Establishment and Validation of Risk Prediction Model for Postpartum Hemorrhage for Pregnant Women ≥35 Years of Age in Natural Delivery.

Context: After the age of 35, women's fertility and physical function gradually decline, and this can significantly increase the risks of postpartum hemorrhage (PPH) after delivery. Sufficient exploration of prenatal indicators of PPH for older pregnant women are still lacking. Objective: The study intended to examine the factors influencing postpartum hemorrhage (PPH) in natural delivery for pregnant women ≥35 years of age and to establish a reliable risk-prediction model. Design: The research team performed a retrospective study. Setting: The study took place at Suzhou Ninth People's Hospital in Suzhou, Jiangsu Province, China. Participants: Participants were 351 pregnant women who had undergone a prenatal examination and vaginal delivery at the hospital between January 2019 and October 2022. Groups: The research team divided participants into two groups: (1) a PPH group, with 52 participants who experienced PPH, and (2) a non-PPH group, with 299 participants who had no PPH. Outcome Measures: The research team: (1) conducted single-factor analysis of the two groups' demographic and clinical characteristics; (2) performed multivariate logistic regression analysis to find the factors influencing PPH; (3) built a risk-prediction model based on the results; and (4) analyzed the model's identification ability, proofreading ability, and clinical applicability using a goodness-of-fit test, a receiver operating characteristic (ROC) curve, a calibration curve, and a decision curve. The team used the SPSS 22.0 and R software for statistical analysis. Results: The incidence of PPH was 14.81%, for the 52 out of 351 participants. The PPH group's age (P < .001), rate of pregnancy-induced hypertension (P = .008), length of the third stage of labor (P = .001), and newborn's birth weight (P < .001) were significantly greater and its FIB before delivery was significantly lower than those of the non-PPH group. The high expression of fibrinogen (FIB) before delivery indicates it may be a protective factor against PPH. The multivariate analysis indicated that a greater age (P = .013), pregnancy-induced hypertension (P = .002), a low FIB level (P < .001), a long third stage of labor (P = .012), and a low birth weight for the newborn (P = .006) were all significantly related to PPH. The research team validated the risk-prediction model, which indicated that the model had good recognition ability (AUC = 0.873). The optimal critical value was 34%, and the sensitivity and specificity were 0.869 and 0.826, respectively. In the comparison of the PPH value that the model predicted and the participants' actual PPH incidence (U = -0.006, Brier = 0.089), the deviation of the model wasn't statistically significant (χ2 = 5.964, P = .651). The analysis of the decision curve found that the net benefits for pregnant women ≥35 years of age were higher than those of the other two extreme curves, showing that the model was clinically effective. Conclusions: The PPH risk-prediction model for vaginal delivery for pregnant women ≥35 years of age showed that a greater age, pregnancy-induced hypertension, a lower prelabor FIB, a longer third stage of labor, and a higher birth weight for the newborn were significantly related to the incidence of PPH and that its use could be clinically helpful.

Optimization of a novel single air-lift sequencing bioreactor for raw piggery wastewater treatment: Nutrients removal and microbial community structure analysis.

In this study, a sequencing batch and intermittent air-lift bioreactor (SBIAB) was evaluated under the three independent variables to treat raw piggery wastewater. The effects of hydraulic retention time (HRT), air flow rate and sludge retention time (SRT) on the nutrients removal of SBIAB were researched. The optimum values of HRT, air flow rate and SRT were 8 d, 2 l/min and 20 d, respectively. Meanwhile, the removal rates of chemical oxygen demand (COD), NH4+-N, total nitrogen (TN) and total phosphorus (TP) were up to 89.5%, 93.5%, 61.1% and 57.3%, respectively. Generally, the nutrients removal performance could be enhanced with increasing HRT from 6 to 10 d, while it was inhibited at air flow rate of 3 l/min. Higher air flow rate caused the alkaline pH and high free ammonia concentration, which imposed restrictions on the process of wastewater treatment. In the SBIAB, a coupling of aerobic/anoxic/anaerobic zone was formed according to the changes of oxidation-reduction potential (ORP) values at the optimum condition. Microbial community structure analysis indicated that the functional microbes including Brachymonas, Prokaryote, Giesbergeria, Comamonadaceae bacterium, Clostridiales bacterium, Comamonas, Tissierella, Aequorivita were enriched in the SBIAB, which played a significant role in the removal of complex organics and nitrogen.

Derivatization strategy combined with parallel reaction monitoring for the characterization of short-chain fatty acids and their hydroxylated derivatives in mouse.

Short-chain fatty acids (SCFAs) and hydroxylated short-chain fatty acids (OH-SCFAs) are crucial intermediates related to a variety of diseases, such as bowel disease, cardiovascular disease, renal disease and cancer. A global profiling method to screen SCFAs and OH-SCFAs was developed by tagging these analytes with d0/d6-N, N-dimethyl-6,7-dihydro-5H-pyrrolo [3,4-d] pyrimidine-2-amine (d0/d6-DHPP) and using ultra-high performance liquid chromatography coupled with high-resolution tandem mass spectrometry (UHPLC-MS/MS) in parallel reaction monitoring (PRM) mode. The derivatization procedure was simple and rapid. The targeted compounds could be derivatized within 3 min under mild condition and analyzed without the need of further purification. The derivatization significantly improved the chromatographic performance and mass spectrometry response. The d6-DHPP tagged standards were used as internal standards, which remarkably reduced the matrix effects. The use of high resolution PRM mode made it possible to locate unknown SCFA and OH-SCFA species, and greatly reduced the false positive identification results. The developed method was successfully applied to the analysis of mouse fecal, serum, and liver tissue samples harvested from the breast cancer nude mice that had been exposed with 2,2',4,4'-tetrabromodiphenyl ether (BDE-47). Results showed that 40 analytes (10 SCFAs and 30 OH-SCFAs) were characterized. Semi-quantitative analysis indicated that the exposure of BDE-47 to the mice altered the SCFA and OH-SCFA metabolism, especially in the high dose group. This study provides a high-throughput method to characterize SCFAs and OH-SCFAs in mouse samples.

Oral administration of curcumin attenuates visceral hyperalgesia through inhibiting phosphorylation of TRPV1 in rat model of ulcerative colitis.

Background Curcumin has been reported to have anti-inflammatory and anti-nociceptive effects. The present study was designed to explore the potential therapeutic effects of curcumin on visceral hyperalgesia and inflammation in a rat model of ulcerative colitis. We observed the effects of orally administered curcumin on the disease activity index, histological change in colon, colorectal distension-induced abdominal withdrawal reflex, the expression of transient receptor potential vanilloid 1 (TRPV1) and phosphorylated TRPV1 in dextran sulfate sodium-induced colitis rats. In addition, a HEK293 cell line stably expressing human TRPV1 (hTRPV1) was used to examine the effects of curcumin on the change in membrane expression of TRPV1 induced by phorbol myristate acetate (a protein kinase C activator). Results Repeated oral administration of curcumin inhibited the increase in abdominal withdrawal reflex score induced by dextran sulfate sodium without affecting dextran sulfate sodium-induced histological change of colon and the disease activity index. A significant increase in colonic expression of TRPV1 and pTRPV1 was observed in dextran sulfate sodium-treated rats and this was reversed by oral administration of curcumin. TRPV1 expression in L6-S1 dorsal root ganglion was increased in the small- to medium-sized isolectin B4-positive non-peptidergic and calcitonin gene-related peptide-positive peptidergic neurons in dextran sulfate sodium-treated rats and oral administration of curcumin mitigated such changes. In the HEK293 cell line stably expressing hTRPV1, curcumin (1, 3 µm) inhibited phorbol myristate acetate-induced upregulation of membrane TRPV1. Conclusion Oral administration of curcumin alleviates visceral hyperalgesia in dextran sulfate sodium-induced colitis rats. The anti-hyperalgesic effect is partially through downregulating the colonic expression and phosphorylation of TRPV1 on the afferent fibers projected from peptidergic and non-peptidergic nociceptive neurons of dorsal root ganglion.

Clarification of phosphorus fractions and phosphorus release enhancement mechanism related to pH during waste activated sludge treatment.

This study aimed to clarify phosphorus (P) fractions in waste activated sludge (WAS) and explore release performance and enhancement mechanism of different P species related to pH. Results showed that inorganic P (IP) was the major P fraction in raw sludge (87.86% of total solid P), and non-apatite inorganic P (NAIP), the most labile P forms, occupied 81.30% of IP, suggesting that WAS could be selected as potential substitution of phosphate rock. The optimized acid and alkaline conditions were pH=4 and pH=12 for molybdate reactive P accumulation, increased by 311.20mg/L and 479.18mg/L compared to raw sludge, which were 3.80 and 5.84 times higher than that of control, respectively. The mechanism study demonstrated that high pH promoted NAIP release, and apatite P was sensitive to low pH. Moreover, the releasable and recoverable P depended on both fractions of different P species in sludge and pH adjustment for sludge treatment.

Role of extracellular polymeric substances in enhancement of phosphorus release from waste activated sludge by rhamnolipid addition.

This study investigated the role of extracellular polymeric substances (EPSs) in enhanced performance of phosphorus (P) release from waste activated sludge (WAS) by adding rhamnolipid (RL). Results showed that compared to WAS without pretreatment, the released PO4(3-)-P increased with RL addition from 0 to 0.2 g/gTSS (total suspended solid), and increased by 208% under the optimal condition (0.1 g RL/g TSS and 72-h fermentation time). The cumulative PO4(3-)-P was better fitted with pseudo-first-order kinetic model. Moreover, the contents of metal ions increased in liquid but decreased in EPSs linearly with RL addition increasing, and WAS solubilizations were positively correlated with the released metal ions. The enhanced total dissolved P mainly came from cells and others (69.39%, 2.27-fold higher than that from EPSs), and PO4(3-)-P was the main species in both liquid and loosely bound EPSs, but organic P should be non-negligible in tightly bound EPSs.