Propensity Score-Matching Analysis Comparing Robotic Versus Laparoscopic Limited Liver Resections of the Posterosuperior Segments: An International Multicenter Study.

OBJECTIVE: The purpose of this study was to compare the outcomes of robotic limited liver resections (RLLR) versus laparoscopic limited liver resections (LLLR) of the posterosuperior segments. BACKGROUND: Both laparoscopic and robotic liver resections have been used for tumors in the posterosuperior liver segments. However, the comparative performance and safety of both approaches have not been well examined in the existing literature. METHODS: This is a post hoc analysis of a multicenter database of 5446 patients who underwent RLLR or LLLR of the posterosuperior segments (I, IVa, VII, and VIII) at 60 international centers between 2008 and 2021. Data on baseline demographics, center experience and volume, tumor features, and perioperative characteristics were collected and analyzed. Propensity score-matching (PSM) analysis (in both 1:1 and 1:2 ratios) was performed to minimize selection bias. RESULTS: A total of 3510 cases met the study criteria, of whom 3049 underwent LLLR (87%), and 461 underwent RLLR (13%). After PSM (1:1: and 1:2), RLLR was associated with a lower open conversion rate [10 of 449 (2.2%) vs 54 of 898 (6.0%); P =0.002], less blood loss [100 mL [IQR: 50-200) days vs 150 mL (IQR: 50-350); P <0.001] and a shorter operative time (188 min (IQR: 140-270) vs 222 min (IQR: 158-300); P <0.001]. These improved perioperative outcomes associated with RLLR were similarly seen in a subset analysis of patients with cirrhosis-lower open conversion rate [1 of 136 (0.7%) vs 17 of 272 (6.2%); P =0.009], less blood loss [100 mL (IQR: 48-200) vs 160 mL (IQR: 50-400); P <0.001], and shorter operative time [190 min (IQR: 141-258) vs 230 min (IQR: 160-312); P =0.003]. Postoperative outcomes in terms of readmission, morbidity and mortality were similar between RLLR and LLLR in both the overall PSM cohort and cirrhosis patient subset. CONCLUSIONS: RLLR for the posterosuperior segments was associated with superior perioperative outcomes in terms of decreased operative time, blood loss, and open conversion rate when compared with LLLR.

Case report: enzyme replacement therapy for Fabry disease presenting with proteinuria and ventricular septal thickening.

Fabry disease (FD) is an uncommon, X-linked, lysosomal storage disease that causes defects in the glycosphingolipid metabolic pathway due to deficient or absent lysosomal α-galactosidase (α-Gal A) activity. This leads to the accumulation of globotriaosylceramide (GL-3) within lysosomes in a wide range of cells, including endothelial, cardiac, renal, and corneal cells, and consequently, the progressive appearance of clinical symptoms in target organs. Enzyme replacement therapy (ERT), which involves the exogenous supplementation of α-Gal A enzyme and has been successfully administered for treating FD.Here, we report a case of a 37-year-old male with complaints of recurrent proteinuria and ventricular septal thickening. A renal biopsy revealed vacuolization and foamy changes in podocytes, and the presence of myelin-like bodies and zebra bodies. The white blood cell α-Gal A activity was very low, while the Lyso-GL-3 level was high. Additionally, genetic analysis revealed a gene variant c.902G > A p. Arg301Gln. The patient was diagnosed with FD, and subsequently received intravenous ERT with a dose of Agalsidase α (0.2 mg/kg, 17.5 mg every 2 weeks). Currently, the values of proteinuria and ventricular septum thickness remain stable during the 6-month follow-up. Initiating ERT at an early age can effectively decrease the deposition of GL-3, attenuate the progressive clinical manifestations of FD, and provide greater long-term benefits.

Prevalence and trends of Chlamydia trachomatis infection in female sex workers and men who have sex with men in China: a systematic review and meta-analysis.

INTRODUCTION: Chlamydia trachomatis infection can cause a significant disease burden in high-risk populations. This study aimed to assess the overall prevalence of C. trachomatis infection, and determine the long-term trends and geographic distribution of this infection among female sex workers (FSWs) and men who have sex with men (MSM) in China. METHODS: The PubMed, Web of Science, CNKI, Wanfang Data and VIP databases were searched from 1 January 1990 through 30 April 2023. Publications in which C. trachomatis infection was detected using nucleic acid amplification tests (NAATs) were included. The Q test and I2 statistics were used to assess the heterogeneity between studies. A random-effect model was used to estimate the pooled prevalence of C. trachomatis infection. Subgroup, meta-regression, and sensitivity analyses were performed to explore the sources of heterogeneity. Publication bias was evaluated using Egger's test. Trend analysis of the prevalence was performed using the Jonckheere-Terpstra trend test method. RESULTS: Sixty-one studies were eligible for inclusion (including 38 for FSWs and 23 for MSM). The pooled prevalence of C. trachomatis infection was 19.5% (95% CI: 16.4, 23.0) among FSWs and 12.7% (95% CI: 9.2, 17.7) in the rectum, 6.4% (95% CI: 5.3, 7.8) in the urethra and 1.3% (95% CI: 0.8, 2.1) in the oropharynx from MSM in China. The subgroup analyses showed that the sample size, study period, study region, specimen collection type, molecular diagnosis method, and recruitment site could explain some heterogeneity among studies of FSWs, and the publication language, study period, study region, molecular diagnosis method, and specimen collection anatomical site could explain some heterogeneity among studies of MSM. From 1998 to 2004, 2005 to 2009, 2010 to 2015, and 2016 to 2021, the pooled prevalence of C. trachomatis infection among FSWs were 30.3%, 19.9%, 21.4%, and 11.3%, respectively. For MSM, the pooled prevalence from 2003 to 2009, 2010 to 2015, and 2016 to 2022 were 7.8%, 4.7%, and 6.5%, respectively. However, no overall decline in the prevalence of C. trachomatis infection was observed among FSWs (z = -1.51, P = 0.13) or MSM (z = -0.71, P = 0.48) in China. CONCLUSIONS: The prevalence of C. trachomatis infection was high in these two high-risk populations in China. The findings of this study provide evidence for the formulation of effective surveillance and screening strategies for the prevention and control of C. trachomatis infection among these two specific populations.

Coexistence of anti-glomerular basement membrane disease and IgA nephropathy: an illustrative case and comprehensive literature review.

Anti-glomerular basement membrane (GBM) disease is a rare autoimmune condition characterized by the presence of positive anti-GBM autoantibodies, linear deposition of immunoglobulin G (IgG) along the GBM and severe kidney injury. In a limited number of cases, the association of anti-GBM disease with other glomerulonephritis has been reported. Herein, we present the case of a 66-year-old female patient with progressive worsen kidney function and decreased urine output. A renal biopsy revealed crescent glomerulonephritis with lineal IgG deposition along the GBM and mesangial IgA deposition, which supported the diagnosis of concurrent anti-GBM disease and IgA nephropathy (IgAN). In an extensive literature review, we identified a total of thirty-nine patients were reported anti-GBM disease combined with IgAN. The clinical characteristics of these patients demonstrate that the anti-GBM disease combined with IgAN tends to be milder with a more indolent course and a better prognosis than the classic anti-GBM disease, and its potential pathogenesis deserves to be further explored.

Defining Global Benchmarks for Laparoscopic Liver Resections: An International Multicenter Study.

OBJECTIVE: To establish global benchmark outcomes indicators after laparoscopic liver resections (L-LR). BACKGROUND: There is limited published data to date on the best achievable outcomes after L-LR. METHODS: This is a post hoc analysis of a multicenter database of 11,983 patients undergoing L-LR in 45 international centers in 4 continents between 2015 and 2020. Three specific procedures: left lateral sectionectomy (LLS), left hepatectomy (LH), and right hepatectomy (RH) were selected to represent the 3 difficulty levels of L-LR. Fifteen outcome indicators were selected to establish benchmark cutoffs. RESULTS: There were 3519 L-LR (LLS, LH, RH) of which 1258 L-LR (40.6%) cases performed in 34 benchmark expert centers qualified as low-risk benchmark cases. These included 659 LLS (52.4%), 306 LH (24.3%), and 293 RH (23.3%). The benchmark outcomes established for operation time, open conversion rate, blood loss ≥500 mL, blood transfusion rate, postoperative morbidity, major morbidity, and 90-day mortality after LLS, LH, and RH were 209.5, 302, and 426 minutes; 2.1%, 13.4%, and 13.0%; 3.2%, 20%, and 47.1%; 0%, 7.1%, and 10.5%; 11.1%, 20%, and 50%; 0%, 7.1%, and 20%; and 0%, 0%, and 0%, respectively. CONCLUSIONS: This study established the first global benchmark outcomes for L-LR in a large-scale international patient cohort. It provides an up-to-date reference regarding the "best achievable" results for L-LR for which centers adopting L-LR can use as a comparison to enable an objective assessment of performance gaps and learning curves.

Propensity-score Matched and Coarsened-exact Matched Analysis Comparing Robotic and Laparoscopic Major Hepatectomies: An International Multicenter Study of 4822 Cases.

OBJECTIVE: To compare the outcomes between robotic major hepatectomy (R-MH) and laparoscopic major hepatectomy (L-MH). BACKGROUND: Robotic techniques may overcome the limitations of laparoscopic liver resection. However, it is unknown whether R-MH is superior to L-MH. METHODS: This is a post hoc analysis of a multicenter database of patients undergoing R-MH or L-MH at 59 international centers from 2008 to 2021. Data on patient demographics, center experience volume, perioperative outcomes, and tumor characteristics were collected and analyzed. Both 1:1 propensity-score matched (PSM) and coarsened-exact matched (CEM) analyses were performed to minimize selection bias between both groups. RESULTS: A total of 4822 cases met the study criteria, of which 892 underwent R-MH and 3930 underwent L-MH. Both 1:1 PSM (841 R-MH vs. 841 L-MH) and CEM (237 R-MH vs. 356 L-MH) were performed. R-MH was associated with significantly less blood loss {PSM:200.0 [interquartile range (IQR):100.0, 450.0] vs 300.0 (IQR:150.0, 500.0) mL; P = 0.012; CEM:170.0 (IQR: 90.0, 400.0) vs 200.0 (IQR:100.0, 400.0) mL; P = 0.006}, lower rates of Pringle maneuver application (PSM: 47.1% vs 63.0%; P < 0.001; CEM: 54.0% vs 65.0%; P = 0.007) and open conversion (PSM: 5.1% vs 11.9%; P < 0.001; CEM: 5.5% vs 10.4%, P = 0.04) compared with L-MH. On subset analysis of 1273 patients with cirrhosis, R-MH was associated with a lower postoperative morbidity rate (PSM: 19.5% vs 29.9%; P = 0.02; CEM 10.4% vs 25.5%; P = 0.02) and shorter postoperative stay [PSM: 6.9 (IQR: 5.0, 9.0) days vs 8.0 (IQR: 6.0 11.3) days; P < 0.001; CEM 7.0 (IQR: 5.0, 9.0) days vs 7.0 (IQR: 6.0, 10.0) days; P = 0.047]. CONCLUSIONS: This international multicenter study demonstrated that R-MH was comparable to L-MH in safety and was associated with reduced blood loss, lower rates of Pringle maneuver application, and conversion to open surgery.

Mosaic Evolution of Beta-Barrel-Porin-Encoding Genes in Escherichia coli.

Bacterial porin-encoding genes are often found under positive selection. Local recombination has also been identified in a few of them to facilitate bacterial rapid adaptation, although it remains unknown whether it is a common evolutionary mechanism for the porins or outer membrane proteins in Gram-negative bacteria. In this study, we investigated the beta-barrel (ß-barrel) porin-encoding genes in Escherichia coli that were reported under positive Darwinian selection. Besides fhuA that was found with ingenic local recombination previously, we identified four other genes, i.e., lamB, ompA, ompC, and ompF, all showing the similar mosaic evolution patterns. Comparative analysis of the protein sequences disclosed a list of highly variable regions in each family, which are mostly located in the convex of extracellular loops and coinciding with the binding sites of bacteriophages. For each of the porin families, mosaic recombination leads to unique combinations of the variable regions with different sequence patterns, generating diverse protein groups. Structural modeling indicated a conserved global topology among the different porins, with the extracellular surface varying a lot due to individual or combinatorial variable regions. The conservation of global tertiary structure would ensure the channel activity, while the wide diversity of variable regions may represent selection to avoid the invasion of phages, antibiotics or immune surveillance factors. Our study identified multiple bacterial porin genes with mosaic evolution. We hypothesize that this could be generalized strategy for outer membrane proteins to both maintain normal life processes and evade the attack of unfavored factors rapidly. IMPORTANCE Microevolution studies can disclose more elaborate evolutionary mechanisms of genes, appearing especially important for genes with multifaceted function such as those encoding outer membrane proteins. However, in most cases, the gene is considered as a whole unit, and the evolutionary patterns are disclosed. Here, we report that multiple bacterial porin proteins follow mosaic evolution, with local ingenic recombination combined with spontaneous mutations based on positive Darwinian selection, and conservation for most structural regions. This could represent a common mechanism for bacterial outer membrane proteins. The variable regions within each porin family showed large coincidence with the binding sites of bacteriophages, antibiotics, and immune factors and therefore would represent effective targets for the development of new antibacterial agents or vaccines.

External validation of different difficulty scoring systems of laparoscopic liver resection for hepatocellular carcinoma.

BACKGROUND: Several difficulty scoring systems (DSSs) have been proposed for evaluating difficulty of laparoscopic liver resection (LLR) and no study has validated their performance in a hepatocellular carcinoma (HCC)-only cohort at the same time. METHODS: All cases with HCC that underwent LLR from January 2015 to December 2020 in our center were retrospectively collected. Performance of the IWATE-DSS, Halls-DSS, Hasegawa-DSS, and Kawaguchi-DSS in predicting perioperative outcomes was evaluated. Subgroup analyses were conducted to compare perioperative outcomes between surgeons on the learning curve and surgeons that have gone through the learning curve. RESULTS: For all four DSSs, there were significant distributions of applying bleeding control, surgical time, estimated blood loss, postoperative major complications, and postoperative hospital stay among different groups of each DSS (P all < 0.05). Conversion to laparotomy or not was significantly distributed in different groups of the IWATE-DSS (P = 0.006) and Halls-DSS (P = 0.022), while it was not in the Hasegawa-DSS (P = 0.056) and Kawaguchi-DSS (P = 0.183). Trend tests showed that the conversion rates increased with higher DSS points in the IWATE-DSS (P < 0.001) and the Kawaguchi-DSS (P = 0.021), while not in the Halls-DSS (P = 0.064) and the Hasegawa-DSS (P = 0.068). In the medium and advanced/expert difficulty-level subgroups defined by the IWATE-DSS, there were larger estimated blood loss (P in medium-difficulty group = 0.009; P in the advanced/expert difficulty group = 0.004) and longer postoperative hospital stay (P in the medium-difficulty group = 0.012; P in the advanced/expert group = 0.035) in the learner-performed cases. CONCLUSIONS: All DSSs performed well in predicting applying bleeding control, surgical time, estimated blood loss, postoperative major complications, and postoperative hospital stay, while only the IWATE-DSS was able to predict whether conversion to laparotomy or not for HCC patients underwent LLR. The IWATE-DSS was also able to help surgeons on the LLR learning curve choose cases and guide clinical practices.

p-Cresyl sulfate predicts clinical outcomes in sustained peritoneal dialysis: a 5-year follow-up cohort study and meta-analysis.

BACKGROUND: The impact of p-cresyl sulfate (PCS) and indoxyl sulfate (IS) on the prognosis of patients with uremia remains controversial. We performed a prospective study on peritoneal dialysis (PD) to investigate the relationship between PCS or IS levels with clinical outcomes. METHODS: This prospective cohort study investigated the association of serum PCS and IS with clinical outcomes in patients undertaking PD. We performed a correlations analysis to explore the influencing factors of PCS an IS. Meta-analysis was conducted to objectively evaluate the prognostic effects of PCS and IS on different stages of CKD patients. RESULTS: A total of 127 patients were enrolled consecutively and followed with an average period of 51.3 months. Multivariate Cox regression showed that serum total PCS not only contributed to the occurrence of PD failure event (HR: 1.05, 95% CI = 1.02 to 1.07, p < 0.001), but also increased the risk of cardiovascular event (HR: 1.08, 95% CI = 1.04 to 1.13, p < 0.001) and PD-associated peritonitis (HR: 1.04, 95% CI = 1.02 to 1.08, p = 0.001). Dividing the total PCS level by 18.99 mg/L, which was calculated from the best cutoff value of the ROC curve, patients with total PCS higher than 18.99 mg/L had worse prognosis. Meta-analysis confirmed its value in cardiovascular event in PD. CONCLUSION: The serum total PCS concentration was a detrimental factor for higher PD failure event, cardiovascular event, and PD-associated peritonitis. It could be used as an innovative marker in predicting poor clinical outcome in PD.

Identification of Human Global, Tissue and Within-Tissue Cell-Specific Stably Expressed Genes at Single-Cell Resolution.

Stably Expressed Genes (SEGs) are a set of genes with invariant expression. Identification of SEGs, especially among both healthy and diseased tissues, is of clinical relevance to enable more accurate data integration, gene expression comparison and biomarker detection. However, it remains unclear how many global SEGs there are, whether there are development-, tissue- or cell-specific SEGs, and whether diseases can influence their expression. In this research, we systematically investigate human SEGs at single-cell level and observe their development-, tissue- and cell-specificity, and expression stability under various diseased states. A hierarchical strategy is proposed to identify a list of 408 spatial-temporal SEGs. Development-specific SEGs are also identified, with adult tissue-specific SEGs enriched with the function of immune processes and fetal tissue-specific SEGs enriched in RNA splicing activities. Cells of the same type within different tissues tend to show similar SEG composition profiles. Diseases or stresses do not show influence on the expression stableness of SEGs in various tissues. In addition to serving as markers and internal references for data normalization and integration, we examine another possible application of SEGs, i.e., being applied for cell decomposition. The deconvolution model could accurately predict the fractions of major immune cells in multiple independent testing datasets of peripheral blood samples. The study provides a reliable list of human SEGs at the single-cell level, facilitates the understanding on the property of SEGs, and extends their possible applications.

Modulating the Acidic and Basic Site Concentration of Metal-Organic Framework Derivatives to Promote the Carbon Dioxide Epoxidation Reaction.

Metal-organic framework (MOF) is an ideal precursor/template for porous carbon, and its active components are uniformly doped, which can be used in energy storage and catalytic conversion fields. Metal-organic framework PCN-224 with carboxylporphyrin as the ligand was synthesized, and then Zn2+ and Co2+ ions were coordinated in the center of the porphyrin ring by post-modification. Here, PCN-224-ZnCo with different ratios of bimetallic Zn2+ /Co2+ ions were used as the precursor, and the metal-nitrogen-carbon(M-N-C) material of PCN-224-ZnCo-950 was obtained by pyrolyzing the precursor at 950 °C in Ar. Because Zn is easy to volatilize at 950 °C, the formed M-N-C materials can reflect different Co contents and different basic site concentrations. The formed material still maintains the original basic framework. With the increase of Zn2+ /Co2+ ratio in precursor, the concentration of N-containing alkaline sites in pyrolysis products gradually increase. Compared with the precursor, PCN-224-ZnCo1 -950 with Zn2+ /Co2+ =1 : 1 has greatly improved basicity and suitable acidic/ alkaline site concentration. It can be efficiently used to carbon dioxide absorption and catalyze the cycloaddition of CO2 with epoxide. More importantly, the current method of adjusting the acidic/basic sites in M-N-C materials through volatilization of volatile metals can provide an effective strategy for adjusting the catalysis of MOF derivatives with porphyrin structure.

In Situ Determination of Cannabidiol in Hemp Oil by Near-Infrared Spectroscopy.

Cannabidiol (CBD, 1) is an active component of hemp oil and many other products that offers diverse health benefits. Near-infrared spectroscopy (NIRS) coupled with chemometrics was utilized to quantify the CBD (1) concentration in the hemp oil through the containing glass vial. NIRS provided a fast and cost-effective tool to measure chemical profiles for the hemp oil samples with various concentrations of CBD (1) and its acid precursor, i.e., cannabidiolic acid (CBDA, 2). The measured NIR spectra were transformed by using a Savitzky-Golay first-derivative filter to remove baseline drift. Two self-optimizing chemometric methods, super partial least-squares regression (sPLSR) and self-optimizing support vector elastic net (SOSVEN), were applied to construct automatically multivariate models that predict the concentrations of CBD (1) and total CBD (sum of 1 and 2 concentrations) of the hemp oil samples. The SOSVEN had validation errors of 6.4 mg/mL for the prediction of CBD (1) concentration and 6.6 mg/mL for the prediction of total CBD concentration, which are significantly lower than the errors given by sPLSR. Other than the lower validation errors, SOSVEN has another advantage over sPLSR in that it builds a multivariate model while selecting spectral features at the same time. These results demonstrated that NIR spectroscopy combined with chemometrics can be used as a rapid and cost-effective approach to determine the CBD (1) and total CBD concentrations in hemp oil. Manufacturers would benefit from the fast and reliable approach in quality assurance.

Self-Optimizing Support Vector Elastic Net.

Chemometrics is widely used to solve various quantitative and qualitative problems in analytical chemistry. A self-optimizing chemometrics method facilitates scientists to exploit the advantages of chemometrics. In this report, a parameter-free support vector elastic net that self-optimizes two key regularization constants, i.e., λ for L2 regularization and t for L1 regularization, is developed and referred to as self-optimizing support vector elastic net (SOSVEN). Response surface modeling (RSM) and bootstrapped Latin partitions (BLPs) are incorporated for the optimization. Responses at a set of design points over the ranges of the two factors are evaluated with an internal BLP validation using a calibration set. A 2-dimensional interpolation with a cubic spline fits a response surface to determine the best condition that gives the best-estimated response. The SOSVEN with RSM had comparable performances with the one tuned by grid search, while the RSM is more efficient. The developed SOSVEN was compared with two parameter-free chemometrics methods, super partial least-squares regression (sPLSR) and super support vector regression (sSVR) for calibration, and sPLS-discriminant analysis (sPLS-DA) and support vector classification (SVC) for classification. For calibration, the SOSVEN with RSM worked equivalently well or better than the other two self-optimizing methods for the evaluations using meat and hemp oil data sets. For classification, a reference wine data set and mass spectra of different marijuana extracts were used. The three classifiers had similar performances to identify the cultivars of wines with nearly 98% of accuracy. The SOSVEN significantly outperformed sPLS-DA and SVC to classify the mass spectra of marijuana extracts with an overall accuracy of 97%. These results demonstrated excellent abilities of SOSVEN for classification and calibration.

Endothelium-Independent Vasodilatory Effects of Isodillapiolglycol Isolated from Ostericum citriodorum.

Ostericum citriodorum is a plant with a native range in China used in herbal medicine for treating angina pectoris. In this study, we investigated the vasodilatory effects of isodillapiolglycol (IDG), which is one of the main ingredients isolated from O. citriodorum ethyl acetate extract, in Sprague-Dawley rat aortic rings, and measured intracellular Ca2+ ([Ca2+]in) using a molecular fluo-3/AM probe. The results show that IDG dose-dependently relaxed endothelium-intact or -denuded aortic rings pre-contracted with noradrenaline (NE) or potassium chloride (KCl), and inhibited CaCl2-induced contraction in high K+ depolarized aortic rings. Tetraethyl ammonium chloride (a Ca2+-activated K+ channel blocker) or verapamil (an L-type Ca2+ channel blocker) significantly reduced the relaxation of IDG in aortic rings pre-contracted with NE. In vascular smooth muscle cells, IDG inhibited the increase in [Ca2+]in stimulated by KCl in Krebs solution; likewise, IDG also attenuated the increase in [Ca2+]in induced by NE or subsequent supplementation of CaCl2. These findings demonstrate that IDG relaxes aortic rings in an endothelium-independent manner by reducing [Ca2+]in, likely through inhibition of the receptor-gated Ca2+ channel and the voltage-dependent Ca2+ channel, and through opening of the Ca2+-activated K+ channel.

Pipeline for High-Throughput Modeling of Marijuana and Hemp Extracts.

Authentication of Cannabis products is important for assuring the quality of manufacturing, with the increasing consumption and regulation. In this report, a two-stage pipeline was developed for high-throughput screening and chemotyping the spectra from two sets of botanical extracts from the Cannabis genus. The first set contains different marijuana samples with higher concentrations of tetrahydrocannabinol (THC). The other set includes samples from hemp, a variety of Cannabis sativa with the THC concentration below 0.3%. The first stage applies the technique of class modeling to determine whether spectra belong to marijuana or hemp and reject novel spectra that may be neither marijuana nor hemp. An automatic soft independent modeling of class analogy (aSIMCA) that self-optimizes the number of principal components and the decision threshold is utilized in the first pipeline process to achieve excellent efficiency and efficacy. Once these spectra are recognized by aSIMCA as marijuana or hemp, they are then routed to the appropriate classifiers in the second stage for chemotyping the spectra, i.e., identifying these spectra into different chemotypes so that the pharmacological properties and cultivars of the spectra can be recognized. Three multivariate classifiers, a fuzzy rule building expert system (FuRES), super partial least-squares-discriminant analysis (sPLS-DA), and support vector machine tree type entropy (SVMtreeH), are employed for chemotyping. The discriminant ability of the pipeline was evaluated with different spectral data sets of these two groups of botanical samples, including proton nuclear magnetic resonance, mass, and ultraviolet spectra. All evaluations gave good results with accuracies greater than 95%, which demonstrated promising application of the pipeline for automated high-throughput screening and chemotyping marijuana and hemp, as well as other botanical products.

Exactly Solvable BCS-Hubbard Model in Arbitrary Dimensions.

We introduce in this Letter an exact solvable BCS-Hubbard model in arbitrary dimensions. The model describes a p-wave BCS superconductor with equal spin pairing moving on a bipartite (cubic, square, etc.) lattice with on-site Hubbard interaction U. We show that the model becomes exactly solvable for arbitrary U when the BCS pairing amplitude Δ equals the hopping amplitude t. The nature of the solution is described in detail in this Letter. The construction of the exact solution is parallel to the exactly solvable Kitaev honeycomb model for S=1/2 quantum spins and can be viewed as a generalization of Kitaev's construction to S=1/2 interacting lattice fermions. The BCS-Hubbard model discussed in this Letter is just an example of a large class of exactly solvable lattice fermion models that can be constructed similarly.

Analysis of characteristics and changes in three-dimensional spatial and temporal distribution of aerosol types in Central Asia.

Atmospheric aerosol types and characteristics have regional and seasonal characteristics mainly due spatial and temporal differences in emission sources and diffuse transport conditions. We explored regional three-dimensional spatial and temporal distribution characteristics of aerosol types in Central Asia from daytime to nighttime by using long-term (2007-2021) CALIPSO lidar measurements. The three results are as follows: (1) Average aerosol optical depth (AOD) values during the 14 years were 0.44 and 0.47 during daytime and nighttime, respectively, with an overall decreasing trend, among which the AOD in spring in the southern border region and in winter in the northern border region showed high values, 0.66 and 0.31 during daytime and 0.69 and 0.33 during nighttime, respectively, and nighttime AOD values were higher than those of daytime, possibly due to the lower signal-to-noise ratio of the CALIPSO during the daytime than during the nighttime. (2) The primary representative aerosol type in the Taklamakan Desert region being pure sand and dust, and more apparent winter-polluted sand and dust exist along the northern slope of the Tianshan Mountains in Xinjiang in winter than in other areas. High-altitude soot mainly existed below 4 km and was primarily concentrated in northern Central Asia, with the highest values (0.016 and 0.003) in summer and winter, respectively, which may be due to different diffusion and transport conditions. (3) Dust aerosols in spring were mainly concentrated in the region of 2-6 km in the Taklamakan Desert area; pure dust particles in summer and fall lifted height diffusion and gradually moved to the northern border region; polluted dust was mainly in northern Xinjiang in fall and winter and spread to northern Central Asia; and the average top height of aerosols in the transmission process reached the top of the troposphere, and transmission height was higher than source area.

Application of immune checkpoint inhibitors for resectable gastric/gastroesophageal cancer.

Gastric/gastroesophageal junction (G/GEJ) cancer represents a significant global health challenge. Radical surgery remains the cornerstone of treatment for resectable G/GEJ cancer. Supported by robust evidence from multiple clinical studies, therapeutic approaches, including adjuvant chemotherapy or chemoradiation, and perioperative chemotherapy, are generally recommended to reduce the risk of recurrence and enhance long-term survival outcomes post-surgery. In recent years, immune checkpoint inhibitors (ICIs) have altered the landscape of systemic treatment for advanced or metastatic G/GEJ cancer, becoming the standard first-line therapy for specific patients. Consequently, exploring the efficacy of ICIs in the adjuvant or neoadjuvant setting for resectable G/GEJ cancer is worthwhile. This review summarizes the current advances in the application of ICIs for resectable G/GEJ cancer.

A sensitive lateral flow test strip sensor for visual detection of acid red 18 in food using bicentric-emission carbon dots.

Hazardous synthetic colorants have found widespread use in food production, and excessive consumption of these pigments can pose potential risks to human health. In this study, we propose an ultrasensitive fluorescence method for the analysis of Acid Red 18 (AR18) in food products. The method is based on the nitrogen-doped carbon dots (N-CDs) derived from tris and resorcinol through a hydrothermal way. The as-synthesized N-CDs exhibit two emission centers at 425 nm and 541 nm, corresponding to the excitation wavelengths of 377 nm and 465 nm, respectively. Upon the addition of AR18, the fluorescence intensity at 541 nm significantly decreases with a simultaneous, though less pronounced, reduction in the intensity at 425 nm, which is attributed to the localization of fluorescence resonance energy transfer (L-FRET). Specifically, a novel ratiometric fluorescent probe was constructed based on the extracted data from the 3D fluorescence excitation-emission matrix. This probe demonstrates a wide linear range from 0.0539 to 30 µM and a low limit of detection (LOD) of 53.9 nM. For practical applications, a portable fluorescent sensor based on a lateral flow test strip (LFTS) was designed for real-time monitoring of AR18. Color channel values were determined using a smartphone application, resulting in a satisfactory LOD of 75.3 nM. Furthermore, the suitability of the proposed ratiometric fluorescent probe was validated through the detection of AR18 in real food samples, consistently achieving recovery rates in the range of 99.7-101.4%. This research not only expands the scope of CDs in sensing fields, but also provides an effective strategy for the development of an excellent platform for real-time AR18 detection, contributing to public food safety.

Reporting and influencing factors of patient-reported outcomes in acupuncture randomised controlled trials: a cross-sectional study protocol.

INTRODUCTION: Patient-reported outcomes (PROs) are health reports that come directly from the patients themselves and represented the experience and insights of the patient's perspective on the impact of the intervention. PROs were increasingly emphasised in acupuncture randomised controlled trials (RCTs). However, the reporting quality of PROs in acupuncture RCTs has not been investigated to date. Therefore, we constructed this study to reveal the basic characteristics and reporting quality of PROs in acupuncture RCTs, and explore the relationship between concealment, blinding and RROs. We hope our findings can provide guidance for the reporting standards and future development of PROs in acupuncture RCTs in reverse. METHODS AND ANALYSIS: RCTs using acupuncture treatment as the intervention and PROs as primary outcomes or secondary outcomes will be systematically searched through seven databases MEDLINE, EMBASE, CENTRAL, CBM, CNKI, Wanfang and VIP between 1 January 2012 and 15 October 2022. The basic characteristics, concealment, blinding design and the characteristics of PROs in included RCTs will be summarised. The reporting quality of PROs will be assessed based on the CONSORT PRO extension. Logistic analysis will be performed to identify the association between concealment, blinding and RROs. ETHICS AND DISSEMINATION: Ethical approval is not required for this study. This protocol has been registered in Open Science Framework (OSF) Registries. The findings of this study will be submitted to a peer-reviewed academic journal.