Validation of a pulmonary embolism risk assessment model in gynecological inpatients : Clinical trial: A single-center, retrospective study.

OBJECTIVE: To compare the predictive efficacy of the PADUA and Caprini models for pulmonary embolism (PE) in gynecological inpatients, analyze the risk factors for PE, and validate whether both models can effectively predict mortality rates. METHODS: A total of 355 gynecological inpatients who underwent computed tomography pulmonary angiography (CTPA) were included in the retrospective analysis. The comparative assessment of the predictive capabilities for PE between the PADUA and Caprini was carried out using receiver operating characteristic (ROC) curves. Logistic regression analysis was used to identify risk factors associated with PE. Additionally, Kaplan-Meier survival analysis plots were generated to validate the predictive efficacy for mortality rates. RESULTS: Among 355 patients, the PADUA and Caprini demonstrated the area under the curve (AUC) values of 0.757 and 0.756, respectively. There was no statistically significant difference in the AUC between the two models (P = 0.9542). Multivariate logistic analysis revealed immobility (P < 0.001), history of venous thromboembolism (VTE) (P = 0.002), thrombophilia (P < 0.001), hormonal treatment (P = 0.022), and obesity (P = 0.019) as independent risk factors for PE. Kaplan-Meier survival analysis demonstrated the reliable predictive efficacy of both the Caprini (P = 0.00051) and PADUA (P = 0.00031) for mortality. ROC for the three- and six-month follow-ups suggested that the Caprini model exhibited superior predictive efficacy for mortality. CONCLUSIONS: The PADUA model can serve as a simple and effective tool for stratifying high-risk gynecological inpatients before undergoing CTPA. The Caprini model demonstrated superior predictive efficacy for mortality rates.

Quantitative 1H NMR with global spectral deconvolution approach for quality assessment of natural and cultured Cordyceps sinensis.

Cordyceps sinensis is a precious medicinal food which has been successfully cultivated indoors. It remains to be investigated for a simultaneous comparison on aqueous components of natural and cultivated samples. Herein, an approach of quantitative nuclear magnetic resonance (qNMR) analysis combined with global spectral deconvolution (GSD) was established for simultaneous quantification of 26 aqueous components in C. sinensis. Processed by GSD, the distorted baselines of 1H NMR spectra were greatly improved, and overlapped signals were also well separated so as to achieve accurate identification and quantitation of components in C. sinensis. Method validation by UHPLC-QTOF-MS and TOF-SIMS analysis revealed that qNMR combined with GSD is a reliable approach for simultaneous quantification of multiple components including characteristic markers of glutamine, GABA and trehalose in authentic and fake C. sinensis. The well-established qNMR approach can be used for quality assessment of natural and cultivated C. sinensis as well as differentiation from fake ones.

[Form and valence of arsenic in dry and fresh Cordyceps breeding products based on HPLC-ICP-MS and its risk assessment].

A comparative study was conducted for the first time on the form and valence of arsenic in the dry and fresh Cordyceps breeding products to clarify the specific morphology and valence of arsenic in Cordyceps breeding products and its safety. Arsenic betai-ne(AsB), arsenite(AsⅢ), dimethyl arsenic(DMA), arsenocholine(AsC), monomethyl arsenic(MMA), and arsenate(AsⅤ) in the dry and fresh samples were investigated using a bionic extraction method combined with HPLC-ICP-MS. The HPLC separation was performed on a DioncxIonPac~(TM) AS7 anion exchange column with a mobile phase of 100 mmol·L~(-1) ammonium carbonate-water for gradient elution at room temperature and the flow rate of 0.8 mL·min~(-1). HPLC was coupled with ICP-MS for the determination. The arsenic content was characterized in combination with chemometrics. The health safety risk of inorganic arsenic in the samples was assessed using the margin of exposure(MOE). The results of methodological validation showed that the six arsenic compounds showed good linearity(R~2>0.999) from 10 to 500 ng·mL~(-1), with precision RSDs of 1.8%-3.0%, recoveries(n=6) of 84.15%-98.28%, reproducibility RSDs of 6.4%-7.7%, and sample stability RSDs of 8.3%-14% within 10 h. Trace AsⅢ and AsⅤ were detected in 30 batches of dry and fresh Cordyceps breeding products, while arsenic compounds in other forms and valence were not detected. In the dry products, AsⅢ was 0.019-0.040 mg·kg~(-1) and AsV was 0.024-0.061 mg·kg~(-1), while in the fresh products, AsⅢ was 0.002 3-0.006 1 mg·kg~(-1) and AsⅤ was 0.008-0.016 mg·kg~(-1). The risk assessment results showed that the MOE of inorganic arsenic was much higher than 1 in both dry and fresh products, and the potential health safety risk of inorganic arsenic was low. The HPLC-ICP-MS method established in this study was efficient, rapid, accurate, and stable for the determination of six arsenic compounds in Cordyceps breeding products. The results of this study provide a basis for the safety and quality control of Cordyceps breeding products.

Spatial distribution of heavy metals in rice grains and human health risk assessment in Hunan Province, China.

Rice is the main food in China, and its pollution by heavy metals has attracted widespread attention. In this study, rice grain samples were collected from 14 prefecture-level cities in Hunan Province, China. The contents of 9 heavy metals (i.e., As, Cr, Co, Ni, Cu, Zn, Cd, Pb, and Sb) were measured using graphite digestion-inductively coupled plasma mass spectrometry (ICP-MS). Pearson correlation analysis and principal component analysis were performed to evaluate the correlation among these heavy metals. In addition, ordinary kriging interpolation were applied to investigate the spatial distribution pattern of the heavy metals. Results showed that the average concentrations of these heavy metals were 0.48 (As), 1.28 (Cr), 0.03 (Co), 0.84 (Ni), 2.39 (Cu), 15.73 (Zn), 0.28 (Cd), 0.66 (Pb), and 0.0043 (Sb) mg/kg, respectively. The single-factor pollution index (SFPI) contamination assessment showed that As, Pb, Cr, Ni, and Cd accumulated significantly in the rice grain, with over-standard rates of 100%, 100%, 64.70%, 47.05%, and 44.12%, respectively. The Sb concentrations at the sampling sites were low, and there was no obvious pollution. Health risk assessment showed that the target hazard quotient followed the order of As> Cr> Cd> Pb> 1.0> Co> Cu> Zn> Ni> Sb, and the carcinogenic risk value was in the order of Cd> Ni> As> Cr> 1.0×10-4> Pb. In particular, quick actions should be taken to regulate As, Cr, and Cd contents in rice because they posed greater non-carcinogenic and carcinogenic health risks than the others to the local residents.

Reinforcer pathology of internet-related behaviors among college students: Data from six countries.

Research has demonstrated that repeated engagement in low-effort behaviors that are associated with immediate reward, such as Internet use, can result in a pathological reinforcement process in which the behavior is increasingly selected over other activities due, in part, to a low availability of alternative activities and to a strong preference for immediate rather than delayed rewards (delay discounting). However, this reinforcer pathology model has not been generalized to other Internet-related behaviors, such as online gaming or smartphone use. Given the widespread availability of these technologies, it is also important to examine whether reinforcer pathology of Internet-related behaviors is culturally universal or culture-specific. The current study examines relations between behavioral economic constructs (Internet demand, delay discounting, and alternative reinforcement) and Internet-related addictive behaviors (harmful Internet use, smartphone use, online gaming, and Internet sexual behavior) in a cross-sectional sample of college students (N = 1,406) from six different countries (Argentina, Australia, India, Malaysia, the United Kingdom, and the United States). Using structural equation modeling, Internet demand was associated with harmful Internet use, smartphone use, and online gaming; delay discounting was associated with harmful smartphone use; and alternative reinforcement was associated with harmful Internet and smartphone use. The models were partially invariant across countries. However, mean levels of behavioral economic variables differed across countries, country-level gross domestic product, person-level income, and sex at birth. Results support behavioral economic theory and highlight the importance of considering both individual and country-level sociocultural contextual factors in models for understanding harmful engagement with Internet-related behaviors. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Develop a Mobile Nursing App to Improve Nursing Workflow and Effectiveness Assessment.

We develop a mobile care application that includes tools such as voice input, image upload, and image recognition. This procedure will be used in clinical care. The study is expected to undergo actual use testing in the ward and a questionnaire survey three months after use. During use, the mobile phone connection data will continuously monitor to analyze the number and time of connection records.

Various myosteatosis selection criteria and their value in the assessment of short- and long-term outcomes following liver transplantation.

Body composition and myosteatosis affect clinical outcomes in orthotopic liver transplantation (OLT). Here we aimed to compare the value and limitations of various selection criteria to define pre-transplant myosteatosis in the assessment of short- and long-term outcomes following OLT. We retrospectively analyzed the data of 264 consecutive recipients who underwent deceased donor OLT at a German university medical centre. Myosteatosis was evaluated by preoperative computed-tomography-based segmentation. Patients were stratified using muscle radiation attenuation of the whole muscle area (L3Muslce-RA), psoas RA (L3Psoas-RA) and intramuscular adipose tissue content (IMAC) values. L3Muslce-RA, L3Psoas-RA and IMAC performed well without major differences and identified patients at risk for inferior outcomes in the group analysis. Quartile-based analyses, receiver operating characteristic curve and correlation analyses showed a superior association of L3Muslce-RA with perioperative outcomes when compared to L3Psoas-RA and L3IMAC. Long-term outcome did not show any major differences between the used selection criteria. This study confirms the prognostic role of myosteatosis in OLT with a particularly strong value in the perioperative phase. Although, based on our data, L3Muscle-RA might be the most suitable and recommended selection criterion to assess CT-based myosteatosis when compared to L3Psoas-RA and L3IMAC, further studies are warranted to validate these findings.

Active Enhancer Assessment by H3K27ac ChIP-seq Reveals Claudin-1 as a Biomarker for Radiation Resistance in Colorectal Cancer.

BACKGROUND: Colorectal cancer (CRC) represents the third most common malignant tumor in the worldwide. Radiotherapy is the common therapeutic treatment for CRC, but radiation resistance is often encountered. ChIP-seq of Histone H3K27 acetylation (H3K27ac) has revealed enhancers that play an important role in CRC. This study examined the relationship between an active CRC enhancer and claudin-1 (CLDN1), and its effect on CRC radiation resistance. METHODS: The target CRC genes of active enhancers were obtained from public H3K27ac ChIP-seq, and the genes highly expressed in radio-resistant CRC were screened and intersected with enhancer-driven genes. The clinical roles of CLDN1 in radiation resistance were examined using the t-test, standard mean deviation (SMD), summary receiver operating characteristic curve and Kaplan-Meier curves. The co-expressed genes of CLDN1 were calculated using Pearson Correlation analysis, and Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes and Gene Set Variation Analysis (GSVA) analyses were used to examine the molecular mechanisms of CLDN1. RESULTS: Total 13 703 CRC genes were regulated by enhancers using 58 H3K27ac ChIP-seq. Claudin-1 (CLDN1) was enhancer-driven and notably up-regulated in CRC tissues compared to non-CRC controls, with a SMD of 3.45 (95 CI % = .56-4.35). CLDN1 expression was increased in radiation-resistant CRC with a SMD of .42 (95% CI = .16-.68) and an area under the curve of .74 (95% CI = .70-.77). The cell cycle and immune macrophage levels were the most significant pathways associated with CLDN1. CONCLUSION: CLDN1 as an enhancer-regulated gene that can boost radiation resistance in patients with CRC.

[Seasonal Distribution Characteristics and Health Risk Assessment of Heavy Metals in Surface Water of Qingjiang River].

In order to assess the health risks of heavy metals in surface water of Qingjiang River, surface water samples were taken at designed cross-sections of the river and analyzed for Cr, Cu, Zn, Pb, Cd, As, and Mn. Health risks from these heavy metals for adults and children in wet and dry seasons were compared by water environmental health risk assessment model of the USEPA. It found that the main excessive element is Mn, concentrating in the Danshui, Yantouxi, and Pingluoxi, the slightly excessive element is As, the concentration of Mn was above national standard, and it mainly distributed in Danshui, Yantouxi, and Pingluoxi, As was slightiy over the standard, and it concentrated in Wujiahe, The content of heavy metals during wet season were all higher than those during dry season. Cr, Cu, Zn, and Cd are mainly originated from the nature, Pb and As are separately mainly originated from traffic and agriculture, Mn originated from mining mainly in the downstream, while it has natural source from upper to middle. The health risks of heavy metals in surface water to adults and children in wet season are higher than those in dry season. The main health risk area was the midstream. As was the highest health risk element and children were the most preventive group. Specially, people in towns who drink the water from midstream should pay more attention.

Performance and comparison of assessment models to predict 30-day mortality in patients with hospital-acquired pneumonia.

BACKGROUND: Hospital-acquired pneumonia (HAP) is the most common hospital-acquired infection in China with substantial morbidity and mortality. But no specific risk assessment model has been well validated in patients with HAP. The aim of this study was to investigate the published risk assessment models that could potentially be used to predict 30-day mortality in HAP patients in non-surgical departments. METHODS: This study was a single-center, retrospective study. In total, 223 patients diagnosed with HAP from 2012 to 2017 were included in this study. Clinical and laboratory data during the initial 24 hours after HAP diagnosis were collected to calculate the pneumonia severity index (PSI); consciousness, urea nitrogen, respiratory rate, blood pressure, and age ≥65 years (CURB-65); Acute Physiology and Chronic Health Evaluation II (APACHE II); Sequential Organ Failure Assessment (SOFA); and Quick Sequential Organ Failure Assessment (qSOFA) scores. The discriminatory power was tested by constructing receiver operating characteristic (ROC) curves, and the areas under the curve (AUCs) were calculated. RESULTS: The all-cause 30-day mortality rate was 18.4% (41/223). The PSI, CURB-65, SOFA, APACHE II, and qSOFA scores were significantly higher in non-survivors than in survivors (all P < 0.001). The discriminatory abilities of the APACHE II and SOFA scores were better than those of the CURB-65 and qSOFA scores (ROC AUC: APACHE II vs. CURB-65, 0.863 vs. 0.744, Z = 3.055, P = 0.002; APACHE II vs. qSOFA, 0.863 vs. 0.767, Z = 3.017, P = 0.003; SOFA vs. CURB-65, 0.856 vs. 0.744, Z = 2.589, P = 0.010; SOFA vs. qSOFA, 0.856 vs. 0.767, Z = 2.170, P = 0.030). The cut-off values we defined for the SOFA, APACHE II, and qSOFA scores were 4, 14, and 1. CONCLUSIONS: These results suggest that the APACHE II and SOFA scores determined during the initial 24 h after HAP diagnosis may be useful for the prediction of 30-day mortality in HAP patients in non-surgical departments. The qSOFA score may be a simple tool that can be used to quickly identify severe infections.

Potential value and limitations of different clinical scoring systems in the assessment of short- and long-term outcome following orthotopic liver transplantation.

BACKGROUND: In an attempt to further improve liver allograft utilization and outcome in orthotopic liver transplantation (OLT), a variety of clinical scoring systems have been developed. Here we aimed to comparatively investigate the association of the Balance-of-Risk (BAR), Survival-Outcomes-Following-Liver-Transplant (SOFT), Preallocation-Survival-Outcomes-Following-Liver-Transplant (pSOFT), Donor-Risk-Index (DRI), and the Eurotransplant-Donor-Risk-Index (ET-DRI) scores with short- and long-term outcome following OLT. METHODS: We included 338 consecutive patients, who underwent OLT in our institution between May 2010 and November 2017. For each prognostic model, the optimal cutoff values were determined with the help of the Youden-index and their diagnostic accuracy for 90-day post OLT-mortality and major postoperative complications was measured by the area under the receiver operating characteristic curve (AUROC). Patient- and graft survival were analyzed using the Kaplan-Meier method and the log-rank test. Morbidity was assessed using the Clavien-Dindo classification and the Comprehensive-Complication-Index. RESULTS: BAR, SOFT, and pSOFT performed well above the conventional AUROC-threshold of 0.70 with good prediction of early mortality. Only BAR showed AUC>0.70 for both mortality and major morbidity. With the cutoffs of 14, 31, and 22 respectively for BAR, SOFT, and pSOFT, subgroup analysis showed significant differences (p<0.001) in morbidity and mortality, length of intensive care- and hospital-stay and early allograft dysfunction rates. Five-years patient survival was inferior in the high BAR, pSOFT, and SOFT groups. CONCLUSIONS: Out of all scores tested, the BAR-score had the best value in predicting both 90-day morbidity and mortality after OLT showing the highest AUCs. The pSOFT and SOFT scores demonstrated an acceptable accuracy in predicting 90-day morbidity and mortality. The used BAR, SOFT, and pSOFT cutoffs allowed the identification of patients at risk in terms of five-year patient survival. The DRI and ET-DRI scores have failed to predict recipient outcomes in the present setting.

Delivery of bevacizumab by intracranial injection: assessment in glioma model.

BACKGROUND: Many reports have indicated that the intravenous administration of bevacizumab produces a number of systemic side effects. Therefore, we investigated the therapeutic effects of intratumoral bevacizumab administration using a glioma animal model. METHODS: The glioma cell lines U251 and U87 that carried luciferase were implanted into the brains of mice to develop glioma models. Glioma-bearing mice were treated with bevacizumab intravenously or intratumorally by Alzet micro-osmotic pumps, and the survival time of mice was monitored. Tumor volumes and location were observed by fluorescence imaging and histological analysis. Levels of microvessel marker, cancer stem cell marker as well as angiogenesis-, invasion-, and inflammation-related factors in tumors were examined by immunohistochemical staining. RESULTS: Mice treated with intratumoral low-dose bevacizumab had smaller tumor volumes, longer survival time, lower microvessel density, and fewer cancer stem cells as compared with untreated and intravenously treated mice. Furthermore, expression levels of inflammation-related factors increased signifiwhereas that of angiogenesis- and invasion-related factors decreased in intratumorally treated animals, compared with intravenously treated mice. CONCLUSION: These results implied bevacizumab delivery by intratumoral injection via Alzet micro-osmotic pumps may be a more effective and safer protocol for treating gliomas.

Chemical and biological assessment of Cd-polluted sediment for land use: The effect of stabilization using chitosan-coated zeolite.

Disposal of dredged sediment contaminated with heavy metals on site or in landfills inevitably causes leaching of metals that generate new environmental problems. In this study, we investigated the effectiveness of stabilizing heavy metal Cd in sediment taken from Dongting Lake, China, using a chitosan-coated zeolite, and assessed the feasibility of reusing the stabilized sediment in river bank soil based on chemical and biological analyses. Results showed that the addition of chitosan-coated zeolite significantly reduced acid-exchangeable Cd by 8% in the dredged sediment and 7% in a sediment-soil mixture. Cadmium leachability was greatly reduced in the amended sediment or sediment-soil mixture. Toxicity bioassay using Eisenia fetida showed the mortality rate of worms reduced by 16% in sediment-soil mixture with a Cd concentration of 550 mg/kg and by 17% under a Cd concentration of 250 mg/kg, both with the addition of modified zeolite. Moreover, assimilation of Cd in the earthworms was decreased by a maximum of 36 mg/kg in the sediment-soil mixture with zeolite amendment. These results indicate that the reuse of Cd-contaminated sediment following chitosan-coated zeolite modification is a feasible option for treating the dredged sediment, and could thus benefit both aquatic and terrestrial systems.

Risk assessment of trace metal-polluted coastal sediments on Hainan Island: A full-scale set of 474 geographical locations covering the entire island.

Hainan Island is the second largest island and one of the most famous tourist destinations in China, but sediment contamination by trace metals in coastal areas is a major issue. However, full-scale risk assessments of trace metal-polluted coastal sediments are lacking. In this study, coastal surface sediments from 474 geographical locations covering almost the entire island were collected to identify risk-related variables. Controlling factors and possible sources of trace metals were identified, and the toxicity effects were carefully evaluated. Our results suggest that trace-metal pollution in coastal sediments, which was mainly caused by Pb, Zn and Cu emissions, has primarily resulted from industrial sewage and shipping activities and has threatened the offshore ecosystem of Hainan Island and warrants extensive consideration. This is the first study that has systematically investigated trace metal-polluted coastal sediments throughout the entirety of Hainan Island and provides solid evidence for sustainable marine management in the region.

Assessment of integrated process based on autohydrolysis and robust delignification process for enzymatic saccharification of bamboo.

In this study, bamboo (Phyllostachys pubescens) was successfully deconstructed using an integrated process (autohydrolysis and subsequent delignification). Xylooligosaccharides, high-purity lignin, and digestible substrates for producing glucose can be consecutively collected during the integrated process. The structural change and fate of lignin during autohydrolysis process was deeply investigated. Additionally, the structural characteristics and active functional groups of the lignin fractions obtained by these delignification processes were thoroughly investigated by NMR (2D-HSQC and 31P NMR) and GPC techniques. The chemical compositions (S, G, and H) and major linkages (ß-O-4, ß-ß, ß-5, etc.) were thoroughly assigned and the frequencies of the major lignin linkages were quantitatively compared. Considering the structural characteristics and molecular weights of the lignin as well as enzymatic saccharification ratio of the substrate, the combination of autohydrolysis and organic base-catalyzed ethanol pretreatment was deemed as a promising biorefinery mode in the future based on bamboo feedstock.

Preliminary assessment of two non-destructive instrumental techniques for quality evaluation of Lobelia chinensis Lour.

Two non-destructive instrumental methods, infrared spectroscopy (IR) and X-ray diffraction (XRD), were studied for quality evaluation of Lobelia chinensis Lour. (L. chinensis). We obtained the IR spectra and XRD patterns of L. chinensis collected from different sources. The similarity of samples was analyzed by calculating the cosine coefficient. The cosine values were in the range of 0.83-0.90, indicating that the main components of L. chinensis samples are similar. Sample L1 and L6 showed a slightly lower similarity than that of L2, L3, L4, L5 detected by the two methods, which revealed that IR and XRD methods exhibited analogous detection ability for quality evaluation of L. chinensis. The two methods could be highly recommended as simple and rapid detection means for quality evaluation of L. chinensis.

Genetic dissection of heterosis using epistatic association mapping in a partial NCII mating design.

Heterosis refers to the phenomenon in which an F1 hybrid exhibits enhanced growth or agronomic performance. However, previous theoretical studies on heterosis have been based on bi-parental segregating populations instead of F1 hybrids. To understand the genetic basis of heterosis, here we used a subset of F1 hybrids, named a partial North Carolina II design, to perform association mapping for dependent variables: original trait value, general combining ability (GCA), specific combining ability (SCA) and mid-parental heterosis (MPH). Our models jointly fitted all the additive, dominance and epistatic effects. The analyses resulted in several important findings: 1) Main components are additive and additive-by-additive effects for GCA and dominance-related effects for SCA and MPH, and additive-by-dominant effect for MPH was partly identified as additive effect; 2) the ranking of factors affecting heterosis was dominance > dominance-by-dominance > over-dominance > complete dominance; and 3) increasing the proportion of F1 hybrids in the population could significantly increase the power to detect dominance-related effects, and slightly reduce the power to detect additive and additive-by-additive effects. Analyses of cotton and rapeseed datasets showed that more additive-by-additive QTL were detected from GCA than from trait phenotype, and fewer QTL were from MPH than from other dependent variables.

Interacted QTL mapping in partial NCII design provides evidences for breeding by design.

The utilization of heterosis in rice, maize and rapeseed has revolutionized crop production. Although elite hybrid cultivars are mainly derived from the F1 crosses between two groups of parents, named NCII mating design, little has been known about the methodology of how interacted effects influence quantitative trait performance in the population. To bridge genetic analysis with hybrid breeding, here we integrated an interacted QTL mapping approach with breeding by design in partial NCII mating design. All the potential main and interacted effects were included in one full model. If the number of the effects is huge, bulked segregant analysis were used to test which effects were associated with the trait. All the selected effects were further shrunk by empirical Bayesian, so significant effects could be identified. A series of Monte Carlo simulations was performed to validate the new method. Furthermore, all the significant effects were used to calculate genotypic values of all the missing F1 hybrids, and all these F1 phenotypic or genotypic values were used to predict elite parents and parental combinations. Finally, the new method was adopted to dissect the genetic foundation of oil content in 441 rapeseed parents and 284 F1 hybrids. As a result, 8 main-effect QTL and 37 interacted QTL were found and used to predict 10 elite restorer lines, 10 elite sterile lines and 10 elite parental crosses. Similar results across various methods and in previous studies and a high correlation coefficient (0.76) between the predicted and observed phenotypes validated the proposed method in this study.

Controlled attenuation parameter for assessment of hepatic steatosis grades: a diagnostic meta-analysis.

AIM: to evaluate the performance and accuracy of Controlled attenuation parameter CAP for hepatic steatosis detection. METHODS: PubMed, EBSCO, Elsevier Science, Ovid, and Wiley were selected to search studies until August 31, 2014. Quality Assessment of Diagnostic Accuracy Studies checklist was used to assess the quality of included studies. Heterogeneity was evaluated using Q test. Sensitivity, specificity, diagnostic odds ratio (DOR), and the area under curve (AUC) with its 95% confidence intervals (CIs) were calculated to evaluate the accuracy of CAP for assessment of hepatic steatosis stage (≥ S1, ≥ S2 and ≥ S3). RESULTS: Totally 11 studies (13 cohorts) with high methodological qualities were identified. The summary point estimations with 95% CIs of sensitivity, specificity, AUC and DORs were 0.78 (0.71, 0.84), 0.79 (0.70, 0.86), 0.86 (0.82, 0.88), and 14 (7, 27) for ≥ S1; 0.82 (0.74, 0.88), 0.79 (0.73, 0.85), 0.88 (0.85, 0.90) and 18 (10, 30) for ≥ S2; 0.86 (0.82, 0.89), 0.89 (0.86, 0.92), 0.94 (0.91, 0.96) and 51 (35, 76) for ≥ S3. Significant heterogeneity was found among the studies in ≥ S1 and ≥ S3. Threshold effect was existed in ≥ S3, but not in ≥ S1 and ≥ S2. Publication bias was not existed in ≥ S1 and ≥ S2 except ≥ S3. CONCLUSION: CAP provides good sensitivity and specificity for detection of ≥ S1, ≥ S2, and ≥ S3 steatosis. However, future studies with large samples are still necessary to confirm the clinical application.

Assessment of integrated process based on hydrothermal and alkaline treatments for enzymatic saccharification of sweet sorghum stems.

In this study, sweet sorghum stem was subjected to hydrothermal pretreatment (HTP) and alkaline post-treatment to enhance its saccharification ratio by reducing its recalcitrance. The results showed that the HTP (110-210°C, 0.5-2.0h) significantly degraded hemicelluloses, and the pretreatment at the temperature higher than 190°C led to the partial degradation of the cellulose. As compared to the sole HTP, the integrated process removed most of lignin and hemicelluloses, which incurred a higher cellulose saccharification ratio. Under an optimum condition evaluated (HTP at 170°C for 0.5h and subsequent 2% NaOH treatment), 77.5% saccharification ratio was achieved, which was 1.8, 2.0 and 5.5 times as compared to the only HTP pretreated substrates, alkaline treated substrates alone and the raw material without pretreatment, respectively. Clearly, the integrated process can be considered as a promising approach to achieve an efficient conversion of lignocellulose to fermentable glucose.