Unfractionated heparin or low-molecular-weight heparin for venous thromboembolism prophylaxis after hepatic resection: A meta-analysis.

BACKGROUND: Two systematic reviews summarized the efficacy and safety of pharmacological prophylaxis for venous thromboembolism (VTE) after hepatic resection, but both lacked a discussion of the differences in the pharmacological prophylaxis of VTE in different ethnicities. Therefore, we aimed to evaluate the efficacy and safety of low-molecular-weight heparin (LMWH) or unfractionated heparin (UFH) for VTE prophylaxis in Asian and Caucasian patients who have undergone hepatic resection. METHODS: We searched PubMed, Web of Science, Embase, China National Knowledge Infrastructure, Wanfang Data, and VIP databases for studies reporting the primary outcomes of VTE incidence, bleeding events, and all-cause mortality from January 2000 to July 2022. RESULTS: Ten studies involving 4318 participants who had undergone hepatic resection were included: 6 in Asians and 4 in Caucasians. A significant difference in VTE incidence was observed between the experimental and control groups (odds ratio [OR] = 0.39, 95% confidence interval [CI]: 0.20, 0.74, P = .004). No significant difference in bleeding events and all-cause mortality was observed (OR = 1.29, 95% CI: 0.80, 2.09, P = .30; OR = 0.71, 95% CI: 0.36, 1.42, P = .33, respectively). Subgroup analyses stratified by ethnicity showed a significant difference in the incidence of VTE in Asians (OR = 0.16, 95% CI: 0.06, 0.39, P < .0001), but not in Caucasians (OR = 0.69, 95% CI: 0.39, 1.23, P = .21). No significant differences in bleeding events were found between Asians (OR = 1.60, 95% CI: 0.48, 5.37, P = .45) and Caucasians (OR = 1.11, 95% CI: 0.58, 2.12, P = .75). The sensitivity analysis showed that Ejaz's study was the main source of heterogeneity, and when Ejaz's study was excluded, a significant difference in VTE incidence was found in Caucasians (OR = 0.58, 95% CI: 0.36, 0.93, P = .02). CONCLUSION: This study's findings indicate that the application of UFH or LMWH for VTE prophylaxis after hepatic resection is efficacious and safe in Asians and Caucasians. It is necessary for Asians to receive drug prophylaxis for VTE after hepatic resection. This study can provide a reference for the development of guidelines in the future, especially regarding the pharmacological prevention of VTE in different ethnicities.

Assessment in carbon-based layered double hydroxides for water and wastewater: Application of artificial intelligence and recent progress.

Layered double hydroxides (LDHs) are a class of clays with brucite like layers and intercalated anions. Hybrids of carbon nanomaterials and layered double hydroxides (C-LDHs) are promising nanomaterials due to their versatile properties and the large number of composition/preparation variables available for fine-tuning. Several techniques are available for the synthesis of these novel C-LDHs nanocomposites. This article assess developments in the synthesis and applications of C-LDHs in water and wastewater treatment via using artificial intelligence approaches. In addition, current challenges and possible strategies are discussed from the viewpoint of synthesis and application. It is concluded that the use of C-LDH is expected to produce interesting results. The anisotropic properties and good dispersion ability make them suitable to be used as particulates in the dispersion phase of electro-responsive and electro-rheological fluids. Although these materials have been tested for the removal of contaminants from single component solutions in water. In addition, application of artificial intelligence in this regard is discussed. At the end, the necessity of evaluating their performance in the removal of contaminants from multi-components solutions is proposed. Finally the challenges in obtaining material with precisely controlled particle sizes and morphology must be addressed.