Body composition assessment by artificial intelligence can be a predictive tool for short-term postoperative complications in Hartmann's reversals.

BACKGROUND: Hartmann's reversal, a complex elective surgery, reverses and closes the colostomy in individuals who previously underwent a Hartmann's procedure due to colonic pathology like cancer or diverticulitis. It demands careful planning and patient optimisation to help reduce postoperative complications. Preoperative evaluation of body composition has been useful in identifying patients at high risk of short-term postoperative outcomes following colorectal cancer surgery. We sought to explore the use of our in-house derived Artificial Intelligence (AI) algorithm to measure body composition within patients undergoing Hartmann's reversal procedure in the prediction of short-term postoperative complications. METHODS: A retrospective study of all patients who underwent Hartmann's reversal within a single tertiary referral centre (Western) in Melbourne, Australia and who had a preoperative Computerised Tomography (CT) scan performed. Body composition was measured using our previously validated AI algorithm for body segmentation developed by the Department of Surgery, Western Precinct, University of Melbourne. Sarcopenia in our study was defined as a skeletal muscle index (SMI), calculated as Skeletal Muscle Area (SMA) /height2 < 38.5 cm2/m2 in women and < 52.4 cm2/m2 in men. RESULTS: Between 2010 and 2020, 47 patients (mean age 63.1 ± 12.3 years; male, n = 28 (59.6%) underwent body composition analysis. Twenty-one patients (44.7%) were sarcopenic, and 12 (25.5%) had evidence of sarcopenic obesity. The most common postoperative complication was surgical site infection (SSI) (n = 8, 17%). Sarcopenia (n = 7, 87.5%, p = 0.02) and sarcopenic obesity (n = 5, 62.5%, p = 0.02) were significantly associated with SSIs. The risks of developing an SSI were 8.7 times greater when sarcopenia was present. CONCLUSION: Sarcopenia and sarcopenic obesity were related to postoperative complications following Hartmann's reversal. Body composition measured by a validated AI algorithm may be a beneficial tool for predicting short-term surgical outcomes for these patients.

Can AI-based body composition assessment outperform body surface area in predicting dose-limiting toxicities for colonic cancer patients on chemotherapy?

PURPOSE: Gold standard chemotherapy dosage is based on body surface area (BSA); however many patients experience dose-limiting toxicities (DLT). We aimed to evaluate the effectiveness of BSA, two-dimensional (2D) and three-dimensional (3D) body composition (BC) measurements derived from Lumbar 3 vertebra (L3) computed tomography (CT) slices, in predicting DLT in colon cancer patients. METHODS: 203 patients (60.87 ± 12.42 years; 97 males, 47.8%) receiving adjuvant chemotherapy (Oxaliplatin and/or 5-Fluorouracil) were retrospectively evaluated. An artificial intelligence segmentation model was used to extract 2D and 3D body composition measurements from each patients' single mid-L3 CT slice as well as multiple-L3 CT scans to produce a 3D BC report. DLT was defined as any incidence of dose reduction or discontinuation due to chemotherapy toxicities. A receiver operating characteristic (ROC) analysis was performed on BSA and individual body composition measurements to demonstrate their predictive performance. RESULTS: A total of 120 (59.1%) patients experienced DLT. Age and BSA did not vary significantly between DLT and non-DLT group. Females were significantly more likely to experience DLT (p = 4.9 × 10-3). In all patients, the predictive effectiveness of 2D body composition measurements (females: AUC = 0.50-0.54; males: AUC = 0.50-0.61) was equivalent to that of BSA (females: AUC = 0.49; males: AUC = 0.58). The L3 3D skeletal muscle volume was the most predictive indicator of DLT (AUC of 0.66 in females and 0.64 in males). CONCLUSION: Compared to BSA and 2D body composition measurements, 3D L3 body composition measurements had greater potential to predict DLT in CRC patients receiving chemotherapy and this was sex dependent.

A Quadruplex Ultrasensitive Immunoassay for Simultaneous Assessment of Human Reproductive Hormone Proteins in Multiple Biofluid Samples.

Reproductive hormones play vital roles in reproductive health and can be used to assess a woman's ovarian function and diagnose diseases associated with reproductive endocrine disorders. As these hormones are important biomarkers for reproductive health monitoring and diagnosis, a rapid, high-throughput, and low-invasive detection and simultaneous assessment of the levels of multiple reproductive hormones has important clinical applications. In this work, a quadruplex ultrasensitive immunoassay was developed for simultaneous assessment of 4 human reproductive hormone proteins (follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), and anti-Müllerian hormone (AMH)) in a variety of human biofluid samples. This assay takes advantage of single-molecule imaging of microwell arrays and capture antibody beads as a reaction interface to construct multiplex bead array immunoassays. The analyte-bound beads can easily be parsed to individual wells and detected via fluorophores, emitting distinct wavelengths associated to the beads. As a result, this proposed quadruplex immunoassay exhibits four good 4-parameter logistic calibration curves ranging from 2.7 to 2000, 1.6 to 1200, 1.8 to 1300, and 0.3 to 220 pg/mL with limits of detection of 0.32, 0.28, 0.14, and 0.02 pg/mL for FSH, LH, PRL, and AMH, respectively. Furthermore, the developed quadruplex immunoassay was used to test clinical venous serum samples where it showed remarkable consistency with clinical test results in methodological comparison and the diagnosis of polycystic ovary syndrome. In addition, we successfully applied the ultrasensitive capability of this assay to the simultaneous testing and evaluation of four proteins in fingertip blood as well as urine samples, in which the urinary AMH level (1.42-156 pg/mL) was measured and assessed quantitatively for the first time.

Distribution, sources and risk assessment of polycyclic aromatic hydrocarbons in surface sediments from the Yellow Sea coast, China.

To study the distribution, sources, ecological/health risks, and the impact of regional economic variations on polycyclic aromatic hydrocarbons (PAHs) contaminations along the coast of the Yellow Sea in China, sediments from a broad coastal coverage were collected and analyzed. The total contents of 16 priority PAHs varied between 1.4 and 1675.9 ng/g except in the site of H18 (3191.4 ng/g) adjacent to Qingdao City, with an average value of 295.7 ng/g. PAH pollution along the coast presented a distinctive geographical feature, which was closely linked to local human activities, such as Rongcheng with industrial zones and aquacultural areas, and Yancheng Wetland with developed aquaculture. The source analysis results indicated that PAHs were mainly from pyrolytic sources, with smaller contributions from petroleum spills and combustion. Risk assessment suggested that PAH pollution along the Yellow Sea coast showed negligible biological risks and health risks in most areas.

Sediment characteristics and environmental quality assessment in Kompong Som Bay, Cambodia.

The grain size and heavy metals (Cu, Pb, Zn, Cr, Cd, and Hg) in 42 seafloor and eight river sediments from the Kompong Som Bay of Cambodia were analyzed to identify sediment characteristics and environmental quality. The high-value areas for all the metals were mainly distributed in the northern and central parts of the bay, occupied by fine-grained sediments. There was slightly to moderately severe enrichment of Pb, Cd, and Hg in the southern and western coastal areas of Sihanoukville. Although the current ecological environment risk was relatively low, the coastal areas of Sihanoukville had low to moderate pollution of Pb, Cd, and Hg, which were closely related to pollutant emissions from the industrial production from power plants and oil refineries. It is recommended to establish a normalized monitoring mechanism and control the discharge of coastal pollutants to ensure the sustainable development of the coastal environment.

Formation of nanoscale Te0 and its effect on TeO32- reduction in CH4-based membrane biofilm reactor.

Formation and recovery of elemental tellurium (Te0) from wastewaters are required by increasing demands and scarce resources. Membrane biofilm reactor (MBfR) using gaseous electron donor has been reported as a low-cost and benign technique to reduce and recover metal (loids). In this study, we demonstrate the feasibility of nanoscale Te0 formation by tellurite (TeO32-) reduction in a CH4-based MBfR. Biogenic Te0 intensively attached on cell surface, within diameters ranging from 10 nm to 30 nm and the hexagonal nanostructure. Along with the Te0 formation, the TeO32- reduction was inhibited. After flushing, biofilm resumed the TeO32- reduction ability, suggesting that the formed nanoscale Te0 might inhibit the reduction by hindering substrate transfer of TeO32- to microbes. The 16S rRNA gene amplicon sequencing revealed that Thermomonas and Hyphomicrobium were possibly responsible for TeO32- reduction since they increased consecutively along with the experiment operation. The PICRUSt (Phylogenetic Investigation of Communities by Reconstruction of Unobserved States) analysis showed that the sulfite reductases were positively correlated with the TeO32- flux, indicating they were potential enzymes involved in reduction process. This study confirms the capability of CH4-based MBfR in tellurium reduction and formation, and provides more techniques for resources recovery and recycles.

Distribution, sources and ecological risk assessment of PAHs in surface sediments from the Luan River Estuary, China.

The distribution, sources and risk assessment of 16 polycyclic aromatic hydrocarbons (PAHs) of surface sediments in the Luan River Estuary, China, have been investigated in the research. The results indicated that the total concentrations of 16 PAHs in surface sediments of the Luan River Estuary ranged from 5.1 to 545.1 ng g(-1)dw with a mean value of 120.8 ng g(-1)dw, which is relatively low in comparison with other estuaries around the world. The PAHs in the study area were mainly originated from pyrogenic sources. Besides, PAHs may be contaminated by petrogenic PAHs as indicated by the selected ratios of PAHs, the 2-tailed Pearson correlation analysis and principal components analysis at different sites. The result of the ecological risk assessment shows little negative effect for most individual PAHs in surface sediments of the Luan River Estuary, China.