Carboxymethylated Lignin Reinforcement of SPI Adhesive: Enhancing Strength, Antimicrobial, and Flame-Retardant Properties without Excessive Alkali Introduction.

To address the challenges associated with formaldehyde emissions in engineered wood adhesives and simultaneously enhance adhesive properties related to water resistance, fire resistance, and mold resistance, a novel environmentally sustainable biomass-based adhesive was formulated. In this work, kraft lignin was carboxymethylated and then blended with the soy protein isolate (SPI)-based adhesive, the dry and wet shear strength of the plywood bonded by the resultant adhesive was enhanced from 1.10 and 0.63 MPa to 1.73 and 1.23 MPa, respectively, resulting in improvements of 157% and 195%. Carboxymethylated lignin (CML) significantly improved the mold resistance and flame-resistance residual rate of the adhesive and decreased the water absorption rate from 190% to 108%. Furthermore, the adhesive exhibits outstanding flame-retardancy, with self-extinguishing capability rendering it suitable for industrial production. In addition, we also evaluated the performances of resulting adhesives cured with different diepoxides and triepoxides, and the comparisons of the adhesive in this work to commercial urea glue and soy protein-based adhesives were conducted. To our delight, the SPI-10CML adhesive presented comparable or even improved performances, showing its promising practical applications such as for fire doors.

Unraveling the enigma: A comprehensive review of solid pseudopapillary tumor of the pancreas.

Solid pseudopapillary tumor of the pancreas (SPTP) is a rare neoplasm predominantly observed in young females. Pathologically, CTNNB1 mutations, ß-catenin nuclear accumulation, and subsequent Wnt-signaling pathway activation are the leading molecular features. Accurate preoperative diagnosis often relies on imaging techniques and endoscopic biopsies. Surgical resection remains the mainstay treatment. Risk models, such as the Fudan Prognostic Index, show promise as predictive tools for assessing the prognosis of SPTP. Establishing three types of metachronous liver metastasis can be beneficial in tailoring individualized treatment and follow-up strategies. Despite advancements, challenges persist in understanding its etiology, establishing standardized treatments for unresectable or metastatic diseases, and developing a widely recognized grading system. This comprehensive review aims to elucidate the enigma by consolidating current knowledge on the epidemiology, clinical presentation, pathology, molecular characteristics, diagnostic methods, treatment options, and prognostic factors.

External validation of fistula risk scores for postoperative pancreatic fistula after distal pancreatectomy.

BACKGROUND: Fistula risk scores such as distal fistula risk scores and DISPAIR have been recently developed to assess the risk of clinically relevant postoperative pancreatic fistula after distal pancreatectomy. This study aimed to validate these models externally using a large-scale Chinese cohort. METHODS: The study enrolled adult patients who underwent distal pancreatectomy at a high-volume single center between January 2011 and December 2021. The clinically relevant postoperative pancreatic fistula was defined as grade B/C, according to the 2016 International Study Group of Pancreatic Surgery. Model performance was evaluated using the area under the curve. RESULTS: Among 653 eligible patients, 126 (19.3%) suffered from clinically relevant postoperative pancreatic fistulas. Independent predictors for clinically relevant postoperative pancreatic fistulas included body mass index, diabetes mellitus, pancreatic thickness at both neck and transection sites, main pancreatic duct diameter, and soft pancreas. Clinically relevant postoperative pancreatic fistula risk increased with increasing score severity. All 3 prediction models showed acceptable discrimination, with area under the curve values of preoperative distal fistula risk score at 0.723 (95% confidence interval 0.687-0.757), intraoperative distal fistula risk score at 0.737 (95% confidence interval 0.701-0.770), and DISPAIR at 0.721 (95% confidence interval 0.685-0.755). No significant differences were found among them. CONCLUSION: Distal fistula risk scores and DISPAIR are useful tools for predicting clinically relevant postoperative pancreatic fistula after distal pancreatectomy, highlighting their importance in guiding surgical approach decisions and mitigating strategies against this complication in clinical practice.

Predicting pancreatic fistula after central pancreatectomy using current fistula risk scores for pancreaticoduodenectomy and distal pancreatectomy.

BACKGROUND: The incidence of clinically relevant postoperative pancreatic fistula (CR-POPF) after central pancreatectomy (CP) is high, yet an effective predictive method is currently lacking. This study aimed to predict CR-POPF after CP by utilizing existing fistula risk scores (FRSs) for pancreaticoduodenectomy (PD) and distal pancreatectomy (DP). METHODS: A retrospective analysis was conducted on patients undergoing CP at our institution between January 2010 and July 2022. The primary outcome was CR-POPF (grade B/C) according to the 2016 International Study Group of Pancreatic Surgery definition. To establish predictive models for CR-POPF after CP, we combined the FRSs for PD and DP using a calculation formula that considers the probability of the union of two events. As a result, we obtained twelve central FRS (C-FRS) models. The performance of each C-FRS was assessed using the area under the curves (AUC) and calibration plots. RESULTS: A total of 115 patients undergoing CP were included. Among them, 38 (33%) were male, with a median age of 53 years. CR-POPF occurred in 35 (30.4%) patients, specifically 33 (28.7%) with grade B and 2 (1.7%) with grade C. Multivariate analysis showed that body mass index (BMI) [odds ratio (OR) 1.260, 95% confidence interval (CI) 1.039-1.528, P = 0.019), pancreatic thickness at the cephalic transection site (OR 1.228, 95% CI 1.074-1.405, P = 0.003), cephalic main pancreatic duct (MPD) size (OR 41.872, 95%CI 7.614-230.265, P < 0.001), and distal MPD size (OR 0.142, 95% CI 0.036-0.561, P = 0.005) were independent predictive factors for CR-POPF. Discrimination was generally acceptable for all C-FRS models, with an AUC ranging from 0.748 (DISPAIR-a-FRS: 95% CI, 0.659-0.824) to 0.847 (Intraop-D-a-FRS: 95% CI, 0.768-0.907). The models were calibrated with adequate Brier scores ranging from 0.157 to 0.183. The performance in all subgroups was similar as that of the entire cohort. Three preoperative risk groups (low, intermediate, and high) were identified based on the clinical applicability of the Preop-D-Roberts-FRS, with corresponding incidences of CR-POPF as 0% (0/24), 30% (21/70), and 66.7% (14/21), respectively. CONCLUSION: The derived C-FRS models show potential for accurately predicting the development of CR-POPF after CP. However, further validation studies are required to determine the most effective model. In the meantime, the Preop-D-Roberts-FRS is recommended for clinical practice due to its ease of use and preoperative predictability.

Improving Bond Performance and Reducing Cross-Linker Dosage of Soy Protein Adhesive via Hyper-Branched and Organic-Inorganic Hybrid Structures.

Eco-friendly soybean protein adhesives could be an ideal substitute for replacing traditional formaldehyde-based adhesives in wood industry. However, a large number of cross-linking agents are required in soy protein adhesive formulations to obtain sufficiently performing properties. Inspired by the high performance of nacre and branched structures, a hyper-branched amine (HBPA) was synthesized and grafted to graphene oxide (GO), generating a hyper-branched amine-functionalized GO (FGO). A novel soy protein-based adhesive was developed by mixing FGO with soy protein (SPI) and a low dose polyamidoamine-epichlorohydrin (PAE). Results showed that the addition of only 0.4 wt% FGO and 0.75 wt% PAE to the SPI adhesive formulation enhanced the wet shear strength of plywood to 1.18 MPa, which was 181% higher than that of the adhesive without enhancement. The enhanced performance is attributed to the denser cross-linking structure and improved toughness of the adhesive layer. Using FGO in the adhesive formulation also greatly reduced the concentration of the additive cross-linker by up to 78.6% when compared with values reported in the literature. Thus, using a hyper-branched functionalized nano-material to form an organic-inorganic hybrid structure is an effective and efficient strategy to reinforce the composites and polymers. It significantly reduces the chemical additive levels, and is a practical way to develop a sustainable product.

Clinical significance of variant hepatic artery in pancreatic resection: A comprehensive review.

The anatomical structure of the pancreaticoduodenal region is complex and closely related to the surrounding vessels. A variant of the hepatic artery, which is not a rare finding during pancreatic surgery, is prone to intraoperative injury. Inadvertent injury to the hepatic artery may affect liver perfusion, resulting in necrosis, liver abscess, and even liver failure. The preoperative identification of hepatic artery variations, detailed planning of the surgical approach, careful intraoperative dissection, and proper management of the damaged artery are important for preventing hepatic hypoperfusion. Nevertheless, despite the potential risks, planned artery resection has become acceptable in carefully selected patients. Arterial reconstruction is sometimes essential to prevent postoperative ischemic complications and can be performed using various methods. The complexity of procedures such as pancreatectomy with en bloc celiac axis resection may be mitigated by the presence of an aberrant right hepatic artery or a common hepatic artery originating from the superior mesenteric artery. Here, we comprehensively reviewed the anatomical basis of hepatic artery variation, its incidence, and its effect on the surgical and oncological outcomes after pancreatic resection. In addition, we provide recommendations for the prevention and management of hepatic artery injury and liver hypoperfusion. Overall, the hepatic artery variant may not worsen surgical and oncological outcomes if it is accurately identified pre-operatively and appropriately managed intraoperatively.

Prevalence and prognosis of increased pancreatic enzymes in patients with COVID-19: A systematic review and meta-analysis.

INTRODUCTION: The prevalence of increased pancreatic enzymes (elevated serum amylase and/or lipase) and its relationship to clinical outcomes in patients with coronavirus disease 2019 (COVID-19) infection is not known. METHODS: A systematic review and meta-analysis of relevant studies reporting prevalence and impact of increased pancreatic enzymes (defined as an elevation in amylase and/or lipase levels above the upper limit of normal [ULN] value) in COVID-19 was undertaken. RESULTS: A total of 36,496 patients from 21 studies were included for this meta-analysis. The overall prevalence and mortality for increased pancreatic enzymes (>ULN) in COVID-19 were 25.4% (95% CI, 15.8%-36.2%) and 34.6% (95% CI, 25.5%-44.4%), respectively. The overall prevalence and mortality for increased pancreatic enzymes (>3 × ULN) were 6.1% (95% CI, 3.6%-9.2%) and 39.2% (95% CI, 18.7%-61.6%), respectively. Patients with increased pancreatic enzymes, including elevated serum lipase or amylase of either type, had worse clinical outcomes, including need for ICU admission, mechanical ventilation and mortality. DISCUSSION: Increased pancreatic enzymes is frequent and may exacerbate the consequences of COVID-19 infection.

The Effect of Enzymolysis on Performance of Soy Protein-Based Adhesive.

In this study, bromelain was used to break soy protein molecules into polypeptide chains, and triglycidylamine (TGA) was added to develop a bio-adhesive. The viscosity, residual rate, functional groups, thermal behavior, and fracture surface of different adhesives were measured. A three-ply plywood was fabricated and evaluated. The results showed that using 0.1 wt% bromelain improved the soy protein isolate (SPI) content of the adhesive from 12 wt% to 18 wt%, with viscosity remaining constant, but reduced the residual rate by 9.6% and the wet shear strength of the resultant plywood by 69.8%. After the addition of 9 wt% TGA, the residual rate of the SPI/bromelain/TGA adhesive improved by 13.7%, and the wet shear strength of the resultant plywood increased by 681.3% relative to that of the SPI/bromelain adhesive. The wet shear strength was 30.2% higher than that of the SPI/TGA adhesive, which was attributed to the breakage of protein molecules into polypeptide chains. This occurrence led to (1) the formation of more interlocks with the wood surface during the curing process of the adhesive and (2) the exposure and reaction of more hydrophilic groups with TGA to produce a denser cross-linked network in the adhesive. This denser network exhibited enhanced thermal stability and created a ductile fracture surface after the enzymatic hydrolysis process.

Improve the Performance of Soy Protein-Based Adhesives by a Polyurethane Elastomer.

The purpose of this study was to improve the performance of soy protein isolate (SPI) adhesives using a polyurethane elastomer. Triglycidylamine (TGA), SPI, thermoplastic polyurethane elastomer (TPU), and γ-(2,3-epoxypropoxy) propyltrimethoxysilane (KH-560) were used to develop a novel SPI-based adhesive. The residual rate, functional groups, thermal stability, and fracture surface micrographs of the cured adhesives were characterized. Three-ply plywood was fabricated, and the dry/wet shear strength was determined. The experimental results suggested that introducing 2% TGA improved the residual rate of the SPI/TGA adhesive by 4.1% because of the chemical cross-linking reaction between epoxy groups and protein molecules. Incorporating 7% TPU into the SPI/TGA adhesive, the residual rate of the adhesive increased by 5.2% and the dry/wet shear strength of plywood bonded by SPI/TGA/TPU adhesive increased by 10.7%/67.7%, respectively, compared with that of SPI/TGA adhesive. When using KH-560 and TPU together, the residual rate of the adhesive improved by 0.9% compared with that of SPI/TGA/TPU adhesive. The dry and wet shear strength of the plywood bonded by the SPI/TGA/TPU/KG-560 adhesive further increased by 23.2% and 23.6% respectively when compared with that of SPI/TGA/TPU adhesive. TPU physically combined with the SPI/TGA adhesive to form a interpenetration network and KH-560 acted as a bridge to connect TPU and SPI/TGA to form a joined crosslinking network, which improved the thermo stability/toughness of the adhesive and created a uniform ductile fracture section of the adhesive.