Solidophobic Surface for Electrochemical Extraction of High-Valued Mg(OH)2 Coupled with H2 Production from Seawater

A significant challenge in direct seawater electrolysis is the rapid deactivation of the cathode due to the large scaling of Mg(OH)2. Herein, we synthesized a Pt-coated highly disordered NiCu alloy (Pt-NiCu alloy) electrode with superior solidophobic behavior, enabling stable hydrogen generation (100 mA cm-2, >1000 h durability) and simultaneous production of Mg(OH)2 (>99.0% purity) in electrolyte enriched with Mg2+ and Ca2+. The unconventional solidophobic property primarily stems from the high surface energy of the NiCu alloy substrate, which facilitates the adsorption of surface water and thereby compels the bulk formation of Mg(OH)2 via homogeneous nucleation. The discovery of this solidophobic electrode will revolutionarily simplify the existing techniques for seawater electrolysis and increase the economic viability for seawater electrolysis.

Self-Supported WO3@RuO2 Nanowires for Electrocatalytic Acidic Water Oxidation

Developing catalysts with high catalytic activity and stability in acidic media is crucial for advancing hydrogen production in proton exchange membrane water electrolyzers (PEMWEs). To this end, a self-supported WO3@RuO2 nanowire structure was grown in situ on a titanium mesh using hydrothermal and ion-exchange methods. Despite a Ru loading of only 0.098 wt %, it achieves an overpotential of 246 mV for the oxygen evolution reaction (OER) at a current density of 10 mA·cm-2 in acidic 0.5 M H2SO4 while maintaining excellent stability over 50 h, much better than that of the commercial RuO2. After the establishment of the WO3@RuO2 heterostructure, a reduced overpotential of the rate-determining step from M-O* to M-OOH* is confirmed by the DFT calculation. Meanwhile, its enhanced OER kinetics are also greatly improved by this self-supported system in the absence of the organic binder, leading to a reduced interface resistance between active sites and electrolytes. This work presents a promising approach to minimize the use of noble metals for large-scale PEMWE applications.

Three-dimensional pseudo-continuous arterial spin-labelled perfusion imaging for diagnosing upper cervical lymph node metastasis in patients with nasopharyngeal carcinoma: a whole-node histogram analysis

AIM

To evaluate whole-node histogram parameters of blood flow (BF) maps derived from three-dimensional pseudo-continuous arterial spin-labelled (3D pCASL) imaging in discriminating metastatic from benign upper cervical lymph nodes (UCLNs) for nasopharyngeal carcinoma (NPC) patients.

MATERIALS AND METHODS

Eighty NPC patients with a total of 170 histologically confirmed UCLNs (67 benign and 103 metastatic) were included retrospectively. Pre-treatment 3D pCASL imaging was performed and whole-node histogram analysis was then applied. Histogram parameters and morphological features, such as minimum axis diameter (MinAD), maximum axis diameter (MaxAD), and location of UCLNs, were assessed and compared between benign and metastatic lesions. Predictors were identified and further applied to establish a combined model by multivariate logistic regression in predicting the probability of metastatic UCLNs. Receiver operating characteristic (ROC) curves were used to analyse the diagnostic performance.

RESULTS

Metastatic UCLNs had larger MinAD and MinAD/MaxAD ratio, greater energy and entropy values, and higher incidence of level II (upper jugular group), but lower BF10th value than benign nodes (all p<0.05). MinAD, BF10th, energy, and entropy were validated as independent predictors in diagnosing metastatic UCLNs. The combined model yielded an area under the curve (AUC) of 0.932, accuracy of 84.42 %, sensitivity of 80.6 %, and specificity of 90.29 %.

CONCLUSIONS

Whole-node histogram analysis on BF maps is a feasible tool to differentiate metastatic from benign UCLNs in NPC patients, and the combined model can further improve the diagnostic efficacy.

Identification and analysis of MSC-Exo-derived LncRNAs related to the regulation of EMT in hypospadias

OBJECTIVE

This study aims to screen the differentially expressed long non-coding RNAs (DELncRNAs) related to the regulation of epithelial-mesenchymal transition (EMT) in hypospadias in mesenchymal stem cell-derived exosomes (MSC-Exons) and explore the potential mechanism of these lncRNAs for the EMT in hypospadias.

METHODS

In this study, the microarray data related to MSC-Exos and hypospadias were downloaded from Gene Expression Omnibus (GEO). Besides, the lncRNAs highly expressed in MSC-Exos and the differentially expressed mRNAs and lncRNAs in children with hypospadias were screened, respectively. In addition, the lncRNAs enriched in MSC-Exos and differentially expressed lncRNAs in hypospadias were intersected to obtain the final DElncRNAs. Moreover, the co-expression interaction pairs of differentially expressed lncRNAs and mRNAs were analyzed to construct a Competing Endogenous RNA (ceRNA) network. Finally, the candidate lncRNAs in exosomes were subjected to in vitro cell function verification.

RESULTS

In this study, a total of 4 lncRNAs were obtained from the microarray data analysis. Further, a ceRNA regulatory network of MSC-Exo-derived lncRNAs related to the regulation of EMT in hypospadias was constructed, including 4 lncRNAs, 2 mRNAs, and 6 miRNAs. The cell function verification results indicated that the exosomes secreted by MSCs may transport HLA complex group 18 (HCG18) into target cells, which promoted the proliferation, migration, and EMT of these cells.

CONCLUSION

MSC-Exo-derived lncRNA HCG18 can enter target cells, and it may be involved in the regulation of EMT in hypospadias through the ceRNA network.

The construction of a nomogram to predict the prognosis and recurrence risks of UPJO

Objective

This study was conducted to explore the risk factors for the prognosis and recurrence of ureteropelvic junction obstruction (UPJO).

Methods

The correlation of these variables with the prognosis and recurrence risks was analyzed by binary and multivariate logistic regression. Besides, a nomogram was constructed based on the multivariate logistic regression calculation. After the model was verified by the C-statistic, the ROC curve was plotted to evaluate the sensitivity of the model. Finally, the decision curve analysis (DCA) was conducted to estimate the clinical benefits and losses of intervention measures under a series of risk thresholds.

Results

Preoperative automated peritoneal dialysis (APD), preoperative urinary tract infection (UTI), preoperative renal parenchymal thickness (RPT), Mayo adhesive probability (MAP) score, and surgeon proficiency were the high-risk factors for the prognosis and recurrence of UPJO. In addition, a nomogram was constructed based on the above 5 variables. The area under the curve (AUC) was 0.8831 after self cross-validation, which validated that the specificity of the model was favorable.

Conclusion

The column chart constructed by five factors has good predictive ability for the prognosis and recurrence of UPJO, which may provide more reasonable guidance for the clinical diagnosis and treatment of this disease.

Nephroblastoma-specific dysregulated gene SNHG15 with prognostic significance: scRNA-Seq with bulk RNA-Seq data and experimental validation

Wilms tumor (WT) is the most common malignancy of the genitourinary system in children. Currently, the Integration of single-cell RNA sequencing (scRNA-Seq) and Bulk RNA sequencing (RNA-Seq) analysis of heterogeneity between different cell types in pediatric WT tissues could more accurately find prognostic markers, but this is lacking. RNA-Seq and clinical data related to WT were downloaded from the Therapeutically Applicable Research to Generate Effective Treatments (TARGET) database. Small nucleolar RNA host gene 15 (SNHG15) was identified as a risk signature from the TARGET dataset by using weighted gene co-expression network analysis, differentially expressed analysis and univariate Cox analysis. After that, the functional mechanisms, immunological and molecular characterization of SNHG15 were investigated at the scRNA-seq, pan-cancer, and RNA-seq levels using Gene ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), ESTIMATE, and CIBERSORT. Based on scRNA-seq data, we identified 20 clusters in WT and annotated 10 cell types. Integration of single-cell and spatial data mapped ligand-receptor networks to specific cell types, revealing M2 macrophages as hubs for intercellular communication. In addition, in vitro cellular experiments showed that siRNAs interfering with SNHG15 significantly inhibited the proliferation and migration of G401 cells and promoted the apoptosis of G401 cells compared with the control group. The effect of siRNAs interfering with SNHG15 on EMT-related protein expression was verified by Western blotting assay. Thus, our findings will improve our current understanding of the pathogenesis of WT, and they are potentially valuable in providing novel prognosis markers for the treatment of WT.

Progress in Anode Stability Improvement for Seawater Electrolysis to Produce Hydrogen

Seawater electrolysis for hydrogen production is a sustainable and economical approach that can mitigate the energy crisis and global warming issues. Although various catalysts/electrodes with excellent activities have been developed for high-efficiency seawater electrolysis, their unsatisfactory durability, especially for anodes, severely impedes their industrial applications. In this review, attention is paid to the factors that affect the stability of anodes and the corresponding strategies for designing catalytic materials to prolong the anode's lifetime. In addition, two important aspects-electrolyte optimization and electrolyzer design-with respect to anode stability improvement are summarized. Furthermore, several methods for rapid stability assessment are proposed for the fast screening of both highly active and stable catalysts/electrodes. Finally, perspectives on future investigations aimed at improving the stability of seawater electrolysis systems are outlined.

Ag Nanoparticle-Induced Surface Chloride Immobilization Strategy Enables Stable Seawater Electrolysis

Although hydrogen gas (H2 ) storage might enable offshore renewable energy to be stored at scale, the commercialization of technology for H2 generation by seawater electrolysis depends upon the development of methods that avoid the severe corrosion of anodes by chloride (Cl- ) ions. Here, it is revealed that the stability of an anode used for seawater splitting can be increased by more than an order of magnitude by loading Ag nanoparticles on the catalyst surface. In experiments, an optimized NiFe-layered double hydroxide (LDH)@Ag electrode displays stable operation at 400 mA cm-2 in alkaline saline electrolyte and seawater for over 5000 and 2500 h, respectively. The impressive long-term durability is more than 20 times that of an unmodified NiFe-LDH anode. Meticulous characterization and simulation reveals that in the presence of an applied electric field, free Cl- ions react with oxidized Ag nanoparticles to form stable AgCl species, giving rise to the formation of a Cl- -free layer near the anode surface. Because of its simplicity and effectiveness, it is anticipated that the proposed strategy to immobilize chloride ions on the surface of an anode has the potential to become a crucial technology to control corrosion during large-scale electrolysis of seawater to produce hydrogen.

Concerns on the Effects of Electrode Positions in Electrolyte Container for the Oxygen Evolution Reaction

Water electrolysis is currently a major technique to produce clean hydrogen, which is regarded as a promising and sustainable energy carrier. The efficiency of water electrolysis is highly dependent on the oxygen evolution reaction (OER) on the anode. The evaluation of an OER electrocatalyst is frequently carried out on a three-electrode system in a container of electrolyte. Herein, we found that the electrode positions in the electrolyte container could significantly affect the data acquisition of OER performance. After a detailed investigation, we reveal that the difference of the OER activity of an electrocatalyst at a different position is originated from their different iRu drop and the gas diffusion resistance. For the first time, this work evokes concerns on the accurate evaluation of electrocatalysts regarding the electrode position. For fair comparisons and reliable results, it is strongly suggested to keep the electrode position unchanged in the electrochemical measurements. In addition, the establishment of a standard electrolyzer setup for electrocatalysis evaluation in the electrochemical community is also called for.

Self-Supporting Mn-RuO2 Nanoarrays for Stable Oxygen Evolution Reaction in Acid

Currently, the process of an acidic oxygen evolution reaction (OER) necessitates the use of Iridium dioxygen (IrO2), which is both expensive and incredibly scarce on Earth. Ruthenium dioxygen (RuO2) offers high activity for acidic OERs and presents a potential substitution for IrO2. Nevertheless, its practical application is hindered by its relatively poor stability. In this study, we have developed Mn-doped RuO2 (Mn-RuO2) nanoarrays that are anchored on a titanium (Ti) mesh utilizing a two-step methodology involving the preparation of MnO2 nanoarrays followed by a subsequent Ru exchange and annealing process. By precisely optimizing the annealing temperature, we have managed to attain a remarkably low overpotential of 217 mV at 10 mA cm-2 in a 0.5 M H2SO4 solution. The enhanced catalytic activity of our Mn-RuO2 nanoarrays can be attributed to the electronic modification brought about by the high exposure of active sites, Mn dopant, efficient mass transfer, as well as the efficient transfer of electrons between the Ti mesh and the catalyst arrays. Furthermore, these self-supported Mn-RuO2 nanoarrays demonstrated excellent long-term stability throughout a chronoamperometry test lasting for 100 h, with no discernible changes observed in the Ru chemical states.

[Effect of recombinant human thrombin for hemostasis in liver resection: a randomized controlled phase Ⅲ clinical trial]

Objective: To evaluate the hemostatic efficacy, safety and immunogenicity of recombinant human thrombin in the treatment of liver wounds that still ooze after conventional surgical hemostasis. Methods: A multicenter, stratified randomized, double-blind, placebo-controlled phase Ⅲ trial with a planned enrollment of 510 subjects at 33 centers, with a 2∶1 randomization to the thrombin group versus the placebo group. An interim analysis will be conducted after approximately 70% of the subjects have completed the observation period. The primary efficacy endpoint was the rate of hemostasis within 6 minutes at the point of bleeding that could be evaluated. Safety analysis was performed one month after surgery, and the positive rates of anti-drug antibody (ADA) and neutralizing antibody were evaluated. Results: At the interim analysis, a total of 348 subjects had been randomized and received the study drug (215 were male and 133 were female). They were aged 19-69 (52.9±10.9)years. Among them, 232 were in the thrombin group and 116 were in the placebo group, with balanced and comparable demographics and baseline characteristics between the two groups. The hemostasis rate at 6 minutes was 71.6% (95%CI:65.75%-77.36%) in the thrombin group and 44.0% (95%CI: 34.93%-53.00%) in the placebo group, respectively (P<0.001). No grade≥3 drug-related adverse events and no drug-related deaths were reported from the study.No recombinant human thrombin-induced immunologically-enhanced ADA or immunologically-induced ADA was detected after topical use in subjects. Conclusion: Recombinant human thrombin has shown significant hemostatic efficacy and good safety in controlling bleeding during liver resection surgery, while also demonstrating low immunogenicity characteristics.

Measurement of the Positive Muon Anomalous Magnetic Moment to 0.20 ppm

We present a new measurement of the positive muon magnetic anomaly, a_{μ}≡(g_{μ}-2)/2, from the Fermilab Muon g-2 Experiment using data collected in 2019 and 2020. We have analyzed more than 4 times the number of positrons from muon decay than in our previous result from 2018 data. The systematic error is reduced by more than a factor of 2 due to better running conditions, a more stable beam, and improved knowledge of the magnetic field weighted by the muon distribution, ω[over ˜]_{p}^{'}, and of the anomalous precession frequency corrected for beam dynamics effects, ω_{a}. From the ratio ω_{a}/ω[over ˜]_{p}^{'}, together with precisely determined external parameters, we determine a_{μ}=116 592 057(25)×10^{-11} (0.21 ppm). Combining this result with our previous result from the 2018 data, we obtain a_{μ}(FNAL)=116 592 055(24)×10^{-11} (0.20 ppm). The new experimental world average is a_{μ}(exp)=116 592 059(22)×10^{-11} (0.19 ppm), which represents a factor of 2 improvement in precision.

The Role of Radiation Therapy for Metastatic Cervical Cancer

PURPOSE/OBJECTIVE(S)

Survival rates for women with metastatic cervical cancer (CC) are low, with limited management options. Radiation therapy (RT) for metastatic disease has led to prolonged survival in other malignancies, however, the data are scarce in CC. Herein, we evaluated the effect of RT for metastatic CC.

MATERIALS/METHODS

A total of 58 patients with metastatic CC between September 2019 and January 2023 were retrospectively analyzed. All the patients were treated with platinum-based chemotherapy combined with targeted therapy or immunotherapy followed with or without RT (NRT). The recent efficacy, survival status and prognostic factors were analyzed statistically.

RESULTS

Objective response rate (ORR) was 63.6% with one complete and twenty partial responses in RT group (n = 33) and 40.0% with two complete and eight partial responses in NRT group (n = 25), respectively (p = 0.074). Disease control rate (DCR) of the RT and NRT groups were 79.4% vs 80.0%, respectively (p = 0.861). Median follow-up time was 17 months (3-39months). In RT group, 11(33.3%) patients experienced local regional or distant failure and 9 (27.3%) patients were dead. In NRT group, 15(60%) patients had progression and 8 (32%) patients dead. There was no significant difference between the two groups in overall survival (OS); however, RT group displayed superior progression-free survival (PFS) (1-year OS: 72.7% vs. 68.0%, p = 0.460; 1-year PFS: 66.7% vs. 40.0%, p = 0.039). The multivariate analysis showed that RT, immunotherapy, lymph node metastasis only relevant predictor of superior PFS but not OS. In subgroup analysis, patients treated with RT appeared to have a better PFS in some specific cohorts, such as age>45 years (72.0% vs 36.4% P = 0.015), squamous carcinoma histology (71.0% vs 40.9% P = 0.017), metastatic at diagnosis (75.0% vs 47.6% P = 0.012), non-targeted therapy (72.4% vs 43.8% P = 0.040). No significant increase in treatment-related toxicity was observed in the RT group compared with the NRT group.

CONCLUSION

RT provided superior PFS in metastatic CC patients compared to NRT, and well tolerated. Moreover, RT, immunotherapy, lymph node metastasis only were independent significant prognostic factors for PFS. Subgroup analysis showed that combination of RT and chemotherapy obtained favorable PFS in metastatic CC patients with age>45 years, squamous carcinoma histology, metastatic at diagnosis, non-targeted therapy. Studies with a larger sample size and longer follow-up are warranted.

Radiation Induced Lung Injury in Rats after Pre-Oxygenation Radiotherapy

PURPOSE/OBJECTIVE(S)

Deep inspiratory breath holding (DIBH) has been widely used during the radiotherapy of thoracic tumors. The main disadvantage of voluntary DIBH is the short duration of each breath hold. The hypocapnia induced by hyperoxia (oxygen concentration > 50%) pre-oxygenation (PreO2) combined with mechanical hyperventilation has been reported to prolong the duration of single breath hold, but its safety remains controversial, especially the sensitivity of lung tissue to radiation damage under hyperoxia exposure has not been elucidated. In this study, we aim to investigate the changes of radiation induced lung injury in rats after PreO2 radiation.

MATERIALS/METHODS

We evaluated the lung tissue of rats at different time points (48h, 2w, 4w, 8w, 12w) after thoracic radiation (15Gy single fraction to the right lung), and sequenced the transcriptome of lung tissue at 48 hours after irradiation. Rat cohorts (n = 7/group): 1. Control (Con); 2. Radiation group (RT); 3. Pre-oxygenation (oxygen concentration > 90%) for 8 hours before thoracic radiation (PreO2).

RESULTS

The inflammatory exudation emerged in the pulmonary interstitium at 48 hours, and reached the most serious alveolitis after four weeks of irradiation (the comparison of alveolitis scores in RT4w vs Con4w and PreO2(4w) vs Con4w, P<0.001) on hematoxylin-eosin staining. While the alveolitis scores in RT group and PreO2 group were not statistically different at each time point. Masson staining showed that the pulmonary fibrosis in the RT group and the PreO2 group reached an obvious pathological change at 12 weeks after irradiation, but the difference between the two groups was not significant. Transcriptome sequencing showed that the number of differential genes in PreO2 vs Con was 559 (302 up-regulated genes and 257 down-regulated genes). The GO enrichment analysis indicated that chromosome segregation was the most significant functional item with P value in the comparative analysis, and the KEGG enrichment analysis suggested that cell division was the most significant enrichment pathway of these differential genes. While there was a small quantity of differential genes in PreO2 vs RT group (3 up-regulated genes and 12 down-regulated genes). Pentose and glucuronate conversions were the most significant enrichment pathway of these differential genes.

CONCLUSION

This study demonstrated that PreO2 radiotherapy did not increase the severity of radiation induced lung injury in rats compared to conventional radiotherapy. Further study should be conducted to confirm these results and to investigate the regulatory mechanism of pneumonia caused by PreO2 radiotherapy.

Deep Learning-Based Multi-Modality Segmentation of Primary Gross Tumor Volume in CT and MRI for Nasopharyngeal Carcinoma

PURPOSE/OBJECTIVE(S)

The delineation of primary gross tumor volume (GTV) of nasopharyngeal carcinoma (NPC) is an essential step for radiotherapy planning. In clinical practice, radiation oncologists manually delineate the GTV in planning CT with the help of diagnostic MRI. This is because NPC tumors are closely adjacent to many important anatomic structures, and CT and MRI provide complementary strength to accurately determine the tumor extension boundary. Manual delineation is time-consuming with the potential registration errors between MRI and CT decreasing the delineation accuracy. In this study, we propose a fully automated GTV segmentation method based on CT and MRI by first aligning MRI to CT, and then, segmenting the GTV using a multi-modality deep learning model.

MATERIALS/METHODS

We collected 104 nasopharyngeal carcinoma patients with both planning CT and diagnostic MRI scans (T1 & T2 phases). An experienced radiation oncologists manually delineated the GTV, which was further examined by another senior radiation oncologist. Then, a coarse to fine cross-modality registration from MRI to CT was conducted as follows: (1) A rigid transformation was performed on MRI to roughly align MRI to CT with similar anatomic position. (2) Then, the region of interest (RoI) on both CT and rigid-transformed MRI were cropped. (3) A leading cross-modality deformable registration algorithm, named DEEDS, was applied on the cropped MRI and CT RoIs to find an accurate local alignment. Next, using CT and registered MRI as the combined input, a multi-modality deep segmentation network based on nnUNet was trained to generate the GTV prediction. 20% patients were randomly selected as the unseen testing set to quantitatively evaluate the performance.

RESULTS

The quantitative NPC GTV segmentation performance is summarized in Table 1. The deep segmentation model using CT alone achieved reasonable high performance with 76.6% Dice score and 1.34mm average surface distance (ASD). When both CT and registered MRI were used, the segmentation model further improved the performance by 0.9% Dice score increase and 11% relative ASD error reduction, demonstrating the complementary strength of CT and MRI in determining NPC GTV. Notably, the achieved 77.5% Dice score and 1.19mm ASD by the multimodality model is among the top performing results reported in recent automatic NPC GTV segmentation using either CT or MRI modality.

CONCLUSION

We developed a fully automated multi-modal deep-learning model for NPC GTV segmentation. The developed model can segment the NPC GTV in high accuracy. With further optimization and validation, this automated model has potential to standardize the NPC GTV segmentation and significantly decrease the workload of radiation oncologists in clinical practice.

MOF-Derived CoSe2@NiFeOOH Arrays for Efficient Oxygen Evolution Reaction

Water electrolysis is a compelling method for the production of environmentally friendly hydrogen, minimizing carbon emissions. The electrolysis of water heavily relies on an effective and steady oxygen evolution reaction (OER) taking place at the anode. Herein, we introduce a highly promising catalyst for OER called CoSe2@NiFeOOH arrays, which are supported on nickel foam. This catalyst, referred to as CoSe2@NiFeOOH/NF, is fabricated through a two-step process involving the selenidation of a Co-based porous metal organic framework and subsequent electrochemical deposition on nickel foam. The CoSe2@NiFeOOH/NF catalyst demonstrates outstanding activity for the OER in an alkaline electrolyte. It exhibits a low overpotential (η) of 254 mV at 100 mA cm-2, a small Tafel slope of 73 mV dec-1, and excellent high stability. The good performance of CoSe2@NiFeOOH/NF can be attributed to the combination of the high conductivity of the inner layer and the synergistic effect between CoSe2 and NiFeOOH. This study offers an effective method for the fabrication of highly efficient catalysts for an OER.

Concerning the stability of seawater electrolysis: a corrosion mechanism study of halide on Ni-based anode

The corrosive anions (e.g., Cl-) have been recognized as the origins to cause severe corrosion of anode during seawater electrolysis, while in experiments it is found that natural seawater (~0.41 M Cl-) is usually more corrosive than simulated seawater (~0.5 M Cl-). Here we elucidate that besides Cl-, Br- in seawater is even more harmful to Ni-based anodes because of the inferior corrosion resistance and faster corrosion kinetics in bromide than in chloride. Experimental and simulated results reveal that Cl- corrodes locally to form narrow-deep pits while Br- etches extensively to generate shallow-wide pits, which can be attributed to the fast diffusion kinetics of Cl- and the lower reaction energy of Br- in the passivation layer. Additionally, for the Ni-based electrodes with catalysts (e.g., NiFe-LDH) loading on the surface, Br- causes extensive spalling of the catalyst layer, resulting in rapid performance degradation. This work clearly points out that, in addition to anti-Cl- corrosion, designing anti-Br- corrosion anodes is even more crucial for future application of seawater electrolysis.

Context-aware deep network for coronary artery stenosis classification in coronary CT angiography

Automatic coronary artery stenosis grading plays an important role in the diagnosis of coronary artery disease. Due to the difficulty of learning the informative features from varying grades of stenosis, it is still a challenging task to identify coronary artery stenosis from coronary CT angiography (CCTA). In this paper, we propose a context-aware deep network (CADN) for coronary artery stenosis classification. The proposed method integrates 3D CNN with Transformer to improve the feature representation of coronary artery stenosis in CCTA. We evaluate the proposed method on a multicenter dataset (APOLLO study with NCT05509010). Experimental results show that our proposed method can achieve the accuracy of 0.84, 0.83, and 0.86 for stenosis diagnosis on the lesion, artery, and patient levels, respectively.

Development and validation of a survival prediction model and risk stratification for pancreatic neuroendocrine neoplasms

PURPOSE

We explored risk variables associated with cancer-specific survival (CSS) in patients with pancreatic neuroendocrine neoplasms (PNENs) and created a network dynamic nomogram model to predict patient survival time.

METHODS

A total of 7750 patients with PNENs were included in this analysis, including 134 with functional PNENs and 7616 with nonfunctional PNENs. Clinical feature and prognosis differences between functional and nonfunctional PNENs were compared. Independent prognostic factors affecting CSS were analyzed by univariate and multifactorial Cox regression. Nomogram and web-based prognosis prediction of PNENs were developed and validated by C indices, decision curve analysis, and calibration plots.

RESULTS

Patients with functional PNENs were younger at diagnosis than those with nonfunctional PNENs. Functional PNENs had better prognoses than nonfunctional PNENs (5-year survival rates: 78.55% and 71.10%, respectively). Univariate and multifactorial Cox regression analyses showed that tumor infiltration (T), nodal metastasis (N), metastasis (M), tumor site, differentiation grade, age, marital status, and surgical treatment were independent prognostic risk factors for CSS, which were included in the prognostic nomogram and web-based prognosis calculator. The calibration plots and decision curve analysis showed that the nomogram had excellent prediction and clinical practical ability. The C indices for CSS in the training and validation cohorts were 0.848 (95% CI 0.838-0.8578) and 0.823 (95% CI 0.807-0.839), respectively. We scored all patients according to the nomogram and divided patients into three different risk groups. The prognosis of the low-risk population was significantly better than those of the middle- and high-risk populations based on Kaplan-Meier survival curve.

CONCLUSION

We analyzed the clinical features of PNENs and developed a convenient and web dynamic nomogram to predict CSS.

Association of residential greenness with the risk of metabolic syndrome in Chinese older adults: a longitudinal cohort study

AIMS

We aimed to investigate the association between residential greenness and MetS in older Chinese adults.

METHODS

Longitudinal data on sociodemographic characteristics and lifestyle were collected from the Shenzhen Healthy Ageing Research (SHARE) cohort. Greenness exposure was assessed through satellite-derived Normalized Difference Vegetation Index (NDVI) values in the 250-m, 500-m, and 1250-m radius around the residential address for each participant. MetS was defined by standard guidelines for the Chinese population.

RESULTS

A total of 49,893 older Chinese adults with a mean age of 70.96 (SD = 5.26) years were included in the study. In the fully adjusted models, participants who lived in the highest quartile of NDVI_250-m, NDVI_500-m, and NDVI_1250-m had a 15% (odds ratio, OR = 0.85, 95% confidence interval, CI: 0.80-0.90), 12% (OR = 0.88, 95% CI: 0.83-0.93), and 11% (OR = 0.89, 95% CI: 0.85-0.95) lower incidence of MetS, respectively, than those living in the lowest quartile (all p-_trend < 0.01). Interactions and subgroup analyses showed that age, sex, smoking status, and drinking status were significant effect modifiers (p-_interaction for all NDVI < 0.05).

CONCLUSIONS

Residential greenness is associated with a lower risk of MetS in Chinese older adults, especially for young older adults, females, non-smokers, and non-drinkers.

Cost-Effective H2 O2 -Regeneration of Powdered Activated Carbon by Isolated Fe Sites

The reuse of powdered activated carbon (PAC) vitally determines the economics and security of the PAC-based adsorption process, while state-of-the-art PAC regeneration technologies are usually unsatisfactory. Here, it is demonstrated that isolated Fe sites anchored on commercial PAC enable fast H₂ O₂ activation to produce Fe-based reactive oxygen species for highly efficient PAC regeneration at room temperature. Taking rhodamine B as a representative pollutant, PAC decorated with isolated Fe sites realize H₂ O₂ based regeneration with negligible adsorption capacity degradation for 10 cycles. Moreover, in terms of the PAC loss rate, this technology is greatly superior to traditional Fenton-based regeneration technology. Further operando experiments and theoretical calculations reveal that the high regeneration performance can be attributed to the isolated HOFeO motifs, which activate H₂ O₂ via a nonradical reaction pathway. These findings provide a very promising strategy toward reducing the cost of H₂ O₂ -based PAC regeneration technology.

The effect of interlayer water of metal-modified montmorillonite for catalytic ozonation

The catalytic ozonation-based advanced oxidation process (AOP) is applied to remove nondegradable chemical oxygen demand (COD), while the application in industry is limited by the economics and activity of catalysts. In this study, we demonstrate that by taking atrazine (ATZ) as a model pollutant, the removal rates of catalytic ozonation were negatively correlated with the interlayer water content of metal-modified montmorillonite (M_x@MMT), instead of the loadings metals. Among the modified MMT, Zn_0.1@MMT achieved 83.2% degradation of ATZ within 15 min, and corresponding removal rates of COD and total organic carbon (TOC) reached 40.3% and 46.5%, respectively. Detailed EPR and quenching experiments identified that hydroxyl radicals (HO•) were the main reactive oxygen species and QTOF/MS/MS analysis helped to propose a possible degradation pathway of ATZ. Moreover, the catalytic performance of Zn_0.1@MMT under different conditions was also systematically evaluated.

Atomically Dispersed Dual Metal Sites Boost the Efficiency of Olefins Epoxidation in Tandem with CO2 Cycloaddition

Tandem catalysis provides an economical and energy-efficient process for the production of fine chemicals. In this work, we demonstrate that a rationally synthesized carbon-based catalyst with atomically dispersed dual Fe-Al sites (ADD-Fe-Al) achieves superior catalytic activity for the one-pot oxidative carboxylation of olefins (conversion ∼97%, selectivity ∼91%), where the yield of target product over ADD-Fe-Al is at least 62% higher than that of monometallic counterparts. The kinetic results reveal that the excellent catalytic performance arises from the synergistic effect between Fe (oxidation site) and Al sites (cycloaddition site), where the efficient CO₂ cycloaddition with epoxides in the presence of Al sites (3.91 wt %) positively shifts the oxidation equilibrium to olefin epoxidation over Fe sites (0.89 wt %). This work not only offers an advanced catalyst for oxidative carboxylation of olefins but also opens up an avenue for the rational design of multifunctional catalysts for tandem catalytic reactions in the future.

Plasma amyloid-beta levels and risk of new-onset atrial fibrillation in the general population

Background

Atrial fibrillation (AF) is a major health burden worldwide, with significant sex differences in epidemiology and risk factors. Amyloid-β40 (Aβ40) and Amyloid-β42 (Aβ42), the hallmark of cerebral amyloid angiopathy, have recently been linked to prevalence and prognosis of several cardiovascular outcomes including stroke and coronary heart disease. However, whether these biomarkers are associated with incident AF remains largely unknown.

Purpose

To investigate the associations between plasma concentrations of Aβ40 and Aβ42 with new-onset AF.

Methods

4,134 participants without a history of AF at baseline (from 2002 to 2005) with qualified plasma samples in the Rotterdam Study were included in this study. AF was diagnosed by electrocardiograms, general practitioners' and hospital records. Cox proportional hazards regression models with natural cubic splines were used to assess the linear/nonlinear association between biomarkers and risk of new-onset AF. All models were adjusted for traditional cardiovascular risk factors.

Results

Mean age was 71.3±7.2 years and 2,383 (57.6%) were women. Median follow-up time was 9.2 years. In the fully adjusted model, higher levels of Aβ40 [hazard ratio, 95% confidence interval: 1.16 (1.05–1.28)] and Aβ42 [1.19 (1.09–1.31)], as well as Amyloid-β42 to β40 ratio (Aβ42/40) [1.09 (1.02–1.17)] were significantly associated with incident AF. The observed association between Aβ40 and AF attenuated after mutual adjustment for Aβ42 [1.05 (0.92–1.19)]. In addition, a J-shaped association was found between Aβ40 and AF with the lowest AF risk at Aβ40 values of 212.5 pg/ml.

Conclusions

Both Aβ40 and Aβ42 were independently significantly associated with new-onset AF in the general population independent of cardiovascular risk factors. Findings also suggest a stronger association between AF onset and Aβ42 and AF onset, compared to Aβ40. A nonlinear association was found between Aβ40 and AF, reflecting a substantially increased AF risk among participants with severely increased Aβ40 values.

Funding Acknowledgement

Type of funding sources: None.

Cardiometabolic multimorbidity and lifetime risk of atrial fibrillation among men and women

Background

Atrial fibrillation (AF) is the most common cardiac arrythmia worldwide, with an increased risk of comorbidity, and significant sex differences in pathophysiology and prognosis. Cardiometabolic disorders, including obesity, hypertension, diabetes mellitus, coronary heart disease, stroke, and heart failure commonly coexist with AF. However, the sex-specific patterns and (combined) impact of cardiometabolic disorders on the risk of new-onset AF remains largely unknown.

Purpose

To examine the association between patterns of cardiometabolic multimorbidity and new-onset AF and lifetime risk of AF incidence among men and women.

Methods

4,113 men and 5,432 women free of prevalent AF at baseline (from 1996 to 2008) from the Rotterdam Study were included. AF incidents were assessed by electrocardiograms and general practitioners' and hospital records, and followed up to January 1st, 2014. Sex-specific Cox proportional hazards regression models were used to assess the association between the amount of cardiometabolic disorders and risks of new-onset AF. Models were adjusted for traditional cardiovascular risk factors. Remaining lifetime risk for AF was estimated across the cardiometabolic multimorbidity groups at index ages of 55, 65, and ≥75 years up to age 108.

Results

Mean age at baseline was 65.5±9.4 years. Median follow-up time was 10.8 years. In the fully-adjusted model, a significant association was found between the amount of cardiometabolic disorders and incident AF among women but not men. Compared to women without cardiometabolic disorders, women with 3 (hazard ratios, 95% conference intervals: 2.17 (1.24–3.79)) and ≥4 comorbidities (4.58 (2.22–9.48)) had higher AF risks. The lifetime risk for AF was significantly increased with the number of cardiometabolic disorders among both men and women. At index age of 55 years, the lifetime risks (95% confidence interval) for AF were 25.2% (17.1–33.4), 24.2% (20.0–28.9), 27.1% (23.2–31.0), 30.0% (24.3–35.7) and 34.1% (22.4–45.7), for 0, 1, 2, 3, and ≥4 comorbid cardiometabolic disorders among men, respectively. Corresponding risks were 16.3% (6.68–25.9), 20.3% (16.3–24.3), 27.6% (24.1–31.2), 23.6% (17.8–29.4) and 33.3% (16.0–50.2) among women.

Conclusions

We observed a significant combined impact of cardiometabolic disorders on AF risk, most evidently among women. Participants with cardiometabolic multimorbidity had a significantly increased lifetime risk of AF, especially at a young index age.

Funding Acknowledgement

Type of funding sources: None.

Downregulated TICAM1 is a prognostic biomarker and associated with immune tolerance of Wilms tumor patients

Background

TIR domain containing adaptor molecule 1 (TICAM1) is a coding gene participating in immune and inflammation responses to malignant cells. However, the role of TICAM1 in Wilms tumor (WT) is rarely known.

Materials and methods

The expression level of TICAM1 was calculated in the WT TARGET cohort and validated using the GSE66405 cohort. The Kaplan–Meier method was employed to investigate the potential clinical value of TICAM1 and the association between its expression level and clinical features. The influence of TICAM1 on immune infiltration was examined by ESTIMATE, CIBERSORT and MCPcounter algorithms. IC50 of chemotherapeutic drugs was calculated by “pRRophetic” R package.

Results

TICAM1 was downregulated in WT patients with worse prognosis and a more advanced clinical stage. Moreover, a low expression level of TICAM1 contributed to less immune cell infiltration, few protective immune cells and more antitumor immune cells.

Conclusions

TICAM1 exerts a significant impact on the prognosis, progression and immune infiltration condition of WT.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12920-022-01326-5.

Lithium chloride promotes neural functional recovery after local cerebral ischaemia injury in rats through Wnt signalling pathway activation

BACKGROUND

Lithium chloride (LiCl) has a significant neuroprotective effect in cerebral ischaemia. However, to date, there is a paucity of evidence on the role of LiCl in neural restoration after brain ischaemia and the signalling pathways involved remain unclear.

MATERIALS AND METHODS

Therefore, to address this gap, the middle cerebral artery occlusion (MCAO) rat model was used to simulate human ischaemia stroke. Male Sprague-Dawley rats were given MCAO for 90 min followed by reperfusion, and Dickkopf-1 (DKK1, 5.0 μg/kg) was administered half an hour before MCAO. Rats were then treated with hypodermic injection of LiCl (2.0 mmol/kg) twice a day for 1 week. After treatment, cognitive impairment was assessed by the Morris water maze test. Neurological deficit score, 2,3,5-triphenyl tetrazolium chloride staining, brain water content, and histopathology were used to evaluate brain damage. Enzyme-linked immunosorbent assay was used to measure oxidative stress damage and inflammatory cytokines. Apoptosis of the hippocampal neurons was tested by western blot. The key factors of Wnt signalling pathway in the ischaemic penumbra were detected by immunofluorescence staining and quantitative real-time polymerase chain reaction.

RESULTS

Current experimental results showed that LiCl treatment significantly improved the impaired spatial learning and memory ability, suppressed oxidative stress, inflammatory reaction, and neuron apoptosis accompanied by attenuating neuronal damage, which subsequently decreased the brain oedema, infarct volume and neurological deficit. Furthermore, the treatment of LiCl activated Wnt signalling pathway. Interestingly, the aforementioned effects of LiCl treatment were markedly reversed by administration of DKK1, an inhibitor of Wnt signalling pathway.

CONCLUSIONS

These results indicate that LiCl exhibits neuroprotective effects in focal cerebral ischaemia by Wnt signalling pathway activation, and it might have latent clinical application for the prevention and treatment of ischaemic stroke.

P-382 Decrease of serum estradiol prior to human chorionic gonadotrophin administration have an impact on live birth in IVF/ICSI cycles

Study question

Whether decrease of serum estradiol prior to human chorionic gonadotrophin administration have an impact on live birth in IVF/ICSI cycles?

Summary answer

The E2 change before the day of hCG administration had significant correlation with live birth. The live birth rate decreased with decreasing serum E2 level.

What is known already

The objective of this study was to assess the effects of a decrease of estradiol (E2) levels on the day of human chorionic gonadotrophin (hCG) administration on in vitro fertilization /intracytoplasmic sperm injection (IVF/ICSI) outcomes, including cycles with long, antagonist and micro stimulus protocols.

Study design, size, duration

In this retrospective cohort study, 1303 patients who received IVF/ICSI non-donor treatment were identified. Patients were divided into two groups according to live birth and the characteristics of IVF/ICSI cycles were compared between groups, including baseline infertility parameters, ovarian stimulation characteristics and embryo laboratory manipulation parameters.

Participants/materials, setting, methods

In this retrospective cohort study, 1303 patients who received IVF/ICSI non-donor treatment were identified. Patients were divided into two groups according to live birth and the characteristics of IVF/ICSI cycles were compared between groups, including baseline infertility parameters, ovarian stimulation characteristics and embryo laboratory manipulation parameters. The multivariate logistic regression model was performed to adjust potential confounders and assess correlation between E2 dynamics before hCG administration and live birth.

Main results and the role of chance

Our results revealed that patients without live birth had higher age (32.13 ± 4.33 vs. 30.21 ± 3.71, P &lt; 0.001) and pervious miscarriages (0.57 ± 0.95 vs. 0.46 ± 0.83, P = 0.0295), while had lower number of oocytes retrieved (8.95 ± 4.69 vs. 12.36 ± 5.54, P &lt; 0.001), day of hCG E2 (8269.53 ± 4104.22 vs. 9580.71 ± 3534.11, P &lt; 0.001) and endometrium thickness (10.37 ± 3.66 vs. 11.50 ± 3.40, P &lt; 0.001) compared with patients with live birth. Additionally, the multivariate logistic regression analysis displayed significant impact of serum E2 change on the live birth, and the achievement of live birth [OR (95%CI) 0.81 (0.71, 0.92), P = 0.001] decreased with the decreasing level of serum E2 before hCG trigger day. Estradiol stratification analyses displayed the OR and 95% CI for the association between △E2 and live birth among patients with different levels of estradiol decline (&lt;25%, 25%–50%, 50%–75%, &gt;75%). Compared with the &lt;25% decline and 25%–50% decline groups, the ORs of 50%–75% and &gt;75% decline groups were 1.66 (95% CI: 1.12-2.45, P = 0.012) and 2.00 (95% CI: 1.39-2.89, P &lt; 0.001), respectively, after adjusting potential confounders.

Limitations, reasons for caution

There was concealment of randomization and blinding of outcome assessments reducing the risk of selection and measurement bias.

Wider implications of the findings

In summary, the E2 change before the day of hCG administration had significant correlation with live birth, and the live birth decreased with the decreasing level of serum E2 before hCG trigger day. The patients with a greater decline in the E2 level more likely to had poor clinical outcomes.

Trial registration number

Chi CTR1900026088

Women-specific risk factors and risk of incident atrial fibrillation in UK Biobank

Funding Acknowledgements

Type of funding sources: None.

Background

Atrial fibrillation (AF) is the most common cardiac arrhythmia worldwide and carries a large morbidity and mortality risk. Recent evidence suggests differences in epidemiology and pathophysiology of AF between women and men and underscores a poorer prognosis of AF among women. This calls for further investigation regarding the impact of women-specific risk factors on AF development.

Purpose

To investigate the association between women-specific risk factors and new-onset AF.

Methods

235,191 women (mean [standard deviation] age: 55.7 [8.1] years) free of AF and without a history of hysterectomy and/or bilateral oophorectomy from the UK Biobank were included. Various women-specific risk factors were assessed from 2006 to 2010. Follow-up of new-onset AF occurred through October 2020. Cox proportional hazards analyses were performed to investigate prospective associations between each risk factor and incident AF. Additionally, natural splines were used to identify any potential nonlinear associations.

Results

After a median follow-up of 11.6 (interquartile range: 10.9–12.3) years, 4,629 (2%) women experienced new-onset AF. In fully adjusted models, having experienced irregular menstrual cycle was significantly associated with increased new-onset AF risk [hazard ratio (HR); 95% confidence interval (CI): 1.34; 1.01-1.79]. In addition, nonlinear associations were found between menopausal age, menarcheal age, number of live births, and number of total reproductive years with incident AF. Compared to the reference, early menopause (menopause &lt;45 years of age) or delayed menopause (&gt;60 years) significantly increased risks of incident AF (HR; 95CI: 1.24; 1.10-1.39 and 1.34; 1.01-1.78, respectively). Compared to the reference, both early menarche (menarche ≤11 years) and late menarche (menarche ≥13 years) were associated with AF incidence (HR; 95CI: 1.10; 1.00-1.21 and 1.08; 1.00-1.17, respectively). Compared to women with one or two children, having no children (HR; 95CI: 1.13; 1.04-1.24), or more than six children (HR; 95%CI: 1.67; 1.03-2.70) were associated with higher AF risks. Having reproductive years ≤20 years was significantly associated with incident AF (HR; 95CI: 1.74; 1.07-2.86).

Conclusions

Having experienced early or delayed menopause, early or late menarche, or irregular menstrual cycles conferred higher risks of incident AF among women in the UK Biobank. Interestingly, both nulliparity and multiparity, compared to having one or two children, were associated with an increased AF risk. Our results highlight the importance of knowledge regarding the reproductive history of women in devising screening strategies for AF prevention.

Tafel Analysis Guided Optimization of ZnNP-O-C Catalysts for the Selective 2-Electron Oxygen Reduction Reaction in Neutral Media

The lack of characterizations of the adsorption capability toward intermediates during reactions causes difficulties in determining the structural optimization principle of the catalysts for the 2-electron oxygen reduction reaction (2e^- ORR). Here, a Tafel-θ method is proposed to evaluate the surface coverage (θ) of important intermediates (*OOH and *OH) on the material surface and further help optimize the catalyst. With the assistance of Tafel-θ analysis, a Zn nanoparticle incorporated oxygen-doped carbon (Zn_NP-O-C) catalyst with high 2e^- ORR performance (onset of ∼0.57 V and selectivity of >90.4%) in neutral media was achieved. Both the theoretical calculation and characterization results are consistent with the Tafel-θ deduction, revealing that an appropriate ratio of Zn nanoparticles and bridging O can optimize the *OOH adsorption/desorption strength of the adjacent carbon site. This study not only provides an advanced Zn_NP-O-C catalyst for electrochemical H₂O₂ production but also proposes a fast and precise method for the comprehensive assessment of future catalysts.

Fate of thiamethoxam from treated seeds in mesocosms and response of aquatic invertebrate communities

Thiamethoxam is a neonicotinoid insecticide widely applied in the Canadian Prairies. It has been detected in surface waters of agro-ecosystems, including wetlands, but the potential effects on non-target invertebrate communities in these wetlands have not been well characterized. In an effort to understand better the fate of thiamethoxam in wetlands and the response of invertebrates (zooplankton and emergent insects), model systems were used to mimic wetland flooding into planted fields. Outdoor mesocosms were treated with a single application of thiamethoxam-treated canola seeds at three treatment levels based on a recommended seeding rate (i.e., 6 kg/ha; 1×, 10×, and 100× seeding rate) and monitored over ten weeks. The mean half-life of thiamethoxam in the water column was 6.2 d. There was no ecologically meaningful impact on zooplankton abundances or community structure among treatments. Statistically significant differences were observed in aquatic insect abundance between control mesocosms and the two greatest thiamethoxam treatments (10× and 100× seeding rate). The observed results indicate exposure to thiamethoxam at environmentally relevant concentrations likely does not represent a significant ecological risk to abundance and community structure of wetland zooplankton and emergent insects.

Multidimensional, High Precision Measurements of Beam Single Spin Asymmetries in Semi-inclusive π^{+} Electroproduction off Protons in the Valence Region

High precision measurements of the polarized electron beam-spin asymmetry in semi-inclusive deep inelastic scattering (SIDIS) from the proton have been performed using a 10.6 GeV incident electron beam and the CLAS12 spectrometer at Jefferson Lab. We report here a high precision multidimensional study of single π^{+} SIDIS data over a large kinematic range in Bjorken x, fractional energy, and transverse momentum of the hadron as well as photon virtualities Q^{2} ranging from 1-7  GeV^{2}. In particular, the structure function ratio F_{LU}^{sinϕ}/F_{UU} has been determined, where F_{LU}^{sinϕ} is a twist-3 quantity that can reveal novel aspects of emergent hadron mass and quark-gluon correlations within the nucleon. The data's impact on the evolving understanding of the underlying reaction mechanisms and their kinematic variation is explored using theoretical models for the different contributing transverse momentum dependent parton distribution functions.

Ligand Defect Density Regulation in Metal-Organic Frameworks by Functional Group Engineering on Linkers

Defects in solid materials vitally determine their physicochemical properties; however, facile regulation of the defect density is still a challenge. Herein, we demonstrate that the ligand defect density of metal-organic frameworks (MOFs) with a UiO-66 structural prototype is precisely regulated by tuning the linker groups (X = OMe, Me, H, F). Detailed analyses reveal that the ligand defect concentration is positively correlated with the electronegativity of linker groups, and Ce-UiO-66-F, constructed by F-containing ligands and Ce-oxo nodes, possesses the superior ligand defect density (>25%) and identifiable irregular periodicity. The increase in ligand defect density results in the reduction of the valence state and the coordination number of Ce sites in Ce-UiO-66-X, and this merit further validates the relationship between the defective structure and catalytic performance of CO₂ cycloaddition reaction. This facile, efficient, and reliable strategy may also be applicable to precisely constructing the defect density of porous materials in the future.

Predictive Value of Geriatric Nutritional Risk Index in Older Adult Cancer Patients

BACKGROUND AND AIMS

To compare the association of geriatric nutritional risk index (GNRI) and controlling nutritional status (CONUT) scores with malnutrition, and to study their association with clinical outcomes in older adult cancer patients.

METHODS

This retrospective analysis was conducted on 854 older adult cancer patients collected from 34 hospitals in 18 cities in China between June and September 2014. Anthropometric and hematological examination results at admission were collected, and subjective global assessment was used. Clinical outcomes, such as complications, length of hospital stays, and hospital costs, were recorded. Receiver operating characteristic curves were used to evaluate the accuracy of the two nutritional assessment tools for malnutrition. The association between GNRI and CONUT score and clinical outcomes was analyzed using the chi-square test, t-test, or rank sum test.

RESULTS

Among 854 patients with cancer, the prevalence of malnutrition was 42.7%. Compared with subjective global assessment, the GNRI had a significantly higher accuracy than the CONUT score in predicting malnutrition (area under the curve 0.704, 95% confidence interval, 0.658 - 0.750, P < 0.001). The GNRI was significantly associated with the occurrence of complications (χ2 = 4.985, P = 0.026), and low GNRI (≤98) was associated with a longer length of hospital stay (t = -2.179, P = 0.030).

CONCLUSIONS

The GNRI may be used to assess malnutrition in older adult cancer patients and can predict poor clinical outcomes in these patients.

The global prevalence of sexual violence against pregnant women: a systematic review and meta-analysis

When committed against pregnant women, sexual violence may have adverse health consequences for both the mother and the unborn child. To date, no studies have systematically summarized the global prevalence of sexual violence against pregnant women. We conducted a comprehensive search of PubMed, Embase and Web of Science from inception dates to January 2021 for studies reporting the prevalence of sexual violence against pregnant women. Prevalence was estimated using a random-effects meta-analysis. Heterogeneity was evaluated using the I² statistic. Differences by study level characteristics were estimated through subgroup analysis and meta-regression. A total of 10 cross-sectional studies (a total of 8,439 participants) were included. The pooled proportion of sexual violence was 0.31 (95% CI: 0.22-0.40). Subgroup analyses showed higher prevalence of sexual violence against pregnant women in the 2010-2019 period (0.35, 95% CI0.15-7.53) and developing countries (0.32, 95% CI0.19-0.45). Almost one in three (31%) pregnant women around the world has been a victim of sexual violence in their lifetime. Sexual violence against pregnant women continues to be a major public health challenge. The global prevalence of sexual violence against pregnant women warrants the collective attention of the entire society.

Standard practice of presacral exposure during transvaginal natural orifice transluminal endoscopic surgery for sacrocolpopexy

We describe the standard practice of presacral exposure during transvaginal natural orifice transluminal endoscopic surgery (vNOTES) for sacrocolpopexy in women with uterine prolapse. In this video, we demonstrate the key techniques: identifying the right hypogastric nerve (rHN) before opening the pelvic peritoneum; removing the fat and loose connective tissue along the rHN to expose the presacral fascia; incising the presacral fascia to reach the presacral space to expose the middle sacral vasculature and the anterior longitudinal ligament (ALL) of the first sacral vertebra (S1) below the promontory; attaching the mesh to the ALL to avoid vessel injury; and completing the peritonealisation.

Atomically Dispersed High-Density Al-N4 Sites in Porous Carbon for Efficient Photodriven CO2 Cycloaddition

Highly active catalysts that can directly utilize renewable energy (e.g., solar energy) are desirable for CO₂ value-added processes. Herein, aiming at improving the efficiency of photodriven CO₂ cycloaddition reactions, a catalyst composed of porous carbon nanosheets enriched with a high loading of atomically dispersed Al atoms (≈14.4 wt%, corresponding to an atomic percent of ≈7.3%) coordinated with N (AlN₄ motif, Al-N-C catalyst) via a versatile molecule-confined pyrolysis strategy is reported. The performance of the Al-N-C catalyst for catalytic CO₂ cycloaddition under light irradiation (≈95% conversion, reaction rate = 3.52 mmol g^-1 h^-1 ) is significantly superior to that obtained under a thermal environment (≈57% conversion, reaction rate = 2.11 mmol g^-1 h^-1 ). Besides the efficient photothermal conversion induced by the carbon matrix, both experimental and theoretical analysis reveal that light irradiation favors the photogenerated electron transfer from the semiconductive Al-N-C catalyst to the epoxide reactant, facilitating the formation of a ring-opened intermediate through the rate-limiting step. This study not only provides an advanced Al-N-C catalyst for photodriven CO₂ cycloaddition, but also furnishes new insight for the rational design of superior photocatalysts for diverse heterogeneous catalytic reactions in the future.

Study on a new manner of the magnetization switching actuated by a unidirectional pulse current

A new writing scheme with a unidirectional pulse current is proposed for spin transfer torque (STT) based magnetic random-access memory (MRAM). To investigate the feasibility of the writing scheme, bilayered nano-pillars composed of a soft layer with small in-plane shape anisotropy and a hard layer with either large perpendicular anisotropy (PMA) or in-plane anisotropy (IMA) are designed and their switching behaviors are studied. It is found that in either type of bilayered nano-pillars, with the aid of the attached hard layer, the magnetization of the soft layer can be switched back and forth under a unidirectional pulse current. In an IMA/IMA nano-pillar, the magnetization of the free layer (FL) can achieve excellent alignment, which is in contrast to the IMA/PMA nano-pillar. By optimizing the dimensions and magnetic parameters of the IMA/IMA nano-pillar, a decently low switching current density (4.3 × 10¹¹A m^-2) and ultrashort switching time (<1 ns) can be reached. Based on these results, the unidirectional writing scheme is practical if an IMA/IMA bilayer is used to replace the FL in a magnetic tunnel junction. Considering that a unidirectional writing scheme can enable the application of materials with high spin polarization such as half metals, and avoid the injection of writing current into junction using a special design, it may be very promising for STT-MRAM.

Imaging-based body fat depots and new-onset atrial fibrillation in general population

Background

Obesity is a well-established risk factor for incident atrial fibrillation (AF). Whether different body fat depots differentially associate with AF development remains largely unknown.

Purpose

We aimed to investigate the associations between various body fat depots and the risk of new-onset AF among middle-aged and elderly individuals from general population.

Methods

In the prospective population-based cohort study, body composition was assessed using dual-energy X-ray absorptiometry (DXA) and total body mass, lean mass, fat mass, android and gynoid fat were analyzed (N=3468). Liver fat and epicardial fat were assessed using computed tomography (CT) (N=2145). A body fat score was defined by adding tertiles of each fat depot. All participants were followed for the occurrence of AF until 1st Jan. 2014. Principle component analysis was conducted to identify body fat distribution patterns. Time-to-event analyses were performed using Cox proportional hazards regression analysis. Hazard ratios (HR) and 95% confidence-intervals (95% CI), adjusted for cardiovascular risk factors, were calculated.

Results

Mean (standard deviation) of age for participants in DXA study and CT study was 74.42 (6.85) and 68.66 (6.41) years, respectively. AF incidence rate was 13.1 per 1000 person-years during a median follow-up time of 9.62 years. In the adjusted model, fat mass (HR; 95% CI: 1.33; 1.05–1.68), lean mass (1.40; 1.15–1.72), gynoid fat mass (1.36; 1.12–1.65), and total body mass (1.51; 1.21–1.89) were significantly associated with new-onset AF. Of note, android-to-gynoid fat ratio was inversely associated with incident AF (HR; 95% CI: 0.81; 0.70–0.94). Larger body fat score was associated with increased risk of incident AF (P for trend &lt;0.01). Two fat distribution patterns were identified. Adherence to the fat- and gynoid fat- pattern (P for trend = 0.035), but not muscle- and visceral fat- pattern (P for trend = 0.35), was significantly associated with larger risk of new-onset AF.

Conclusions

Various body fat depots were associated with new-onset AF. Larger values of total body mass carried the highest risk for incident AF. The inverse association between android to gynoid fat ratio with AF presents a novel finding. A significant dose-response relationship between body fat accumulation and risk of new-onset AF was observed, implying a collective impact of fat depots on AF development. Findings also suggest that various fat depots, characterized by different fat distribution patterns, may exert differential combined effect on the risk of incident AF.

Funding Acknowledgement

Type of funding sources: None. Fat depots and atrial fibrillation

Constipation is associated with worse prognosis of thrombolytic AIS: a single-center prospective study

Background and purpose

Previous clinical studies have found that constipation was associated with the prognosis of ischemic stroke patients. This information may provide new ideas for thrombolytic AIS (acute cerebral arterial thrombosis) patients' short-term prognostic assessment. Our study was designed to investigate the risk factors of constipation and its association with the prognosis in thrombolytic AIS patients.

Methods

The prospective cohort study included 97 AIS patients treated with intravenous thrombolysis. Three days without defecation in thrombolytic patients was recorded as constipation in clinic. The risk factors for constipation included demographics, clinical characteristics, laboratory parameters and partial treatments. Scores of NIHSS and mRS and length of stay (LOS) in ICU and hospital were used to evaluate the effect of constipation on patients' neurological function and short-term prognosis.

Results

The incidence of constipation was 49.48% in the first three days after intravenous thrombolysis. The use of stomach tube and antibiotics made patients more prone to constipation (odds ratio OR: 5.01, 95% CI: 2.04–12.32, P=0.000; odds ratio: 6.06, 95% CI: 2.35–15.61, P=0.000). The occurrence of constipation resulted in significantly longer ICU and hospital LOS (2.29±1.63 versus 4.75±4.22, P=0.000; 11.08±10.01 versus 15.73±12.36, P=0.044). Moreover, constipation worsened the thrombolytic AIS patients' short-term neurological recovery (mRS at 3 months: 1.53±1.72 versus 2.41±1.92, P=0.02). Oral probiotics for constipation during hospitalization not only prolonged patients' stay in the ICU (2.91±2.28 versus 6.44±4.88, P=0.003), but also resulted in poorer short-term neurological functional outcomes (mRS at 3 months: 1.57±1.53 versus 3.26±1.91, P=0.002).

Conclusions

The occurrence of constipation in the first three days was associated with the longer ICU and hospital stay and a worse short-term prognosis, suggesting that constipation may be a predictor of thrombolytic AIS patients' prognosis. Further studies of constipation and its appropriate therapy strategy are needed to solve the plight of thrombolytic AIS with constipation.

Funding Acknowledgement

Type of funding sources: None.