Analysis of Prognostic Factors in Non-Traumatic and Non-Diabetic Retinopathy Patients Undergoing Vitrectomy.

AIM: Vitrectomy is one of the crucial therapeutic interventions for non-traumatic and non-diabetic retinal diseases. However, the prognosis of patients undergoing this procedure and the factors affecting prognosis remain to be clarified. The aim of this study was to analyze the prognostic factors of non-traumatic and non-diabetic retinopathy complicated by vitreous hemorrhage. METHODS: A retrospective study was conducted on 352 patients, including 152 (43.18%) females, who underwent vitrectomy in our hospital from March 2018 to December 2022, divided into Group A (postoperative complications) and Group B (no complications) according to whether complications occurred during postoperative follow-up. General and clinical data of the two groups were collected and compared. Binary logistic regression was used to analyze the main factors affecting prognosis. RESULTS: All patients were followed up for 12 months. A total of 87 patients had postoperative complications, accounting for 24.72% (87/352), and were classified as Group A. A total of 265 patients who had no postoperative complications, accounting for 75.28% (265/352), were classified as Group B. There were significant differences in preoperative visual acuity, time of surgical intervention, preoperative fundus condition, stage of retinopathy, preoperative intraocular pressure and age between the two groups (p < 0.05), and these indices were identified as independent risk factors affecting the prognosis of patients (odds ratio >1). CONCLUSIONS: Preoperative visual acuity, time of surgical intervention, preoperative fundus condition, stage of retinopathy, preoperative intraocular pressure and age are all factors affecting the prognosis of patients with non-traumatic and non-diabetic retinopathy while undergoing vitrectomy. Personalized care is required to improve the surgical outcome for these patients.

Pattern of cooling benefits from ecospaces during urbanization: A case study of the Yangtze River Economic Belt.

Urban ecological spaces are effective thermoregulators under global warming. However, the cooling efficiency of urban ecological spaces during the urbanization has not been studied comprehensively. Here, we investigate the spatio-temporal dynamics of Urban Cold Island (UCI) intensity in 11 typical cities of the Yangtze River Economic Belt (YREB). We determined the impact of ecological landscape trends on these dynamics by using GlobalLand and MODIS 8 d mean land surface temperature (LST) data for three periods (2000, 2010, and 2020), and the landscape pattern index and diversity index. We found that in the past 20 years, the built-up area has increased by sixfold; 62.53 % and 37.47 % of YREB were warming or cooling, with 71.22 % of the daytime cooling and 93 % of the nighttime warming. The average UCI intensity of YREB has increased from 0.518 to 0.847 and is negatively correlated with LST with a decreasing slope. As the UCI intensity of green spaces increased, that of blue spaces decreased. Surface area and landscape pattern are the key determinants of UCI intensity in blue and green spaces, respectively, especially the landscape shape index (LSI). Therefore, maintaining ecological spaces, enriching the structural integrity of green spaces, and improving blue space connectivity can help cities at different development levels cope with heat stress during regional urbanization.

Polymer Coatings Affect Transport and Remobilization of Colloidal Activated Carbon in Saturated Sand Columns: Implications for In Situ Groundwater Remediation.

Colloidal activated carbon (CAC) is an emerging technology for the in situ remediation of groundwater impacted by per- and polyfluoroalkyl substances (PFAS). In assessing the long-term effectiveness of a CAC barrier, it is crucial to evaluate the potential of emplaced CAC particles to be remobilized and migrate away from the sorptive barrier. We examine the effect of two polymer stabilizers, carboxymethyl cellulose (CMC) and polydiallyldimethylammonium chloride (PolyDM), on CAC deposition and remobilization in saturated sand columns. CMC-modified CAC showed high mobility in a wide ionic strength (IS) range from 0.1 to 100 mM, which is favorable for CAC delivery at a sufficient scale. Interestingly, the mobility of PolyDM-modified CAC was high at low IS (0.1 mM) but greatly reduced at high IS (100 mM). Notably, significant remobilization (release) of deposited CMC-CAC particles occurred upon the introduction of solution with low IS following deposition at high IS. In contrast, PolyDM-CAC did not undergo any remobilization following deposition due to its favorable interactions with the quartz sand. We further elucidated the CAC deposition and remobilization behaviors by analyzing colloid-collector interactions through the application of Derjaguin-Landau-Verwey-Overbeek theory, and the inclusion of a discrete representation of charge heterogeneity on the quartz sand surface. The classical colloid filtration theory was also employed to estimate the travel distance of CAC in saturated columns. Our results underscore the roles of polymer coatings and solution chemistry in CAC transport, providing valuable guidelines for the design of in situ CAC remediation with maximized delivery efficiency and barrier longevity.

Divergent synthesis of carbamates and N-methyl carbamates from dimethyl carbonate and nitroarenes with Mo(CO)6 as a multiple promoter.

Dialkyl carbonates are green and versatile reagents that can be used in alkylation and alkoxycarbonylation reactions. Herein, we disclosed a reductive methoxycarbonylation of aromatic nitro compounds with dimethyl carbonate for the construction of diverse carbamates and N-methyl carbamates. Using Mo(CO)6 as a multiple promoter, different nitroarenes were smoothly transformed into the corresponding carbamates in yields between 27 and 94% using DMC as both solvent and reagent. It is worth noting that the choice of different bases allowed the desired products to be controlled: K3PO4 favoured the formation of carbamates as the primary product, whereas DBU facilitated the formation of N-methyl carbamates as the main product.

Porphyromonas gingivalis GroEL exacerbates orthotopic allograft transplantation vasculopathy via impairment of endothelial cell function.

Orthotopic allograft transplantation (OAT) is a significant approach to addressing organ failure. However, persistent immune responses to the allograft affect chronic rejection, which induces OAT vasculopathy (OATV) and organ failure. Porphyromonas gingivalis can infiltrate remote organs via the bloodstream, thereby intensifying the severity of cardiovascular, respiratory, and neurodegenerative diseases and cancer. GroEL, a virulence factor of P. gingivalis promotes pro-inflammatory cytokine production in host cells, which assumes to play a pivotal role in the pathogenesis of cardiovascular diseases. Although the aggravation of OATV is attributable to numerous factors, the role of GroEL remains ambiguous. Therefore, this study aimed to investigate the impact of GroEL on OATV. Aortic grafts extracted from PVG/Seac rats were transplanted into ACI/NKyo rats and in vitro human endothelial progenitor cell (EPC) and coronary artery endothelial cell (HCAEC) models. The experimental findings revealed that GroEL exacerbates OATV in ACI/NKyo rats by affecting EPC and smooth muscle progenitor cell (SMPC) function and enabling the anomalous accumulation of collagen. In vitro, GroEL spurs endothelial-mesenchymal transition in EPCs, reduces HCAEC tube formation and barrier function by downregulating junction proteins, accelerates HCAEC aging by lowering mitochondrial membrane potential and respiratory function, and impedes HCAEC migration by modulating cytoskeleton-associated molecules. This study suggests that P. gingivalis GroEL could potentially augment OATV by impacting vascular progenitor and endothelial cell functions.

Multidimensional item response theory models for testlet-based doubly bounded data.

A testlet-based visual analogue scale (VAS) is a doubly bounded scaling approach (e.g., from 0% to 100% or from 0 to 1) composed of multiple adjectives, nouns, or sentences (statements/items) within testlets for measuring individuals' attitudes, opinions, or career interests. While testlet-based VASs have many advantages over Likert scales, such as reducing response style effects, the development of proper statistical models for analyzing testlet-based VAS data lags behind. This paper proposes a novel beta copula model and a competing logit-normal model based on the item response theory framework, assessed by Bayesian parameter estimation, model comparison, and goodness-of-fit statistics. An empirical career interest dataset based on a testlet-based VAS design was analyzed using the proposed models. Simulation studies were conducted to assess the two models' parameter recovery. The results show that the beta copula model had superior fit in the empirical data analysis, and also exhibited good parameter recovery in the simulation studies, suggesting that it is a promising statistical approach to testlet-based doubly bounded responses.

Experimental study on flow resistance characteristics of the uniform steam injection outflow control device.

Introduction: Multi-point steam injection technology is a new completion method for heavy oil horizontal wells to solve the uneven distribution of the intake profile in the horizontal section. It is equipped with the flow control device to achieve the effect of balanced steam injection. Methods: The steady-state experiment method was adopted; Considering the variable mass complex flow of the steam-liquid two-phase flow in the downhole flow device, the pressure loss of downhole tools through uniform steam injection with different steam-liquid compositions was tested, the influencing factors of the pressure drop were analyzed, and a more reliable pressure drop calculation method was established. Results: The overflow pressure drop can be adjusted by changing the aperture, steam dryness, and fluid flow of the downhole outflow control device (OCD). Discussion: By comparing the experimental and theoretical results, the calculation method of the overflow resistance of single-phase and steam-liquid two-phase fluids in OCD is given, and the error is within the usable range.

Direct synthesis of phthalimides via palladium-catalysed double carbonylation of o-dihaloarenes with nitroarenes.

The direct carbonylation of readily available nitro compounds is more attractive and straightforward than the use of traditional amines as nucleophiles. Herein, a practical palladium-catalysed double carbonylation of nitroarenes with o-dihaloarenes has been developed for the construction of various N-aryl phthalimides. Key to the success of this transformation is the use of Mo(CO)6, which acts as both a reducing agent and a solid carbonyl source. A wide range of nitroarenes and o-dihaloarenes as well as o-iodobenzoic acids reacted smoothly to give phthalimides in 27-94% yields.

Efficacy and safety of immune checkpoint inhibitor rechallenge in non-small cell lung cancer: A systematic review and meta-analysis.

BACKGROUND: The aim of the study was to explore the efficacy and safety of immune checkpoint inhibitor (ICI) rechallenge in patients with non-small cell lung cancer (NSCLC). METHODS: Studies that enrolled NSCLC patients treated with two lines of ICIs were included using four databases. The initial line (1L-) and subsequent lines (2L-) of ICIs were defined as 1L-ICI and 2L-ICI, respectively. RESULTS: A total of 17 studies involving 2100 patients were included. The pooled objective response rate (ORR), disease control rate (DCR), median progression-free survival (mPFS), and median overall survival (mOS) for 2L-ICIs were 10%, 50%, 3.0 months, and 13.1 months, respectively. The 2L-ICI discontinuation rates caused by toxicities ranged from 0% to 23.5%. Original data were extracted from six studies, covering 89 patients. Patients in whom 1L-ICIs were discontinued following clinical decision (the mPFS of 2L-ICIs was not reach) achieved a more prolonged mPFS of 2L-ICIs than those due to toxicity (5.2 months) and progressive disease (2.1 months) (p < 0.0001). Patients' 1L-PFS for more than 2-years had preferable 2L-ORR (35.0% vs. 9.8%, p = 0.03), 2L-DCR (85.0% vs. 49.0%, p = 0.007), and 2L-mPFS (12.4 vs. 3.0 months, p < 0.0001) than those less than 1-year. Patients administered the same drugs achieved a significantly prolonged mPFS compared with the remaining patients (5.4 vs. 2.3 months, p = 0.0004), and those who did not accept antitumor treatments during the intervals of two lines of ICIs achieved a prolonged mPFS compared to those patients who did accept treatments (7.6 vs. 1.9 months, p < 0.0001). CONCLUSIONS: ICI rechallenge is a useful therapeutic strategy for NSCLC patients, especially suitable for those who achieve long-term tumor remission for more than 2-years under 1L-ICIs.

Online Parameter Estimation for Student Evaluation of Teaching.

Student evaluation of teaching (SET) assesses students' experiences in a class to evaluate teachers' performance in class. SET essentially comprises three facets: teaching proficiency, student rating harshness, and item properties. The computerized adaptive testing form of SET with an established item pool has been used in educational environments. However, conventional scoring methods ignore the harshness of students toward teachers and, therefore, are unable to provide a valid assessment. In addition, simultaneously estimating teachers' teaching proficiency and students' harshness remains an unaddressed issue in the context of online SET. In the current study, we develop and compare three novel methods-marginal, iterative once, and hybrid approaches-to improve the precision of parameter estimations. A simulation study is conducted to demonstrate that the hybrid method is a promising technique that can substantially outperform traditional methods.

Animal Models for Heart Transplantation Focusing on the Pathological Conditions.

Cardiac transplant recipients face many complications due to transplant rejection. Scientists must conduct animal experiments to study disease onset mechanisms and develop countermeasures. Therefore, many animal models have been developed for research topics including immunopathology of graft rejection, immunosuppressive therapies, anastomotic techniques, and graft preservation techniques. Small experimental animals include rodents, rabbits, and guinea pigs. They have a high metabolic rate, high reproductive rate, small size for easy handling, and low cost. Additionally, they have genetically modified strains for pathological mechanisms research; however, there is a lacuna, as these research results rarely translate directly to clinical applications. Large animals, including canines, pigs, and non-human primates, have anatomical structures and physiological states that are similar to those of humans; therefore, they are often used to validate the results obtained from small animal studies and directly speculate on the feasibility of applying these results in clinical practice. Before 2023, PubMed Central® at the United States National Institute of Health's National Library of Medicine was used for literature searches on the animal models for heart transplantation focusing on the pathological conditions. Unpublished reports and abstracts from conferences were excluded from this review article. We discussed the applications of small- and large-animal models in heart transplantation-related studies. This review article aimed to provide researchers with a complete understanding of animal models for heart transplantation by focusing on the pathological conditions created by each model.

Tumor Necrosis Factor Superfamily 14 (LIGHT) Restricts Neovascularization by Decreasing Circulating Endothelial Progenitor Cells and Function.

Tumor necrosis factor superfamily 14 (TNFSF14) is also known as the LT-related inducible ligand (LIGHT). It can bind to the herpesvirus invasion mediator and lymphotoxin-ß receptor to perform its biological activity. LIGHT has multiple physiological functions, including strengthening the synthesis of nitric oxide, reactive oxygen species, and cytokines. LIGHT also stimulates angiogenesis in tumors and induces the synthesis of high endothelial venules; degrades the extracellular matrix in thoracic aortic dissection, and induces the expression of interleukin-8, cyclooxygenase-2, and cell adhesion molecules in endothelial cells. While LIGHT induces tissue inflammation, its effects on angiogenesis after tissue ischemia are unclear. Thus, we analyzed these effects in the current study. In this study, the animal model of hind limb ischemia surgery in C57BL/6 mice was performed. Doppler ultrasound, immunohistochemical staining, and Western blotting were employed to analyze the situation of angiogenesis. In addition, human endothelial progenitor cells (EPCs) were used for in vitro studies to analyze the possible mechanisms. The results in the animal study showed that LIGHT injection inhibited angiogenesis in ischemic limbs. For the in vitro studies, LIGHT inhibited the expression of integrins and E-selectin; decreased migration and tube formation capabilities, mitochondrial respiration, and succinate dehydrogenase activity; and promoted senescence in EPCs. Western blotting revealed that the impairment of EPC function by LIGHT may be due to its effects on the proper functioning of the intracellular Akt signaling pathway, endothelial nitrite oxide synthase (eNOS), and mitochondrial respiration. In conclusion, LIGHT inhibits angiogenesis after tissue ischemia. This may be related to the clamped EPC function.

Low Early Antifactor Xa Target Achievement Rate of Low-Molecular-Weight Heparin for Treating Venous Thromboembolism in Patients in Intensive Care.

This study aimed to evaluate whether early antifactor Xa (anti-Xa) achieved the target range when venous thromboembolism (VTE) was treated with low-molecular-weight heparin (LMWH), based on body weight and renal function in patients treated in intensive care units (ICUs). Anti-Xa levels in patients treated with LMWH for VTE in ICU and medical wards between January 1, 2021, and June 30, 2022, were retrospectively assessed. The demographics, laboratory parameters, and early anti-Xa peak levels of patients were collected. All patients were followed up for 3 months to collect VTE recurrence/bleeding events. Univariate and multivariate linear regression analyses were used to identify the factors affecting anti-Xa levels. A total of 108 patients were enrolled in this study, including 70 patients in ICU and 38 patients on medical wards. The early anti-Xa level (0.36 vs 0.61 IU/mL, P < .001) and target achievement rate (21.4% vs 39.5%, P = .015) of patients in ICU were lower than those in medical wards. Multivariate linear regression showed that only antithrombin (AT) significantly affected anti-Xa levels in patients in ICU (ß = 0.008, 95%CI 0.005 to 0.011, P < .001). There was no significant difference in VTE recurrence events (11.8% vs 7.5%, P = .628) and bleeding events (29.4% vs 17.0%, P = .304) between the early anti-Xa within-target group and the early anti-Xa below-target group. Low anti-Xa peak levels are common in patients in ICU. AT activity should be monitored when using LMWH in critically ill patients.

E-cigarettes Induce Dysregulation of Autophagy Leading to Endothelial Dysfunction in Pulmonary Arterial Hypertension.

Given the increasing popularity of electronic cigarettes (e-cigs), it is imperative to evaluate the potential health risks of e-cigs, especially in users with preexisting health concerns such as pulmonary arterial hypertension (PAH). The aim of the present study was to investigate whether differential susceptibility exists between healthy and patients with PAH to e-cig exposure and the molecular mechanisms contributing to it. Patient-specific induced pluripotent stem cell-derived endothelial cells (iPSC-ECs) from healthy individuals and patients with PAH were used to investigate whether e-cig contributes to the pathophysiology of PAH and affects EC homeostasis in PAH. Our results showed that PAH iPSC-ECs showed a greater amount of damage than healthy iPSC-ECs upon e-cig exposure. Transcriptomic analyses revealed that differential expression of Akt3 may be responsible for increased autophagic flux impairment in PAH iPSC-ECs, which underlies increased susceptibility upon e-cig exposure. Moreover, knockdown of Akt3 in healthy iPSC-ECs significantly induced autophagic flux impairment and endothelial dysfunction, which further increased with e-cig treatment, thus mimicking the PAH cell phenotype after e-cig exposure. In addition, functional disruption of mTORC2 by knocking down Rictor in PAH iPSC-ECs caused autophagic flux impairment, which was mediated by downregulation of Akt3. Finally, pharmacological induction of autophagy via direct inhibition of mTORC1 and indirect activation of mTORC2 with rapamycin reverses e-cig-induced decreased Akt3 expression, endothelial dysfunction, autophagic flux impairment, and decreased cell viability, and migration in PAH iPSC-ECs. Taken together, these data suggest a potential link between autophagy and Akt3-mediated increased susceptibility to e-cig in PAH.

Impact of clinical pharmacist services on physicians' guideline compliance and prognosis of patients for venous thromboembolism prophylaxis in ICU.

BACKGROUND: Whether the clinical pharmacist services (CPS) improve ICU physicians' compliance with venous thromboembolism (VTE) prophylaxis guidelines remains unclear, and the impact of CPS on VTE incidence and mortality in ICU patients should also be investigated. MATERIALS AND METHODS: ICU patients were assigned to a CPS group or a control group according to the medical arrangements of the day of patient admission, without any intervention. The impact of CPS on guideline compliance, VTE incidence, and mortality was assessed. RESULTS: A total of 338 patients were included. With CPS, ICU physicians' compliance with VTE prophylaxis guideline was improved by 7 - 25% (p < 0.001). The incidences of VTE (9 vs. 17%, p = 0.037) and bleeding events (5 vs. 11%, p = 0.042) were both lower in the CPS group than in the control group. Multivariate Cox regression model showed that CPS was an independent risk factor for VTE events (HR = 0.438, 95% CI = 0.224 - 0.857, p = 0.016) and 14-day mortality (HR = 0.416, 95%CI = 0.25 - 0.692, p = 0.001). CONCLUSION: CPS could significantly improve ICU physician compliance with VTE prophylaxis guidelines and reduce the incidence of VTE events and mortality in ICU patients. A clinical pharmacist should be involved in the daily management of ICU patients as an important member of the clinical team.

Synergistic passivation and stepped-dimensional perovskite analogs enable high-efficiency near-infrared light-emitting diodes.

Formamidinium lead iodide (FAPbI3) perovskites are promising emitters for near-infrared light-emitting diodes. However, their performance is still limited by defect-assisted nonradiative recombination and band offset-induced carrier aggregation at the interface. Herein, we introduce a couple of cadmium salts with acetate or halide anion into the FAPbI3 perovskite precursors to synergistically passivate the material defects and optimize the device band structure. Particularly, the perovskite analogs, containing zero-dimensional formamidinium cadmium iodide, one-dimensional δ-FAPbI3, two-dimensional FA2FAn-1PbnI3n+1, and three-dimensional α-FAPbI3, can be obtained in one pot and play a pivotal and positive role in energy transfer in the formamidinium iodide-rich lead-based perovskite films. As a result, the near-infrared FAPbI3-based devices deliver a maximum external quantum efficiency of 24.1% together with substantially improved operational stability. Combining our findings on defect passivation and energy transfer, we also achieve near-infrared light communication with device twins of light emitting and unprecedented self-driven detection.

Efficient Metropolis-Hastings Robbins-Monro Algorithm for High-Dimensional Diagnostic Classification Models.

The expectation-maximization (EM) algorithm is a commonly used technique for the parameter estimation of the diagnostic classification models (DCMs) with a prespecified Q-matrix; however, it requires O(2 K ) calculations in its expectation-step, which significantly slows down the computation when the number of attributes, K, is large. This study proposes an efficient Metropolis-Hastings Robbins-Monro (eMHRM) algorithm, needing only O(K + 1) calculations in the Monte Carlo expectation step. Furthermore, the item parameters and structural parameters are approximated via the Robbins-Monro algorithm, which does not require time-consuming nonlinear optimization procedures. A series of simulation studies were conducted to compare the eMHRM with the EM and a Metropolis-Hastings (MH) algorithm regarding the parameter recovery and execution time. The outcomes presented in this article reveal that the eMHRM is much more computationally efficient than the EM and MH, and it tends to produce better estimates than the EM when K is large, suggesting that the eMHRM is a promising parameter estimation method for high-dimensional DCMs.

Identifying and Targeting Prediction of the PI3K-AKT Signaling Pathway in Drug-Induced Thrombocytopenia in Infected Patients Receiving Linezolid Therapy: A Network Pharmacology-Based Analysis.

The pharmacological mechanisms underlying the adverse effects of linezolid on thrombocytopenia have not been conclusively determined. This network pharmacology study aimed at investigating the potential pharmacological mechanisms of linezolid-induced adverse reactions in thrombocytopenia. In this study, target genes for linezolid and thrombocytopenia were compared and analyzed. Overlapping thrombocytopenia-associated targets and predicted targets of linezolid were imported to establish protein-protein interaction networks. Gene Ontology and the Kyoto Encyclopedia of Genes and Genome pathway enrichment analyses were performed to determine the enriched biological terms and pathways. The mechanisms involved in linezolid-induced thrombocytopenia were established to be associated with various biological processes, including T cell activation, peptidyl serine modification, and peptidyl serine phosphorylation. The top five relevant protein targets were obtained, including ALB, AKT1, EGFR, IL6, and MTOR. Enrichment analysis showed that the targets of linezolid were positively correlated with T cell activation responses. The mechanism of action of linezolid was positively correlated with the PI3K-AKT signaling pathway and negatively correlated with the Ras signaling pathway. We identified the important protein targets and signaling pathways involved in linezolid-induced thrombocytopenia in anti-infection therapy, providing new information for subsequent studies on the pathogenesis of drug-induced thrombocytopenia and potential therapeutic strategies for rational use of linezolid in clinical settings.