Use of colloids and crystalloids for perioperative clinical infusion management in cardiac surgery patients and postoperative outcomes: a meta-analysis.

BACKGROUND: The optimal fluid management strategy for patients undergoing cardiac surgery was controversial regarding fluid volume and intraoperative fluid types. This study aimed to assess the correlation between colloids and crystalloids used for perioperative fluid therapy in cardiac surgery patients and postoperative prognosis. METHODS: The Ovid MEDLINE(R) ALL, Embase, and Cochrane Central Register of Controlled Trials databases were searched for eligible studies on fluid management strategies using colloids and crystalloids for cardiac surgery patients published before August 25th, 2023. RESULTS: Ten randomized controlled trials met the eligibility criteria. Compared to the use of crystalloids, the use of colloids, including hydroxyethyl starch (HES), albumin, and gelatine, did not show any differences in mortality, transfusion, acute kidney injury, and atrial fibrillation rates, postoperative blood loss, the length of hospital stay, or the length of intensive care unit (ICU) stay. The results of this meta-analysis showed that the crystalloid group had significantly reduced postoperative chest tube output compared to the colloid group. In the subgroup analysis, the amount of fresh frozen plasma (FFP) infused was significantly lower when using fluid management in the ICU and when using isotonic crystalloids compared to the colloids. In addition, when using fluid management in the ICU, patients in the colloid group had a significant increase in urine volume 24 h after surgery. However, other related factors, including the type of crystalloid solution, type of colloidal solution, and timing of liquid management, did not affect most outcomes. CONCLUSION: Both colloids and crystalloids could be used as alternatives for perioperative fluid management after cardiac surgery. The use of crystalloids significantly reduced the postoperative chest tube output, and the need for FFP infusion decreased significantly with the use of isotonic crystalloids or fluid management during the ICU stay. ICU patients in the colloid group had higher urine output 24 h after surgery. In addition, although the infusion method was not related to most outcomes, the rates of red blood cell and FFP transfusion and postoperative blood loss in the crystalloid group seemed to be lower, which needed to be further studied in high-quality and large-sample RCTs. TRIAL REGISTRATION: PROSPERO, CRD42023415234.

Alcohol consumption and all-cause and cause-specific mortality among US adults: prospective cohort study.

BACKGROUND: Previous studies have shown inconsistent findings regarding the association of light to moderate alcohol consumption with cause-specific mortality. Therefore, this study sought to examine the prospective association of alcohol consumption with all-cause and cause-specific mortality in the US population. METHODS: This was a population-based cohort study of adults aged 18 years or older in the National Health Interview Survey (1997 to 2014) with linkage to the National Death Index records through December 31, 2019. Self-reported alcohol consumption was categorized into seven groups (lifetime abstainers; former infrequent or regular drinkers; and current infrequent, light, moderate, or heavy drinkers). The main outcome was all-cause and cause-specific mortality. RESULTS: During an average follow-up of 12.65 years, among the 918,529 participants (mean age 46.1 years; 48.0% male), 141,512 adults died from all causes, 43,979 from cardiovascular disease (CVD), 33,222 from cancer, 8246 from chronic lower respiratory tract diseases, 5572 from accidents (unintentional injuries), 4776 from Alzheimer's disease, 4845 from diabetes mellitus, 2815 from influenza and pneumonia, and 2692 from nephritis, nephrotic syndrome, or nephrosis. Compared with lifetime abstainers, current infrequent, light, or moderate drinkers were at a lower risk of mortality from all causes [infrequent-hazard ratio: 0.87; 95% confidence interval: 0.84 to 0.90; light: 0.77; 0.75 to 0.79; moderate 0.82; 0.80 to 0.85], CVD, chronic lower respiratory tract diseases, Alzheimer's disease, and influenza and pneumonia. Also, light or moderate drinkers were associated with lower risk of mortality from diabetes mellitus and nephritis, nephrotic syndrome, or nephrosis. In contrast, heavy drinkers had a significantly higher risk of mortality from all causes, cancer, and accidents (unintentional injuries). Furthermore, binge drinking ≥ 1 day/week was associated with a higher risk of mortality from all causes (1.15; 1.09 to 1.22), cancer (1.22; 1.10 to 1.35), and accidents (unintentional injuries) (1.39; 1.11 to 1.74). CONCLUSIONS: Infrequent, light, and moderate alcohol consumption were inversely associated with mortality from all causes, CVD, chronic lower respiratory tract diseases, Alzheimer's disease, and influenza and pneumonia. Light or moderate alcohol consumption might also have a beneficial effect on mortality from diabetes mellitus and nephritis, nephrotic syndrome, or nephrosis. However, heavy or binge had a higher risk of all-cause, cancer, and accidents (unintentional injuries) mortality.

Effects of landscape modification on coastal sediment nitrogen availability, microbial functional gene abundances and N2O production potential across the tropical-subtropical gradient.

Wetland sediment is an important nitrogen pool and a source of the greenhouse gas nitrous oxide (N2O). Modification of coastal wetland landscape due to plant invasion and aquaculture activities may drastically change this N pool and the related dynamics of N2O. This study measured the sediment properties, N2O production and relevant functional gene abundances in 21 coastal wetlands across five provinces along the tropical-subtropical gradient in China, which all had experienced the same sequence of habitat transformation from native mudflats (MFs) to invasive Spartina alterniflora marshes (SAs) and subsequently to aquaculture ponds (APs). Our results showed that change from MFs to SAs increased the availability of NH4+-N and NO3--N and the abundance of functional genes related to N2O production (amoA, nirK, nosZ Ⅰ, and nosZ Ⅱ), whereas conversion of SAs to APs resulted in the opposite changes. Invasion of MFs by S. alterniflora increased N2O production potential by 127.9%, whereas converting SAs to APs decreased it by 30.4%. Based on structural equation modelling, nitrogen substrate availability and abundance of ammonia oxidizers were the key factors driving the change in sediment N2O production potential in these wetlands. This study revealed the main effect patterns of habitat modification on sediment biogeochemistry and N2O production across a broad geographical and climate gradient. These findings will help large-scale mapping and assessing landscape change effects on sediment properties and greenhouse gas emissions along the coast.

Effects of conversion of coastal marshes to aquaculture ponds on sediment anaerobic CO2 production and emission in a subtropical estuary of China.

The extensive conversion of carbon-rich coastal wetland to aquaculture ponds in the Asian Pacific region has caused significant changes to the sediment properties and carbon cycling. Using field sampling and incubation experiments, the sediment anaerobic CO2 production and CO2 emission flux were compared between a brackish marsh and the nearby constructed aquaculture ponds in the Min River Estuary in southeastern China over a three-year period. Marsh sediment had a higher total carbon and lower C:N ratio than aquaculture pond sediment, suggesting the importance of marsh vegetation in supplying labile organic carbon to the sediment. Conversion to aquaculture ponds significantly decreased sediment anaerobic CO2 production rates by 69.2% compared to the brackish marsh, but increased CO2 emission, turning the CO2 sink (-490.8 ± 42.0 mg m-2 h-1 in brackish marsh) into a source (6.2 ± 3.9 mg m-2 h-1 in aquaculture pond). Clipping the marsh vegetation resulted in the highest CO2 emission flux (382.6 ± 46.7 mg m-2 h-1), highlighting the critical role of marsh vegetation in capturing and sequestering carbon. Sediment anaerobic CO2 production and CO2 uptake (in brackish marsh) and emission (in aquaculture ponds) were highest in the summer, followed by autumn, spring and winter. Redundancy analysis and structural equation modeling showed that the changes of sediment temperature, salinity and total carbon content accounted for more than 50% of the variance in CO2 production and emission. Overall, the results indicate that vegetation clearing was the main cause of change in CO2 production and emission in the land conversion, and marsh replantation should be a primary strategy to mitigate the climate impact of the aquaculture sector.

Large increase in CH4 emission following conversion of coastal marsh to aquaculture ponds caused by changing gas transport pathways.

Methane emissions from aquatic ecosystems play an important role in global carbon cycle and climate change. Reclamation of coastal wetlands for aquaculture use has been shown to have opposite effects on sediment CH4 production potential and CH4 emission flux, but the underlying mechanism remained unclear. In this study, we compared sediment properties, CH4 production potential, emission flux, and CH4 transport pathways between a brackish marsh and the nearby reclaimed aquaculture ponds in the Min River Estuary in southeastern China. Despite that the sediment CH4 production potential in the ponds was significantly lower than the marsh, CH4 emission flux in the ponds (17.4 ± 2.7 mg m-2 h-1) was 11.9 times higher than the marsh (1.3 ±  0.2 mg m-2 h-1). Plant-mediated transport accounted for 75% of the total CH4 emission in the marsh, whereas ebullition accounted for 95% of the total CH4 emission in the ponds. CH4 emission fluxes in both habitat types were highest in the summer. These results suggest that the increase in CH4 emission following the conversion of brackish marsh to aquaculture ponds was not caused by increased sediment CH4 production, but rather by eliminating rhizospheric oxidation and shifting the major transport pathway to ebullition, allowing sediment CH4 to bypass oxidative loss. This study improves our understanding of the impacts of modification of coastal wetlands on greenhouse gas dynamics.

Trends in Abdominal Obesity and Central Adiposity Measures by Dual-Energy X-Ray Absorptiometry Among US Children: 2011-2018.

Objective: Previous studies that have reported trends on abdominal obesity among US children were usually based on anthropometric assessments. However, little is known about the recent trends in central adiposity measures by DXA and abdominal obesity since 2011-2012. Study Design: A serial cross-sectional analysis of US population-weighted data among children from NHANES 2011 to 2018 was conducted. Results: Between 2011-2012 and 2017-2018, there was a relatively stable trend among children aged 8-19 years in trunk fat and trunk fat percentage. During the same time periods, there were no significant changes in prevalence of abdominal obesity by waist circumference (18.6 vs. 21.1%) among those aged 2-19 years, and abdominal obesity by WHtR (34.1 vs. 36.2%) among those aged 6-19 years. However, a significant increase trend among boys aged 2-19 years was found in prevalence of abdominal obesity by waist circumference (16.1-22.7%; P = 0.004). For Mexican American youth and non-Hispanic Asian boys, there is a significant increase in mean trunk fat percentage and waist circumference. Conclusion: Between 2011-2012 and 2017-2018, there have been no significant changes in central adiposity measured by DXA and prevalence of abdominal obesity among US children. Our study further supports that there is an urgent need to improve their lifestyle to reduce abdominal obesity for US children, especially for Mexican American youth and non-Hispanic Asian boys.

Antitumor Effects of Astaxanthin on Esophageal Squamous Cell Carcinoma by up-Regulation of PPARγ.

Esophageal squamous cell carcinoma is a malignant tumor that is difficult to find and has a poor prognosis. The aim of this study is to explore the chemoprevention effect of Astaxanthin (AST) and reveal the possible mechanism of AST on the development of esophageal cancer based on PPARγ. We found that a stable and strong binding between PPARγ molecules and AST molecules using Autodock 4.0 software. AST significantly inhibited the viability of EC109 cells in a dose and time dependent manners (all P < 0.05), and up-regulated the protein expression level of PPARγ from the concentration of 6.25 µM (P < 0.05). Animal experiment showed that AST significantly decreased the incidences of NMBzA-induced esophageal carcinogenesis at 50 mg/kg AST in F344 rats (P < 0.05). AST inhibited the oxidative stress by improving the levels of superoxide dismutase (SOD), total antioxidant capacity (TAOC) and suppressing malondialdehyde (MDA) in serum, and increasing the protein of PPARγ, Bax/Bcl-2, Caspase-3 in esophagus tissue, especially in the 50 mg/kg of AST intervention group (all P < 0.05). In conclusion, our data suggested that protective effect of AST on esophageal cancer by inhibiting oxidative stress, up-regulating PPARγ, and activating the apoptotic pathway, which could provide a basis for clinical application of AST.

Association between Dietary Vitamin E Intake and Esophageal Cancer Risk: An Updated Meta-Analysis.

Epidemiological studies have provided ambiguous evidence on the association between vitamin E and esophageal cancer risk. To resolve this controversy, we performed this meta-analysis. The literature was searched by using Excerpta Medica Database (EMBASE), PubMed, the Web of Science, and the Cochrane Library from the inception to April 2018. A random effect model was utilized to calculate the odds ratio (OR) with the 95% confidence interval (95% CI). Twelve articles reporting 14 studies involving 3013 cases and 11,384 non-cases were included. By comparing the highest category with the lowest category of dietary vitamin E intake, we found that dietary vitamin E intake was inversely related to esophageal cancer risk (OR = 0.47, 95% CI: 0.36⁻0.60). Subgroup analysis revealed that dietary vitamin E intake had a significantly negative association with both the esophageal squamous cell carcinoma risk (OR = 0.29, 95% CI: 0.18⁻0.44) and the esophageal adenocarcinoma risk (OR = 0.66, 95% CI: 0.49⁻0.88). No study significantly affected the findings in the sensitivity analysis. Publication bias was discovered, however, the OR (95% CI) remained unchanged after the trim-and-fill analysis. This meta-analysis showed that the higher dietary vitamin E intake is associated with a lower esophageal cancer risk. However, the association still needs to be upheld by more large-scaled randomized controlled trials and prospective studies.

Breastfeeding and early childhood caries: a meta-analysis of observational studies.

BACKGROUND AND OBJECTIVES: The associations of breastfeeding and early childhood caries (ECC) risk have been evaluated in several epidemiological studies with conflicting results. We performed an update meta-analysis to estimate the association of feeding patterns, breastfeeding durations and ECC risk. METHODS AND STUDY DESIGN: Studies were identified through searching Pubmed, Web of Science, and Embase from January 1990 to December 2015. RESULTS: Thirty-five studies involving 73,401 participants aged 0-71 months were included. The overall analysis showed children ever breastfed had a reduced risk of ECC compared with those never breastfed (OR=0.77, 95% CI: 0.61-0.97, p=0.026). Subgroup analysis revealed ever breastfeeding significantly reduced ECC risk for the studies with 3-6 years old children (OR=0.70, 95% CI: 0.54-0.90, p=0.005), with sample size >500 subjects (OR=0.63, 95% CI: 0.46-0.87, p=0.004), with Newcastle-Ottawa Scale (NOS) score >=6 (OR=0.66, 95% CI: 0.46-0.94, p=0.023), published after 2010 (OR=0.50, 95% CI: 0.30-0.82, p=0.006), with adjusted OR (OR=0.40, 95% CI: 0.18-0.88, p=0.023). Exclusive breastfeeding did not significantly decrease ECC risk compared with bottle feeding (OR=0.68, 95% CI: 0.35-1.31, p=0.248). The children breastfed >=12 months significantly increased ECC risk compared with those breastfed <12 months (OR=1.86, 95% CI: 1.37-2.52, p<0.001). Whereas, children breastfed >=6 months did not significantly increase ECC risk compared with those breastfed <6 months (OR=1.13, 95% CI: 0.83-1.53, p=0.428). CONCLUSIONS: Our analysis suggests ever breastfeeding may protect children from ECC, and breastfeeding duration >=12 months is associated with higher ECC risk. Additional large cohort studies are required to illustrate the relationship in further study.

Protective Effect of Dietary Calcium Intake on Esophageal Cancer Risk: A Meta-Analysis of Observational Studies.

Although several epidemiological studies have investigated the association between dietary calcium intake and the risk of esophageal cancer, the results are inconsistent. This study aimed to make a comprehensive evaluation regarding the association between calcium intake and risk of esophageal cancer through a meta-analysis approach. We searched for all relevant articles from the inception to April 2017, using PUBMED, EMBASE, and Web of Knowledge. The pooled odds ratio (ORs) with the 95% confidence interval (95% CI) for the highest versus the lowest categories of calcium intake was calculated using a Mantel-Haenszel fixed-effect model. In total, 15 articles reporting 17 studies including 3396 esophageal cancer cases and 346,815 controls were selected for the meta-analysis. By comparing the highest vs. the lowest levels of dietary calcium intake, we found that dietary calcium intake was inversely associated with the risk of esophageal cancer (OR = 0.80, 95% CI: 0.71-0.91, I² = 33.6%). The subgroup analysis indicated that the protective function of dietary calcium intake were observed in esophageal squamous cell cancer, but not in esophageal adenocarcinoma in the studies conducted in Asia, but not those in Europe and America. In conclusion, our results suggest that higher dietary calcium intake is associated with a lower risk of esophageal cancer-especially esophageal squamous cell cancer-in Asian populations, though more data from prospective cohort studies are needed.

Flavonoids, Flavonoid Subclasses, and Esophageal Cancer Risk: A Meta-Analysis of Epidemiologic Studies.

Flavonoids have been suggested to play a chemopreventive role in carcinogenesis. However, the epidemiologic studies assessing dietary intake of flavonoids and esophageal cancer risk have yielded inconsistent results. This study was designed to examine the association between flavonoids, each flavonoid subclass, and the risk of esophageal cancer with a meta-analysis approach. We searched for all relevant studies with a prospective cohort or case-control study design published from January 1990 to April 2016, using PUBMED, EMBASE, and Web of Science. Pooled odds ratios (ORs) were calculated using fixed or random-effect models. In total, seven articles including 2629 cases and 481,193 non-cases were selected for the meta-analysis. Comparing the highest-intake patients with the lowest-intake patients for total flavonoids and for each flavonoid subclass, we found that anthocyanidins (OR = 0.60, 95% CI: 0.49-0.74), flavanones (OR = 0.65, 95% CI: 0.49-0.86), and flavones (OR = 0.78, 95% CI 0.64-0.95) were inversely associated with the risk of esophageal cancer. However, total flavonoids showed marginal association with esophageal cancer risk (OR = 0.78, 95% CI: 0.59-1.04). In conclusion, our study suggested that dietary intake of total flavonoids, anthocyanidins, flavanones, and flavones might reduce the risk of esophageal cancer.