Impact of visceral obesity on infectious complications after resection for colorectal cancer: a retrospective cohort study.

OBJECTIVES: To explore the impact of visceral obesity (VO) measured by preoperative abdominal computed tomography (CT) on postoperative infectious complications for colorectal cancer (CRC) patients and establish a predictive model. METHODS: Patients who underwent resection for colorectal cancer between January 2015 and January 2021 were enrolled in this study. All patients were measured for body mass index (BMI) and visceral fat area (VFA) preoperatively. Infectious complications were compared between the different groups according to BMI and VO categories. Univariate and multivariate logistic regression were used to analyze whether VO was an independent risk factor for postoperative infectious complications. According to the results of logistic regression, six machine learning approaches were used to establish predictive models and perform internal validation. The best-performing model was interpreted by the SHAPley Additive exPlanations value. RESULTS: Approximately 64.81% of 520 patients had VO. VO was significantly connected with postoperative infectious complications (P < 0.001), coronary heart disease (P = 0.004), cerebral infarction (P = 0.001), hypertension (P < 0.001), diabetes (P < 0.001), and fatty liver (P < 0.001). The rates of wound infection (P = 0.048), abdominal or pelvic infection (P = 0.006), and pneumonia (P = 0.008) increased obviously in patients with VO. Compared to the low BMI group, a high BMI was found to be significantly associated with hypertension (P=0.007), fatty liver (P＜0.001), and a higher rate of postoperative infection (P=0.003). The results of logistic regression revealed that VO (OR = 2.01, 95% CI 1.17 ~ 3.48, P = 0.012), operation time ≥ 4 h (OR = 2.52, 95% CI 1.60 ~ 3.97, P < 0.001), smoking (OR = 2.04, 95% CI 1.16 ~ 3.59, P = 0.014), ostomy (OR = 1.65, 95% CI 1.04 ~ 2.61, P = 0.033), and chronic obstructive pulmonary disease (COPD) (OR = 2.23, 95% CI 1.09 ~ 4.57, P = 0.029) were independent risk factors. The light gradient boosting machine (LGBM) model displayed the largest area under the receiver operating characteristic curve (AUC) (0.74, 95% CI 0.68 ~ 0.81). CONCLUSIONS: In this study, VO was superior to BMI in evaluating the influence of obesity on metabolic comorbidities and postoperative infectious complications in colorectal cancer patients.

Influence of cascade reservoir operation in the Upper Mekong River on the general hydrological regime: A combined data-driven modeling approach.

Cross-border impact assessment of cascade reservoir operation on hydrological regimes is a vital prerequisite for the sustainable development and management of transboundary waters. However, assessment based on traditional hydrological modeling for transboundary rivers is limited by the availability of meteorological and hydrological data. In this study, a combined data-driven model (CV-LSTM) was built to simulate natural runoff without dam construction in the Upper Mekong River. Then, the simulated natural runoff was compared against the observation runoff influenced by dam operation to assess the impacts of reservoirs on flood and drought events. The research results are as follows: (1) CV-LSTM improved simulation performance by effectively utilizing spatial information from more extensive and diversified data, and it could overcome the limitation of classic data-driven models in that the spatial heterogeneity of input variables cannot be sufficiently considered. (2) Reservoir operation decreased the annual streamflow of the Upper Mekong River by 1.07% during the 2001-2016. In particular, with the operation of two mega reservoirs (Xiaowan and Nuozadu) after 2008, the annual streamflow decreased by 3.95%. (3) The upstream reservoirs exerted significant runoff regulative effects on the Lower Mekong during 2001-2016. Drought duration and severity significantly decreased at the Chiang Sean hydrological station, flood frequency decreased by 11%, and the mean day of flood occurrence decreased by 30%. This study developed an innovative approach, CV-LSTM, based on open-source spatial information, which could effectively analyze the cross-border impact of cascade reservoir operation. The results provide new insights into the quantitative assessment of the transboundary influence of upstream-downstream runoff change induced by cascade dams in international rivers.

Increasing plant availability of legacy phosphorus in calcareous soils using some phosphorus activators.

Legacy phosphorus (P) in soil, accumulated over several years of fertilizer application in excess of crop demand, represents a huge and largely untapped resource. P activators can increase the availability of this P to plants by accelerating its transformation into soluble P fractions. In this study, we evaluated the potentials of four "P activators" (oxalic acid, lignin, phytase and ascorbic acid) to increase plant available P in a laboratory incubation experiment with two P-deficient calcareous soils used for wheat production. Samples were analysed for Olsen P, phosphomonoesterase and with Hedley sequential P fractionation. All four treatments had significant effects on different soil P fractions. Oxalic acid mainly enhanced inorganic P (Pi) solubility from the HCl-extractable P pool. Lignin enhanced P lability from the NaOH-, HCl- and residual-P pools. Phytase and ascorbic acid principally affected the organic P fractions (Po). Oxalic acid and lignin showed most potential to improve P (H2O-P, NaHCO3-Pi and NaHCO3-Po) availability, which increased by 110-419% and 4.1-122%, respectively. These findings illustrated the potential mechanisms responsible for P release associated with different P activators and reinforced the case for their use in increasing legacy P availability for agriculture in calcareous soils.

Characterization of phosphate solubilizing bacteria isolated from heavy metal contaminated soils and their potential for lead immobilization.

Phosphate solubilizing bacteria (PSB) were isolated from heavy metal contaminated soils and their potentials for lead (Pb) immobilization in soil were studied in this paper. 53 PSB strains were isolated and their minimum inhibitory concentrations (MICs) for lead were determined. The results showed that strains B3, B4, B10, F2-1 and L1-5 had relatively high lead resistant capabilities with MICs ranged from 0.5 to 8 mM, and were identified as species of Leclercia adecarboxylata and Pseudomonas putida by 16S rRNA. The most efficient PSB strains could solubilize 200 mg L-1 of P, and phosphate solubilizing capacity of those PSBs was related to the concentrations of organic acids, acid phosphatase activity and pH. Furthermore, the growth pattern of L1-5 strain with the presence of Pb(NO3)2 was observed and a mechanism of biomineralization of lead ions in bacteria biomass was determined by FT-IR and XRD analyses. Results showed that high concentration of lead can inhibit the growth of PSBs, and L1-5 isolate can transform lead ions into lead hydroxyapatite and pyromorphite. The PSBs, which possessing the properties of immobilizing lead through phosphate solubilization and biomineralization could be exploited for bioremediation of Pb polluted soils in future.

Effects of opioid-free propofol or remimazolam balanced anesthesia on hypoxemia incidence in patients with obesity during gastrointestinal endoscopy: A prospective, randomized clinical trial.

There are presently no consensuses on the optimal sedation strategy for obese patients during gastrointestinal endoscopy. This study aim to explore the effects of opioid-free propofol or remimazolam balanced anesthesia on hypoxemia incidence in patients with obesity. A total of 264 patients were randomized to remimazolam + esketamine group (group R) or propofol + esketamine group (group P). Anesthesia in group P was administrated by propofol, esketamine and in group R by remimazolam, esketamine. The primary outcome was incidence of hypoxemia. Secondary outcomes were the time to loss of consciousness (LoC) and to recovery and the incidence of intraoperative and postoperative adverse reactions. We found the incidence of mild hypoxemia in group R was similar to that in group P (14.2% vs. 11.5%, p = 0.396). The incidence of severe hypoxemia in group R was significantly lower than Group P (4.2% vs. 9.2%, p = 0.019). The time to LoC in group R was longer than group P [Median (interquartile range, IQR): 53 s (45 to 61) vs. 50 s (42 to 54), p = 0.001]. The time to recovery from anesthesia in group R was less than group P [Median (IQR): 48 min (41 to 58) vs. 55.5 min (46 to 67), p<0.001]. There was no significant difference in the incidence of adverse events (p > 0.05 for all). We concluded that compared with propofol combined with esketamine, remimazolam combined with esketamine can reduce the incidence of severe hypoxemia during gastrointestinal endoscopy in obese patients. Clinical Trial Registration: www.chictr.org.cn, Identifier: ChiCTR2200065575.

Effective passivation of lead by phosphate solubilizing bacteria capsules containing tricalcium phosphate.

Phosphate solubilizing bacteria (PSBs) shows high potential to be used for lead passivation in sediments due to the abilities of releasing phosphate and the subsequent formation of insoluble Pb-phosphate compounds. In this research, microbial capsules implemented with sodium alginate and CaCl2, containing Leclercia adecarboxylata L15 (a lead resistant PSB) and Ca3(PO4)2, were developed and the performance on lead passivation under different conditions was examined. The optimal concentrations of sodium alginate and CaCl2 for formulating the capsules were determined to be 0.3% and 10%, respectively. The removal efficiency of Pb2+ by capsules containing L15 and Ca3(PO4)2 was up to 98% with a capsule dosage of 2%, initial Pb2+ concentration of 1mM and pH of 3.0, which was better than that of free L15 (18%) and capsules containing only L15 (34%). Lead was immobilized via the formation of Pb5(PO4)3Cl on the surface and Pb3(PO4)2 in the interior of the capsules. The simulated sediment remediation experiments showed that the acid soluble fraction of lead reduced from 28% to 14% and transformed into more stable fractions after 10 days. The experiment results indicated that PSBs capsules coupled with phosphate materials have a great promise for application in remediation of lead contaminated sediments.

Enhanced passivation of lead with immobilized phosphate solubilizing bacteria beads loaded with biochar/ nanoscale zero valent iron composite.

Phosphate solubilizing bacteria (PSBs) can effectively enhance the stability of lead via the formation of insoluble Pb-phosphate compounds. This research presents a bio-beads, which was implemented with the help of a self-designed porous spheres carrier, by immobilized PSBs strains Leclercia adecarboxylata (hereafter referred as L1-5). In addition, the passivation efficiency of lead via bio-beads under different conditions and its mechanism were also investigated in this study. The results indicated that phosphate solubilized by bio-beads could reach 30 mg/L in Ca3(PO4)2 medium containing 1 mM Pb2+, and the highest removal rate of Pb2+ in beef peptone liquid medium could reach 93%, which is better than that of free bacteria. Furthermore, it was also concluded that the lead could be transformed into stable crystal texture, such as Pb5(PO4)3Cl and Pb5(PO4)3OH. Both hydrophobic and hydrophilic groups in the bio-beads could capture Pb2+, which indicated that electrostatic attraction and ion-exchange were also the mechanism of Pb2+ adsorption. All the experimental findings demonstrated that this bio-bead could be consider as an efficient way for the lead immobilization in contaminated soil in the future.

Effects of Pb(II) and Cr(VI) Stress on Phosphate-Solubilizing Bacteria (Bacillus sp. Strain MRP-3): Oxidative Stress and Bioaccumulation Potential.

The aim of this work was to ascertain the effects of Pb(II) and Cr(VI) on bacterial growth, generation of reactive oxygen species (ROS), activities of superoxide dismutase (SOD), and catalase (CAT), as well as the localization of bioaccumulated heavy metals in a phosphate-solubilizing bacterium. The results showed that the ROS increased from 1.4-fold to 1.8-fold of control under Pb(II) stress and decreased from 1.6-fold to 1.1-fold of control under Cr(VI) stress corresponding to metal concentrations (0.5-5 mmol·L-1). The SOD activities were ROS dependent; however, the CAT activities increased under both Pb(II) and Cr(VI) stress, from 11.4 to 21.8 U·mg-1 and 11.4 to 32.9 U·mg-1, respectively. Intra/extracellular accumulation were investigated by scanning transmission electron microscopy with energy dispersive X-ray spectroscopy (STEM-EDS) and it was calculated that extracellular accumulated Pb accounted for 61.7-95.9% of the total accumulation, while extracellular accumulated Cr only accounted for up to 3.6% of the total accumulation. Attenuated total reflection/Fourier-transform infrared spectroscopy (ATR-FTIR) analysis confirmed that the functional groups involved in those extracellular accumulation were not located in the loosely bound extracellular polysaccharides substances.