Efficacy of esketamine for the treatment of postpartum depression and pain control following cesarean section: a randomized, double-blind, controlled clinical trial.

BACKGROUND: Postpartum depression (PPD) following a cesarean delivery is a frequently seen complication. Despite the prophylactic effects of ketamine, the impact of esketamine on PPD in women undergoing cesarean section remains uncertain. This study aimed to assess the effectiveness of esketamine as an adjunct to patient-controlled intravenous analgesia (PCIA) in preventing PPD in women undergoing caesarean section. METHODS: A total of 275 parturients undergoing caesarean section and subsequent patient-controlled intravenous analgesia (PCIA) were randomly assigned to receive either the control treatment (sufentanil 2 µg/kg + tropisetron 10 mg) or the experimental treatment with additional esketamine (1.5 mg/kg). The primary outcome measured was the incidence of postpartum depression (PPD), classified by Edinburgh Postnatal Depression Scale (EPDS) scores equal to or greater than 13 indicating PPD. Secondary outcomes included cumulative sufentanil consumption during specific time periods (0-24 h, 24-48 h, and 0-48 h) after the surgical procedure and numerical rating scale (NRS) scores at rest and during movements. RESULTS: The final analysis included a total of 246 postpartum women who had undergone caesarean delivery. On postoperative day 42, the incidence of depression among the control group was 17.6%, which was significantly higher compared to the esketamine group with a rate of 8.2% (P = 0.02). The EPDS scores also showed a significant difference between the two groups, with a mean score of 9.02 ± 2.21 in the control group and 6.87 ± 2.14 in the esketamine group (p < 0.0001). In terms of pain management, the esketamine group showed lower sufentanil consumption in the 0-24 h (42.5 ± 4.58 µg vs. 50.15 ± 5.47 µg, P = 0.04) and 0-48 h (87.40 ± 9.51 µg vs. 95.10 ± 9.36 µg, P = 0.04) postoperative periods compared to the control group. Differences in movement were also observed between the two groups at 24 and 48 h after the cesarean Sect. (3.39 ± 1.57 vs. 4.50 ± 0.80, P = 0.02; 2.43 ± 0.87 vs. 3.56 ± 0.76, P = 0.02). It is worth noting that the frequency of side effects observed in both groups was comparable. CONCLUSIONS: Esketamine at a dose of 1.5 mg/kg, when used as a supplement in PCIA, has been shown to significantly reduce the occurrence of PPD within 42 days. Additionally, it has been found to decrease cumulative consumption of sufentanil over a 48-hour period following cesarean operation, all without increasing the rate of adverse effects. TRIAL REGISTRATION: Registered in the Chinese Clinical Trial Registry (ChiCTR2200067054) on December 26, 2022.

Collagen Extracted from Bigeye Tuna (Thunnus obesus) Skin by Isoelectric Precipitation: Physicochemical Properties, Proliferation, and Migration Activities.

Collagen was extracted from bigeye tuna (Thunnus obesus) skins by salting-out (PSC-SO) and isoelectric precipitation (PSC-IP) methods. The yield of the PSC-IP product was approximately 17.17% (dry weight), which was greater than the yield obtained from PSC-SO (14.14% dry weight). Sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis indicated that collagen from bigeye tuna skin belongs to collagen type I. Inductively coupled plasma mass spectrometry results indicate that the heavy metal abundance in PSC-IP was lower than the maximum acceptable amounts according to Chinese regulatory standards. In addition, results from a methylthiazolyldiphenyl-tetrazolium bromide assay and an in vitro scratch assay demonstrated that PSC-IP could promote the proliferation and migration of NIH-3T3 fibroblasts. Overall, results suggest PSC-IP could be used to rapidly extract collagen from marine by-products instead of traditional salting-out methods. Collagen from bigeye tuna skin may also have strong potential for cosmetic and biomedical applications.

Novel Entropy and Rotation Forest-Based Credal Decision Tree Classifier for Landslide Susceptibility Modeling.

Landslides are a major geological hazard worldwide. Landslide susceptibility assessments are useful to mitigate human casualties, loss of property, and damage to natural resources, ecosystems, and infrastructures. This study aims to evaluate landslide susceptibility using a novel hybrid intelligence approach with the rotation forest-based credal decision tree (RF-CDT) classifier. First, 152 landslide locations and 15 landslide conditioning factors were collected from the study area. Then, these conditioning factors were assigned values using an entropy method and subsequently optimized using correlation attribute evaluation (CAE). Finally, the performance of the proposed hybrid model was validated using the receiver operating characteristic (ROC) curve and compared with two well-known ensemble models, bagging (bag-CDT) and MultiBoostAB (MB-CDT). Results show that the proposed RF-CDT model had better performance than the single CDT model and hybrid bag-CDT and MB-CDT models. The findings in the present study overall confirm that a combination of the meta model with a decision tree classifier could enhance the prediction power of the single landslide model. The resulting susceptibility maps could be effective for enforcement of land management regulations to reduce landslide hazards in the study area and other similar areas in the world.

Nanomedicines Targeting Tumor Cells or Tumor-Associated Macrophages for Combinatorial Cancer Photodynamic Therapy and Immunotherapy: Strategies and Influencing Factors.

Immunotherapy is a promising cancer treatment because of its ability to sustainably enhance the natural immune response. However, the effects of multiple immunotherapies, including ICIs, are limited by resistance to these agents, immune-related adverse events, and a lack of reasonable therapeutic targets available at the right time and place. The tumor microenvironment (TME), which features tumor-associated macrophages (TAMs), plays a significant role in resistance owing to its hypoxic microenvironment and lack of blood vessels, resulting in cancer immune evasion. To enhance immunotherapy, photodynamic therapy (PDT) can increase innate and adaptive immune responses through immunogenic cell death (ICD) and improve the TME. Traditional photosensitizers (PSs) also include novel nanomedicines to precisely target tumor cells or TAMs. Here, we reviewed and summarized current strategies and possible influencing factors for nanomedicines for cancer photoimmunotherapy.

Revealing the crucial roles of suppressive immune microenvironment in cardiac myxoma progression.

Cardiac myxoma is a commonly encountered tumor within the heart that has the potential to be life-threatening. However, the cellular composition of this condition is still not well understood. To fill this gap, we analyzed 75,641 cells from cardiac myxoma tissues based on single-cell sequencing. We defined a population of myxoma cells, which exhibited a resemblance to fibroblasts, yet they were distinguished by an increased expression of phosphodiesterases and genes associated with cell proliferation, differentiation, and adhesion. The clinical relevance of the cell populations indicated a higher proportion of myxoma cells and M2-like macrophage infiltration, along with their enhanced spatial interaction, were found to significantly contribute to the occurrence of embolism. The immune cells surrounding the myxoma exhibit inhibitory characteristics, with impaired function of T cells characterized by the expression of GZMK and TOX, along with a substantial infiltration of tumor-promoting macrophages expressed growth factors such as PDGFC. Furthermore, in vitro co-culture experiments showed that macrophages promoted the growth of myxoma cells significantly. In summary, this study presents a comprehensive single-cell atlas of cardiac myxoma, highlighting the heterogeneity of myxoma cells and their collaborative impact on immune cells. These findings shed light on the complex pathobiology of cardiac myxoma and present potential targets for intervention.

Changes in permafrost extent and active layer thickness in the Northern Hemisphere from 1969 to 2018.

Understanding the evolutions of the permafrost extent and active layer thickness (ALT) in the Northern Hemisphere (NH) are critical for global carbon flux simulation, climate change prediction, and engineering risk assessment. The temporal change characteristics of the permafrost extent and ALT for the NH have not been studied. We used the Kudryavtsev method, integrating a 0.5° × 0.5° spatial resolution of air temperature, soil texture, snow depth, vegetation type, soil volume moisture content, and organic content to simulate the changes of permafrost extent and ALT in the NH from 1969 to 2018. The results indicated that permafrost extent decreased from 23.25 × 106 km2 (average from 1969 to 1973) to 21.64 × 106 km2 (average from 2014 to 2018), with a linear rate of -0.023 × 106 km2/a. Siberia had the highest degradation rate of 0.014 × 106 km2/a, followed by Alaska, Mongolian Plateau, Qinghai-Tibet Plateau, Northern Canada, and Greenland, with linear rates of -0.012 × 106, -0.005 × 106, -0.004 × 106, -0.0014 × 106, and - 0.0004× 106 km2/a, respectively. The average ALT in the NH increased at a linear rate of 0.0086 m/a. Alaska and Mongolian Plateau had the highest thickening rate of 0.024 m/a, followed by Qinghai-Tibet Plateau, Siberia, Northern Canada, and Greenland, which had linear rates of 0.009, 0.008, 0.0072, and 0.003 m/a, respectively. The uncertainty of the results could be attributed to the inaccurate forcing data and limitations of the Kudryavtsev model.

Performance evaluation of the GIS-based data mining techniques of best-first decision tree, random forest, and naïve Bayes tree for landslide susceptibility modeling.

The main aim of the present study is to explore and compare three state-of-the art data mining techniques, best-first decision tree, random forest, and naïve Bayes tree, for landslide susceptibility assessment in the Longhai area of China. First, a landslide inventory map with 93 landslide locations was randomly divided, with 70% of the area used for training landslide models and 30% used for the validation process. A spatial database of 14 conditioning factors was constructed under a geographic information system environment. Subsequently, the ReliefF method was employed to assess the prediction capability of the conditioning factors in landslide models. Multicollinearity of these factors was verified using the variance inflation factor, tolerance, and Pearson's correlation coefficient. Finally, the three resulting models were evaluated and compared using the area under the receiver operating characteristic (AUROC) curve, standard error, 95% confidence interval, accuracy, precision, recall, and F-measure. The random forest model showed the AUROC values (0.869), smallest standard error (0.025), narrowest 95% confidence interval (0.819-0.918), highest accuracy value (0.774), highest precision (0.662), and highest F-measure (0.662) for the training dataset. Thus, the random forest model is a promising technique that could be used for landslide susceptibility mapping.

[Dynamics of biomass and net primary productivity in succession of south subtropical forests in southwest Guangdong].

Coniferous forest (Pinus massoniana community), pine-borad leaved mixed forest (Pinus massoniana + Castanopsis kawakamii + Schima superba + Liquidambar formosana) and evergreen broad-leaved forest (Ixonanthes chinensis + Artocarpus styacifolius + Ormosia glaberrima + Cryptocarya concinna) are the three main communities representing 3 major stages in a secondary succession series in Heishiding Nature Reserve, Guangdong Province. Their biomass and net primary productivity (NPP) were studied by using harvest method (for trees and lianas) and clear cut method (for shrub and herb). The biomass and NPP were 246.697 t.hm-2 and 14.715 t.hm-2.yr-1 for the coniferous forest, 287.367 t.hm-2 and 17.179 t.hm-2.yr-1 for the pine-broad leaved mixed forest, and 357.976 t.hm-2 and 18.730 t.hm-2 yr-1 for the evergreen broad-leaved forest, respectively. These results indicated that these three stages were very close in the succession process, and that coniferous forest and mixed forest were more mature, while broad-leaved forest was relatively young. Therefore, under the conditions of no or only minor disturbance, their biomass and NPP showed an increasing trend with the succession of the forest communities in Heishiding.