Characterization and properties of phenolic resin doped modified lignin.

Phenolic resins occupy an important position in industrial applications, but since phenol, one of the raw materials for synthesis, is a non-renewable resource. Lignin, as a natural polymer containing phenolic hydroxyl groups, alcohol hydroxyl groups and other reactive groups, can replace some of the phenol in the synthesis of phenolic resins, which can reduce the amount of phenol, thus reducing the cost of phenolic resins, while effectively promoting the high value-added use of renewable biomass resources. Due to its low reactivity, alkaline lignin is usually discharged as production waste, unaware that lignin macromolecules can be modified. In this paper, the phenolic monomers were obtained by acid-catalyzed depolymerization of DES (choline chloride/p-toluenesulfonic acid or choline chloride/lactic acid) from waste alkaline lignin, and the recovery rate of the DES solution during the catalytic treatment was more than 85 %, in which the main monomer was 2-methoxy-4-(1-propyl) phenol. The degradation of alkaline lignin is still favorable after five times of DES solvent recovery. The depolymerized lignin monomer replaced phenol by 50 wt% and then ternary co-polymerized with phenol and formaldehyde to form a biomass phenol-based phenolic resin, providing a green route for phenolic resin production. The cost of resin preparation was economically calculated, and it was found that the cost of resin after accumulating 4 cycles of DES treatment was only 51.1 % of that of pure phenolic resin. The density functional theory (DFT) was used to simulate the possible radical reactions in the intermediate process of phenolic resin reaction, to explore the microscopic mechanism and competition, to provide theoretical reference for further experimental realization of resin structure control and optimization, and to improve the theoretical system of resin synthesis.

Alteration of the gut microbiota in patients with lung cancer accompanied by chronic obstructive pulmonary diseases.

Aim: To explore the abundance and diversity of the gut microbiota in patients with lung cancer accompanied by chronic obstructive pulmonary disease (LC-COPD). Methods: The study cohort comprised 15 patients with LC-COPD, 49 patients with lung cancer, and 18 healthy control individuals. ELISA was used to detect inflammatory factors in venous blood. 16S rDNA sequencing was performed to determine the abundance and diversity of the gut microbiota. Gas chromatography-mass spectrometry was used to determine the concentration of short-chain fatty acids (SCFAs) in feces samples. Results: The α-diversity index indicated that the richness and diversity of the gut microbiota were lower in patients with LC-COPD compared with patients with lung cancer and controls. Principal component analysis revealed significant differences among the three groups (P < 0.05). The linear discriminant analysis effect size algorithm indicated that the o_Lactobacillales, g_Lactobaccillus, f_Lactobaccillaceae, s_Lactobaccillus_oris, c_Bacilli, g_Anaerofustis, s_uncultured organism, and s_bacterium_P1C10 species were prevalent in patients with LC-COPD, while the g_Clostridium_XIVa and g_Butyricicoccus species were prevalent in patients with lung cancer. Furthermore, the concentrations of the SCFAs butyric acid, isobutyric acid, isovaleric acid, and valeric acid tended to be lower in patients with LC-COPD compared with patients with lung cancer and healthy controls, although these intergroup differences were not significant (P > 0.05). Patients with lung cancer had the lowest serum concentration of tumor necrosis factor (TNF)-a. There were no intergroup differences in the concentrations of other inflammatory factors. Conclusions: The present study indicated that the abundance and structure of the gut microbiota is altered, and the concentrations of SCFAs may be decreased in patients with LC-COPD. In addition, patients with lung cancer had the lowest serum concentration of TNF-a.

Cu/CeO2 catalysts for reverse water gas shift reactions: the effect of the preparation method.

The reverse water gas shift reaction is one of the most prospective CO2 utilization approaches. Cu has excellent selectivity for CO and CeO2 is rich in surface oxygen vacancies for CO2 activation. These unique properties are often used to develop efficient Cu/CeO2 catalysts in RWGS. In this paper, Cu/CeO2 is prepared by plasma-induced micro-combustion. The effect of the subsequent calcination after micro-combustion on the structure and catalytic property is systemically studied. Because of the mild temperature of micro-combustion, highly dispersed Cu species load on the surface of CeO2 for the catalyst without calcination (Cu/CeO2-mc). During calcination, the highly dispersed Cu species form two kinds of species, Cu-Ce solid solution structure and small CuO clusters (Cu/CeO2-mcc). The Cu-Ce solid solution effectively enhances the generation of oxygen vacancies, which improves the adsorption and activation of CO2. The catalytic performance of Cu/CeO2-mcc thereby is superior to Cu/CeO2-mc in RWGS. In situ diffuse reflectance infrared fourier transform spectroscopy analysis demonstrates that the formate pathway is the main mechanism of RWGS. CO2 adsorbed on the surface of Cu/CeO2-mcc mainly forms bidentate species. While monodentate generates on the surface of Cu/CeO2-mc. And decomposes to CO easier than , thus Cu/CeO2-mcc exhibits excellent catalytic properties. This work provides a new approach for structural modulation of catalysts with excellent catalytic performance in RWGS.

Thresholds in PROMIS Scores Anchored to Subsequent Unscheduled Health Service Use Among People Diagnosed With Cancer.

PURPOSE: To establish thresholds in the Patient-Reported Outcomes Measurement Information System (PROMIS) pain interference, physical function, fatigue, and depression scores on the basis of their association with subsequent use of the emergency department (ED) or urgent care by people diagnosed with cancer. METHODS: Retrospective data from 952 people seen at Henry Ford Cancer and insured through the Health Alliance Plan were analyzed using generalized linear mixed-effects models. The log odds of ED or urgent care use during 14 or 30 days after each patient-reported outcome (PRO) assessment were related to PRO scores, while adjusting for comorbidity, sociodemographic, and tumor characteristics. RESULTS: Pain interference and physical function were associated with subsequent ED or urgent care visits, but fatigue and depression were not, and the results for 14- and 30-day visits were similar. Thresholds anchored in the likelihood of these visits differed according to cancer stage. For people with advanced cancer, a pain interference score of 60 or higher (odds ratio [OR] 3.75, [95% CI, 1.53 to 7.87]) and a physical function score lower than 40 (OR 2.94, [95% CI, 1.22 to 7.06]) produced the largest ORs with narrowest CIs for 30-day visits. For people with nonadvanced cancer, the thresholds of 65 for pain interference (OR 2.64, [95% CI, 1.40 to 5.01]) and 35 for physical function (OR 1.87, [95% CI, 1.01 to 3.45]) produced largest ORs with narrowest CIs for 30-day visits. CONCLUSION: These anchor-based thresholds in PROMIS scores can inform clinicians' actions with the goal of preventing ED or urgent care visits.

Preparation and research progress of lignin-based supercapacitor electrode materials.

The reserve of lignin in the biological world is the second largest biomass resource after cellulose. Lignin has the characteristics of wide sources, low cost, and rich active components. Due to environmental pollution and energy scarcity, lignin is often used as a substitute good for petrochemical products. Lignin-based functional materials can be prepared by chemical modification or compounding, which are widely used in the fields of energy storage, chemical industry, and medicine. Among them, lignin-based carbon materials have the features of stable chemical properties, large pH application range, ideal electrical conductivity, developed pore size, and high specific surface area, which have great application prospects as supercapacitor materials. This paper mainly introduces the structural properties of lignin, the methods, and mechanisms of carbonization, pore-making, and pore-expansion, as well as the research progress of lignin-based carbon materials for supercapacitors, while looking forward to the future research direction of lignin carbon materials.

Vertically aligned MoS2 nanosheets on monodisperse MXene as electrolyte-philic cathodes for zinc ion batteries with enhanced capacity.

Zinc ion batteries (ZIBs) have attracted extensive attention for their high safety and environmentally friendly nature, and considerable theoretical capacities. Due to its unique two-dimensional layered structure and high theoretical specific capacities, molybdenum disulfide (MoS2) presents as a promising cathode material for ZIBs. Nevertheless, the low electrical conductivity and poor hydrophilicity of MoS2 limits its wide application in ZIBs. In this work, MoS2/Ti3C2Tx composites are effectively constructed using a one-step hydrothermal method, where two-dimensional MoS2 nanosheets are vertically grown on monodisperse Ti3C2Tx MXene layers. Contributing to the high ionic conductivity and good hydrophilicity of Ti3C2Tx, MoS2/Ti3C2Tx composites possess improved electrolyte-philic and conductive properties, leading to a reduced volume expansion effect of MoS2 and accelerated Zn2+ reaction kinetics. As a result, MoS2/Ti3C2Tx composites exhibit high voltage (1.6 V) and excellent discharge specific capacity of 277.8 mA h g-1 at 0.1 A g-1, as well as cycle stability as cathode materials for ZIBs. This work provides an effective strategy for developing cathode materials with high specific capacity and stable structure.

Preparation of Symmetrical Capacitors from Lignin-Derived Phenol and PANI Composites with Good Electrical Conductivity.

As a natural polymer, lignin is only less abundant in nature than cellulose. It has the form of an aromatic macromolecule, with benzene propane monomers connected by molecular bonds such as C-C and C-O-C. One method to accomplish high-value lignin conversion is degradation. The use of deep eutectic solvents (DESs) to degrade lignin is a simple, efficient and environmentally friendly degradation method. After degradation, the lignin is broken due to ß-O-4 to produce phenolic aromatic monomers. In this work, lignin degradation products were evaluated as additives for the preparation of polyaniline conductive polymers, which not only avoids solvent waste but also achieves a high-value use of lignin. The morphological and structural characteristics of the LDP/PANI composites were investigated using 1H NMR, Fourier-transform infrared spectroscopy, scanning electron microscopy, transmission electron microscopy, thermogravimetric analysis and elemental analysis. The LDP/PANI nanocomposite provides a specific capacitance of 416.6 F/g at 1 A/g and can be used as a lignin-based supercapacitor with good conductivity. Assembled as a symmetrical supercapacitor device, it provides an energy density of 57.86 Wh/kg, an excellent power density of 952.43 W/kg and, better still, a sustained cycling stability. Thus, the combination of polyaniline and lignin degradate, which is environmentally friendly, amplifies the capacitive function on the basis of polyaniline.

Comparison of anticoagulation monitoring strategies for adults supported on extracorporeal membrane oxygenation: A systematic review.

BACKGROUND: Anticoagulation is critical in patients supported on extracorporeal membrane oxygenation (ECMO). The appropriate monitoring strategies for heparin remain unclear. OBJECTIVES: This systematic review aimed to compare the accuracy and safety of various monitoring strategies for patients supported on ECMO. METHODS: The PubMed and Web of Science databases were searched for articles in March 2023 without restrictions on publication date. Anticoagulation monitoring strategies for adults supported on ECMO were compared across all included studies. The incidence of bleeding, thrombosis, mortality, blood transfusion, correlation between tests and heparin dose, and the discordance between different tests were discussed in the included studies. The risk of bias was assessed using the Newcastle-Ottawa Scale and Cochrane Collaboration's tool. RESULTS: Twenty-six studies, including a total of 1,684 patients, met the inclusion criteria. The monitoring of anticoagulation by activated partial thromboplastin time (aPTT) resulted in less blood product transfusion than that by activated clotting time (ACT). Moreover, the monitoring of anticoagulation by anti-factor Xa (Anti-Xa) resulted in a more stable anticoagulation than that by aPTT. Anti-Xa and aPTT correlated with heparin dose better than ACT, and the discordance between different monitoring tests was common. Finally, combined monitoring showed some advantages in reducing mortality and blood product transfusion. CONCLUSION: Anti-Xa and aPTT are more suitable for anticoagulation monitoring for patients supported on ECMO than ACT. Thromboelastography and combination strategies are less applied. Most of the studies were retrospective, and their sample sizes were relatively small; thus, more appropriate monitoring strategies and higher quality research are needed.

Adsorption Studies on the Removal of Anionic and Cationic Dyes from Aqueous Solutions Using Discarded Masks and Lignin.

The carbon materials derived from discarded masks and lignin are used as adsorbent to remove two types of reactive dyes present in textile wastewater: anionic and cationic. This paper introduces the results of batch experiments where Congo red (CR) and Malachite green (MG) are removed from wastewater onto the carbon material. The relationship between adsorption time, initial concentration, temperature and pH value of reactive dyes was investigated by batch experiments. It is discovered that pH 5.0-7.0 leads to the maximum effectiveness of CR and MG removal. The equilibrium adsorption capacities of CR and MG are found to be 232.02 and 352.11 mg/g, respectively. The adsorption processes of CR and MG are consistent with the Freundlich and Langmuir adsorption models, respectively. The thermodynamic processing of the adsorption data reveals the exothermic properties of the adsorption of both dyes. The results show that the dye uptake processes follow secondary kinetics. The primary adsorption mechanisms of MG and CR dyes on sulfonated discarded masks and alkaline lignin (DMAL) include pore filling, electrostatic attraction, π-π interactions and the synergistic interactions between the sulphate and the dyes. The synthesized DMAL with high adsorption efficiency is promising as an effective recyclable adsorbent for adsorbing dyes, especially MG dyes, from wastewater.

Real time patient-reported outcome measures in patients with cancer: Early experience within an integrated health system.

BACKGROUND: While patient-reported outcome measures (PROMs) have benefit in cancer clinical trials, real-world applications are lacking. This study describes the method of implementation of a cancer enterprise-wide PROMs platform. METHODS: After establishing a multispecialty stakeholder group within a large integrated health system, domain-specific instruments were selected from the National Institutes of Health's Patient-Reported Outcomes Measurement Information System (PROMIS) instruments (pain interference, fatigue, physical function, and depression) and were administered at varying frequencies throughout each patient's cancer journey. All cancer patients with an oncologic visit were eligible to complete the PROMs prior to the visit using a patient portal, or at the time of the visit using a tablet. PROMs were integrated into clinical workflow. Clinical partnerships were essential for successful implementation. Descriptive preliminary data were compared using multivariable logistic regression to determine the factors associated with method of PROMs completion. RESULTS: From September 16, 2020 to July 23, 2021, 23 of 38 clinical units (60.5%) implemented PROMs over 2392 encounters and 1666 patients. Approximately one third of patients (n = 629, 37.8%) used the patient portal. Black patients (aOR 0.70; 95% CI: 0.51-0.97) and patients residing in zip codes with higher percentage of unemployment (aOR: 0.07, 95% CI: 0.01-0.41) were among the least likely to complete PROMs using the patient portal. CONCLUSIONS: Successful system-wide implementation of PROMs among cancer patients requires engagement from multispecialty stakeholders and investment from clinical partners. Attention to the method of PROMs collection is required in order to reduce the potential for disparities, such as Black populations and those residing in areas with high levels of unemployment.

A Biocompatible Probe for the Detection of Neutrophil Elastase Free from the Interference of Structural Changes and Its Application to Ratiometric Photoacoustic Imaging In Vivo.

Neutrophil elastase (NE) plays a key role in chronic inflammation and acute responses to infection and injury. Effective disease interventions thus call for precise identification of NE to aid the clinical treatment of such diseases. However, the detection process suffers from the interference of structural changes of NE. Herein, we introduce a molecular probe with high biocompatibility to overcome the interference, which was achieved by combining theoretical calculations and experimental studies, that permits highly specific and sensitive detection of NE in cells and in vivo. The upregulated NE accumulation was specifically measured in inflammation by ratiometric photoacoustic and near-infrared fluorescence imaging, providing a new method for developing more specific fluorogenic probes for other enzymes.

Polyaniline as a Nitrogen Source and Lignosulfonate as a Sulphur Source for the Preparation of the Porous Carbon Adsorption of Dyes and Heavy Metal Ions.

Using agricultural and forestry wastes as raw materials, adsorbent materials were prepared for dye adsorption in wastewater, which can minimize the environmental load and fully realize sustainability by treating waste with waste. Taking lignosulfonate as a raw material, due to its molecular structure having more reactive groups, it is easy to form composite materials via a chemical oxidation reaction with an aniline monomer. After that, using a sodium lignosulfonate/polyaniline composite as the precursor, the activated high-temperature pyrolysis process is used to prepare porous carbon materials with controllable morphology, structure, oxygen, sulfur, and nitrogen content, which opens up a new way for the preparation of functional carbon materials. When the prepared O-N-S co-doped activated carbon materials (SNC) were used as adsorbents, the adsorption study of cationic dye methylene blue was carried out, and the removal rate of SNC could reach up to 99.53% in a methylene blue solution with an initial concentration of 100 mg/L, which was much higher than that of undoped lignocellulosic carbon materials, and the kinetic model conformed to the pseudo-second-order kinetic model. The adsorption equilibrium amount of NC (lignosulfonate-free) and SNC reached 478.30 mg/g and 509.00 mg/g, respectively, at an initial concentration of 500 mg/L, which was consistent with the Langmuir adsorption isothermal model, and the adsorption of methylene blue on the surface of the carbon material was a monomolecular layer. The adsorption of methylene blue dye on the carbon-based adsorbent was confirmed to be a spontaneous and feasible adsorption process by thermodynamic parameters. Finally, the adsorption of SNC on methylene blue, rhodamine B, Congo red, and methyl orange dyes were compared, and it was found that the material adsorbed cationic dyes better. Furthermore, we also studied the adsorption of SNC on different kinds of heavy metal ions and found that its adsorption selectivity is better for Cr3+ and Pb2+ ions.

Associations between the use of aspirin or other antiplatelet drugs and all-cause mortality among patients with COVID-19: A meta-analysis.

Introduction: Whether aspirin or other antiplatelet drugs can reduce mortality among patients with coronavirus disease (COVID-19) remains controversial. Methods: We identified randomized controlled trials, prospective cohort studies, and retrospective studies on associations between aspirin or other antiplatelet drug use and all-cause mortality among patients with COVID-19 in the PubMed database between March 2019 and September 2021. Newcastle-Ottawa Scale and Cochrane Risk of Bias Assessment Tool were used to assess the risk of bias. The I2 statistic was used to assess inconsistency among trial results. The summary risk ratio (RR) and odds ratio (OR) were obtained through the meta-analysis. Results: The 34 included studies comprised three randomized controlled trials, 27 retrospective studies, and 4 prospective cohort studies. The retrospective and prospective cohort studies showed low-to-moderate risks of bias per the Newcastle-Ottawa Scale score, while the randomized controlled trials showed low-to-high risks of bias per the Cochrane Risk of Bias Assessment Tool. The randomized controlled trials showed no significant effect of aspirin use on all-cause mortality in patients with COVID-19 {risk ratio (RR), 0.96 [95% confidence interval (CI) 0.90-1.03]}. In retrospective studies, aspirin reduced all-cause mortality in patients with COVID-19 by 20% [odds ratio (OR), 0.80 (95% CI 0.70-0.93)], while other antiplatelet drugs had no significant effects. In prospective cohort studies, aspirin decreased all-cause mortality in patients with COVID-19 by 15% [OR, 0.85 (95% CI 0.80-0.90)]. Conclusion: The administration of aspirin may reduce all-cause mortality in patients with COVID-19.

A highly sensitive and versatile fluorescent biosensor for pathogen nucleic acid detection based on toehold-mediated strand displacement initiated primer exchange reaction.

Existing detection methods for pathogen nucleic acid detection, such as polymerase chain reaction (PCR), are complicated and expensive to perform. Here, we report a simple and versatile strategy for highly sensitive detection of pathogen nucleic acid based on toehold-mediated strand displacement initiated primer exchange amplification (t-PER). In the presence of the target, the blocked hairpin substrate is released by toehold-mediated strand displacement, which triggers the primer exchange reaction amplification. Then, multiple long tandem-repeat single-strands generated by PER open the molecular beacon to recover the fluorescence signal. The t-PER protocol also successfully directly detected human papilloma virus from clinical cervical swab samples, with consistent results compared to real time-polymerase chain reaction (RT-PCR). Moreover, the versatility and clinical feasibility of this method was further confirmed by measuring Epstein-Barr virus, hepatitis B virus, and Ureaplasma urealyticum from different clinical samples (serum samples and urine samples). This simple platform enabled specific and sensitive detection of pathogen nucleic acid in a format that might hold great potential for point-of-care infection diagnosis.

Novel Polarity Fluorescent Probe for Dual-Color Visualization of Lysosomes and Plasma Membrane during Apoptosis.

Apoptosis plays a crucial role in the occurrence of cancer and other diseases. Real-time monitoring of the cell apoptosis process has great significance for cell viability and drug screening. Herein, a novel fluorescent probe was constructed based on the fluorescence resonance energy transfer mechanism, which track the sensitivity of polarity changes, as well as detect the drug-induced cell apoptosis process in a dual-color mode. Importantly, the change of cellular microenvironmental polarity makes it possible to dynamically visualize the process of drug-induced cell apoptosis. More significantly, the designed probe targeted the lysosomes in the living cells to give a blue emission, and it accumulated on the plasma membrane to display red fluorescence during the drug-induced cell apoptosis process. Thus, cell viability could be monitored by both the localization and emission colors of the robust probe. We expect that the unique probe can provide a new blueprint for evaluating and screening apoptosis-related drugs.

A Fluorescent Probe Targeting Mitochondria and Lipid Droplets for Visualization of Cell Death.

Subcellular organelles play an indispensable role in various biological process. Therefore, it is very important to develop fluorescent probe to identify different organelles and their dynamics in specific biological processes. Herein, a new fluorescent probe has been prepared, which can be used to visualize cell death via targeting mitochondria and lipid droplets (LDs) in dual-emission channels. The new probe appeared in the form of ring-open in mitochondria to emit strong yellow fluorescence in living cells, while it carried out intramolecular spiral cyclization reaction to target LDs and give a cyan emission in dead cells. The performance of cell death in the UV-exposure, lipopolysaccharide and hydrogen peroxide treatment is successfully revealed by the probe. The probe has great potential in dual colour biomedical imaging of dynamic changes of mitochondria and LDs in biological processes.

Racial Differences in Planned Hysterectomy Procedure Route.

Background: Hysterectomies can be performed with a minimally invasive surgical (MIS) approach or a laparotomic (abdominal) approach. The objective of this study was to assess any racial differences in the likelihood of having a planned MIS hysterectomy. Materials and Methods: A prospective cohort study of women undergoing hysterectomy at Henry Ford Health System was conducted where laparotomic and MIS approaches are available to all patients. All procedures were performed between October, 2015, and August, 2017. For this study, women were asked to report demographic and insurance information and complete validated questionnaires from 2 weeks before hysterectomy and up to six additional times in the year after hysterectomy. Clinical and operative characteristics were collected from electronic health records. Logistic regression and multinomial logistic regression models were applied to assess the association between race and the surgical approach. Results: Analyses included 235 White women and 196 Black women. Black women were less likely to have any MIS planned for their hysterectomy (odds ratio [OR] = 0.46, 95% confidence interval [CI] 0.3-0.71, p < 0.05), a laparoscopic hysterectomy (relative risk ratio [RRR] = 0.46, 95% CI 0.29-0.73, p < 0.05), or a vaginal hysterectomy (RRR = 0.45, 95% CI 0.25-0.81, p = 0.01) compared with White women. After adjusting for confounders, uterine weight and indication for surgery was fibroids, these racial differences did not remain statistically significant (MIS vs. abdominal [adjusted odds ratio {aOR} = 0.93, 95% CI 0.55-1.57, p = 0.79], laparoscopic vs. abdominal [adjusted relative risk ratio {aRRR} = 0.89, 95% CI 0.52-1.51, p = 0.54], and vaginal vs. abdominal [aRRR = 1.22, 95% CI 0.61-2.45, p = 0.58]). The associations were not confounded by the baseline survey data from standardized questionnaires on depression, financial distress, and satisfaction with their decision. Conclusions: Black women were not less likely than White women to have planned an MIS hysterectomy after controlling for important confounding variables. These results emphasize the importance of considering all important confounders when examining racial differences.

Synthesis, molecular docking calculation, fluorescence and bioimaging of mitochondria-targeted ratiometric fluorescent probes for sensing hypochlorite in vivo.

Mitochondria are the main sites for the production of hypochlorite (OCl-). The protein adenine nucleotide translocase (ANT) is located in the inner mitochondria membrane, which is mainly participated in the transportation of ions and metabolites. At the cellular organelle level, overexpression of ANT is associated with enhanced production of OCl-, however, abnormal levels of OCl- cause redox imbalance and loss of function of mitochondria. Herein, a novel mitochondria-targeted ratiometric fluorescent probe Mi-OCl-RP has been developed. Molecular docking calculation suggested a potential molecular target for the probe in the ANT, and the high binding energy (-8.58 kcal mol-1) may explain the high mitochondria selectivity of Mi-OCl-RP. The unique probe exhibits excellent spectral properties including ratiometric fluorescence response signals to OCl- (within 7 s), high selectivity and sensitivity, and a large Stokes shift (278 nm). In addition, the colocalization coefficient confirms that Mi-OCl-RP can effectively target mitochondria. Furthermore, Mi-OCl-RP has low toxicity and good permeability, and was successfully employed in ratiometric imaging of OCl-in vivo, affording a robust molecular tool for investigating the biological functions of OCl- in living systems.

The Effects of Harm Events on 30-Day Readmission in Surgical Patients.

ABSTRACT: Readmission is an increasingly important focus for improvement regarding quality, value, and patient burden in our surgical patient population. We hypothesized that inpatient harm events increase the likelihood of readmission in surgical patients. We created a system-wide inpatient registry with 30-day readmission. A surgical subset was created, and harm events were tracked through the electronic health record system. Between 2015 and 2017, 37,048 surgical patient encounters met inclusion criterion. A total of 2,887 patients (7.69%) were readmitted. After multiple logistic regression of the highly significant harm measures, seven harm measures remained statistically significant (p < .05). Those with the three highest odds ratios were mucosal pressure ulcer, Clostridium difficile, and glucose <40. Incorporating harm measures to the traditional risk, predictive model for 30-day readmission improved our model performance (area under the ROC curve from 0.68 to 0.71). This study demonstrated that inpatient hospital-based harm events can be electronically monitored and used to predict 30-day readmission.

A Prospective Study of Patterns of Regret in the Year After Hysterectomy.

PURPOSE: This study sought to identify patterns of self-reported regret after hysterectomy. METHODS: Women undergoing hysterectomy for a benign indication were recruited in the 2 weeks prior to surgery. Women reported demographics and completed validated questionnaires (Decisional Regret Scale, Patient Health Questionnaire-9, Decisional Conflict Scale, and the Comprehensive Score for Financial Toxicity) up to 7 times over the first year postsurgery. Medical records were reviewed for clinical and operative details. Latent class growth mixture models were applied to the repeated regret scores to identify patterns after hysterectomy. Clinical and other participant characteristics were compared across the classes. RESULTS: Three latent classes were identified among the 459 participants (422 of whom completed questionnaires at 12 months): "High Regret" (7.4%), women with a high regret score at baseline that did not improve over time; "Decreasing Regret" (13.3%), women with high baseline levels of regret but whose regret scores improved over time; and "Least Regret" (79.3%), women with the lowest baseline regret scores that remained low after surgery. These classes did not vary with respect to indication for surgery, clinical characteristics, age, or body mass index. Disproportionately more African American women (adjusted odds ratio: 1.99, 95% CI: 1.01-3.9) were in the "Decreasing Regret" versus "Least Regret" classes. Baseline satisfaction varied between the classes, with the "Least Regret" group having higher baseline satisfaction with their decision. Women with "Decreasing Regret" reported worse financial toxicity associated with surgery versus women in the "Least Regret" class (adjusted odds ratio: 0.95, 95% CI: 0.92-0.99). CONCLUSIONS: For some women, decisional regret may worsen after hysterectomy. More often, initial regret lessens over time. Future studies that identify factors strongly associated with self-reported regret could lead to improved counseling about postsurgical expectations.