Effects of weight loss on QTc in people with obesity: a systematic review and meta-analysis.

BACKGROUND AND AIMS: Overweight and obesity have been found to exhibit a statistically significant increase in corrected QT interval (QTc), a major contributing factor to sudden death. However, the influence of widely used weight loss strategies including diet, exercise, anti-obesity drugs, and bariatric surgery on QTc remains inconsistent. Therefore, the present systematic review and meta-analysis aim to quantitatively analyse and evaluate the effect of weight loss on QTc in obese patients after diet control with exercise intervention and anti-obesity drugs, as well as bariatric surgery. METHODS: Twenty randomised controlled trials (RCT) and observational studies were included in the meta-analysis on the effects of weight loss on QTc. The fixed-effects model was employed in the RCTs, and the random-effects model was employed due to the presence of statistical heterogeneity among observational studies. Subgroup analysis was conducted to understand the differences in distinct weight loss methods and follow-up time. RESULTS: Overall, the QTc of people with obesity after weight loss was shorter than that before (mean difference (MD) = 21.97 ms, 95% confidence interval (CI) = 12.42, 31.52, p < .0001). Subgroup analysis restricted to seven included studies whose intervention was diet control with exercise showed a decrease of QTc with statistical significance (MD = 9.35 ms, 95%CI = 2.56, 37.54, p = .007). In the remaining 11 studies, bariatric surgery was the weight loss method. The results also showed a shortening of QTc after surgery, and the difference was statistically significant (MD = 29.04 ms, 95%CI = -16.46, 41.62, p < .00001). A statistically significant difference in QTc shortening at 6 months compared to pre-operation values was further observed (MD = -31.01 ms, 95%CI = -2.89, -59.12, p = .03). The shortening of QTc at 12 months of follow-up was also significantly different from that before surgery (MD = 36.47 ms, 95%CI = 14.17, 58.78, p < .00001). Moreover, the differences became more pronounced as the follow-up time extended. CONCLUSIONS: We demonstrate that weight loss links to a shortened QTc, without considering the means of weight loss. Bariatric surgery has been found to result in a greater reduction in QTc.

NY-ESO-1 antigen-antibody interaction process based on an TFBG plasmonic sensor.

Autoantibodies against New York esophageal squamous cell cancer 1 (NY-ESO-1) play a crucial role in the diagnosis of esophageal cancer. In this work, a surface plasmonic tilted fiber Bragg grating (TFBG) biosensor is proposed for the detection of NY-ESO-1 antibody, as well as the investigation of the hook effect (which refers to the false negative result in some immunoassays when the concentration of antibodies in the sample is very high) during biomolecular binding between NY-ESO-1 antigen and antibody. The biosensor is made by an 18° TFBG coated with a 50-nm-thick gold film over the fiber surface together with NY-ESO-1 antigens attached to the metallic surface serving as bio-receptors. This biosensor can provide a limit of detection at a concentration of 2 × 10-7 µg/ml with a good linearity in the range from 2 × 10-7 to 2 × 10-5 µg/ml. For a concentration higher than 2 × 10-3 µg/ml, the performance of the sensor probe is reduced owing to the hook effect. Furthermore, experimental results have also demonstrated the repeatability of the proposed biosensor. This proposed biosensor features label-free, compactness, and fast response, which could be potentially applied in the diagnosis of esophageal cancer.

Stereo-electroencephalography-guided three-dimensional radiofrequency thermocoagulation for mesial temporal lobe epilepsy with hippocampal sclerosis: A retrospective study with long-term follow-up.

OBJECTIVE: Stereo-electroencephalography-guided three-dimensional radiofrequency thermocoagulation (SEEG-3D RFTC) is a minimally invasive treatment for mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS). This study aimed to investigate the long-term prognosis after SEEG-3D RFTC treatment in patients with MTLE-HS. METHODS: This single-center retrospective study included 28 patients with MTLE-HS treated with SEEG-3D RFTC from January 2016 to May 2018. Postoperative curative effects were evaluated using the Engel classification, and the patients were followed up for 5 years. RESULTS: The proportions of patients categorized as Engel I between 1 and 5 years after surgery were 72.41% (12 months after surgery), 67.86% (18 months after surgery), 62.07% (24 months after surgery), 50.00% (36 months after surgery), 42.86% (48 months after surgery), and 42.86% (60 months after surgery), respectively. Regarding long-term efficacy, based on the Engel classification, SEEG-3D RFTC showed room for improvement. SIGNIFICANCE: This was the first study to evaluate the efficacy of SEEG-3D RFTC for MTLE-HS with long-term follow-up. SEEG-3D RFTC is a promising alternative for patients with MTLE-HS. PLAIN LANGUAGE SUMMARY: This study explored the potential of stereoelectroencephalography-guided three-dimensional radiofrequency thermocoagulation, a minimally invasive approach, for treating medial temporal lobe epilepsy with hippocampal sclerosis. Involving 28 patients, the research tracked the treatment's success over five years using the Engel classification. Initial results were promising, with 72.41% of patients achieving the most favorable outcome (Engel I) at one year. While there was a gradual decrease in this proportion over time, 42.86% of patients maintained this positive outcome at five years, highlighting the treatment's potential for long-term efficacy.

Initial suction drainage decreases severe postoperative complications after pancreatic trauma: A cohort study.

BACKGROUND: Few studies have addressed the question of which drain types are more beneficial for patients with pancreatic trauma (PT). AIM: To investigate whether sustained low negative pressure irrigation (NPI) suction drainage is superior to closed passive gravity (PG) drainage in PT patients. METHODS: PT patients who underwent pancreatic surgery were enrolled consecutively at a referral trauma center from January 2009 to October 2021. The primary outcome was defined as the occurrence of severe complications (Clavien-Dindo grade ≥ Ⅲb). Multivariable logistic regression was used to model the primary outcome, and propensity score matching (PSM) was included in the regression-based sensitivity analysis. RESULTS: In this study, 146 patients underwent initial PG drainage, and 50 underwent initial NPI suction drainage. In the entire cohort, a multivariable logistic regression model showed that the adjusted risk for severe complications was decreased with NPI suction drainage [14/50 (28.0%) vs 66/146 (45.2%); odds ratio (OR), 0.437; 95% confidence interval (CI): 0.203-0.940]. After 1:1 PSM, 44 matched pairs were identified. The proportion of each operative procedure performed for pancreatic injury-related and other intra-abdominal organ injury-related cases was comparable in the matched cohort. NPI suction drainage still showed a lower risk for severe complications [11/44 (25.0%) vs 21/44 (47.7%); OR, 0.365; 95%CI: 0.148-0.901]. A forest plot revealed that NPI suction drainage was associated with a lower risk of Clavien-Dindo severity in most subgroups. CONCLUSION: This study, based on one of the largest PT populations in a single high-volume center, revealed that initial NPI suction drainage could be recommended as a safe and effective alternative for managing complex PT patients.

Multiple portions enteral nutrition and chyme reinfusion of a blunt bowel injury patient with hyperbilirubinemia undergoing open abdomen: A case report.

Blunt bowel injury (BBI) is relatively rare but life-threatening when delayed in surgical repair or anastomosis. Providing enteral nutrition (EN) in BBI patients with open abdomen after damage control surgery is challenging, especially for those with discontinuity of the bowel. Here, we report a 47-year-old male driver who was involved in a motor vehicle collision and developed ascites on post-trauma day 3. Emergency exploratory laparotomy at a local hospital revealed a complete rupture of the jejunum and then primary anastomosis was performed. Postoperatively, the patient was transferred to our trauma center for septic shock and hyperbilirubinemia. Following salvage resuscitation, damage control laparotomy with open abdomen was performed for abdominal sepsis, and a temporary double enterostomy (TDE) was created where the anastomosis was ruptured. Given the TDE and high risk of malnutrition, multiple portions EN were performed, including a proximal portion EN support through a nasogastric tube and a distal portion EN via a jejunal feeding tube. Besides, chyme delivered from the proximal portion of TDE was injected into the distal portion of TDE via a jejunal feeding tube. Hyperbilirubinemia was alleviated with the increase in chyme reinfusion. After 6 months of home EN and chyme reinfusion, the patient finally underwent TDE reversal and abdominal wall reconstruction and was discharged with a regular diet. For BBI patients with postoperative hyperbilirubinemia who underwent open abdomen, the combination of multiple portions EN and chyme reinfusion may be a feasible and safe option.

Ultrasensitive detection of endocrine disruptors via superfine plasmonic spectral combs.

The apparent increase in hormone-induced cancers and disorders of the reproductive tract has led to a growing demand for new technologies capable of detecting endocrine disruptors. However, a long-lasting challenge unaddressed is how to achieve ultrahigh sensitive, continuous, and in situ measurement with a portable device for in-field and remote environmental monitoring. Here we demonstrate a simple-to-implement plasmonic optical fiber biosensing platform to achieve an improved light-matter interaction and advanced surface chemistry for ultrasensitive detection of endocrine disruptors. Our platform is based on a gold-coated highly tilted fiber Bragg grating that excites high-density narrow cladding mode spectral combs that overlap with the broad absorption of the surface plasmon for high accuracy interrogation, hence enabling the ultrasensitive monitoring of refractive index changes at the fiber surface. Through the use of estrogen receptors as the model, we design an estradiol-streptavidin conjugate with the assistance of molecular dynamics, converting the specific recognition of environmental estrogens (EEs) by estrogen receptor into surface-based affinity bioassay for protein. The ultrasensitive platform with conjugate-induced amplification biosensing approach enables the subsequent detection for EEs down to 1.5 × 10-3 ng ml-1 estradiol equivalent concentration level, which is one order lower than the defined maximal E2 level in drinking water set by the Japanese government. The capability to detect EEs down to nanogram per liter level is the lowest limit of detection for any estrogen receptor-based detection reported thus far. Its compact size, flexible shape, and remote operation capability open the way for detecting other endocrine disruptors with ultrahigh sensitivity and in various hard-to-reach spaces, thereby having the potential to revolutionize environment and health monitoring.

Environmental Risk Assessment of Metals in the Volcanic Soil of Changbai Mountain.

Tianchi volcano is a dormant active volcano with a risk of re-eruption. Volcanic soil and volcanic ash samples were collected around the volcano and the concentrations of 21 metals (major and trace elements) were determined. The spatial distribution of the metals was obtained by inverse distance weight (IDW) interpolation. The metals' sources were identified and their pollution levels were assessed to determine their potential ecological and human health risks. The metal concentrations were higher around Tianchi and at the north to the west of the study area. According to the geo-accumulation index (Igeo), enrichment factor (EF) and contamination factor (CF) calculations, Zn pollution was high in the study area. Pearson's correlation analysis and principal component analysis showed that with the exception of Fe, Mn and As, the metals that were investigated (Al, K, Ca, Na, Mg, Ti, Cu, Pb, Zn, Cr, Ni, Ba, Ga, Li, Co, Cd, Sn, Sr) were mostly naturally derived. A small proportion of Li, Pb and Zn may have come from vehicle traffic. There is no potential ecological risk and non-carcinogenic risk because of the low concentrations of the metals; however, it is necessary to pay attention to the carcinogenic risk of Cr and As in children.

Highly sensitive gas refractometers based on optical microfiber modal interferometers operating at dispersion turning point.

In most fiber-optic gas sensing applications where the interested refractive index (RI) is ~1.0, the sensitivities are greatly constrained by the large mismatch between the effective RI of the guided mode and the RI of the surrounding gaseous medium. This fundamental challenge necessitates the development of a promising fiber-optic sensing mechanism with the outstanding RI sensitivity to achieve reliable remote gas sensors. In this work, we report a highly sensitive gas refractometer based on a tapered optical microfiber modal interferometer working at the dispersion turning point (DTP). First, we theoretically analyze the essential conditions to achieve the DTP, the spectral characteristics, and the sensing performance at the DTP. Results show that nonadiabatic tapered optical microfibers with diameters of 1.8-2.4 µm possess the DTPs in the near-infrared range and the RI sensitivities can be improved significantly around the DTPs. Second, we experimentally verify the ultrahigh RI sensitivity around the DTP using a nonadiabatic tapered optical microfiber with a waist diameter of ~2 µm. The experimental observations match well with the simulation results and our proposed gas refractometer provides an exceptional sensitivity as high as -69984.3 ± 2363.3 nm/RIU.

Large-scale synthesis of single-crystalline self-standing SnSe2 nanoplate arrays for wearable gas sensors.

Advances in two-dimensional semiconducting thin films enable the realization of wearable electronic devices in the form factor of flexible substrate/thin films that can be seamlessly adapted in our daily lives. For wearable gas sensing, two-dimensional materials, such as SnSe2, are particularly favorable because of their high surface-to-volume ratio and strong adsorption of gas molecules. Chemical vapor deposition and liquid/mechanical exfoliation are the widely applied techniques to obtain SnSe2 thin films. However, these methods normally result in non-uniform and isolated flakes which cannot apply to the practical industrial-scale wearable electronic devices. Here, we demonstrate large-scale (10 cm × 10 cm), uniform, and self-standing SnSe2 nanoplate arrays by co-evaporation process on flexible polyimide substrates. Both structural and morphological properties of the resulting SnSe2 nanoplates are systematically investigated. Particularly, the single-crystalline SnSe2 nanoplates are achieved. Furthermore, we explore the application of the polyimide/SnSe2 nanoplate arrays as wearable gas sensors for detecting methane. The wearable gas sensors show high sensitivity, fast response and recovery, and good uniformity. Our approach not only provides an efficient technique to obtain large-area, uniform and high-quality single-crystalline SnSe2 nanoplates, but also impacts on the future developments of layered metal dichalcogenides-based wearable devices.

Ultrasensitive measurement of gas refractive index using an optical nanofiber coupler.

We report an ultrasensitive gas refractive index (RI) sensor based on optical nanofiber couplers (ONCs). Theoretical analysis reveals that a dispersion turning point (DTP) exists when the diameter of the coupler is below 1000 nm. Leveraging this DTP, the gas RI sensitivity can be significantly improved to infinity. Then we experimentally demonstrate a DTP and achieve ultrahigh sensitivities of 46,470 nm/refractive index unit (RIU) and -45,550 nm/RIU around the DTP using an ONC with a diameter of 700 nm. More importantly, the unique twin dips/peaks interference characteristics around the DTP offers further enhancement on the sensitivity to 92,020 nm/RIU. The demonstrated sensor not only shows vast potential in ultrasensitive pressure sensing, acoustic sensing, gas sensing, and gas phase biomarker detection, but also provides a new tool for nonlinear optics, ultrafast optics, quantum optics, and ultracold atom optics.

Gold nanoparticle amplified optical microfiber evanescent wave absorption biosensor for cancer biomarker detection in serum.

Sensitive and selective detection for cancer biomarkers is critical in cancer clinical diagnostics. In this work, we report a new optical microfiber (OMF) biosensor using gold nanoparticles (GNPs) as amplification labels for the detection of alpha-fetoprotein (AFP) in serum samples. By combining the unique optical property of OMFs and the strong optical absorption of GNPs, very high sensitivity and selectivity can be achieved. Critical parameters namely fiber diameter and GNP size were optimized for better performance. The limit of detection (LOD) of this sensor for AFP is 0.2 ng/mL in PBS and 2 ng/mL in bovine serum, which is comparable to conventional assays. The advantages of this biosensor are simple detection scheme, fast response time, and ease of miniaturization, which might make this biosensor a promising platform for clinical cancer diagnosis and prognosis.