light on the contribution of human exome genetic variants to the susceptibility to POA.

Bariatric surgery induces pancreatic cell transdifferentiation as indicated by single-cell transcriptomics in Zucker diabetic rats

AIMS

Bariatric surgery results in rapid recovery of glucose control in subjects with type 2 diabetes mellitus. However, the underlying mechanisms are still largely unknown. The present study aims to clarify how bariatric surgery modifies pancreatic cell subgroup differentiation and transformation in the single-cell RNA level.

METHODS

Male, 8-week-old Zucker diabetic fatty (ZDF) rats with obesity and diabetes phenotypes were randomized into sleeve gastrectomy (Sleeve, n = 9), Roux-en-Y gastric bypass (RYGB, n = 9), and Sham (n = 7) groups. Two weeks after surgery, the pancreas specimen was further analyzed using single-cell RNA-sequencing technique.

RESULTS

Two weeks after surgery, compared to the Sham group, the metabolic parameters including fasting plasma glucose, plasma insulin, and oral glucose tolerance test values were dramatically improved after RYGB and Sleeve procedures (p < .05) as predicted. In addition, RYGB and Sleeve groups increased the proportion of pancreatic β cells and reduced the ratio of α cells. Two multiple hormone-expressing cells were identified, the Gcg+/Ppy + and Ins+/Gcg+/Ppy + cells. The pancreatic Ins+/Gcg+/Ppy + cells were defined for the first time, and further investigation indicates similarities with α and β cells, with unique gene expression patterns, which implies that pancreatic cell transdifferentiation occurs following bariatric surgery.

CONCLUSIONS

For the first time, using the single-cell transcriptome map of ZDF rats, we reported a comprehensive characterization of the heterogeneity and differentiation of pancreatic endocrinal cells after bariatric surgery, which may contribute to the underlying mechanisms. Further studies will be needed to elucidate these results.

[Application value of questionnaires in the screening obstructive sleep apnea syndrome in pregnancy across trimesters]

Objective: To evaluate the clinical utility value of questionnaires of Berlin, STOP, STOP-Bang (SBQ), Epworth Sleepiness Scale (ESS) in screening obstructive sleep apnea syndrome (OSAS) in pregnant women of different trimesters. Methods: Consecutive pregnant women at high risk for OSAS were enrolled from January, 2021 to April, 2022 at the obstetric clinic of Peking University People's Hospital. They completed questionnaires of Berlin, STOP, SBQ, ESS and also underwent an overnight polysomnography (PSG). To evaluate the accuracy of questionnaires of Berlin, STOP, SBQ, ESS, sensitivity, specificity, positive predictive values, negative predictive values and the area under the receiver operating characteristics (ROC) curve of these questionnaires in pregnancy across trimesters (Pregnancy 1-15 weeks was the first stage, pregnancy 16-27 weeks was the second stage, and pregnancy 28-40 weeks was the third stage) were calculated. Results: A total of 100 pregnant women [(34.5±4.3) years old (26-46 years old)] were included in this study, including 20, 35 and 45 pregnant women in the first, second and third trimester of pregnancy, respectively. Based on PSG results, 45 (45%) of 100 pregnant women were diagnosed with OSAS. The overall predictive values of the four questionnaires were not good, area under[AUC(95%CI)] the ROC curve ESS, Berlin questionnaire STOP and SBQ were 0.54(0.43, 0.66), 0.59 (0.47, 0.70), 0.62(0.51, 0.73) and 0.61 (0.49, 0.72), respectively, sensitivity was 35.6%, 65.9%, 48.9%, 28.9%, specificity was 71.7%, 52.5%, 73.6%, 92.5%. When categorized according to trimesters, the predicted values of the four questionnaires increased in the first trimester, the AUC (95%CI) of STOP questionnaire was 0.81 (0.61, 1.00), sensitivity was 75.0%, specificity was 87.5%. Conclusion: The overall predictive power of the four screening questionnaires is limited in pregnant women. But predictive value of STOP questionnaire is acceptable in the first trimester.

The relationship between the oblique sagittal temporomandibular joint disc position and the volume surface area of the condyle in young TMD adults

The present study aims to compare the volume surface area of the condyle, the horizontal condylar axial angle and the disc-condyle angle between temporomandibular disorder (TMD) and asymptomatic volunteers, explore and analyze the relationship between the temporomandibular joint (TMJ) disc position in oblique sagittal plane and the volume surface area of the condyle in young adults with TMD symptoms. 84 young adult volunteers were received TMJ examination by Magnetic Resonance Imaging (MRI) and Cone Beam Computed Tomography (CBCT). TMD and asymptomatic volunteers were 42 each. MRI was used to assess the position of TMJ disc in the oblique sagittal plane with the condyle apex method. CBCT data were used for three-dimensional (3D) reconstruction of condyle and the measurements of the horizontal condylar axial angle and the volume surface area of the condyle. The condylar volume surface area of the TMD group was smaller than that of the asymptomatic group (p < 0.05), the disc condyle angle was larger than that of the asymptomatic group (p < 0.05), and no significant difference was found in the horizontal condylar axial angle (p > 0.05). In terms of correlation, the volume surface area of the condyle were negatively correlated with the position of the articular disc in TMD patients (p < 0.05). This significant negative correlation suggests that the possibility of disc displacement can be considered when poor condylar morphology is found.

396 MHz CPA femtosecond laser system based on a single crystal fiber rod-type amplifier

The paper presents the results of multiplying the repetition frequency of the seed source to 396 MHz using an extra-cavity fiber multiplication method. The single crystal fiber rod-type amplifier was able to boost the average output power to approximately 15.9 W. Using a transmission gratings-based pulse compressor, an average output power of 9.56 W was achieved, corresponding to a burst energy of up to 382 µJ and a compression efficiency of 81.7%. The shortest pulse duration was optimized to be 594 fs; however, an obvious pedestal was also observed. This system reduces the impact of nonlinear effects on the device by increasing the repetition frequency, thereby increasing the injection energy of a single process in industrial processing.

Maize straw application reduced cadmium and increased arsenic uptake in wheat and enhanced the rhizospheric bacterial communities in alkaline-contaminated soil

Many fields where wheat is grown in northern China are co-polluted by arsenic (As) and cadmium (Cd). Thus, remediation of As and Cd-contaminated alkaline soils is crucial for safe wheat production. In this study, a pot experiment was carried out to investigate the impact of 1% and 2% maize straw (MS) incorporation on As and Cd bioavailability, binding forms, uptake by winter wheat (Triticum aestivum L.), and bacterial communities in smelter (SS) and irrigation (IS) alkaline contaminated soils. The results indicated that 2% MS incorporation significantly (p < 0.05) increased bioavailable-As by 37% (SS) and 39% (IS) with no significant change in the bioavailable-Cd in SS2% (31.95%) from 31.95% (SSCK) and IS2% (33.33%) from 32.82% (ISCK). Incorporation of 2% MS increased the grain As concentration from 0.22 mg kg-1 (SSCK) to 0.51 mg kg-1 (SS2%) and from 0.59 mg kg-1 (ISCK) to 0.84 mg kg-1 (IS2%) which is above the acceptable standard of 0.5 mg kg-1 (GB2726-2017). In contrast, the Cd content in grains was maintained at 0.09 (SS1%), 0.04 (SS2%) and 0.03 (IS1%), 0.02 (IS2%) below the acceptable standard of 0.10 mg kg-1 (GB2762-2017). The amendment through dissolved organic carbon mediated As desorption enhanced As transfer to wheat grain, decreasing DTPA-Cd in the soils and its consequent translocation to wheat leaves and grain. The 2% MS incorporation increased the active As fractions, reduced mobile Cd into immobile fractions, and promoted the abundance of Actinobacteria, Bacteroidetes, and Firmicutes in the two soils. These attributes of MS in decreasing the accumulation of Cd in wheat leaves and grains signified its potential as a suitable ingredient for Cd sequestration and food safety in Cd-contaminated soils.

Immediate implant placement in single mandibular molar with chronic periapical periodontitis

INTRODUCTION

The present study aims to assess and compare the clinical outcomes of immediate implant placement in the mandibular molar region with or without the presence of chronic periapical periodontitis.

MATERIALS AND METHODS

Employing a case-control design, this study encompassed a cohort of patients necessitating implant surgery to supplant a single, failed mandibular molar. Participants exhibiting periapical lesions measuring between > 4 mm and < 8 mm were assigned to the test group, while those without periapical lesions to the control group. Subsequent to flap surgery and tooth extraction, extraction sockets were debrided thoroughly, and implants were immediately implanted (baseline). Permanent restorative procedures were carried out three months post-operation, with follow-up conducted one year post-surgery. During the study period, parameters including implant survival rate, Cone Beam Computer Tomography (CBCT) data, implant stability quotient (ISQ), insertional torque values (ITV), and potential complications were closely monitored.

RESULTS

Throughout the yearlong observation period subsequent to implant placement, both groups exhibited a 100% implant survival rate. None of the participants experienced any complications. Both groups demonstrated significant decreases in the height and width of the alveolar bone (P < 0.05). However, there were no statistically discernible differences between corresponding areas in the two groups (P > 0.05). The differences in ITV between the test group (37.94 ± 2.12 N•cm) and the control group (38.55 ± 2.71 N•cm) were not statistically significant at baseline (P > 0.05). A significant rise in ISQ was noted within the same group between baseline and three months post-operation (P < 0.05), while no significant variations in ISQ changes were noted between the two groups (P > 0.05).

CONCLUSION

Given the constraints of this investigation, the preliminary clinical outcomes of immediate implant placement in the mandibular molar region with chronic periapical periodontitis do not significantly differ from those observed in instances devoid of chronic periapical periodontitis.

Routine gastric suspension technique in single-port sleeve gastrectomy procedure

BACKGROUND

Due to limited technical demand, single-port sleeve gastrectomy (SPSG) is a feasible laparoscopic technique for sleeve gastrectomy (SG). Nonetheless, difficulties exist when performing the single-port technique, and in this study, we aim to describe a slight maneuver that can improve the SPSG procedure.

METHODS

Patients who underwent laparoscopic SG between January 2022 and May 2023 at our hospital were included. The patients were classified into two groups: (1) SPSG and (2) multiple-port SG (MPSG). The parameters for this analysis were the patients' age, gender, weight, body mass index (BMI), conversion rate, drainage placement, 30-day readmission rate, and postoperative complications. Postoperative one-month and three-month percentages of total weight loss (%TWL) were calculated and compared.

RESULTS

171 patients were included in this study: (1) the SPSG group (n = 96) and (2) the MPSG group (n = 75). No statistically significant difference was observed within the preoperative (age, gender, height, weight, and BMI) and the perioperative parameters between SPSG and MPSG (operation time, drainage placement, 30-day readmission) (p > 0.05). Per Clavien-Dindo's grading, two patients in the SPSG group suffered grade 1 complications; for the MPSG group, one patient sustained grade 2 and another suffered grade 3b complication. No statistical significance was observed on the %TWL between the two groups (p > 0.05).

CONCLUSION

Our study found that performing SPSG in specific patient is feasible and non-inferior when compared to the MPSG. Further studies will be needed to elucidate better the efficacy and safety of performing SPSG.

Assessment and Exposure Analysis of Trace Metals in Different Age Groups of the Male Population in Southern Punjab, Pakistan

In developing countries, like Pakistan, the pursuit of urbanization and economic development disrupts the delicate ecosystem, resulting in additional biogeochemical emissions of heavy metals into the human habitat and posing significant health risks. The levels of these trace elements in humans remain unknown in areas at higher risk of pollution in Pakistan. In this investigation, selected trace metals including Copper (Cu), Chromium (Cr), Lead (Pb) Cadmium (Cd), Cobalt (Co), Nickel (Ni), and Arsenic (As) were examined in human hair, urine, and nail samples of different age groups from three major cities (Muzaffargarh, Multan, and Vehari) in Punjab province, Pakistan. The results revealed that the mean concentrations (ppm) of Cr (1.1) and Cu (9.1) in hair was highest in Muzaffargarh. In urine samples, the mean concentrations (μg/L) of Co (93), As (79), Cu (69), Cr (56), Ni (49), Cd (45), and Pb (35) were highest in the Multan region, while As (34) and Cr (26) were highest in Vehari. The mean concentrations (ppm) of Ni (9.2), Cr (5.6), and Pb (2.8), in nail samples were highest in Vehari; however, Multan had the highest Cu (28) concentration (ppm). In urine samples, the concentrations of all the studied metals were within permissible limits except for As (34 µg/L) and Cr (26 µg/L) in Vehari. However, in nail samples, the concentrations of Ni in Multan (8.1 ppm), Muzaffargarh (9 ppm), Vehari (9.2 ppm), and Cd (3.69 ppm) in Muzaffargarh exceeded permissible limits. Overall, the concentrations of metals in urine, nail, and hair samples were higher in adults (39-45 age group). Cr, Cu, and Ni revealed significantly higher concentrations of metals in hair and water in Multan, whereas As in water was significantly (p < 0.001) correlated with urinary As in Multan, indicating that the exposure source was region-specific.

Fabrication of Co3O4@ZnIn2S4 for photocatalytic hydrogen evolution: Insights into the synergistic mechanism of photothermal effect and heterojunction

Integration of photothermal materials and photocatalysts can effectively improve photocatalytic hydrogen production. However, the synergistic mechanism of photothermal effect and heterojunction still need to be deeply investigated. Herein, Co3O4@ZnIn2S4 (ZIS) core-shell heterojunction was constructed as a photothermal/ photocatalytic integrated system for photocatalytic hydrogen production. The photothermal effect induced by Co3O4 boosts the surface reaction kinetic of hydrogen evolution with an apparent activation energy decrease from 42.0 kJ⋅mol-1 to 33.5 kJ⋅mol-1. The photothermal effect also increases the charge concentrations of Co3O4@ZIS, which ameliorates the conductivity of Co3O4@ZIS and thus benefits to charge transfer. In addition, a p-n junction forms between Co3O4 and ZIS and provides a built-in electric field to enhance charge separate and prolong charge life time. Benefiting from the synergy of photothermal effect and heterojunction, the photocatalytic performance of Co3O4@ZIS is significantly improved with a highest hydrogen evolution rate of 4515 μmol⋅g-1⋅h-1, which is about 3.5 times higher than that of pure ZIS. This work offers a full perspective to understand the photothermal/photocatalytic integrated conception for solar hydrogen production.

Improved Short-Circuit Current and Fill Factor in PM6:Y6 Organic Solar Cells through D18-Cl Doping

Based on the PM6:Y6 binary system, a novel non-fullerene acceptor material, D18-Cl, was doped into the PM6:Y6 blend to fabricate the active layer. The effects of different doping ratios of D18-Cl on organic solar cells were investigated. The best-performing organic solar cell was achieved when the doping ratio of D18-Cl reached 20 wt%. It exhibited a short-circuit current of 28.13 mA/cm2, a fill factor of 70.25%, an open-circuit voltage (Voc) of 0.81 V, and a power conversion efficiency of 16.08%. The introduction of an appropriate amount of D18-Cl expanded the absorption spectrum of the active layer, improved the morphology of the active layer, reduced large molecular aggregation and defects, minimized bimolecular recombination, and optimized the collection efficiency of charge carriers. These results indicate the critical importance of selecting an appropriate third component in binary systems and optimizing the doping ratio to enhance the performance of ternary organic solar cells.

Assessing the possibility of China reaching carbon emission peak by 2030 in the context of the COVID-19 pandemic

At this stage, it is an important goal for China to solve environmental problems to limit the carbon emission peak by 2030 and then to lower its quality gradually thereafter. The outbreak of the COVID-19 pandemic in 2020 seriously impacted all aspects of China's social economy and brought many uncertainties to the realization of the carbon emission peak. Based on the fact, it has important theoretical and practical significance to take the problem of China's carbon emissions during the COVID-19 as the research object. Thus, this paper analyzes the current situation of China's CO2 emissions and finds out that in the context of ongoing COVID-19 response, stimulated by China's economic stimulus policies, CO2 emissions decrease firstly and then gradually rebound. On this basis, the paper constructs a dynamic model of China's CO2 emission system to simulate the change in China's CO2 emissions under different economic stimulus policies. The relevant simulation results demonstrate the following: (1) China cannot realize the CO2 emission goal by 2030 only by adopting traditional economic stimulus policies. (2) The green economic stimulus policy oriented to the development of clean energy will rebound China's CO2 emissions in the short term, but it can effectively reduce CO2 emissions in the long run. The most important factors affecting CO2 emission reduction are industrial energy consumption and industrial structure, while the energy power generation structure and the transportation structure have a relatively weak impact on the emission reduction effect. (3) The green economic stimulus policy combined with economic stimulus measures and a variety of low-carbon measures can enable China to peak CO2 emissions before 2030, with a peak value of 11.059 billion tons. In general, green economic stimulus policies can achieve a win-win situation for China's economic recovery and carbon emission peak.

Lycium barbarum Polysaccharides Improved Glucose Metabolism in Prediabetic Mice by Regulating Duodenal Contraction

Lycium barbarum polysaccharides (LBPs) have been shown to exert an antiglycemic effect. Emerging evidence suggests that patients with hyperglycemia have a hypercontractility of duodenum, and targeting duodenal contraction of duodenum can be beneficial to glucose metabolism. However, it is unknown whether LBPs can improve glucose metabolism by regulating the hypercontractility of the duodenum. Our aim was to explore the effect of LBPs on duodenal contraction in prediabetic mice and also preliminarily investigate the mechanism. The results showed that LBPs improved glucose homeostasis by decreasing the duodenal amplitude of contraction rather than frequency. Moreover, LBPs ameliorated the gut microbiota composition and the levels of short-chain fatty acids, especially acetic acid, which might bind to the receptor on neurons to regulate the contraction of the duodenum. Acetic acid was hypothesized to play a key role in the above process. Then, acetic acid was determined to exert an antiglycemic effect as expected. In conclusion, LBPs may rely on acetic acid to regulate duodenal contraction to ameliorate glucose metabolism in prediabetic mice, which provides a new therapeutic strategy to treat dysglycemia.

The impact of maize straw incorporation on arsenic and cadmium availability, transformation and microbial communities in alkaline-contaminated soils

Increasing evidence of the uncertainty of crop straw returning in heavy metal-contaminated soil is a significant concern. The present study investigated the influence of 1 and 2% maize straws (MS) amendment on As and Cd bioavailability in two different alkaline soils (A-industrial and B-irrigation) after 56 days of ageing. Adding MS to the two soils decreased the pH by 1.28 (A soil) and 1.13 (B soil) and increased the concentration of dissolved organic carbon (DOC) by 54.40 mg/kg (A soil) and 100.00 mg/kg (B soil) during the study period. After 56 days of ageing, the overall NaHCO3-As and DTPA-Cd increased by 40% and 33% (A) and 39% and 41% (B) soils, respectively. The MS additions increased the alteration of As and Cd exchangeable and residual fractions, whereas advanced solid-state 13C nuclear magnetic resonance (NMR) revealed that alkyl C and alkyl O-C-O in A soil and alkyl C, Methoxy C/N-alkyl, and alkyl O-C-O in B soil significantly contributed to the As and Cd mobilisation. Collectively, 16 S rRNA analyses revealed Acidobacteria, Firmicutes, Chloroflexi, Actinobacteria and Bacillus promoted the As and Cd mobilisation following the MS addition, while principle component analysis (PCA) demonstrated that bacterial proliferation significantly influenced MS decomposition, resulting in As and Cd mobilisation in the two soils. Overall, the study highlights the implications of applying MS to As- and Cd-contaminated alkaline soil and offers the framework for conditions to be considered during As- and Cd-remediation efforts, especially when MS is the sole remediation component.

High quality stealth dicing of sapphire with a picosecond Bessel beam by controlling the polarization direction

Sapphire is an important substrate material in optoelectronic devices, and it is also widely used as a touch screen panel. In order to achieve high quality cutting of sapphire, the stealth dicing of 500 µm thick sapphire by a picosecond Bessel beam is studied in this paper. The influences of laser polarization direction and process parameters on cutting section roughness were studied. By controlling the laser polarization direction, different crack propagation morphologies were obtained. When the polarization direction was vertical to the cutting path, the crack propagation path was straighter, and the sapphire had better cutting quality. The laser processing parameters, including burst mode, hole spacing, and pulse energy, had a significant impact on the cutting section roughness. When the polarization direction was vertical to the cutting path under the optimal process parameters, the cutting section was uniform and flat, with no recondensable particles, no ripples, and no chamfer, and an 89.7 nm average roughness of the cutting section could be obtained.

Changes of people's fertility attitudes based on analysis of online public opinion on three-child policy in China

In response to the population aging, on May 31, 2021, the Political Bureau of the Central Committee of the Communist Party of China (CPC) proposed the policy that a couple can have three children and rolled out more supportive measures to further optimize fertility policies, which is another major initiative following the universal two-child policy introduced in November 2015. Currently, a series of population policy innovations have aroused great attractions among the public and triggered a hot debating on the Internet. People's fertility attitude tendency under different related policies can reflect their current fertility intentions. Based on the fact, this paper firstly classifies the sentiment of online comment data on the three-child policy and analyzes people's sentiment tendency toward the three-child policy from the spatio-temporal perspectives. Secondly, people's points of view on the three-child policy are summarized by using Latent Dirichlet Allocation (LDA) thematic clustering. The reasons for the change in people's fertility attitude tendency under different fertility policies are analyzed by comparing the change in people's fertility attitude tendency with the change in people's attentions. Finally, a multiple regression equation is constructed to analyze the key factors influencing people's intention to have three children by using public opinion data and its extension data. The findings demonstrate: (1) people's fertility attitudes toward the three-child policy are negative and similar among different regions; (2) compared to the two-child policy, the percentage of negative and neutral attitudes toward the three-child policy increases, while the percentage of positive attitudes decreases; (3) the increase in fertility costs, the deterioration of women's employment environment, and the change in the concept of marriage and childbirth become important reasons for the negative change in people's fertility attitudes toward different policies. Therefore, the government should take measures to reduce the burden of childbirth and guide the correct concept of marriage and childbirth to improve people's fertility intentions.

What are the risks associated with lipiodol hysterosalpingography? A literature review

INTRODUCTION

Hysterosalpingography is widely used as a first-line investigation for infertility, and may also be therapeutic, increasing pregnancy rates. Aqueous and oil-based contrast agents can be used. Some studies suggest Lipiodol hysterosalpingography has a greater therapeutic effect on fertility than aqueous contrast, though this is contentious. There are additionally safety concerns surrounding Lipiodol hysterosalpingography. This review summarises the adverse effects associated with Lipiodol hysterosalpingography, particularly on thyroid function.

KEY FINDINGS

331 articles were identified. Of these, 46 met inclusion criteria. 3 further articles were identified from reference lists. Complications typically cited in the literature include pain, intravasation, life-threatening oil embolism, and lipogranuloma formation. Emerging evidence suggests that Lipiodol hysterosalpingography may also impact maternal and neonatal thyroid function. Women may develop hypo- or hyperthyroidism. Thyroid dysfunction is clinically significant as even subclinical hypothyroidism reduces fertility, increases the risk of pregnancy complications including miscarriage, pre-eclampsia and perinatal mortality, and adversely impacts foetal neurodevelopment. One study suggested a possible link with neonatal congenital hypothyroidism.

CONCLUSION

There is emerging evidence to suggest that Lipiodol hysterosalpingography can cause hypo- or hyperthyroidism, in addition to known adverse effects of pain, intravasation, oil embolism, and lipogranuloma formation.

IMPLICATIONS FOR PRACTICE

Given the significance of these risks, and contention surrounding whether Lipiodol truly increases pregnancy rates compared to aqueous mediums, careful consideration is required in the selection of contrast agent. In particular, Lipiodol hysterosalpingography may not be suitable for women with pre-existing thyroid dysfunction.

RETRACTED ARTICLE: Analysis of fractured soft rock characteristics in fault rupture zones and laneway shoring

Fault rupture is a common phenomenon in geotechnical engineering. To prevent rupture, laneway shoring is performed, prior to which, convergence deformation, failure criteria, and fracture development in soft rocks in the fault rupture zone are carefully analyzed. Then, a supporting structure corresponding to the actual situation of the soft rock in the rupture zone is created. Herein, the water-rich laneway shoring through the fault rupture zone of the Hongqingliang coal mine located in the Inner Mongolia Autonomous Region is taken as the research object. Then, the fracture development and characteristics of argillaceous siltstones and laneway shoring cross-fault rupture zone are studied. Site inspection, indoor and field tests, theoretical analysis, numerical simulation, and field monitoring were used for systematic fracture analysis. Results indicated that laneway shoring through the fault fracture zone in the Hongqingliang coal mine could help prevent disasters. This method was extended to laneway supports built through the fault rupture zones in mines in other areas of China.

[Relationships between hypertensive disorders in pregnancy and obstructive sleep apnea syndrome]

Objective: To investigate the impact of obstructive sleep apnea syndrome (OSAS) on pregnancy outcomes, especially the relationship between OSAS and hypertensive disorders in pregnancy (HDP). Methods: A total of 228 pregnant women with high risk of OSAS who underwent sleep monitoring during pregnancy in Peking University People's Hospital from January 2021 to April 2022 were collected by reviewing their medical records for retrospective analysis. According to the diagnosis of OSAS, the pregnant women were divided into OSAS group (105 cases) and non-OSAS group (123 cases). The non-parametric Mann-Whitney U test, χ2 test or Fisher's exact test were used to compare the general data and maternal and fetal outcomes between the two groups, and the occurrence of each type of HDP was further compared. Results: (1) Compared with the non-OSAS group, the median pre-pregnancy body mass index (23.6 vs 27.6 kg/m2) and the proportion of snoring [28.9% (33/114) vs 59.2% (61/103)] in the OSAS group were higher, and the differences were both statistically significant (both P<0.001). (2) The incidence of HDP [67.6% (71/105) vs 39.0% (48/123)] and gestational diabetes mellitus [GDM; 40.0% (42/105) vs 26.8% (33/123)] of pregnant women in the OSAS group were higher than those in the non-OSAS group, and the median delivery week was shorter than that in the non-OSAS group (38.4 vs 39.0 weeks). The differences were all statistically significant (all P<0.05). Between-group differences for the delivery way, postpartum hemorrhage, the rate of intensive care unit admission, preterm birth, small for gestational age infants, neonatal asphyxia, the rate of neonatal intensive care unit admission, newborn birth weight and the proportion of umbilical artery blood pH<7.00 were not statistically significant (all P>0.05). (3) Compared with the non-OSAS group, the incidence of chronic hypertension [11.4% (14/123) vs 22.9% (24/105)] and chronic hypertension with superimposed pre-eclampsia [11.4% (14/123) vs 30.5% (32/105)] were higher in the OSAS group, and the differences were both statistically significant (both P<0.01). Conclusion: OSAS is related to HDP (especially chronic hypertension and chronic hypertension with superimposed pre-eclampsia) and GDM, which could provide a practical basis for the screening, diagnosis and treatment of OSAS in pregnant women at high risk.

Organic Matter Counteracts the Enhancement of Cr(III) Extractability during the Fe(II)-Catalyzed Ferrihydrite Transformation: A Nanoscale- and Molecular-Level Investigation

Phase transformation of ferrihydrite to more stable Fe (oxyhydr)oxides, catalyzed by iron(II) [Fe(II)], significantly influences the mobility of heavy metals [e.g., chromium (Cr)] associated with ferrihydrite. However, the impact of organic matter (OM) on the behavior of Cr(III) in the Fe(II)-catalyzed transformation of ferrihydrite and the underlying mechanisms are unclear. Here, the Fe(II)-catalyzed transformation of the coprecipitates of Fe(III), Cr(III), or rice straw-derived OM was studied at the nanoscale and molecular levels using Fe and Cr K-edge X-ray absorption spectroscopy and spherical aberration corrected scanning transmission electron microscopy (Cs-STEM). Batch extraction results suggested that the OM counteracted the enhancement of Cr(III) extractability during the Fe(II)-catalyzed transformation. Cs-STEM and XAS analysis suggested that Cr(III) could be incorporated into the goethite formed by Fe(II)-catalyzed ferrihydrite transformation, which, however, was inhibited by the OM. Furthermore, Cs-STEM analysis also provided direct nanoscale level evidence that residual ferrihydrite could re-immobilize the released Cr(III) during the Fe(II)-catalyzed transformation process. These results highlighted that the decreased extractability of Cr(III) mainly resulted from the inhibition of OM on the Fe(II)-catalyzed transformation of ferrihydrite to secondary Fe (oxyhydr)oxides, which facilitates insightful understanding and prediction of the geochemical cycling of Cr in soils with active redox dynamics.

Cutaneous hyphomycosis Caused by Purpureocillium lilacinus Infection Associated with Superficial Venipuncture: A Case Report

Cutaneous hyphomycosis caused by Purpureocillium lilacinus is a relatively uncommon event in patients, but there has been a gradual increase in reported cases. A 71-year-old female patient was hospitalized in May 2022 due to an acute episode of chronic obstructive pulmonary disease and received glucocorticoid infusion. The skin around the puncture point on the back of her right hand showed erythema, nodules, scabs, and pus discharge, which gradually worsened. Fungal examination revealed the presence of hyphae, while treatment with terbinafine was ineffective. After fungal culture, pathological analysis, and molecular biology identification techniques, this case was diagnosed as cutaneous and subcutaneous infections caused by Purpureocillium lilacinus. After 2 weeks of treatment with itraconazole, the patient recovered. Patients on long-term hormone preparations who undergo superficial venipuncture should be aware of the risk of skin damage and potential infection by Purpureocillium lilacinus. Prompt fungal culture, histopathological analysis, and molecular identification are crucial for accurate diagnosis. Antifungal susceptibility testing should be considered for effective treatment.