Association of preoperative red blood cell width and postoperative 30-day mortality in patients undergoing non-cardiac surgery: a retrospective cohort study using propensity-score matching.

BACKGROUND: In terms of predicting surgery mortality, it is controversial whether red blood cell width works independently. In non-cardiac surgery patients older than 18 years, we intend to examine the relationship between red blood cell width and postoperative 30-day mortality. METHODS: In this retrospective cohort study, 90,785 Singapore General Hospital patients were matched by propensity score between January 1, 2012 and October 31, 2016. It was determined that red blood cell width at baseline and mortality within 30 days after surgery were the independent and dependent variables. We used a non-parametric multivariate logistic regression to balance the confounders among 7807 patients with high RDW and 7807 patients with non-high RDW in the propensity score matching. We investigated the association between RDW and 30-day mortality after surgery using the doubly robust estimation method. RESULTS: Cohorts matched according to propensity score, the risk of 30-day mortality after surgery increased by 114.6.0% among the high RDW group (OR = 2.146, 95% CI 1.645-2.799, P < 0.00001). In the crude model, there was a significant association between RDW and 30-day mortality after surgery (OR = 1.877, 95% CI 1.476-2.388, P < 0.00001). In the propensity-score adjusted model, the risk of 30-day mortality after surgery in the high RDW group compared to the control group was not as high as in the non-adjusted model (OR = 1.867, 95% CI 1.467-2.376, P < 0.00001). Compared to non-high RDW group, the risk of 30-day mortality after surgery increased by 117.0% and 127.7% among high RDW group in the original cohort (OR 2.170, 95% CI 1.754-2.683, P < 0.00001) and the weighted cohort (OR 2.272, 95% CI 2.009-2.580, P < 0.00001), respectively. CONCLUSIONS: According to the results of this observational, propensity score-matched cohort study, uncontrolled high RDW before surgery is associated with an increased risk of death within 30 days after surgery, that is to say, patients over the age of 18 with high preoperative RDW who undergo non-cardiac surgery have a worse postoperative prognosis than those with normal RDW.

Gastrointestinal microbiota and metabolites responses to dietary cereal grains in an adult pig model.

Corn (C), wheat (W), and paddy rice (PR) are important energy sources and are commonly used in feed production for swine. This study mainly focuses on the variation and regularities of microbiota and metabolites in the gastrointestinal tract (GIT) of pigs in response to C, W, and PR. A total of 18 pigs were allotted into three dietary groups with six replicated pigs and received diets containing C, W, or PR as the sole energy source, respectively. The results showed that digestive parts significantly affected the diversity of microbial communities. Cereal grain sources significantly influenced the ß-diversity of microbial communities in the colon and rectum. Campylobacterota and Proteobacteria are mainly distributed in the duodenum, Lactobacillus in the jejunum, and Bacteroidota in the colon and rectum. The W diet increased the Bacteroidota, Spirochaetota, and Prevotellaceae_NK3B31_group abundances and showed the highest concentrations of all short-chain fatty acids (SCFAs) in the hindgut. Fibrobacterota, Bacteroidota, Spirochaetota, Prevotellaceae_NK3B31_group, Prevotella, and Treponema in the colon or rectum were positively correlated with acetate, propionate, butyrate, and total SCFAs. These findings suggested that aerobic bacteria and facultative anaerobes in the foregut will gradually be replaced by anaerobes in the hindgut. The W diet had the best fermentability and was beneficial to the colonization of microbial communities that mainly used carbohydrates. The hindgut flora of the PR diet group may be more balanced with fewer potential pathogenic bacteria. Many microbial communities have been identified to contribute positively to the SCFA production of the hindgut. Collectively, our study revealed the spatial variation regularities of GIT microbial communities in an adult pig model and provided new insights into GIT microbiota and responses of metabolites to cereal grain diets.

Customizing H2O-Poor Electric Double Layer and Boosting Texture Exposure of Zn (101) Plane towards Super-High Areal Capacity Zinc Metal Batteries.

The catastrophic dendrite hyperplasia and parasitic reactions severely impede the future deployment of aqueous Zn-ion batteries. Controlling zinc orientation growth is considered to be an effective method to overcome the aforementioned concerns, especially for regulating the (002) plane of deposited Zn. Unfortunately, Zn (002) texture is difficult to obtain stable cycling under high deposition capacity resulting from its large lattice distortion and nonuniform distribution in electric field. Herein, different from traditional cognition, a crystallization orientation regulation tactic is proposed to boost Zn (101) texture exposure and inhibit zinc dendrite proliferation during plating/stripping. Experimental results and theoretical calculations demonstrate the malate molecules preferentially adsorb on the Zn (002) facet, leading to the texture exposure of distinctive Zn (101) plane. Meanwhile, the -COOH and -OH groups of malate molecules exhibit strong adsorption on the Zn anode surface and chelate with Zn2+, achieving H2O-poor electrical double layer. Very impressively, the multifunctional malate additive enlists zinc anode to survive for 600 h under a harsh condition of 15 mAh cm-2/15 mAh cm-2. Moreover, the symmetric cell harvests highly-reversible cycling life of 6600 h at 5 mA cm-2/1.25 mAh cm-2, remarkably outperforming the ZnSO4 electrolyte. The assembled Zn//MnO2 full cells also demonstrate prominent electrochemical reversibility.

Chloride-Ion-Enriched Solid Electrolyte Interphase with Rapid Na+ Migration toward High-Performance Sodium-Ion Batteries.

Sodium-ion batteries (SIBs) have emerged as potential alternatives to lithium-ion batteries (LIBs), particularly for large-scale applications. Alloy-type anode materials for sodium-ion batteries are esteemed as prospective candidate materials for sodium-ion anodes, owing to their elevated theoretical capacity, heightened utilization efficiency, and minimal production of insulating byproducts. However, the severe volume changes and sluggish ion diffusion kinetics can lead to irreversible particle fragmentation and reaggregation phenomena, ultimately resulting in electrode degradation. Additionally, repetitive volume changes can cause an unstable solid electrolyte interphase (SEI). This study presents the synthesis of chloride-ion-modulated bimetallic SnSb/C nanoparticle anode materials, highlighting the following advantages: (i) Designing a bimetallic SnSb alloy structure serves to buffer the structural stresses generated during sodium insertion/extraction processes, effectively mitigating particle fracture phenomena induced by electrode material expansion/contraction. (ii) Nanostructuring both alloy materials enables the full utilization of active materials and shortens diffusion pathways, thereby significantly enhancing the diffusion rate of sodium ions. (iii) Introducing a carbonaceous matrix serves to alleviate self-agglomeration phenomena of the material during charge/discharge cycles, enhancing the material's conductivity and structural stability. (iv) Utilizing chloride-ion interface modification to achieve a chloride-rich solid-electrolyte interphase (SEI) enhances battery performance.

Evaluating the efficacy and safety of different neoadjuvant immunotherapy combinations in locally advanced HNSCC: a systematic review and meta-analysis.

Background: Immune checkpoint inhibitors have demonstrated promising therapeutic outcomes in recurrent/metastatic (R/M) Head and Neck Squamous Cell Carcinoma (HNSCC), prompting numerous clinical trials to investigate the safety and efficacy of this approach in neoadjuvant therapy. This systematic review aims to consolidate and analyze the findings from various clinical trials combining neoadjuvant immunotherapy for HNSCC, with the goal of identifying the most effective neoadjuvant immunotherapy regimen. Methods: The system conducted searches across electronic databases including PubMed, Embase, the Cochrane Library and Web of science from their inception to July 1, 2024. The primary focus was on evaluating efficacy (particularly pathological complete response (pCR), major pathological response (MPR), and overall response rate (ORR)) and safety (primarily assessed by grade 3-4 treatment-related adverse reactions). Results: A total of 1943 patients from 32 studies were analyzed. Combining neoadjuvant immunotherapy with chemotherapy or radiotherapy demonstrated superiority over neoadjuvant immunotherapy alone in terms of the MPR rate, while showing no statistically significant difference in the pCR rate. Furthermore, the combination of neoadjuvant immunotherapy with chemotherapy or radiotherapy exhibited a lower CR rate compared to neoadjuvant immunotherapy with radiotherapy alone, but a higher PR rate and SD rate. Apart from the neoadjuvant immunotherapy group in isolation, there were no statistically significant differences in grade ≥3 treatment-related adverse events (TRAEs) and immune-related adverse events (irAEs) among the other three combination therapy groups. Conclusion: This systematic review and meta-analysis indicate that patients with locally advanced HNSCC might benefit from neoadjuvant immunotherapy, particularly when used in conjunction with chemotherapy or radiotherapy. Nonetheless, additional data is required to definitively confirm its efficacy. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=553753, identifier CRD42024553753.

Dissociable dorsal medial prefrontal cortex ensembles are necessary for cocaine seeking and fear conditioning in mice.

The dorsal medial prefrontal cortex (dmPFC) plays a dual role in modulating drug seeking and fear-related behaviors. Learned associations between cues and drug seeking are encoded by a specific ensemble of neurons. This study explored the stability of a dmPFC cocaine seeking ensemble over 2 weeks and its influence on persistent cocaine seeking and fear memory retrieval. In the first series of experiments, we trained TetTag c-fos-driven-EGFP mice in cocaine self-administration and tagged strongly activated neurons with EGFP during the initial day 7 cocaine seeking session. Subsequently, a follow-up seeking test was conducted 2 weeks later to examine ensemble reactivation between two seeking sessions via c-Fos immunostaining. In the second series of experiments, we co-injected viruses expressing TRE-cre and a cre-dependent inhibitory PSAM-GlyR into the dmPFC of male and female c-fos-tTA mice to enable "tagging" of cocaine seeking ensemble or cued fear ensemble neurons with inhibitory chemogenetic receptors. These c-fos-tTA mice have the c-fos promoter that drives expression of the tetracycline transactivator (tTA). The tTA can bind to the tetracycline response element (TRE) site on the viral construct, resulting in the expression of cre-recombinase, which enables the expression of cre-dependent inhibitory chemogenetic receptors and fluorescent reporters. Then we investigated ensemble contribution to subsequent cocaine seeking and fear recall during inhibition of the tagged ensemble by administering uPSEM792s (0.3 mg/kg), a selective ligand for PSAM-GlyR. In both sexes, there was a positive association between the persistence of cocaine seeking and the proportion of reactivated EGFP+ neurons within the dmPFC. More importantly, inhibition of the cocaine seeking ensemble suppressed cocaine seeking, but not recall of fear memory, while inhibition of the fear ensemble reduced conditioned freezing but not cocaine seeking. The results demonstrate that cocaine and fear recall ensembles in the dmPFC are stable, but largely exclusive from one another.

Efficient RNA interference method by feeding in Brachionus plicatilis (Rotifera).

Rotifers are small, ubiquitous invertebrate animals found throughout the world and have emerged as a promising model system for studying molecular mechanisms in the fields of experimental ecology, aquatic toxicology, and geroscience. However, the lack of efficient gene expression manipulation techniques has hindered the study of rotifers. In this study, we used the L4440 plasmid with two reverse-oriented T7 promoters, along with RNase-deficient E. coli HT115, to efficiently produce dsRNA and thereby present an efficient feeding-based RNAi method in Brachionus plicatilis. We targeted Bp-Ku70 & Ku80, key proteins in the DNA double-strand breaks repair pathway, and then subjected rotifers to UV radiation. We found that the mRNA expression, fecundity, as well as survival rate diminished significantly as a result of RNAi. Overall, our results demonstrate that the feeding-based RNAi method is a simple and efficient tool for gene knockdown in B. plicatilis, advancing their use as a model organism for biological research.

CXCR4 orchestrates the TOX-programmed exhausted phenotype of CD8+ T cells via JAK2/STAT3 pathway.

Evidence from clinical trials suggests that CXCR4 antagonists enhance immunotherapy effectiveness in several cancers. However, the specific mechanisms through which CXCR4 contributes to immune cell phenotypes are not fully understood. Here, we employed single-cell transcriptomic analysis and identified CXCR4 as a marker gene in T cells, with CD8+PD-1high exhausted T (Tex) cells exhibiting high CXCR4 expression. By blocking CXCR4, the Tex phenotype was attenuated in vivo. Mechanistically, CXCR4-blocking T cells mitigated the Tex phenotype by regulating the JAK2-STAT3 pathway. Single-cell RNA/TCR/ATAC-seq confirmed that Cxcr4-deficient CD8+ T cells epigenetically mitigated the transition from functional to exhausted phenotypes. Notably, clinical sample analysis revealed that CXCR4+CD8+ T cells showed higher expression in patients with a non-complete pathological response. Collectively, these findings demonstrate the mechanism by which CXCR4 orchestrates CD8+ Tex cells and provide a rationale for combining CXCR4 antagonists with immunotherapy in clinical trials.

Plasma Cell-Free DNA Concentration and Fragmentomes Predict Neoadjuvant Chemotherapy Response in Cervical Cancer Patients.

Cervical cancer remains one of the most lethal gynecological malignancies. However, biomarkers for more precise patient care are an unmet need. Herein, the concentration of 285 plasma cell-free DNA (cfDNA) samples are analyzed from 84 cervical patients and the clinical significance of cfDNA fragmentomic characteristics across the neoadjuvant chemotherapy (NACT) treatment. Patients with poor NACT response exhibit a significantly greater escalation in cfDNA levels following the initial cycle of treatment, in comparison to patients with a favorable response. Distinctive end motif profiles and promoter coverages of cfDNA in initial plasma are observed between patients with differing NACT responses. Notably, the DNASE1L3 analysis further demonstrates the intrinsic association between cfDNA characteristics and chemotherapy resistance. The cfDNA and motif ratios show a good discriminative capacity for predicting non-responders from responders (area under the curve (AUC) > 0.8). In addition, transcriptional start sites (TSS) coverages around promoters discern the alteration of biological processes associated with chemotherapy resistance and reflect the potential value in predicting chemotherapy response. These findings in predictive biomarkers may optimize treatment selection, minimize unnecessary treatment, and assist in establishing personalized treatment strategies for cervical cancer patients.

[Design and simulation study of positive pressure ventilation system in a simulated human biological lung].

Simulation of the human biological lung is a crucial method for medical professionals to learn and practice the use of new pulmonary interventional diagnostic and therapeutic devices. The study on ventilation effects of the simulation under positive pressure ventilation mode provide valuable guidance for clinical ventilation treatment. This study focused on establishing an electrical simulation ventilation model, which aims to address the complexities in parameter configuration and slow display of air pressure and airflow waveforms in simulating the human biological lung under positive pressure ventilation mode. A simulated ventilation experiment was conducted under pressure-regulated volume control (PRVC) positive pressure ventilation mode, and the resulting ventilation waveform was compared with that of normal adults. The experimental findings indicated that the average error of the main reference index moisture value was 9.8% under PRVC positive pressure ventilation mode, effectively simulating the ventilatory effect observed in normal adults. So the established electrical simulation ventilation model is feasible, and provides a foundation for further research on the simulation of human biological lung positive pressure ventilation experimental platform.

A Synergistically Regulated Cathode/Electrolyte Interphase With High Stability and Rapid Zn2+ Migration Toward Advanced Flexible Zinc-Ion Batteries.

Na3V2(PO4)3(NVP), as a representative sodium superionic conductor with a stable polyanion framework, is considered a cathode candidate for aqueous zinc-ion batteries attributed to their high discharge platform and open 3D structure. Nevertheless, the structural stability of NVP and the cathode-electrolyte interphase (CEI) layer formed on NVP can be deteriorated by the aqueous electrolyte to a certain extent, which will result in slow Zn2+ migration. To solve these problems, doping Si elements to NVP and adding sodium acetate (NaAc) to the electrolyte are utilized as a synergistic regulation route to enable a highly stable  CEI with rapid Zn2+ migration. In this regard, Ac- competitively takes part in the solvation structure of Zn2+ in aqueous electrolyte, weakening the interaction between water and Zn2+, and meanwhile a highly stable CEI is formed to avoid structural damage and enable rapid Zn2+ migration. The NVPS/C@rGO electrode exhibits a notable capacity of 115.5 mAh g-1 at a current density of 50 mA g-1 in the mixed electrolyte (3 M ZnOTF2+3 M NaAc). Eventually, a collapsible "sandwich" soft pack battery is designed and fabricated and can be used to power small fans and LEDs, which proves the practical application of aqueous zinc-ion batteries in flexible batteries.

Global school plate waste estimates highlight the need for building a sustainable food education system.

Food waste reduction is essential for supporting the sustainability of food systems. Wasteful behaviours are difficult to change after they have been formed, highlighting the importance of early interventions. Here we present an assessment of school plate food waste from 29 countries, and examine the environmental implications, causes, and interventions. School plate waste ranged from 4% to 46% per capita per meal and was positively correlated with country income levels. On a global scale, this waste embodies ∼150 Mha of cropland and ∼770 MtCO2e of greenhouse gas emissions; hence, reducing school plate food waste offers potentially large environmental gains. We propose a comprehensive, multistakeholder framework centred around sustainable food education that cultivates food systems knowledge and skills, and an appreciation for nature and food labour to reduce the psychological distance between youth and their food waste. To effectively implement the framework requires the support and engagement of families, communities and the broader society beyond the confines of schools.

Regulation of CC bonds in penta-graphene by oxidative functionalization: a prototype of penta-graphene oxide (PGO).

Penta-graphene (PG) is currently a research hotspot for carbon-based nanomaterials. Herein, we studied the effect of oxidative functionalization on the electric properties of PG by regulating the CC bond. Our results show that the chemical reactivity of the oxidative functionalized PG system is significantly enhanced due to the presence of the dangling bonds, which is achieved at the cost of reduced stability. The oxidative functionalized PG shows enhanced hydrophilicity, which is similar to graphene oxide (GO). More importantly, we found that the adsorption energy decreased gradually with the increase of oxidative functional group coverage, which indicated that hydrogen bonds (H-bonds) between the polarized groups could improve the stability of the oxidative functionalized PG. Finally, we discussed the ratio of carbon and oxygen to hydrogen in oxidative functionalized PG to provide theoretical guidance for experimental characterization. These findings are expected to provide deep insights into understanding the CC regulation in PG and rationally designing and preparing penta-graphene oxide (PGO).

A special coupling strategy: Cu2MoS4 as a large-sized co-catalyst for promoting photocatalytic hydrogen production performance.

The photocatalytic hydrogen production performance of semiconductor materials can be improved by co-catalyst modification. In most of the studies, the size of the co-catalyst is relatively small compared to the primary catalyst. However, in this study, we employed a novel strategy by synthesizing a relatively large-sized Cu2MoS4 as the co-catalyst and in situ loading smaller-sized Zn0.5Cd0.5S onto Cu2MoS4, verifying that Cu2MoS4 enhances the photocatalytic hydrogen production efficiency of Zn0.5Cd0.5S. It can be observed by scanning electron microscopy (SEM) that the lateral size of 2D Cu2MoS4 is at least 50 times larger than the Zn0.5Cd0.5S nanoparticle particle size. In addition, Density Functional Theory (DFT) calculations have demonstrated that the active site for hydrogen production in the composite is located in Cu2MoS4. The large-sized of Cu2MoS4 not only provides more active sites but also broadens the electron transport channel, which is conducive to promoting the transfer of photogenerated electrons from Zn0.5Cd0.5S. This work enriches the study of large-sized materials as co-catalyst and provides a strategy for the construction of composite catalysts.

In-hospital cardiac arrest characteristics, causes and outcomes in patients with cardiovascular disease across different departments: a retrospective study.

BACKGROUND: Cardiac etiologies arrest accounts for almost half of all in-hospital cardiac arrest (IHCA), and previous studies have shown that the location of IHCA is an important factor affecting patient outcomes. The aim was to compare the characteristics, causes and outcomes of cardiovascular disease in patients suffering IHCA from different departments of Fuwai hospital in Beijing, China. METHODS: We included patients who were resuscitated after IHCA at Fuwai hospital between March 2017 and August 2022. We categorized the departments where cardiac arrest occurred as cardiac surgical or non-surgical units. Independent predictors of in-hospital survival were assessed by logistic regression. RESULTS: A total of 119 patients with IHCA were analysed, 58 (48.7%) patients with cardiac arrest were in non-surgical units, and 61 (51.3%) were in cardiac surgical units. In non-surgical units, acute myocardial infarction/cardiogenic shock (48.3%) was the main cause of IHCA. Cardiac arrest in cardiac surgical units occurred mainly in patients who were planning or had undergone complex aortic replacement (32.8%). Shockable rhythms (ventricular fibrillation/ventricular tachycardia) were observed in approximately one-third of all initial rhythms in both units. Patients who suffered cardiac arrest in cardiac surgical units were more likely to return to spontaneous circulation (59.0% vs. 24.1%) and survive to hospital discharge (40.0% vs. 10.2%). On multivariable regression analysis, IHCA in cardiac surgical units (OR 5.39, 95% CI 1.90-15.26) and a shorter duration of resuscitation efforts (≤ 30 min) (OR 6.76, 95% CI 2.27-20.09) were associated with greater survival rate at discharge. CONCLUSION: IHCA occurring in cardiac surgical units and a duration of resuscitation efforts less than 30 min were associated with potentially increased rates of survival to discharge.

Spatiotemporal and Multilayer Trade Network Patterns of the Global Cobalt Cycle.

Recent years have witnessed increasing attempts to track trade flows of critical materials across world regions and along the life cycle for renewable energy and the low carbon transition. Previous studies often had limited spatiotemporal coverage, excluded end-use products, and modeled different life cycle stages as single-layer networks. Here, we integrated material flow analysis and complex network analysis into a multilayer framework to characterize the spatiotemporal and multilayer trade network patterns of the global cobalt cycle from 1988 to 2020. We found substantial growth and notable structural changes in global cobalt trade over the past 30 years. China, Germany, and the United States play pivotal roles in different layers and stages of the global cobalt cycle. The interlayer relationships among alloys, batteries, and materials are robust and continually strengthening, indicating a trend toward synergistic trade. However, cobalt ore-exporting countries are highly concentrated and rarely involved in later life cycle stages, resulting in the weakest relationship between the ore layer and other layers. This causes fluctuations and uncertainty in the global cobalt trade. Our model, linking industrial ecology, supply chain analysis, and network analysis, can be extended to other materials that are critical for the future green transition.

Did the International Trade in Crops Lead to Global Cropland Saving or Wasting in the Period 2000-2022?

The international food trade is beneficial for enhancing global food security but also raises issues such as global cropland redistribution, land use efficiency, and environmental problems. While current studies have examined the impacts of the international food trade on these issues, its long-term effects on global cropland use efficiency remain unclear, especially when considering different crops and countries. Utilizing the international trade theory and the principle of virtual cropland, this study explores the relationship between international food trade and global cropland use efficiency from 2000 to 2022. The results illustrate that the global crop trade surged by 142%, outpacing the 102% increase in virtual cropland trade, which was attributed to crop yield enhancements. By 2022, the global virtual cropland trade encompassed 10.7% of the total croplands, with China emerging as the foremost importer, particularly due to soybean imports. Notably, the global crop trade led to substantial cropland savings and higher cropland use efficiency, totaling 1244.9 million hectares (Mha) between 2000 and 2020. These gains were largely attributed to the superior yields of major crop-exporting countries. Despite these gains, socio-economically vulnerable countries face significant challenges, potentially compromising their food security amidst the complexities of the global trade dynamics.

Spatial multi-omics: deciphering technological landscape of integration of multi-omics and its applications.

The emergence of spatial multi-omics has helped address the limitations of single-cell sequencing, which often leads to the loss of spatial context among cell populations. Integrated analysis of the genome, transcriptome, proteome, metabolome, and epigenome has enhanced our understanding of cell biology and the molecular basis of human diseases. Moreover, this approach offers profound insights into the interactions between intracellular and intercellular molecular mechanisms involved in the development, physiology, and pathogenesis of human diseases. In this comprehensive review, we examine current advancements in multi-omics technologies, focusing on their evolution and refinement over the past decade, including improvements in throughput and resolution, modality integration, and accuracy. We also discuss the pivotal contributions of spatial multi-omics in revealing spatial heterogeneity, constructing detailed spatial atlases, deciphering spatial crosstalk in tumor immunology, and advancing translational research and cancer therapy through precise spatial mapping.