Influence of Impaired Hydration Status on Postoperative in-Hospital Death in Patients with Acute Type A Aortic Dissection.

Background: The hydration state of the body is getting more and more attention from researchers. The purpose of this study is to investigate the relationship between impaired hydration status and postoperative hospitalization death in patients with A AAD. Methods: From January 2019 to October 2021, the clinical data of 299 patients undergoing A AAD surgery were retrospectively analyzed. Patients were divided into normal hydration group, imminent dehydration group and current dehydration group according to the dehydration standard at admission. Univariate and multivariate logistic regression analysis were used to determine the independent risk factors for in-hospital death of patients with A AAD. Results: Postoperative in-hospital death in A AAD patients was significantly more common in the imminent and current dehydration groups (>295mmol/L) (26.7% vs 11.9%; P=0.001). The length of ICU stay was significantly longer in the impending and current dehydration groups (P<0.05). After controlling for other factors by multivariate logistic regression analysis, the results showed that the group of impending and current dehydration (>295) (OR=3.61, 95% confidence interval [CI]: 1.61-8.06; P=0.002), CRRT (OR=10.55, 95%[CI]: 3.59-31.01; P<0.001), lactic acid (OR=1.25, 95%[CI]: 1.13-1.38; P<0.001), CAD (OR=5.27, 95%[CI]: 1.12-24.80; P=0.035) was an independent risk factor for in-hospital death in A AAD patients. Albumin (OR=0.92, 95%[CI]: 0.85-0.99; P=0.040) is a protective factor. Conclusion: The presence of high serum osmotic pressure on admission of A AAD patients can independently predict postoperative death, and the impaired body hydration status should be paid attention to.

The blood glucose-potassium ratio at admission predicts in-hospital mortality in patients with acute type A aortic dissection.

Acute type A aortic dissection (ATAAD) is a serious cardiovascular emergency with high risk and mortality after surgery. Recent studies have shown that serum glucose-potassium ratio (GPR) is associated with the prognosis of cerebrovascular diseases. The purpose of this study was to investigate the relationship between GPR and in-hospital mortality in patients with ATAAD. From June 2019 to August 2021, we retrospectively analyzed the clinical data of 272 patients who underwent ATAAD surgery. According to the median value of GPR (1.74), the patients were divided into two groups. Univariate and multivariate logistic regression analysis were used to determine the risk factors of in-hospital mortality after ATAAD. In-hospital death was significantly more common in the high GPR group (> 1.74) (24.4% vs 13.9%; P = 0.027). The incidence of renal dysfunction in the low GPR group was significantly higher than that in the high GPR group (26.3% vs 14.8%: P = 0.019). After controlling for potential confounding variables and adjusting for multivariate logistic regression analysis, the results showed a high GPR (> 1.74) (AOR 4.70, 95% confidence interval (CI) 2.13-10.40; P = < 0.001), lactic acid (AOR 1.14, 95% CI 1.03-1.26; P = 0.009), smokers (AOR 2.45, 95% CI 1.18-15.07; P = 0.039), mechanical ventilation (AOR 9.47, 95% CI 4.00-22.38; P = < 0.001) was independent risk factor for in-hospital mortality in ATAAD patients, albumin (AOR 0.90, 95% CI 0.83-0.98; P = 0.014) was a protective factor for in-hospital prognosis. High GPR is a good predictor of in-hospital mortality after ATAAD surgery.

Cluster Head Selection Method for Edge Computing WSN Based on Improved Sparrow Search Algorithm.

Sensor nodes are widely distributed in the Internet of Things and communicate with each other to form a wireless sensor network (WSN), which plays a vital role in people's productivity and life. However, the energy of WSN nodes is limited, so this paper proposes a two-layer WSN system based on edge computing to solve the problems of high energy consumption and short life cycle of WSN data transmission and establishes wireless energy consumption and distance optimization models for sensor networks. Specifically, we propose the optimization objective of balancing load and distance factors. We adopt an improved sparrow search algorithm to evenly distribute sensor nodes in the system to reduce resource consumption, consumption, and network life. Through the simulation experiment, our method is illustrated, effectively reducing the network's energy consumption by 26.8% and prolonging the network's life cycle.

Mediating effects of general self-efficacy on social support and quality of life in patients after surgical aortic valve replacement.

AIM: To explore whether general self-efficacy can mediate the relationship between social support and quality of life in patients after surgical aortic valve replacement. DESIGN: A cross-sectional design. METHODS: The final analysis included 283 patients who underwent surgical aortic valve replacement from May 2021 to September 2021. They completed a set of questionnaires, including the Chinese version of the General Self-Efficacy Scale, the Chinese Questionnaire of Quality of life in Patients with Cardiovascular Diseases and the Social Support Rating Scale. The PROCESS Macro in SPSS was used to analyse the mediating effect. RESULTS: Quality of life and all of its dimensions were significantly related to social support and general self-efficacy. A significant indirect effect of social support existed through general self-efficacy in relation to quality of life with the mediation effect ratio of 32.82%.

Mediating role of resilience between learning engagement and professional identity among nursing interns under COVID-19: A cross-sectional study.

AIM: The aim of the study was to explore the mediating effect of resilience between learning engagement and professional identity of nursing interns. DESIGN: A descriptive, cross-sectional study design. METHODS: An online questionnaire survey was conducted among nursing interns in Fujian Medical University from February 2022 to April 2022 by convenience sampling. The scores of learning engagement, resilience and professional identity were evaluated. The PROCESS Marco in SPSS was used to analyse the mediating effect. RESULTS: A total of 222 senior nursing students participated in the questionnaire survey. Both learning engagement (r = 0.491, p < 0.01) and resilience (r = 0.537, p < 0.01) correlated positively with PI. Resilience is also positively related to PI (r = 0.693, p < 0.01). Also resilience played a partial mediating role in the relationship between learning engagement and professional identity (a*b = b = 0.2451, 95% CI: 0.1543, 0.3581), and its effect accounted for 53.3%.

Outcomes of postoperative delirium in patients undergoing cardiac surgery: A systematic review and meta-analysis.

Background: Postoperative delirium (POD) is an acute brain dysfunction that is frequently observed in patients undergoing cardiac surgery. Increasing evidence indicates POD is related to higher mortality among cardiac surgical patients, but the results remain controversial. Moreover, a quantitative evaluation of the influence of POD on hospital days, intensive care unit (ICU) time, and mechanical ventilation (MV) time has not been performed. Objective: This study aimed to evaluate the correlation between POD and outcomes in patients undergoing cardiac surgery by a systematic review and meta-analysis. Materials and methods: A total of 7 electronic databases (Cochrane Library, PubMed, EMBASE, CINAHL Complete, MEDLINE, Wan-fang database, and China National Knowledge Infrastructure) were searched from January 1980 to July 20, 2021, with language restrictions to English and Chinese, to estimate the impact of the POD on outcome in patients who underwent cardiac surgery. The meta-analysis was registered with PROSPERO (Registration: CRD42021228767). Results: Forty-two eligible studies with 19785 patients were identified. 3368 (17.0%) patients were in the delirium group and 16417 (83%) were in the non-delirium group. The meta-analysis showed that compared to patients without POD, patients with POD had 2.77-fold higher mortality (OR = 2.77, 95% CI 1.86-4.11, P < 0.001), 5.70-fold higher MV (>24h) rate (OR = 5.70, 95% CI 2.93-11.09, P < 0.001); and longer MV time (SMD = 0.83, 95% CI 0.57-1.09, P < 0.001), ICU time (SMD = 0.91, 95% CI 0.60-1.22, P < 0.001), hospital days (SMD = 0.62, 95% CI 0.48-0.76, P < 0.001). Conclusion: The synthesized evidence suggests that POD is causally related to the increased risk of mortality, prolonged length of ICU and hospital stay, and a longer duration of MV time. Future research should focus on the interventions for POD, to reduce the incidence. Systematic review registration: [www.crd.york.ac.uk/PROSPERO], identifier [CRD42021228767].

Admission Hyperglycemia in Acute Type A Aortic Dissection Predicts for a Prolonged Duration of Mechanical Ventilation.

Previous studies have demonstrated that admission hyperglycemia is a predictor of mortality and poor prognosis in patients with cardiovascular diseases, such as acute myocardial infarction. However, the prognostic value of admission hyperglycemia in patients with acute type A aortic dissection (AAAD) has never been explored. To clarify the association between hyperglycemia and in-hospital outcomes, we retrospectively analyzed 734 patients with AAAD. The interest endpoints were in-hospital mortality rate, the duration of intensive care unit and hospital stays, the occurrence of prolonged mechanical ventilation (PMV), and other complications. All patients were divided into the normal blood glucose group (≤ 140 mg/dL) and hyperglycemia group (> 140 mg/dL), to compare the in-hospital outcomes rate in the two groups. There were 531 (72.3%) patients with normal blood glucose levels and 203 (27.7%) patients with hyperglycemia. The in-hospital mortality rate was 21.1%, and no statistically significant differences were found between the two groups (20.3% versus 23.2%, P = 0.403). PMV is the most frequent postoperative complication, the incidence of which was significantly higher in the hyperglycemia group than in the normal blood glucose group (59.6% versus 50.8%, P = 0.040). The logistic regression analysis revealed that hyperglycemia (odds ratio (OR): 1.492; 95% CI: 1.014 to 2.197; P = 0.042) was an independent risk factor for PMV after adjusting for confounding factors. Age (OR: 1.021; 95% CI: 1.006-1.037; P = 0.007) and body mass index (OR: 1.101; 95% CI: 1.051-1.153; P < 0.001) were also associated with PMV. In conclusion, our study showed for the first time that a strong correlation between admission hyperglycemia and increased postoperative PMV in patients with AAAD, but not with in-hospital mortality rate.

Fine Mapping, Candidate Gene Identification and Co-segregating Marker Development for the Phytophthora Root Rot Resistance Gene RpsYD25.

Phytophthora root rot (PRR) caused by Phytophthora sojae is a serious disease of soybean. The most effective disease-control strategy is to deploy resistant cultivars carrying Rps genes. Soybean cultivar Yudou25 can effectively resist pathotypes of P. sojae in China. Previous studies have mapped the Rps gene in Yudou25, RpsYD25, on chromosome 3. In this study, at first RpsYD25 was located between SSR markers Satt1k3 (2.2 cM) and BARCSOYSSR_03_0253 (4.5 cM) by using an F2:3 population containing 165 families derived from Zaoshu18 and Yudou25. Then the recombination sites were identified in 1127 F3:4 families derived from Zaoshu18 and Yudou25 using the developed PCR-based SNP, InDel and SSR markers, and RpsYD25 was finely mapped in the a 101.3 kb genomic region. In this region, a zinc ion binding and nucleic acid binding gene Glyma.03g034700 and two NBS-LRR genes Glyma.03g034800 and Glyma.03g034900 were predicted as candidate genes of RpsYD25, and five co-segregated SSR markers with RpsYD25 were identified and validated to be diagnostic markers. Combined with the resistance reaction to multiple P. sojae isolates, seven of 178 soybean genotypes were detected to contain RpsYD25 using the five co-segregated SSR markers. The soybean genotypes carrying RpsYD25 and the developed co-segregated markers can be effectively applied in the breeding for P. sojae resistance in China.

Elevated serum thioredoxin-interacting protein in women with polycystic ovary syndrome is associated with insulin resistance.

OBJECTIVE: Women with polycystic ovary syndrome (PCOS) mostly have profound insulin resistance (IR) and ß-cell dysfunction. Although thioredoxin-interacting protein (TXNIP) is a major regulator in IR and insulin secretion, no data on the plasma TXNIP level in patients with PCOS are available. This study aimed to determine the plasma TXNIP level and discuss the relationship between TXNIP and ß-cell dysfunction/IR in patients with PCOS. PATIENTS: Eighty-three women with PCOS and 52 controls. MEASUREMENTS: Insulin sensitivity was expressed by M value obtained from euglycaemic-hyperinsulinaemic clamp. Homoeostatic model assessment for ß-cell function (HOMA-ß), △Ins30/△Glu30 and AUCins/glu were considered as the indices of fasting state, early-phase and total insulin secretion during oral glucose tolerance test, respectively. To evaluate ß-cell function adjusted for insulin sensitivity, disposition index (DI) was used: basal DI (DI0), early-phase DI (DI30) and total DI (DI120). Plasma TXNIP levels were measured by enzyme-linked immunosorbent assay. DESIGN: Case-control study. RESULTS: Patients with PCOS had higher serum TXNIP, whereas lower M value, DI0, DI30 and DI120 than controls (P < 0·05); their TXNIP correlated positively with weight, waist-to-hip ratio (WHR), body mass index (BMI), Ins0, Ins120 and HOMA-ß and correlated negatively with M value and DI120 (P < 0·05). Multiple stepwise regression analysis indicated that TXNIP remained associated with M value in PCOS subjects, after adjusting weight, BMI, WHR, HOMA-ß, Ins0, Ins120 and DI120. However, no relationship between TXNIP and impaired ß-cell function was found. CONCLUSION: Serum TXNIP is elevated in women with PCOS and may be a contributing factor for IR.