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Surgical site infections (SSIs) post-cardiothoracic surgery represent a significant challenge in patient care. Understanding the risk factors contributing to SSIs is essential for improving surgical outcomes and patient safety. A comprehensive retrospective analysis was conducted at our institution from January 2021 to December 2022. This study included 30 patients with SSIs and 60 without, following cardiothoracic open surgery. Data were collected on various variables, including hypertension, anaemia, operation time, hospital stay, alcohol consumption, smoking habits, Body Mass Index, age, and drainage tube placement. Univariate and multivariate logistic regression analyses were employed using SPSS software to identify significant predictors of SSIs. Univariate analysis indicated a strong correlation between SSIs and factors like smoking, diabetes mellitus, drainage tube placement, anaemia, and significant intraoperative blood loss (≥800 mL). These factors were statistically significant with p-values < 0.05. Multivariate logistic regression further confirmed the impact of these factors, with high odds ratios indicating a substantial increase in SSI risk associated with these conditions. This study highlights intraoperative blood loss, anaemia, drainage tube placement, smoking, and diabetes mellitus as key risk factors for SSIs post-cardiothoracic surgery. Recognising and addressing these factors through targeted preventive measures is crucial in clinical practice to reduce the incidence of SSIs and improve postoperative care in cardiothoracic surgery.
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Anemia , Diabetes Mellitus , Humanos , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/etiologia , Infecção da Ferida Cirúrgica/prevenção & controle , Estudos Retrospectivos , Perda Sanguínea Cirúrgica , Fatores de RiscoRESUMO
OBJECTIVE: To explore the relationship between circular RNA (circRNA) in gestational diabetes mellitus (GDM) and the metabolic profile at the molecular level, and find a biological marker that can predict GDM early. METHODS: A retrospective case-control study was conducted using data and samples from women treated at a hospital in China between January 10 2018 and February 20 2019. Reverse transcription polymerase chain reaction (qRT-PCR) was used to evaluate the expression level of hsa_circRNA_102682 in serum and analyze its correlation with lipid metabolism parameters. RESULTS: Advanced age and higher pre-pregnancy body mass index (BMI) during pregnancy are risk factors for GDM. The expression level of hsa_circ_102682 was lower among the cases than the controls (p=.000). The levels of triglyceride, apolipoprotein A1 (APOA1), APOB, and high-density lipoprotein cholesterol (HDL-C) were different between the controls and cases (p<.05). Hsa_circRNA_102682 was significantly correlated with triglycerides, APOA1, APOB, 1-h blood glucose in the serum of GDM patients, and the correlation coefficients were 0.319, 0.314, 0.286, and 0.311, respectively (p<.05). The area under the receiver operating characteristic curve is 0.684 (95% confidence interval 0.611-0.756, p=.0001). CONCLUSIONS: Hsa_circRNA_102682 may regulate lipid metabolism, participate in the pathogenesis of GDM. It can be used as a marker to predict GDM.
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Diabetes Gestacional/sangue , Metabolismo dos Lipídeos/genética , RNA Circular/sangue , Albumina Sérica Humana/genética , Apolipoproteína A-I/sangue , Apolipoproteínas B/sangue , Glicemia/análise , Estudos de Casos e Controles , China , HDL-Colesterol/sangue , Diabetes Gestacional/genética , Feminino , Expressão Gênica , Humanos , Gravidez , RNA Circular/genética , Estudos Retrospectivos , Triglicerídeos/sangueRESUMO
Bone-related disorders treatment is a serious public health concern, imposing a significant social and economic burden on patients and healthcare systems. Although conventional drug delivery systems have made advances in bone diseases prevention and management, the limited delivery efficiency and convoluted focal environment lead to inadequate drug absorption and lack of specificity to achieve the intended therapeutic impact. Microneedle-based therapy represents an extraordinarily safe and well-tolerable therapeutic approach for treating bone disorders, providing improved efficacy by breaking down the barriers and delivery of therapeutic components to the target sites with programable release profiles in a less invasive manner. Over the past decades, numerous significant achievements in the development of various types of drug-carried microneedles have been made to address the obstacles encountered in the bone-treating procedure, enabling the microneedle-based therapy to take an important step in practical applications. In this light, this review summarizes these remarkable researches in terms of microneedles types and drug delivery strategies, with the goal of demonstrating the benefits of exploiting microneedle-based therapy as a novel strategy for treating bone-related disorders. The remaining challenges and future perspectives are also discussed in the hope of inspiring more efficient and intelligent bone treatment strategies.
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Doenças Ósseas , Sistemas de Liberação de Medicamentos , Humanos , Sistemas de Liberação de Medicamentos/métodos , Preparações Farmacêuticas , Administração Cutânea , Doenças Ósseas/tratamento farmacológico , Agulhas , Microinjeções/métodosRESUMO
PURPOSE: To develop a radiomics-based model from preoperative magnetic resonance imaging (MRI) for predicting the histopathological grades of myxofibrosarcoma. METHODS: This retrospective study included 54 patients. The tumors were classified into high-grade and low-grade myxofibrosarcoma. The tumor size, signal intensity heterogeneity, margin, and surrounding tissue were evaluated on MRI. Using the least absolute shrinkage and selection operator (LASSO) algorithms, 1037 radiomics features were obtained from fat-suppressed T2-weighted images (T2WI), and a radiomics signature was established. Using multivariable logistic regression analysis, three models were built to predict the histopathologic grade of myxofibrosarcoma. A radiomics nomogram represents the integrative model. The three models' performance was evaluated using the receiver operating characteristics (ROC) and calibration curves. RESULTS: The high-grade myxofibrosarcoma had greater depth (P = 0.027), more frequent heterogeneous signal intensity at T2WI (P = 0.015), and tail sign (P = 0.014) than the low-grade tumor. The area under curve (AUC) of these conventional MRI features models was 0.648, 0.656, and 0.668, respectively. Seven radiomic features were selected by LASSO to construct the radiomics signature model, with an AUC of 0.791. The AUC of the integrative model based on radiomics signature and conventional MRI features was 0.875. The integrative model's calibration curve and insignificant Hosmer-Lemeshow test statistic (P = 0.606) revealed good calibration. CONCLUSION: An integrative model using radiomics signature and three conventional MRI features can preoperatively predict low- or high-grade myxofibrosarcoma.
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Imageamento por Ressonância Magnética , Neoplasias , Adulto , Humanos , Estudos Retrospectivos , Imageamento por Ressonância Magnética/métodos , Nomogramas , Curva ROCRESUMO
Antarctica is one of the most vulnerable regions to climate change on Earth and studying the past and present responses of this polar marine ecosystem to environmental change is a matter of urgency. Sedimentary ancient DNA (sedaDNA) analysis can provide such insights into past ecosystem-wide changes. Here we present authenticated (through extensive contamination control and sedaDNA damage analysis) metagenomic marine eukaryote sedaDNA from the Scotia Sea region acquired during IODP Expedition 382. We also provide a marine eukaryote sedaDNA record of ~1 Mio. years and diatom and chlorophyte sedaDNA dating back to ~540 ka (using taxonomic marker genes SSU, LSU, psbO). We find evidence of warm phases being associated with high relative diatom abundance, and a marked transition from diatoms comprising <10% of all eukaryotes prior to ~14.5 ka, to ~50% after this time, i.e., following Meltwater Pulse 1A, alongside a composition change from sea-ice to open-ocean species. Our study demonstrates that sedaDNA tools can be expanded to hundreds of thousands of years, opening the pathway to the study of ecosystem-wide marine shifts and paleo-productivity phases throughout multiple glacial-interglacial cycles.
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Diatomáceas , Regiões Antárticas , DNA Antigo , Diatomáceas/genética , Ecossistema , Eucariotos , Sedimentos GeológicosRESUMO
Ice loss in the Southern Hemisphere has been greatest over the past 30 years in West Antarctica. The high sensitivity of this region to climate change has motivated geologists to examine marine sedimentary records for evidence of past episodes of West Antarctic Ice Sheet (WAIS) instability. Sediments accumulating in the Scotia Sea are useful to examine for this purpose because they receive iceberg-rafted debris (IBRD) sourced from the Pacific- and Atlantic-facing sectors of West Antarctica. Here we report on the sedimentology and provenance of the oldest of three cm-scale coarse-grained layers recovered from this sea at International Ocean Discovery Program Site U1538. These layers are preserved in opal-rich sediments deposited â¼1.2 Ma during a relatively warm regional climate. Our microCT-based analysis of the layer's in-situ fabric confirms its ice-rafted origin. We further infer that it is the product of an intense but short-lived episode of IBRD deposition. Based on the petrography of its sand fraction and the Phanerozoic 40Ar/39Ar ages of hornblende and mica it contains, we conclude that the IBRD it contains was likely sourced from the Weddell Sea and/or Amundsen Sea embayment(s) of West Antarctica. We attribute the high concentrations of IBRD in these layers to "dirty" icebergs calved from the WAIS following its retreat inland from its modern grounding line. These layers also sit at the top of a â¼366-m thick Pliocene and early Pleistocene sequence that is much more dropstone-rich than its overlying sediments. We speculate this fact may reflect that WAIS mass-balance was highly dynamic during the â¼41-kyr (inter)glacial world.
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The Southern Ocean paleoceanography provides key insights into how iron fertilization and oceanic productivity developed through Pleistocene ice-ages and their role in influencing the carbon cycle. We report a high-resolution record of dust deposition and ocean productivity for the Antarctic Zone, close to the main dust source, Patagonia. Our deep-ocean records cover the last 1.5 Ma, thus doubling that from Antarctic ice-cores. We find a 5 to 15-fold increase in dust deposition during glacials and a 2 to 5-fold increase in biogenic silica deposition, reflecting higher ocean productivity during interglacials. This antiphasing persisted throughout the last 25 glacial cycles. Dust deposition became more pronounced across the Mid-Pleistocene Transition (MPT) in the Southern Hemisphere, with an abrupt shift suggesting more severe glaciations since ~0.9 Ma. Productivity was intermediate pre-MPT, lowest during the MPT and highest since 0.4 Ma. Generally, glacials experienced extended sea-ice cover, reduced bottom-water export and Weddell Gyre dynamics, which helped lower atmospheric CO2 levels.
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Poeira , Água do Mar , Regiões Antárticas , Atmosfera , Poeira/análise , Oceanos e MaresRESUMO
The North Pacific Subtropical Gyre circulation redistributes heat from the Western Pacific Warm Pool towards the mid- to high-latitude North Pacific. However, the driving mechanisms of this circulation and how it changed over the Holocene remain poorly understood. Here, we present alkenone-based sea surface temperature reconstructions along the Kuroshio, California and Alaska currents that cover the past ~7,000 years. These and other paleorecords collectively demonstrate a coherent intensification of the boundary currents, and thereby the basin-scale subtropical gyre circulation, since ~3,000-4,000 years ago. Such enhanced circulation during the late Holocene appears to have resulted from a long-term southward migration of the Intertropical Convergence Zone, associated with Holocene ocean cooling. Our results imply that the North Pacific Subtropical Gyre circulation could be weakened under future global warming.
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The Antarctic Circumpolar Current (ACC) plays a crucial role in global ocean circulation by fostering deep-water upwelling and formation of new water masses. On geological time-scales, ACC variations are poorly constrained beyond the last glacial. Here, we reconstruct changes in ACC strength in the central Drake Passage in vicinity of the modern Polar Front over a complete glacial-interglacial cycle (i.e., the past 140,000 years), based on sediment grain-size and geochemical characteristics. We found significant glacial-interglacial changes of ACC flow speed, with weakened current strength during glacials and a stronger circulation in interglacials. Superimposed on these orbital-scale changes are high-amplitude millennial-scale fluctuations, with ACC strength maxima correlating with diatom-based Antarctic winter sea-ice minima, particularly during full glacial conditions. We infer that the ACC is closely linked to Southern Hemisphere millennial-scale climate oscillations, amplified through Antarctic sea ice extent changes. These strong ACC variations modulated Pacific-Atlantic water exchange via the "cold water route" and potentially affected the Atlantic Meridional Overturning Circulation and marine carbon storage.
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Protective carriers that encapsulate probiotics in spray drying could improve the survival ratio of dried cells through different mechanisms. Unveiling the protective mechanism of each carrier will contribute to a rational design of high performance carrier formulation. This study utilized single droplet drying (SDD) technique to investigate the effects of calcium cation in varied carrier formulation. Inactivation histories of Lactobacillus rhamnosus GG (LGG) in different carriers were compared, and cellular injury history of probiotics during droplet drying was studied for the first time. Adding 1mM CaCl2 to lactose carrier protected cell viability, mitigated cellular injuries, and enhanced regrowth capability as drying progressed, demonstrating the positive effect of Ca2+ with possible mechanism of stabilizing sub-cellular structures. At later drying stages, cell survival in Lac/Ca carrier was increased by 0.5-1.5 log on selective media compared to lactose carrier. Supplementing calcium-binding agents lowered the protective effect, shortening the initiation of rapid cell inactivation down to 120s of drying. Adding CaCl2 to trehalose carrier barely improved cell survival, indicating that the protective effect could be influenced by carrier formulation. Pure trehalose carrier exerted excellent protection on LGG, supporting cells to regrow in liquid rich medium even after 180s of drying. The protection of trehalose may stem from stabilization of sub-cellular structures, which possibly overlap the effect of Ca2+. The findings suggested that high performance carrier formulation might be developed by combining carrier materials with different protective mechanisms, for maximizing the survival of active dry probiotics in industrial spray drying operation.
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Reconstituted skim milk (RSM) is a reputed protective carrier for improving the survival ratio of lactic acid bacteria (LAB) after spray drying; however the underlying mechanisms of the prominent protection remains unclear. In this study, the inactivation histories of two LAB strains during droplet drying with four carriers were experimentally determined, and the effects of droplet drying parameters on LAB inactivation were investigated. For the first time, the possible contribution of each RSM components to the maintenance of LAB viability during drying was discussed. Rapid inactivation of LAB cells only started at the later stage of drying, where RSM could maintain viability better upon both high droplet temperature and low moisture content than the other three carriers tested. Such protective effects was attributed to calcium and milk proteins rather than lactose. Upon the rapidly increasing droplet temperature at the later stage, calcium might enhance the heat resistance of LAB cells, whereas proteins might lead to a mild temperature variation rate which was beneficial to cell survival. LAB cells dried in the reconstituted whole milk showed the most advanced transition of rapid viability loss, with transition temperature at around 60°C, in contrast to 65-70°C in lactose and MRS carriers and 75°C in the RSM carrier. The detrimental effects could be due to the high level of milk fat content. The proposed effects of each RSM components on LAB viability would be useful for constructing more powerful protectants for production of active dry LAB cells via spray drying.
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The novel method of improving the quality metric of protein microarray image presented in this paper reduces impulse noise by using an adaptive median filter that employs the switching scheme based on local statistics characters; and achieves the impulse detection by using the difference between the standard deviation of the pixels within the filter window and the current pixel of concern. It also uses a top-hat filter to correct the background variation. In order to decrease time consumption, the top-hat filter core is cross structure. The experimental results showed that, for a protein microarray image contaminated by impulse noise and with slow background variation, the new method can significantly increase the signal-to-noise ratio, correct the trends in the background, and enhance the flatness of the background, the consistency of the signal intensity.