Compatibility versus reaction diffusion: Factors that determine the heterogeneity of polymerized adhesive networks.

OBJECTIVES: Heterogeneity and phase separation during network polymerization is a major issue contributing to the failure of dental adhesives. This study investigates how the ratio of hydrophobic crosslinkers to hydrophilic comonomer (C/H ratio), as well as cosolvent fraction (ethanol/water) influences the degree of heterogeneity and proclivity for phase separation in a series of model adhesive formulations. METHODS: Twelve formulations were investigated, with 4 different C/H ratios (7:1, 2.2:1, 1:1, 0.5:1) and 3 different overall cosolvent fractions (0, 10 and 20 wt%). The heterogeneity and phase behavior were characterized using Fourier Transform Infrared Spectroscopy (FT-IR), dynamic mechanical analysis (DMA), small-angle x-ray scattering (SAXS) and atomic force microscopy (AFM). RESULTS: In resins without cosolvent, all characterizations confirm reduced heterogeneity as C/H ratio decreases. However, when 10 or 20 wt% of cosolvent is included in the adhesive formulation, a higher degree of heterogeneity and even distinct phase separation with domains ranging from a few hundreds of nanometers to a few micrometers in size form. This is particularly noticeable at lower C/H ratios, which is surprising as HEMA is commonly considered a compatibilizer between hydrophobic crosslinkers and aqueous (co)solvents. SIGNIFICANCE: Our experiments demonstrate that formulations with lower C/H ratio and thus a lower viscosity experience later onsets of diffusion limitations during polymerization, which favors thermodynamically driven phase separation. Therefore, to determine or predict the resulting phase structure of adhesive materials, it is necessary to consider the kinetics and diffusion constraints during the formation of the polymer network and not just the compatibility of resin constituents.

Degradation of odorous 2,4,6-trichloroanisole in chlorinated water by UV-LED/chlorination: kinetics and influence factors.

2,4,6-Trichloroanisole (2,4,6-TCA) has aroused a special concern for their odor problem and potential threats. In this study, the degradation of 2,4,6-TCA by UV/chlorination with different UV sources was compared, including low-pressure mercury lamp (LPUV, 254 nm) and ultraviolet light-emitting diode (UV-LED, 275 and 285 nm). The maximum removal of 2,4,6-TCA can be achieved by 275-nm UV-LED/chlorination in neutral and alkaline conditions which was 80.0%. The reaction, kinetics, and water matrix parameters on 2,4,6-TCA degradation were also evaluated. During UV-LED (275 nm)/chlorination, 2,4,6-TCA degradation was mainly caused by direct UV photolysis and indirect hydroxyl radical (HO·) oxidation, while reactive chlorine radicals (RCSs) had a negligible contribution. The second-order rate constant between HO· and 2,4,6-TCA was determined as 3.1 × 109 M-1 s-1. Increasing initial chlorine dosage and decreasing 2,4,6-TCA concentration or pH value significantly promoted 2,4,6-TCA degradation during UV/chlorination process. The presence of natural organic matter (NOM) and bicarbonate (HCO3-) can inhibit 2,4,6-TCA degradation, while chloride ion (Cl-) had a negligible effect. The kinetic model for 2,4,6-TCA degradation was established and validated, and the degradation pathways were proposed based on the identified intermediates. Furthermore, UV-LED (275 nm)/chlorination also exhibited a promising effect on 2,4,6-TCA removal in real water, which can be used to control 2,4,6-TCA pollution and odor problems.

LncRNA IRAR regulates chemokines production in tubular epithelial cells thus promoting kidney ischemia-reperfusion injury.

Increasing evidence demonstrates that long noncoding RNAs (lncRNAs) play an important role in several pathogenic processes of the kidney. However, functions of lncRNAs in ischemic acute kidney injury (AKI) remain undefined. In this study, global lncRNA profiling indicated that many lncRNA transcripts were deregulated in kidney after ischemia reperfusion (IR). Among them, we identified IRAR (ischemia-reperfusion injury associated RNA) as a potential lncRNA candidate, which was mostly expressed by the tubular epithelial cells (TECs) after IR, involved in the development of AKI. GapmeR-mediated silencing and viral-based overexpression of IRAR were carried out to assess its function and contribution to IR-induced AKI. The results revealed that in vivo silencing of IRAR significantly reduced IR-induced proinflammatory cells infiltration and AKI. IRAR overexpression induced chemokine CCL2, CXCL1 and CXCL2 expression both in mRNA and protein levels in TECs, while, silencing of IRAR resulted in downregulation of these chemokines. RNA immunoprecipitation and RNA pulldown assay validated the association between IRAR and CCL2, CXCL1/2. Further examination revealed that specific ablation of CCL2 in TECs reduced macrophages infiltration and proinflammatory cytokine production, attenuated renal dysfunction in IR mice. Inhibition of CXC chemokine receptor 2 (receptor of CXCL1/2) reduced neutrofils infiltration, but had no overt effect on kidney function. To explore the mechanism of IRAR upregulation in kidney during IR, we analyzed promoter region of IRAR and predicted a potential binding site for transcription factor C/EBP ß on IRAR promoter. Silencing of C/EBP ß reduced IRAR expression in TECs. A dual-luciferase reporter assay and chromatin immunoprecipitation (ChIP) confirmed that IRAR was a transcriptional target of the C/EBP ß. Altogether, our findings identify IRAR as a new player in the development of ischemic AKI through regulating chemokine production and immune cells infiltration, suggesting that IRAR is a potential target for prevention and/or attenuation of AKI.

MicroRNA-382 Promotes M2-Like Macrophage via the SIRP-α/STAT3 Signaling Pathway in Aristolochic Acid-Induced Renal Fibrosis.

Aristolochic acid nephropathy (AAN) is a type of drug-induced nephropathy and is correlated with a potentially progression of kidney fibrosis. However, whether miR-382 is implicated in macrophage activation in AA-induced kidney fibrosis remains elusive. Here, cell-sorting experiments defined a significant miR-382 enrichment in renal macrophage after AAN 14 days. Then, we found that treatment of AA induced a significant switch in the phenotype of macrophage both in vivo and in vitro. Furthermore, miR-382 knockout (KO) mice and miR-382-/- bone marrow-derived macrophage (BMDM) were subjected to AA induction. We found that both systemic KO and macrophage-specific miR-382 depletion notably suppressed M2-like macrophage activation as well as kidney interstitial fibrosis. Additionally, adoptive transfer of miR-382 overexpression BMDMs into mice promoted AA-induced kidney injury. Moreover, in cultured macrophage, upregulation of miR-382 promoted M2-related gene expression, accompanied by downregulation of signal regulatory protein α (SIRP-α) and activation of signal transducer and activator of transcription 3 (STAT3). The interaction between miR-382 and SIRP-α was evaluated via dual-luciferase assay. Knockdown of SIRP-α upregulated phosphorylated STAT3 at S727 and Y705. Pharmacological inhibition of STAT3 was performed both in vivo and in vitro. Inhibition of STAT3 attenuated AA-induced kidney fibrosis, in parallel to lesser macrophage M2 polarization. Coculture experiments further confirmed that overexpressed miR-382 in macrophage promoted injuries of tubular cells. Luminex bio-chip detection suggested that IL-4 and CCL-5 were critical in the cross talk between macrophages and tubular cells. Taken together, our data suggest that miR-382 is a critical mediator in M2-like macrophage polarization and can be a promising therapeutic target for kidney fibrosis.

Forest ecosystem service functions and their associations with landscape patterns in Renqiu City.

Forest ecosystems are crucial to the survival and development of human societies. Urbanization is expected to impact forest landscape patterns and consequently the supply of forest ecosystem services. However, the specific ways by which such impacts manifest are unclear. Therefore, to discuss the relationship between them is of great significance for realizing regional sustainable development. Here, we quantitatively assess the intensity of forest ecosystem service functions and forest landscape patterns in Renqiu City of China's Hebei Province in 2019 using ArcGIS and FRAGSTATS. We characterize the relationships between forest ecosystem service capacity and landscape patterns, and identify strategies for the spatial optimization of forests. We find that the ecosystem service intensity of forests are significantly correlated with their spatial distribution, forest area ratio, and landscape patterns. Specifically, the percentage of landscape (PLAND) index, landscape shape index (LSI), and contagion (CONTAG) index indices display second-order polynomial relationships with various forest ecosystem service functions, with critical values of 80, 5, and 70, respectively. We propose that forest ecosystem functions can be optimized by optimizing forest landscape patterns. Specifically, to maximize the function of forest ecosystem services, managers should consider the integrity of forest ecosystems, optimize their ability to self-succession, repair service functions of key nodes within forests, enhance forests' structural stability, optimize forest quality and community structure, and strengthen the efficiency of functional transformation per unit area. Finally, we propose a strategy for the spatial optimization of forests in Renqiu to optimize their associated ecosystem services. This involves protecting important areas for forest ecosystems, rationally organizing different ecological patches such as forests and water bodies to maximize their functions, strengthening the connectivity of scattered forests, and supplementing woodland areas.

Nuclear farnesoid X receptor attenuates acute kidney injury through fatty acid oxidation.

Acute kidney injury (AKI) is a life-threatening condition that is one of most common side effects of cisplatin therapy. Fatty acid oxidation (FAO) is the main source of energy production in kidney proximal tubular epithelial cells (PTECs) but it is inhibited in AKI. Recent work demonstrated that activation of the farnesoid X receptor (FXR) protects against AKI, but the underlying mechanism remains elusive. Using a model of cisplatin-induced AKI, we found that FXR and FAO-related genes were remarkably downregulated while kidney lipid accumulated. Proximal tubule-specific or whole body FXR knockout worsened, while pharmacological activation attenuated these effects. Conversely, FXR knockout in non-proximal tubules did not. RNA-sequencing of PTECs demonstrated increased transcripts involved in metabolic pathways in cells overexpressing FXR versus control after cisplatin treatment, specifically transcripts associated with FAO and peroxisome proliferator-activated receptor-γ (PPARγ) signaling. Furthermore, FXR overexpression or activation improved FAO and inhibited intracellular lipid accumulation in cisplatin-treated cells. In vivo studies have shown that pharmacological activation of PPARγ can prevent cisplatin-induced lipid accumulation, kidney tubule injury and kidney function decline. However, inhibition of PPARγ eliminated the protective effects of FXR compared to control mice during the cisplatin treatment phase and after ischemia-reperfusion injury. Consistent with findings in vivo, FXR/PPARγ reduced lipid accumulation by improving FAO in cisplatin-treated cells. Furthermore, the inhibition of carnitine palmitoyltransferase 1α abolished the protective effect of FXR in cisplatin-treated mice. Thus, FXR improves FAO and reduced lipid accumulation via PPARγ in PTECs of the kidney. Hence, reconstruction of the FXR/PPARγ/FAO axis may be a novel therapeutic strategy for preventing or treating AKI.

The clinical efficacy of Shengyu decoction in the treatment of anemia after PFNA for elderly intertrochanteric fracture: A protocol of prospective, randomized, controlled trial.

BACKGROUND: Femoral intertrochanteric fractures (ITF) occur frequently in the elderly, accounting for 45% of all hip fractures. Postoperative anemia after fracture tends to cause ischemia, hypoxia in cells, tissues and organs, increasing the rate of blood transfusion, risk of infection, disability and mortality. Meanwhile, traditional Chinese medicine is widely used in the treatment of anemia for activating blood circulation and removing blood stasis. METHODS: This study is a prospective, outcome assessor-, and data analyst-blinded randomized controlled clinical trial. The objective of this proposed study was to investigate whether Shengyu Decoction could improve the symptoms of anemia after proximal femoral nail antirotation in elderly ITF patients. After qualifying for screening, patients will be randomized into 2 groups with an allocation ratio of 1:1. Hemoglobin concentration, HBL, and HHS score are outcome measurements. The other outcomes also included time to get out of bed, discharge to home, 30-day readmission rates, and mortality. DISCUSSION: ITF is commonly occurring in senior citizens, and those who are senior in age generally suffer 1 or more basic diseases, whose nutritional status is already poor. Trauma and surgical stimulation not only aggravate the existing disease or induce corresponding cardiovascular complications, but also worsen the nutritional status, which can easily cause postoperative anemia in patients. Because of the limited clinical modalities available for the treatment of postoperative anemia after fracture surgery, and most of them have various side effects that are not easily tolerated by the elderly. Therefore, from a traditional Chinese medicine perspective, we proposed a protocol using mild Chinese herbal decoction to treat postoperative anemia in ITF.Registration number: OSF Registration number: DOI 10.17605/OSF.IO/JQ6ZF.

Effects of Dietary Ginsenoside Rg1 Supplementation on Growth Performance, Gut Health, and Serum Immunity in Broiler Chickens.

The restriction and banning of antibiotics in farm animal feed has led to a search for promising substitutes for antibiotics to promote growth and maintain health for livestock and poultry. Ginsenoside Rg1, which is one of the most effective bioactive components in ginseng, has been reported to have great potential to improve the anti-inflammatory and anti-oxidative status of animals. In this study, 360 Chinese indigenous broiler chickens with close initial body weight were divided into 5 groups. Each group contained 6 replicates and each replicate had 12 birds. The experimental groups were: the control group, fed with the basal diet; the antibiotic group, fed basal diet + 300 mg/kg 15% chlortetracycline; and three Rg1 supplementation groups, fed with basal diet + 100, 200, and 300 mg/kg ginsenoside Rg1, respectively. The growth performance, immune function, and intestinal health of birds were examined at early (day 1-28) and late (day 29-51) stages. Our results showed that dietary supplementation of 300 mg/kg ginsenoside Rg1 significantly improved the growth performance for broilers, particularly at the late stage, including an increase in final body weight and decrease of feed conversion ratio (P < 0.05). Additionally, the integrity of intestinal morphology (Villus height, Crypt depth, and Villus height/Crypt depth) and tight junction (ZO-1 and Occludin), and the secretion of sIgA in the intestine were enhanced by the supplementation of Rg1 in chicken diet (P < 0.05). The immune organ index showed that the weight of the thymus, spleen, and bursa was significantly increased at the early stage in ginsenoside Rg1 supplementation groups (P < 0.05). Our findings might demonstrate that ginsenoside Rg1 could serve as a promising antibiotic alternative to improve the growth performance and gut health for broiler chickens mainly through its amelioration of inflammatory and oxidative activities.

Implementation of Enhanced Recovery After Surgery (ERAS) protocol for elderly patients receiving surgery for intertrochanteric fracture: a propensity score-matched analysis.

PURPOSE: Enhanced Recovery After Surgery (ERAS) is a multimodal approach to perioperative care that aims to reduce patient perioperative complications, accelerate patient recovery, and improve patient satisfaction by refining and optimizing all perioperative management processes. By comparing two groups of patients before and after the implementation of ERAS for intertrochanteric fracture (ITF) with a matching analysis of propensity score (PS), we aimed to demonstrate that the implementation of ERAS protocol shortens the length of hospital stay (LOS), reduces pain, decreases the incidence of postoperative complications, and promotes functional recovery of the joint. METHODS: We selected 2 periods of 1 year, before (n=98patients) and after ERAS implementation (n=92patients). Data were collected on patient demographics, operative and perioperative details, LOS, VAS score, Harris score, and 30-day complications. ERAS-trained nurses are engaged to support patients at each step of the pre/per/postoperative process, including completing a satisfaction survey, with the help of a mobile app. PS analyses were used for dealing with confounding bias in this retrospective observational study. RESULTS: After PS matching, the outcomes of 124 well-balanced pairs of patients were compared (conventional vs ERAS). LOS was significantly reduced from 24.3±3.9 to 15.2±2.9 days (P<0.001). With the same preoperative VAS scores, we found that patients in the ERAS group had significantly lower postoperative VAS scores than those in the conventional group at days 3 and 7 (P<0.001), but the difference was not statistically significant at day 14. patients in the ERAS group had higher Harris scores than those in the conventional group at 1 and 3 months, but the difference was not significant at 6 months. In addition, we found that only one patient in the ERAS group developed complications, while nine patients in the conventional group developed different complications. There was no significant difference concerning the satisfaction survey. CONCLUSION: The introduction of ERAS for ITF in our institution has resulted in a significant decrease in LOS, alleviated patient pain, promoted early recovery of patient's hip function while effectively preventing complications, and obtained patient satisfaction.

Dynamics in perioperative neutrophil-to-lymphocyte*platelet ratio as a predictor of early acute kidney injury following cardiovascular surgery.

BACKGROUND: In this study, we applied a composite index of neutrophil-lymphocyte * platelet ratio (NLPR), and explore the significance of the dynamics of perioperative NLPR in predicting cardiac surgery-associated acute kidney injury (CSA-AKI). METHODS: During July 1st and December 31th 2019, participants were prospectively derived from the 'Zhongshan Cardiovascular Surgery Cohort'. NLPR was determined using neutrophil counts, lymphocyte and platelet count at the two-time points. Dose-response relationship analyses were applied to delineate the non-linear odds ratio (OR) of CSA-AKI in different NLPR levels. Then NLPRs were integrated into the generalized estimating equation (GEE) to predict the risk of AKI. RESULTS: Of 2449 patients receiving cardiovascular surgery, 838 (34.2%) cases developed CSA-AKI with stage 1 (n = 658, 26.9%), stage 2-3 (n = 180, 7.3%). Compared with non-AKI patients, both preoperative and postoperative NLPR were higher in AKI patients (1.1[0.8, 1.8] vs. 0.9[0.7,1.4], p < 0.001; 12.4[7.5, 20.0] vs. 10.1[6.4,16.7], p < 0.001). Such an effect was a 'J'-shaped relationship: CSA-AKI's risk was relatively flat until 1.0 of preoperative NLPR and increased rapidly afterward, with an odds ratio of 1.13 (1.06-1.19) per 1 unit. Similarly, patients whose postoperative NLPR value >11.0 were more likely to develop AKI with an OR of 1.02. Integrating the dynamic NLPRs into the GEE model, we found that the AUC was 0.806(95% CI 0.793-0.819), which was significantly higher than the AUC without NLPR (0.799, p < 0.001). CONCLUSION: Dynamics of perioperative NPLR is a promising marker for predicting acute kidney injury. It will facilitate AKI risk management and allow clinicians to intervene early so as to reverse renal damage.

Plasmonic Photoelectrochemistry: In View of Hot Carriers.

Utilizing plasmon-generated hot carriers to drive chemical reactions has emerged as a popular topic in solar photocatalysis. However, a complete description of the underlying mechanism of hot-carrier transfer in photochemical processes remains elusive, particularly for those involving hot holes. Photoelectrochemistry enables to localize hot holes on photoanodes and hot electrons on photocathodes and thus offers an approach to separately explore the hole-transfer dynamics and electron-transfer dynamics. This review summarizes a comprehensive understanding of both hot-hole and hot-electron transfers from photoelectrochemical studies on plasmonic electrodes. Additionally, working principles and applications of spectroelectrochemistry are discussed for plasmonic materials. It is concluded that photoelectrochemistry provides a powerful toolbox to gain mechanistic insights into plasmonic photocatalysis.

Comparison of Prediction Models for Acute Kidney Injury Among Patients with Hepatobiliary Malignancies Based on XGBoost and LASSO-Logistic Algorithms.

BACKGROUND: Based on the admission data, we applied the XGBoost algorithm to create a prediction model to estimate the AKI risk in patients with hepatobiliary malignancies and then compare its prediction capacity with the logistic model. METHODS: We reviewed clinical data of 7968 and 589 liver/gallbladder cancer patients admitted to Zhongshan Hospital during 2014 and 2015. They were randomly divided into the training set and test set. Data were collected from the electronic medical record system. XGBoost and LASSO-logistic were used to develop prediction models, respectively. The performance measures included the classification matrix, the area under the receiver operating characteristic curve (AUC), lift chart and learning curve. RESULTS: Of 6846 participants in the training set, 792 (11.6%) cases developed AKI. In XGBoost model, the top 3 most important variables for AKI were serum creatinine (SCr), glomerular filtration rate (eGFR) and antitumor treatment in liver cancer patients. Similarly, SCr and eGFR also ranked second and third most important variables in the gallbladder cancer-related AKI model just after phosphorus. In the classification matrix, XGBoost model possessed a comparably better agreement between the actual observations and the predictions than LASSO-logistic model. The Youden's index of XGBoost model was 47.5% and 59.3%, respectively, which was significantly higher than that of LASSO-logistic model (41.6% and 32.7%). The AUCs of XGBoost model were 0.822 in liver cancer and 0.850 in gallbladder cancer. By comparison, the AUC values of Logistic models were significantly lower as 0.793 and 0.740 (p=0.024 and 0.018). With the accumulation of training samples, XGBoost model maintained greater robustness in the learning curve. CONCLUSION: XGBoost model based on admission data has higher accuracy and stronger robustness in predicting AKI. It will benefit AKI risk classification management in clinical practice and take an advanced intervention among patients with hepatobiliary malignancies.

GroupRegNet: a groupwise one-shot deep learning-based 4D image registration method.

Accurate deformable four-dimensional (4D) (three-dimensional in space and time) medical images registration is essential in a variety of medical applications. Deep learning-based methods have recently gained popularity in this area for the significantly lower inference time. However, they suffer from drawbacks of non-optimal accuracy and the requirement of a large amount of training data. A new method named GroupRegNet is proposed to address both limitations. The deformation fields to warp all images in the group into a common template is obtained through one-shot learning. The use of the implicit template reduces bias and accumulated error associated with the specified reference image. The one-shot learning strategy is similar to the conventional iterative optimization method but the motion model and parameters are replaced with a convolutional neural network and the weights of the network. GroupRegNet also features a simpler network design and a more straightforward registration process, which eliminates the need to break up the input image into patches. The proposed method was quantitatively evaluated on two public respiratory-binned 4D-computed tomography datasets. The results suggest that GroupRegNet outperforms the latest published deep learning-based methods and is comparable to the top conventional method pTVreg. To facilitate future research, the source code is available at https://github.com/vincentme/GroupRegNet.

Effects of Adjuvant Therapy Compliance and Anastomotic Leakage on the Oncologic Outcomes of Patients With Rectal Cancer After Curative Resection.

BACKGROUND: Anastomotic leakage might be directly or indirectly related to the prognosis of patients with rectal cancer. OBJECTIVE: This study aimed to investigate whether anastomotic leakage affects the oncologic outcomes in patients with rectal cancer. DESIGN: This was a retrospective analysis of prospectively collected data. SETTINGS: This study was conducted at a teaching hospital between January 2009 and December 2013. PATIENTS: Patients who underwent curative resection for primary rectal cancer were included. MAIN OUTCOME AND MEASURE: Kaplan-Meier analyses were used to evaluate disease-free survival and overall survival. RESULTS: The overall incidence of anastomotic leakage was 2.7% (107/3865). Local recurrence was more frequent in patients with anastomotic leakage than in those without (14.0% vs 6.7%; p = 0.007). By multivariate analysis, anastomotic leakage was associated with increased local recurrence rate (p = 0.014) and poorer overall survival (p = 0.011). In subgroup analysis, compared with other pathologic risk factors, anastomotic leakage was associated with higher occurrence of local and distant recurrence in patients with stage II rectal cancer (p = 0.031 and <0.001). In patients with stage III rectal cancers, adjuvant therapy was more likely to be delayed or canceled in those experiencing anastomotic leakage (63 vs 39 d, p < 0.001; 37.3% vs 66.7%, p < 0.001). In addition, this patient group had the worst survival outcome when compared with those without anastomotic leakage and those with timely adjuvant therapy (5-year disease-free survival rate, p = 0.013; 5-year overall survival rate, p = 0.001). LIMITATIONS: This study is limited by its retrospective nature. CONCLUSIONS: There was a robust association between anastomotic leakage and local recurrence, while also potentially affect long-term survival of the patient group. Delayed or cancelled adjuvant therapy administration because of anastomotic leakage may partly account for the poorer survival in those patients with advanced rectal cancer. See Video Abstract at http://links.lww.com/DCR/B459. EFECTOS DE OBSERVANCIA DE TERAPIA ADYUVANTE Y FUGA ANASTOMTICA, EN RESULTADOS ONCOLGICOS DE PACIENTES CON CNCER RECTAL, DESPUS DE UNA RESECCIN CURATIVA: ANTECEDENTES:La fuga anastomótica podría estar relacionada directa o indirectamente, con el pronóstico de los pacientes con cáncer de recto.OBJETIVO:El estudio tuvo como objetivo investigar si la fuga anastomótica afecta los resultados oncológicos, en pacientes con cáncer de recto.DISEÑO:Fue un análisis retrospectivo de datos recolectados prospectivamente.AJUSTE:El estudio se realizó en un hospital universitario entre enero de 2009 y diciembre de 2013.PACIENTES:Pacientes sometidos a resección curativa por cáncer rectal primario.PRINCIPALES MEDIDAS DE RESULTADO:Se utilizaron análisis de Kaplan-Meier para evaluar la supervivencia libre de enfermedad y supervivencia general.RESULTADOS:La incidencia global de fuga anastomótica fue del 2,7% (107/3865). La recurrencia local fue más frecuente en pacientes con fuga anastomótica, que en aquellos sin ella (14,0% frente a 6,7%, p = 0,007). Por análisis multivariado, la fuga anastomótica se asoció con una mayor tasa de recurrencia local (p = 0,014) y una peor supervivencia general (p = 0,011). En el análisis de subgrupos, en comparación con otros factores de riesgo patológicos, la fuga anastomótica se asoció con una mayor incidencia de recidiva local y a distancia en pacientes con cáncer rectal en estadio II (p = 0,031 y <0,001, respectivamente). En pacientes con cáncer rectal estadio III, la terapia adyuvante tuvo más probabilidades de retrasarse o cancelarse en aquellos que sufrían fuga anastomótica (63 vs 39 días, p <0,001; 37,3% vs 66,7%, p <0,001). Y este grupo de pacientes tuvo el peor resultado de supervivencia en comparación con aquellos sin fuga anastomótica y aquellos con terapia adyuvante oportuna (tasa de supervivencia libre de enfermedad a 5 años, p = 0,013; tasa de supervivencia global a 5 años, p = 0,001).LIMITACIONES:El estudio está limitado por su naturaleza retrospectiva.CONCLUSIONES:Hubo una sólida asociación entre la fuga anastomótica y la recurrencia local, mientras que también afecta potencialmente la supervivencia a largo plazo, del grupo de pacientes. La administración de terapia adyuvante retrasada o cancelada debido a una fuga anastomótica, puede explicar en parte, la menor supervivencia en aquellos pacientes con cáncer rectal avanzado. Consulte Video Resumen en http://links.lww.com/DCR/B459.

Effects of Acanthopanax senticosus supplementation on innate immunity and changes of related immune factors in healthy mice.

Modern scientific research has shown that Acanthopanax senticosus (AS) can regulate the innate immunity of healthy animals, thus affecting the health of animals. However, there are few systematic reports on the changes of innate immune indices of healthy animals after consuming AS. The purpose of this project was to study the effect on healthy mice's innate immunity and changes of related immune factors induced by feeding AS root powder supplementation. The results showed that the killing rate of natural cells increased in a dose-dependent manner in a certain time period. Compared to the control group, the treatment groups (T1, T2 and T3) improved significantly in the innate immune index (lysozyme, ß-defensin-2 and duodenal secretory IgA (SIgA) to varying degrees) and induced corresponding changes of immune factors at certain time periods. The correlation between SIgA and IFN-γ in mouse serum was enhanced, and the higher the concentration of AS in the diet, the stronger the correlation was. However, there was no significant difference in growth performance among groups. It is proved that AS supplementation can enhance innate immunity and change several relevant immune factors and cells of healthy mice without affecting growth performance.

Prediction models for acute kidney injury in patients with gastrointestinal cancers: a real-world study based on Bayesian networks.

BACKGROUND: This study attempts to establish a Bayesian networks (BNs) based model for inferring the risk of AKI in gastrointestinal cancer (GI) patients, and to compare its predictive capacity with other machine learning (ML) models. METHODS: From 1 October 2014 to 30 September 2015, we recruited 6495 inpatients with GI cancers in a tertiary hospital in eastern China. Data on demographics, clinical and laboratory indicators were retrospectively extracted from the electronic medical record system. Predictors of AKI were selected in gLASSO regression, and further incorporated into BNs analysis. RESULTS: The incidences of AKI in patients with esophagus, stomach, and intestine cancer were 20.5%, 13.9%, and 12.5%, respectively. Through gLASSO, 11 predictors were screened out, including diabetes, cancer category, anti-tumor treatment, ALT, serum creatinine, estimated glomerular filtration rate (eGFR), serum uric acid (SUA), hypoalbuminemia, anemia, abnormal sodium, and potassium. BNs model revealed that cancer category, treatment, eGFR, and hypoalbuminemia had direct connections with AKI. Diabetes and SUA were indirectly linked to AKI through eGFR, and anemia created connections with AKI through affecting album level. Compared with other ML models, BNs model maintained a higher AUC value in both the internal and external validation (AUC: 0.823/0.790). CONCLUSION: BNs model not only delineates the qualitative and quantitative relationship between AKI and its associated factors but shows the more robust generalizability in AKI prediction.

A novel machine learning algorithm, Bayesian networks model, to predict the high-risk patients with cardiac surgery-associated acute kidney injury.

BACKGROUND: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a well-recognized complication with an ominous outcome. HYPOTHESIS: Bayesian networks (BNs) not only can reveal the complex interrelationships between predictors and CSA-AKI, but predict the individual risk of CSA-AKI occurrence. METHODS: During 2013 and 2015, we recruited 5533 eligible participants who underwent cardiac surgery from a tertiary hospital in eastern China. Data on demographics, clinical and laboratory information were prospectively recorded in the electronic medical system and analyzed by gLASSO-logistic regression and BNs. RESULTS: The incidences of CSA-AKI and severe CSA-AKI were 37.5% and 11.1%. BNs model revealed that gender, left ventricular ejection fractions (LVEF), serum creatinine (SCr), serum uric acid (SUA), platelet, and aortic cross-clamp time (ACCT) were found as the parent nodes of CSA-AKI, while ultrafiltration volume and postoperative central venous pressure (CVP) were connected with CSA-AKI as children nodes. In the severe CSA-AKI model, age, proteinuria, and SUA were directly linked to severe AKI; the new nodes of NYHA grade and direct bilirubin created relationships with severe AKI through was related to LVEF, surgery types, and SCr level. The internal AUCs for predicting CSA-AKI and severe AKI were 0.755 and 0.845, which remained 0.736 and 0.816 in the external validation. Given the known variables, the risk for CSA-AKI can be inferred at individual levels based on the established BNs model and prior information. CONCLUSION: BNs model has a high accuracy, good interpretability, and strong generalizability in predicting CSA-AKI. It facilitates physicians to identify high-risk patients and implement protective strategies to improve the prognosis.

Assessment of regional greenhouse gas emission from beef cattle production: A case study of Saskatchewan in Canada.

The beef cattle production has been considered as one of the largest sources of greenhouse gases (GHGs) emission. A large amount of GHGs including N2O and CH4 from enteric fermentation and manure are discharged to atmosphere during beef-production process. In addition, a substantial amount of GHGs is also emitted from many other related processes such as feed production, transportation, and energy consumption. In this study, an emission assessment model was developed to quantify the amount of regional GHGs produced from the beef cattle production process. A case study was conducted based on the beef production in Saskatchewan, Canada. The results demonstrated that the GHG emissions from the annual marketed beef cattle in Saskatchewan in 2014 were 8.52 × 109 kg CO2-eq in total and the cattle-source GHGs (enteric CH4, manure CH4, and manure N2O emission) accounted for more than 90% of the total emission. Sensitivity analysis showed that the most critical factors influencing the GHG emission included feedlot manure handling system, cattle diet, feed additives, maximum methane producing capacity (Bo), and climate (temperature, precipitation, and potential evapotranspiration). The potential impacts of climate change on GHG emission from beef cattle production in Saskatchewan were also investigated. An overall decrease in the GHG emission can be observed due to the climate change, which are 3.67%, 4.96%, and 6.63% for 2020-2039, 2040-2059, and 2060-2099, respectively.

Application of coagulation-ultrafiltration-nanofiltration in a pilot study for Tai Lake water treatment.

In this study, the inline coagulation was combined with ultrafiltration and nanofiltration (UF-NF) in a pilot study for Tai Lake water treatment. The results showed that the combination process was very effective for Tai Lake water treatment in terms of organic removal and membrane fouling control. With inline coagulation, no irreversible membrane fouling was observed for either UF or NF at fluxes of 65-90 and 22-26 L/(m2  hr), respectively. The membrane foulants were analyzed, and the results indicated that the low molecular weight fractions in the feed were main membrane fouling contributors for both UF and NF, where hydrophilic substances and proteins, as well as neutral substances and humic acids with polycarboxyl groups, contributed significantly to UF and NF membrane fouling, respectively. Compared with direct UF-NF filtration without coagulation, the coagulants could aggregate organic micromolecules for cake formation. With inline coagulation, the moving flocs could generate shear stress to scrub the membrane surface for fouling control of UF. Moreover, with inline coagulation, the organics removal efficiency could be further increased by 10%-20%. With NF, the permeate had a TOC concentration of less than 0.5 mg/L, satisfying the drinking water quality. Therefore, the coagulation-UF-NF is very useful for Tai Lake water treatment. PRACTITIONER POINTS: Inline coagulation-UF-NF for Tai Lake Water treatment is implemented. Inline coagulation can aggregate hydrophilic substances to reduce membrane fouling. Moving flocs produce shear stress for fouling control of UF-NF. Superior quality of permeate is achieved with the combined coagulation-UF-NF process.

Posttranslational Modification Control of Inflammatory Signaling.

Inflammation is usually the defensive reaction of the immune system to the invasion of pathogen and the exogenous objects. The activation of inflammation helps our body to eliminate pathogenic microbe, virus, and parasite harming our health, while under many circumstances inflammation is the direct cause of the pathological damage in tissues and dysfunction of organs. The posttranslational modification (PTM) of the inflammatory pathways, such as TLR pathways, RLR pathways, NLR pathway, intracellular DNA sensors, intracellular RNA sensors, and inflammasomes, is crucial in the regulation of these signaling trails. Ubiquitination, phosphorylation, polyubiquitination, methylation, and acetylation are the main forms of the PTM, and they respectively play different roles in signaling regulation. The effects of the PTM range from the production of pro-inflammatory factors and the interaction between adaptors and receptors to cell translocation in response to the infectious or other dangerous factors. In this chapter, we will have an overview of the different ways of the posttranslational modifications in different inflammatory signaling pathways and their essential roles in regulation of inflammation.