Development and validation of a multi-modal ultrasomics model to predict response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer.

OBJECTIVES: To assess the performance of multi-modal ultrasomics model to predict efficacy to neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced rectal cancer (LARC) and compare with the clinical model. MATERIALS AND METHODS: This study retrospectively included 106 patients with LARC who underwent total mesorectal excision after nCRT between April 2018 and April 2023 at our hospital, randomly divided into a training set of 74 and a validation set of 32 in a 7: 3 ratios. Ultrasomics features were extracted from the tumors' region of interest of B-mode ultrasound (BUS) and contrast-enhanced ultrasound (CEUS) images based on PyRadiomics. Mann-Whitney U test, spearman, and least absolute shrinkage and selection operator algorithms were utilized to reduce features dimension. Five models were built with ultrasomics and clinical analysis using multilayer perceptron neural network classifier based on python. Including BUS, CEUS, Combined_1, Combined_2 and Clinical models. The diagnostic performance of models was assessed with the area under the curve (AUC) of the receiver operating characteristic. The DeLong testing algorithm was utilized to compare the models' overall performance. RESULTS: The AUC (95% confidence interval [CI]) of the five models in the validation cohort were as follows: BUS 0.675 (95%CI: 0.481-0.868), CEUS 0.821 (95%CI: 0.660-0.983), Combined_1 0.829 (95%CI: 0.673-0.985), Combined_2 0.893 (95%CI: 0.780-1.000), and Clinical 0.690 (95%CI: 0.509-0.872). The Combined_2 model was the best in the overall prediction performance, showed significantly better compared to the Clinical model after DeLong testing (P < 0.01). Both univariate and multivariate logistic regression analyses showed that age (P < 0.01) and clinical stage (P < 0.01) could be an independent predictor of efficacy after nCRT in patients with LARC. CONCLUSION: The ultrasomics model had better diagnostic performance to predict efficacy to nCRT in patients with LARC than the Clinical model.

Parameters estimation-based calibration method for rotational axis of line-structured light 3D reconstruction.

Rotation is a critical component in 3D reconstruction systems, where accurate calibration of rotation axis parameters is essential for 3D stitching. In this study, what we believe to be a novel parameters estimation-based method for calibrating rotation axis parameters using 2D planar targets is proposed. Compared to traditional circle fitting methods, this method takes both orientation and position information into account, resulting in better precision performance. By leveraging the transmission of spatial pose relationships, the parameters estimation-based calibration method also effectively mitigates the impact of noise for more accurate calibration of rotation axis parameters. Error validation and 3D reconstruction experiments proved the superior performance of the proposed method. The experiment results demonstrate the effectiveness and applicability of the approach in enhancing the calibration of rotation axis parameters for 3D reconstruction systems.

[Correlation between cervical vertigo and vestibular function evaluated by vestibular evoked myogenic potentials].

OBJECTIVE: To analyze the relationship between cervical vertigo and vestibular function evaluated by vestibular evoked myogenic potentials(VEMPs) and analyze the correlations between cervical vertigo and vestibular dysfunction, discuss the related factors of cervical vertigo and guide the clinical treatment of patients with cervical vertigo. METHODS: A total of 75 patients with cervical vertigo as the main complaint in the outpatient clinic of the Second Hospital of Shanxi Medical University from August 2019 to July 2020 were set as the diseased group, and 60 patients without cervical and vestibular related diseases in the hospital were selected to set as non-diseased group. The age of diseased group was 12 to 70 years with an average of (46.40±10.91) years, including 25 males and 50 females;and the age of non-diseased group was 22 to 60 years with an average of(43.78±7.75) years, including 19 males and 51 females. VEMPs were performed in the two groups. The data of VEMPs were collected and the results were compared and analyzed. The patients with abnormal cervical myogenic vestibular evoked myogenic potential (cVEMP) were divided into light, moderate and severe groups. The correlation between VEMPs and cervical vertigo and its severity were analyzed by statistical method. RESULTS: (1)The severity of cervical vertigo in diseased group:33 cases of mild, 34 cases of moderate, 8 cases of severe; cVEMP examination:62 cases were positive and 13 cases were negative, including 13 cases of mild, 33 cases of moderate, 16 cases of severe. The cVEMP of non-diseased group:4 cases were positive and 56 cases were negative.(2) The level of cVEMP in diseased group was higher than that in non-diseased group (P<0.001). It can be considered that there was a correlation between cervical vertigo and vestibular function.(3)The correlation between the level of cVEMP and the level of cervical vertigo in diseased group was analyzed. The Spearman rank sum test was used, and the correlation coefficient was 0.687, which was statistically significant (P<0.05). And it can be considered that the two indicators have a high degree of correlation. CONCLUSION: It is feasible to evaluate the relationship between cervical vertigo and vestibular function by VEMPs. For patients with cervical vertigo, the higher the severity, the greater the positive rate of VEMPs, which indicates that it has a greater impact on vestibular function. The treatment of patients with cervical vertigo should be the combination of cervical rehabilitation and vestibular function.

Multi-environment Evaluations Across Ecological Regions Reveal That the Kernel Oil Content of Cottonseed Is Equally Determined by Genotype and Environment.

Cotton is the fifth-largest oil crop in the world. A high kernel oil content (KOC) and high stability are important cottonseed attributes for food security. In this study, the phenotype of KOC and the genotype-by-environment interaction factors were collectively dissected using 250 recombinant inbred lines, their parental cultivars sGK156 and 901-001, and CCRI70 across multi-environments. ANOVA and correlation analysis showed that both genotype and environment contributed significantly to KOC accumulation. Analyses of additive main effect multiplicative interaction and genotype-by-environment interaction biplot models presented the effects of genotype, environment, and genotype by environment on KOC performance and the stability of the experimental materials. Interaction network analysis revealed that meteorological and geographical factors explained 38% of the total KOC variance, with average daily rainfall contributing the largest positive impact and cumulative rainfall having the largest negative impact on KOC accumulation. This study provides insight into KOC accumulation and could direct selection strategies for improved KOC and field management of cottonseed in the future.

Bifunctional Ultrathin PCBM Enables Passivated Trap States and Cascaded Energy Level toward Efficient Inverted Perovskite Solar Cells.

Inverted perovskite solar cells (PSCs) with a C60 framework are known for their common drawback of low power conversion efficiency (PCE) of <20% because of nonradiative recombination and inefficient charge transport at their perovskite interfaces. Here, we report an ultrathin [6,6]-phenyl-C61-butyric acid methyl ester (PCBM) as a cap layer on perovskite films to overcome this issue. Such a functional cap layer efficiently passivates trap states and establishes a gradient energy level alignment onto perovskite, facilitating the efficient charge transfer and extraction. The as-fabricated inverted PSCs capped with such ultrathin PCBM exhibit a record PCE of 20.07%. After the storage under a N2 atmosphere for more than 500 h, the PCE of PSCs retains over 85% of its initial level. Our work provides an effective method to upgrade inverted PSCs with the C60 framework with improved efficiency and stability.

Prognostic Value of Prolonged Feeding Intolerance in Predicting All-Cause Mortality in Critically Ill Patients: A Multicenter, Prospective, Observational Study.

BACKGROUND: The 2012 European Society of Intensive Care Medicine (ESICM) guidelines provided a clear definition of feeding intolerance (FI). The study aimed to investigate the association between FI based on the current ESICM definition and clinical outcome and to further explore the effect of the duration of FI on mortality. METHODS: Adult patients from 14 general intensive care units (ICUs) with an expected ICU stay ≥24 hours were prospectively studied. Based on FI duration in the first week of admission to the ICU, FI was categorized as 7-day persistent feeding tolerance (FT), delayed FT, delayed FI, and 7-day persistent FI. The primary outcomes were 28-day and 60-day all-cause mortality. RESULTS: Of 499 patients, the prevalence of 3-day and 7-day persistent FI was 39.2% (n = 196) and 25.4% (n = 106), respectively. The patients with 3-day FT had lower risk of 28-day and 60-day mortality rates and higher prevalence in ventilator weaning and vasoactive medication on the seventh day of ICU admission than those with 3-day FI. Three-day FI remained an independent predictor for 60-day mortality. In a subgroup analysis including 418 patients with 7-day survival, compared with those with 7-day persistent FT, the odds ratios of 60-day mortality were 1.67, 1.97, and 2.62 in the patients with delayed FT, delayed FI, and 7-day persistent FI, respectively. CONCLUSION: FI was associated with increased mortality and longer duration of mechanical ventilation and vasoactive support. Prolonged or relapsing FI represented an incremental risk of adverse outcomes in critically ill patients.

Organic Monomolecular Layers Enable Energy-Level Matching for Efficient Hole Transporting Layer Free Inverted Perovskite Solar Cells.

High-efficiency hole transport layer free perovskite solar cells (HTL-free PSCs) with economical and simplified device structure can greatly facilitate the commercialization of PSCs. However, eliminating the key HTL in PSCs results usually in a severe efficiency loss and poor carrier transfer due to the energy-level mismatching at the indium tin oxide (ITO)/perovskite interface. In this study, we solve this issue by introducing an organic monomolecular layer (ML) to raise the effective work function of ITO with the assistance of an interface dipole created by Sn-N bonds. The energy-level alignment at the ITO/perovskite interface is optimized with a barrier-free contact, which favors efficient charge transfer and suppressed nonradiative carrier recombination. The HTL-free PSCs based on the ML-modified ITO yield an efficiency of 19.4%, much higher than those of HTL-free PSCs on bare ITO (10.26%), comparable to state-of-the-art PSCs with a HTL. This study provides an in-depth understanding of the mechanism of interfacial energy-level alignment and facilitates the design of advanced interfacial materials for simplified and efficient PSC devices.

Severity of acute gastrointestinal injury grade is a predictor of all-cause mortality in critically ill patients: a multicenter, prospective, observational study.

BACKGROUND: In 2012, the European Society of Intensive Care Medicine proposed a definition for acute gastrointestinal injury (AGI) based on current medical evidence and expert opinion. The aim of the present study was to evaluate the feasibility of using the current AGI grading system and to investigate the association between AGI severity grades with clinical outcome in critically ill patients. METHODS: Adult patients at 14 general intensive care units (ICUs) with an expected ICU stay ≥24 h were prospectively studied. The AGI grade was assessed daily on the basis of gastrointestinal (GI) symptoms, intra-abdominal pressures, and feeding intolerance (FI) in the first week of admission to the ICU. RESULTS: Among the 550 patients enrolled, 456 patients (82.9%) received mechanical ventilation, and 470 patients were identified for AGI. The distribution of the global AGI grade was 24.5% with grade I, 49.4% with grade II, 20.6% with grade III, and 5.5% with grade IV. AGI grading was positively correlated with 28- and 60-day mortality (P < 0.0001). Univariate Cox regression analysis showed that age, sepsis, diabetes mellitus, coronary artery disease, the use of vasoactive drugs, serum creatinine and lactate levels, mechanical ventilation, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and the global AGI grade were significantly (P ≤ 0.02) associated with 60-day mortality. In a multivariate analysis including these variables, diabetes mellitus (HR 1.43, 95% CI 1.03-1.87; P = 0.05), the use of vasoactive drugs (HR 1.56, 95% CI 1.12-2.11; P = 0.01), serum lactate (HR 1.15, 95% CI 1.06-1.24; P = 0.03), global AGI grade (HR 1.65, 95% CI 1.28-2.12; P = 0.008), and APACHE II score (HR 1.04, 95% CI 1.02-1.06; P < 0.001) were independently associated with 60-day mortality. In a subgroup analysis of 402 patients with 7-day survival, in addition to clinical predictors and the AGI grade on the first day of ICU stay, FI within the first week of ICU stay had an independent and incremental prognostic value for 60-day mortality (χ2 = 41.9 vs. 52.2, P = 0.007). CONCLUSIONS: The AGI grading scheme is useful for identifying the severity of GI dysfunction and could be used as a predictor of impaired outcomes. In addition, these results support the hypothesis that persistent FI within the first week of ICU stay is an independent determinant for mortality. TRIAL REGISTRATION: Chinese Clinical Trial Registry identifier: ChiCTR-OCS-13003824 . Registered on 29 September 2013.

Solution-processed solar cells based on inorganic bulk heterojunctions with evident hole contribution to photocurrent generation.

To develop solution-processed and novel device structures is of great importance for achieving advanced and low-cost solar cells. In this paper, we report the solution-processed solar cells based on inorganic bulk heterojunctions (BHJs) featuring a bulk crystalline Sb2S3 absorbing layer interdigitated with a TiO2 nanoarray as an electron transporter. A solution-processed amorphous-to-crystalline transformation strategy is used for the preparation of Sb2S3/TiO2-BHJs. Steady-state and dynamic results demonstrate that the crystalline structure in the Sb2S3 absorbing layer is crucial for efficient devices, and a better Sb2S3 crystallization favors a higher device performance by increasing the charge collection efficiency for a higher short-circuit current, due to reduced interfacial and bulk charge recombinations, and enhancing the open-circuit voltage and fill factor with the reduced defect states in the Sb2S3 layer as well. Moreover, an evident contribution to photocurrent generation from the photogenerated holes in the Sb2S3 layer is revealed by experimental and simulated dynamic data. These results imply a kind of potential non-excitonic BHJ for energy conversion.

Improved open-circuit voltage in polymer/oxide-nanoarray hybrid solar cells by formation of homogeneous metal oxide core/shell structures.

Incorporation of vertically aligned nanorod/nanowire arrays of metal oxide (oxide-NAs) with a polymer can produce efficient hybrid solar cells with an ideal bulk-heterojunction architecture. However, polymer/oxide-NAs solar cells still suffer from a rather low (normally, < 0.4 V) open-circuit voltage (Voc). Here we demonstrate, for the first time, a novel strategy to improve the Voc in polymer/oxide-NAs solar cells by formation of homogeneous core/shell structures and reveal the intrinsic principles involved therein. A feasible hydrothermal-solvothermal combined method is developed for preparing homogeneous core/shell nanoarrays of metal oxides with a single-crystalline nanorod as core and the aggregation layer of corresponding metal oxide quantum dots (QDs) as shell, and the shell thickness (L) is easily controlled by the solvothermal reaction time for growing QDs on the nanorod. The core/shell formation dramatically improves the device Voc up to ca. 0.7-0.8 V depending on L. Based on steady-state and dynamic measurements, as well as modeling by space-charge-limited current method, it is found that the improved Voc originates from the up-shifted conduction band edge in the core by the interfacial dipole field resulting from the decreased mobility difference between photogenerated electrons and holes after the shell growth, which increases the energy difference between the quasi-Fermi levels of photogenerated electrons in the core and holes in the polymer for a higher Voc. Our results indicate that increasing Voc by the core/shell strategy seems not to be dependent on the kinds of metal oxides.

Elevated plasma visfatin concentrations in patients with community-acquired pneumonia.

Visfatin has been associated with some inflammatory disease. This study aimed to compare plasma visfatin levels in patients with community-acquired pneumonia and healthy controls and to furthermore investigate the relationship between their concentrations and 30-day mortality in patients. Plasma visfatin concentrations were measured in 176 patients and 95 healthy controls. The admission visfatin levels were significantly increased in all patients, survivals and non-survivals with community-acquired pneumonia compared with healthy control individuals, associated with pneumonia severity index score, Acute Physiology and Chronic Health Evaluation II score, white blood cell count, and plasma C-reactive protein level, and identified as an independent predictor for 30-day mortality. Its predictive value was similar to those of pneumonia severity index score and Acute Physiology and Chronic Health Evaluation II score. However, visfatin did not statistically significantly improve the predictive values of pneumonia severity index score and Acute Physiology and Chronic Health Evaluation II score. Thus, higher plasma visfatin level correlates with disease severity and markers of system inflammation and represent a novel biomarker for predicting 30-day mortality in patients with community-acquired pneumonia.

ECMO support in a child with acute fulminant myocarditis.

An 11-yr-old boy with acute fulminant myocarditis was treated with routine medical therapy (antibiotics, inotropic and vasosactive agents, etc.) for 5 days, but exacerbated. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) was initiated 39 h after admission to the intensive care unit (ICU). Twenty-four hrs after ECMO, urine volume and blood pressure (BP) improved significantly. After treatment with ECMO for 140 h, the patient's ejection fraction (EF) increased to 45%, BP because normal and urine volume maintained at about 100 ml/h. So, the patient was weaned from the ECMO. The patient was discharged from the hospital on 23rd day post admission, when EF improved to 72% and with normal chest radiograph, echocardiography results and hemodynamics.

[Application of Lund concept in treating brain edema after severe head injury].

OBJECTIVE: To explore if the new treatment with Lund concept could reduce the mortality of patients after severe brain injury. METHODS: This study included 68 severe brain injury patients in whom Gloasgow coma score (GCS) was 3-8, and in 30 of them Lund concept was adopted, and the other 38 patients were taken care of by the conventional treatment in controlling intracranial pressure (ICP). Furthermore, in patients of the Lund group and control group ICP and cerebral perfusion pressure (CPP) were monitored continuously for 5 days. RESULTS: The amount of mannitol (g) used was markedly smaller in Lund group than that in the control group (139.6±25.0 vs. 587.5±31.8, P<0.01). The 28-day mortality of Lund group was significantly lower than that in control group (30.0% vs. 57.9%, P<0.05). In Lund group, the incidence of ICP exceeding 25 mm Hg (1 mm Hg=0.133 kPa) or 35 mm Hg or lowering of CPP by 50 mm Hg observed in the non-survivors (n=9) was greater than that observed in the survivors [n=21, (45.0±23.2)% vs. (7.2±3.6)%, (40.2±18.6)% vs. (2.2±1.6)%, (35.9±12.9)% vs. (3.1±2.4)%, all P<0.05]. CONCLUSION: By adopting the Lund concept, it is possible to reduce postoperative mortality after severe head injury.

[Effect of high volume hemofiltration on respiration, hemodynamics and oxygen metabolism in sepsis with acute respiratory distress syndrome].

OBJECTIVE: To investigate the effect of continuous high volume hemofiltration (HVHF) on respiration, hemodynamics, and oxygen metabolism in severe sepsis patients with acute respiratory distress syndrome (ARDS). METHODS: Twelve adult patients with ARDS received mechanical ventilation and HVHF (80 mlxkg(-1)xh(-1)) lasting 12-18 hours every day. The cardiac output (CO), systemic vascular resistance (SVR), pulmonary vascular resistance (PVR), mean pulmonary arterial pressure (MPAP), pulmonary artery wedge pressure (PAWP), arterial oxygen content (CaO(2)), O(2) content of mixed venous blood (CvO(2)), oxygen consumption (VO(2)), oxygen delivery (DO(2)) and oxygen extraction rate (O(2)ER) were measured with the aid of a Swan-Ganz catheter, the thoracic fluid content (TFC) were measured with BioZ(r) Cardio Dynamics. Concentrations of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), IL-8 and IL-10 were measured pre-continuous HVHF and after continuous HVHF by enzyme linked immunoadsorbent assay (ELISA). Acute physiology and chronic health evaluation II (APACHEII) scores, multiple organ dysfunction syndrome (MODS) evaluation scores and PaO(2)/FiO(2) were observed before and after HVHF. RESULTS: There were significant lowering of concentrations of TNF-alpha, IL-6 and IL-8 after HVHF at 72 hours (all P<0.05), and also in MPAP, PVR and TFC after 48 hours (all P<0.05). DO(2), VO(2) and O(2)ER were stabilized at 72 hours with amelioration of partial pressure of oxygen in artery (PaO(2)), PaO(2)/FiO(2) and peak airway pressure (Ppeak) (P<0.05 or P<0.01). CONCLUSION: Continuous HVHF shows significant beneficial effects on pulmonary function of severe sepsis patients with ARDS as a result of removal of cytokines, decrease of TFC and amelioration of disturbance in respiration, hemodynamics and oxygen metabolism.