Guiding post-pancreaticoduodenectomy interventions for pancreatic cancer patients utilizing decision tree models.

Background: Pancreatic ductal adenocarcinoma (PDAC) is frequently diagnosed in advanced stages, necessitating pancreaticoduodenectomy (PD) as a primary therapeutic approach. However, PD surgery can engender intricate complications. Thus, understanding the factors influencing postoperative complications documented in electronic medical records and their impact on survival rates is crucial for improving overall patient outcomes. Methods: A total of 749 patients were divided into two groups: 598 (79.84%) chose the RPD (Robotic pancreaticoduodenectomy) procedure and 151 (20.16%) chose the LPD (Laparoscopic pancreaticoduodenectomy) procedure. We used correlation analysis, survival analysis, and decision tree models to find the similarities and differences about postoperative complications and prognostic survival. Results: Pancreatic cancer, known for its aggressiveness, often requires pancreaticoduodenectomy as an effective treatment. In predictive models, both BMI and surgery duration weigh heavily. Lower BMI correlates with longer survival, while patients with heart disease and diabetes have lower survival rates. Complications like delayed gastric emptying, pancreatic fistula, and infection are closely linked post-surgery, prompting conjectures about their causal mechanisms. Interestingly, we found no significant correlation between nasogastric tube removal timing and delayed gastric emptying, suggesting its prompt removal post-decompression. Conclusion: This study aimed to explore predictive factors for postoperative complications and survival in PD patients. Effective predictive models enable early identification of high-risk individuals, allowing timely interventions. Higher BMI, heart disease, or diabetes significantly reduce survival rates in pancreatic cancer patients post-PD. Additionally, there's no significant correlation between DGE incidence and postoperative extubation time, necessitating further investigation into its interaction with pancreatic fistula and infection.

Quantitative prediction of AFB1 in various types of edible oil based on absorption, scattering and fluorescence signals at dual wavelengths.

This study aims to address the challenge of matrix interference of various types of edible oils on intrinsic fluorescence of aflatoxin B1 (AFB1) by developing a novel solution. Considering the fluorescence internal filtering effect, the absorption (µa) and reduced scattering (µ's) coefficients at dual wavelengths (excitation: 375 nm, emission: 450 nm) were obtained by using integrating sphere technique, and were used to improve the quantitative prediction results for AFB1 contents in six different kinds of edible oils. A research process of "Monte Carlo (MC) simulation - phantom verification - actual sample validation" was conducted. The MC simulation was used to determine interference rule and correction parameters for fluorescence, the results indicated that the escaped fluorescence flux nonlinearly decreased with the µa, µ's at emission wavelength (µa,em, µ's,em) and µa at excitation wavelength (µa,ex), however increased with the µ's at excitation wavelength (µ's,ex). And the required optical parameters to eliminate the interference of matrix on fluorescence intensity are: effective attenuation coefficients at excitation and emission wavelengths (µeff,ex, µeff,em) and µ's,ex. Phantom verification was conducted to explore the feasibility of fluorescence correction based on the identified parameters by MC simulation, and determine the optimal machine learning method. The modelling results showed that least squares support vector regression (LSSVR) model could reach the best performance. Three kinds of edible oil (peanut, rapeseed, corn), each with two brands were used to prepare oil samples with different AFB1 contamination. The LSSVR model for AFB1 based on µeff,ex, µeff,em, µ's,ex and fluorescence intensity at 450 nm was calibrated, both correlation coefficients for calibration (Rc) and the validation (Rv) sets could reach 1.000, root mean square errors for calibration (RMSEC) and the validation (RMSEV) sets were as low as 0.038 and 0.099 respectively. This study proposed a novel method which is based solely on the absorption, scattering, and fluorescence characteristics at excitation and emission wavelengths to achieve accurate prediction of AFB1 content in different types of vegetable oils.

How does green finance affect cleaner industrial production and end-of-pipe treatment performance? Evidence from China.

Effectively identifying the role and mechanism of green finance in environmental governance provides an important guarantee that green finance serves the ecological environment. Based on the panel data of 30 provinces in China from 2001 to 2015, this paper explores the impact of green finance on cleaner industrial production and end-of-pipe treatment and further reveals the mediating effect of industrial structure optimization and the moderating effect of environmental regulation. The results show that (1) China's cleaner industrial production performance, end-of-pipe treatment performance and systematic governance performance show a clear upwards trend, distributed in stages in the eastern, central and western regions from high to low. (2) At the national level, green finance promotes cleaner production performance but inhibits end-of-pipe treatment performance. However, it can be seen from the results of the sub-sample, the eastern and central regions are consistent with the overall effect, with heterogeneous effects in the western region. (3) The optimization of industrial structure plays a partial intermediary role in the impact of green finance on cleaner production and end-of-pipe treatment. (4) Both "market-incentive" and "command-and-control" environmental regulations weaken the positive impact of green finance on cleaner production; "market-incentive" environmental regulation alleviates the negative impact of green finance on end-of-pipe treatment, while the moderating effect of "command-and-control" environmental regulation on end-of-pipe treatment is not significant.

Whether Green Finance Can Effectively Moderate the Green Technology Innovation Effect of Heterogeneous Environmental Regulation.

As an essential way to promote ecological civilization, green finance is attracting wide attention. However, whether green finance can successfully regulate the green technology innovation effect of heterogeneous environmental regulations and boost green technology innovation in coordination with heterogeneous environmental regulations remains unclear. Based on the re-measurement of the green finance development index of various provinces and cities in China, this study uses the spatial Durbin model to test the above problems empirically. The results show that green finance and "market incentive" environmental regulations can promote regional green technology innovation, while "command and control" environmental regulations inhibit regional green technology innovation. Green finance plays a negative regulatory role in the mechanism of heterogeneous environmental regulations affecting green technology innovation. Green finance alleviates the negative impact of "command and control" environmental regulations on green technology innovation and weakens the positive impact of "market-incentive" environmental regulations on green technology innovation. In terms of spillover effects, green finance can effectively promote green technology innovation in neighboring regions, while heterogeneous environmental regulations have a crowding-out effect on green technology innovation in neighboring regions.

Assessment the flavor of soybean meal hydrolyzed with Alcalase enzyme under different hydrolysis conditions by E-nose, E-tongue and HS-SPME-GC-MS.

In the present study, E-nose, E-tongue, and headspace-solid phase microextraction gas chromatography-mass spectrometry (HS-SPME-GC-MS) technology combined with Principal Component Analysis (PCA) were employed to evaluate the flavor characteristics of the volatile and the non-volatile substances generated during the enzymatic hydrolysis of the soybean meal by Alcalase. The results showed that the enzymatic hydrolysis effectively reduced the content of soybean odorous substance 1-octene-3-ol and led to better flavor. However, the excessive enzymatic hydrolysis resulted in the deterioration of the enzymatic hydrolysates flavor. In addition, both radar graph and PCA of E-tongue were able to provide the distribution of flavor substances during the enzymatic hydrolysis of the soybean meal. These results provided a theoretical basis for the improvement of the flavors of the soybean meal and its derived products.

Assessment of Brain Glucose Metabolism Following Cardiac Arrest by [18F]FDG Positron Emission Tomography.

BACKGROUND: Cardiac arrest (CA) patients who survived by cardiopulmonary resuscitation (CPR) can present different levels of neurological deficits ranging from minor cognitive impairments to persistent vegetative state and brain death. The pathophysiology of the resulting brain injury is poorly understood, and whether changes in post-CA brain metabolism contribute to the injury are unknown. Here we utilized [18F]fluorodeoxyglucose (FDG)-Positron emission tomography (PET) to study in vivo cerebral glucose metabolism 72 h following CA in a murine CA model. METHODS: Anesthetized and ventilated adult C57BL/6 mice underwent 12-min KCl-induced CA followed by CPR. Seventy-two hours following CA, surviving mice were intraperitoneally injected with [18F]FDG (~ 186 µCi/200 µL) and imaged on Molecubes preclinical micro-PET/computed tomography (CT) imaging systems after a 30-min awake uptake period. Brain [18F]FDG uptake was determined by the VivoQuant software on fused PET/CT images with the 3D brain atlas. Upon completion of Positron emission tomography (PET) imaging, remaining [18F]FDG radioactivity in the brain, heart, and liver was determined using a gamma counter. RESULTS: Global increases in brain [18F]FDG uptake in post-CA mice were observed compared to shams and controls. The median standardized uptake value of [18F]FDG for CA animals was 1.79 versus sham 1.25 (p < 0.05) and control animals 0.78 (p < 0.01). This increased uptake was consistent throughout the 60-min imaging period and across all brain regions reaching statistical significance in the midbrain, pons, and medulla. Biodistribution analyses of various key organs yielded similar observations that the median [18F]FDG uptake for brain was 7.04%ID/g tissue for CA mice versus 5.537%ID/g tissue for sham animals, p < 0.05). CONCLUSIONS: This study has successfully applied [18F]FDG-PET/CT to measure changes in brain metabolism in a murine model of asystolic CA. Our results demonstrate increased [18F]FDG uptake in the brain 72 h following CA, suggesting increased metabolic demand in the case of severe neurological injury. Further study is warranted to determine the etiology of these changes.

Benefit-risk assessment of dietary selenium and its associated metals intake in China (2017-2019): Is current selenium-rich agro-food safe enough?

Dietary consumption of selenium-rich agro-food is an effective way to avoid selenium deficiency diseases, however, over consumption of selenium-rich agro-food will result in potential risk of selenosis and problems with associated metals. In this study, we measured the concentrations of selenium and its associated metals in 2756 common and 4894 selenium-rich agro-food samples in 10 regions of China. We found that selenium-rich rice, flour, edible fungi and algae, meat, and tea contain higher levels of associated metals than other selenium-rich agro-food samples. Increasing the consumption of selenium-rich agro-food could make the actual intakes (AIs) of selenium for all population to meet respective recommended daily intakes (RDIs). Benefit-risk assessment results indicated that increasing the consumption of selenium-rich agro-food make AIs of selenium for all populations meet RDIs, chromium intakes for people under 18 years old exceed provisional tolerated daily intake (PTDIs), while arsenic and cadmium intakes are close to PTDIs. The main dietary contributors of selenium, chromium, arsenic and cadmium were meat, edible fungi and algae, rice, and rice, respectively. The study supported the consumption of selenium-rich agro-food for effective selenium supplement, but also emphasized potential risk from associated metals in selenium-rich agro-food, especially chromium.

Determination of Selenium in Common and Selenium-Rich Rice from Different Areas in China and Assessment of Their Dietary Intake.

In this study, 41 common rice varieties and 211 selenium-rich rice varieties from ten representative areas in China were collected in 2017-2019. The selenium contents of rice were analyzed with optimized inductively coupled plasma mass spectrometry (ICP-MS). Selenium concentrations of common rice and selenium-rich rice ranges were 0.81-7.26 and 0.76-180.73 µg/100 g, respectively. The selenium contents in selenium-rich rice from different areas were significantly different (p < 0.001) while those in common rice from different areas were not. The selenium-rich rice in Harbin and Keshan showed the lowest selenium level and those from selenium-rich areas (Enshi and Ankang) were highest. Based on the estimation of the risk assessment software @risk7.0 (Palisade Corporation, New York, NY, USA), the consumption of selenium-rich rice can effectively increase dietary selenium intake for the population. However, the risk index of P95 (Percentile 95) selenium exposure at the tolerable upper intake level for children at 2-14 years old exceeded 100%, with potential risk currently. Therefore, the consumption of selenium-rich rice should be properly monitored for young children and adolescents.

An ultralow dose of the NADPH oxidase inhibitor diphenyleneiodonium (DPI) is an economical and effective therapeutic agent for the treatment of colitis-associated colorectal cancer.

Long-term inflammatory stimulation is considered one of the most important causes of colorectal cancer. Diphenyleneiodonium (DPI), an NADPH oxidase inhibitor, can inhibit a variety of inflammatory responses. However, the systemic toxicity of DPI limits its clinical application. Whether DPI can inhibit colitis-associated colorectal cancer (CAC) at ultralow concentrations remains unknown. Methods: CAC was induced by azoxymethane (AOM) injection followed by treatment with dextran sulfate sodium (DSS), and DPI was intraperitoneally injected (i.p.) in the first cycle for 21 days. Colon tissue was collected and analyzed by western blotting. Immune cell infiltration and macrophage polarization were examined by immunohistochemistry, immunofluorescence, or real-time polymerase-chain reaction (PCR). Reactive oxygen species (ROS) production was measured by flow cytometry. Results: Ultralow dose DPI significantly ameliorated the DSS-induced colitis and attenuated the colon tumorigenesis in the mouse model of AOM/ DSS-induced CAC. Mechanistically, an ultralow dose of DPI inhibited the production of pro-inflammatory cytokines, (tumor necrosis factor (TNF)-α and interleukin (IL)-6), reduced the macrophage infiltration and classical polarization, and induced the ROS generation. These effects were found to be related to the inhibition of the phosphorylation of signal transducer and activator of transcription 3 (STAT3), mitogen-activated protein kinase (MAPK), and nuclear factor kappa B (NF -κB). Conclusion: The present study revealed that an ultralow dose of DPI, with no significant systemic toxicity involved, may be an effective way to prevent the occurrence and development of CAC.

Treatment satisfaction with rheumatoid arthritis in patients with different disease severity and financial burden: A subgroup analysis of a nationwide survey in China.

BACKGROUND: Despite the recent advances in treatments for rheumatoid arthritis (RA), there are still unmet needs in disease outcomes. This study aimed to analyze the satisfaction with drug therapies for RA according to the levels of disease severity (patient-assessed) and proportions of treatment cost to household income. METHODS: This was a subgroup study of a cross-sectional study in patients with RA and their physicians. The patients were subdivided into different subgroups based on their self-assessed severity of RA and on the proportions of treatment cost to household income (<10%, 10-30%, 31-50%, and >50%). The Treatment Satisfaction Questionnaire for Medication version II was used to assess patients' treatment satisfaction. RESULTS: When considering all medications, effectiveness, convenience, and global satisfaction scores were lower in the severe and moderate RA subgroups than those in the mild and extremely mild RA subgroups (all P < 0.001). Effectiveness, side effects, and convenience scores were higher in the <10% subgroup compared to those in the >50% subgroup (all P < 0.05). Global satisfaction score was higher in the <10% subgroup than that in the 31% to 50% subgroup (F = 13.183, P = 0.004). For biological disease-modifying anti-rheumatic drugs, effectiveness and convenience scores were lower in the severe RA subgroup than those in the extremely mild RA subgroup (both P < 0.05). Convenience score was higher in the <10% subgroup compared to that in the 31% to 50% and >50% subgroups (F = 12.646, P = 0.005). Global satisfaction score was higher in the <10% subgroup than that in the 31% to 50% subgroup (F = 8.794, P = 0.032). CONCLUSION: Higher disease severity and higher financial burden were associated with lower patient satisfaction.

Marrow assessment for hemophagocytic lymphohistiocytosis demonstrates poor correlation with disease probability.

OBJECTIVES: To evaluate the amount of hemophagocytosis in 64 marrow core biopsy specimens and aspirates from 58 patients with clinical suspicion for secondary hemophagocytic lymphohistiocytosis (HLH) or reported findings of hemophagocytosis. METHODS: A review of medical records assigned patients to a low-risk (45 patients) or high-risk (13 patients) HLH group, and association with histologic findings was examined using the Fisher exact test. RESULTS: The amount of hemophagocytosis in aspirate or the core biopsy specimen did not correlate with disease probability (P = .17 and P = .63, respectively). Of the clinical/laboratory criteria assessed, the most significant correlations with HLH were highly elevated ferritin (P = .01), cytopenias (P = .02), and fever (P = .009). CONCLUSIONS: Our findings indicated that marrow histologic findings alone do not reliably predict the probability of HLH, and an isolated finding of hemophagocytosis, even when present in a high amount, lacks specificity for HLH.

A recession's impact on pediatric emergency household spending and attitudes about health-care reform.

BACKGROUND: We assessed changes in household spending and opinions about health-care insurance reform among parents in the pediatric emergency department (PED) during the current recession. METHODS: We conducted a survey of parents at a PED. Enrollment was in June and July 2009. We assessed demographics, employment and insurance status, and difficulty paying for household expenses. Open-ended questions addressed attitudes about health-care reform. RESULTS: Among 467 parents, job loss was associated with difficulty paying for food (OR 2.32, 95% CI 1.53-3.52), housing (3.21, 2.11-4.88), and utilities (2.19, 1.44-3.32). In total, 226 respondents cut household expenses. More respondents cut food expenses (20.8%) and utilities (15.8%) than child health care (12.0%). Of 154 respondents providing opinions about health-care reform, 66.9% endorsed reform, and 9.7% disagreed. CONCLUSION: Parents with job loss reported hardship paying for household expenses. One in eight families have cut child health-care expenses. A population of PED parents commonly favored health-care insurance reform.

Assessment of surface water quality using multivariate statistical techniques in red soil hilly region: a case study of Xiangjiang watershed, China.

In the study, multivariate statistical methods including factor, principal component and cluster analysis were applied to analyze surface water quality data sets obtained from Xiangjiang watershed, and generated during 7 years (1994-2000) monitoring of 12 parameters at 34 different profiles. Hierarchical cluster analysis grouped 34 sampling sites into three clusters, including relatively less polluted (LP), medium polluted (MP) and highly polluted (HP) sites, and based on the similarity of water quality characteristics, the watershed was divided into three zones. Factor analysis/principal component analysis, applied to analyze the data sets of the three different groups obtained from cluster analysis, resulted in four latent factors accounting for 71.62%, 71.77% and 72.01% of the total variance in water quality data sets of LP, MP and HP areas, respectively. The PCs obtained from factor analysis indicate that the parameters for water quality variations are mainly related to dissolve heavy metals. Thus, these methods are believed to be valuable to help water resources managers understand complex nature of water quality issues and determine the priorities to improve water quality.