An integrated machine learning model enhances delayed graft function prediction in pediatric renal transplantation from deceased donors.

BACKGROUND: Kidney transplantation is the optimal renal replacement therapy for children with end-stage renal disease; however, delayed graft function (DGF), a common post-operative complication, may negatively impact the long-term outcomes of both the graft and the pediatric recipient. However, there is limited research on DGF in pediatric kidney transplant recipients. This study aims to develop a predictive model for the risk of DGF occurrence after pediatric kidney transplantation by integrating donor and recipient characteristics and utilizing machine learning algorithms, ultimately providing guidance for clinical decision-making. METHODS: This single-center retrospective cohort study includes all recipients under 18 years of age who underwent single-donor kidney transplantation at our hospital between 2016 and 2023, along with their corresponding donors. Demographic, clinical, and laboratory examination data were collected from both donors and recipients. Univariate logistic regression models and differential analysis were employed to identify features associated with DGF. Subsequently, a risk score for predicting DGF occurrence (DGF-RS) was constructed based on machine learning combinations. Model performance was evaluated using the receiver operating characteristic curves, decision curve analysis (DCA), and other methods. RESULTS: The study included a total of 140 pediatric kidney transplant recipients, among whom 37 (26.4%) developed DGF. Univariate analysis revealed that high-density lipoprotein cholesterol (HDLC), donor after circulatory death (DCD), warm ischemia time (WIT), cold ischemia time (CIT), gender match, and donor creatinine were significantly associated with DGF (P < 0.05). Based on these six features, the random forest model (mtry = 5, 75%p) exhibited the best predictive performance among 97 machine learning models, with the area under the curve values reaching 0.983, 1, and 0.905 for the entire cohort, training set, and validation set, respectively. This model significantly outperformed single indicators. The DCA curve confirmed the clinical utility of this model. CONCLUSIONS: In this study, we developed a machine learning-based predictive model for DGF following pediatric kidney transplantation, termed DGF-RS, which integrates both donor and recipient characteristics. The model demonstrated excellent predictive accuracy and provides essential guidance for clinical decision-making. These findings contribute to our understanding of the pathogenesis of DGF.

Patterns of regional lymph node metastasis predict postoperative overall survival and disease-free survival in locally advanced esophageal squamous cell carcinoma.

Background: Lymph nodal characteristics are highly significant in predicting the survival of patients with esophageal squamous cell carcinoma (ESCC). However, there is currently a scarcity of studies examining their role in locally advanced ESCC. In the present study, we attempted to depict the patterns of regional lymph node metastasis and investigate their predictive potential in locally advanced ESCC. Methods: Patients with locally advanced ESCC underwent esophagectomy at the Department of Thoracic Surgery, The First Affiliated Hospital of Shantou University Medical College were included. Kaplan-Meier curve was used to compare the survival differences between groups. Cox regression was constructed to screen the independent risk factors. Results: A total of 439 patients were included. We identified 10% as the optimal cutoff value for positive lymph node ratio (PLNR) with X-tile software. Statistically significant differences were found in both overall survival (OS, P<0.001) and disease-free survival (DFS, P<0.001) among different PLNR groups. PLNR [hazard ratio (HR): 1.85, P<0.001] and metastatic lymph nodes along the left gastric artery (HR: 1.63, P=0.02) were the independent prognostic factors for OS. While PLNR (HR: 1.77, P<0.001) and metastatic total main bronchus lymph nodes (HR: 2.78, P=0.047) were the independent prognostic factors for DFS. Conclusions: We discovered that higher PLNR is associated with poorer OS and DFS of locally advanced ESCC. The lymph nodes along the left gastric artery and the total main bronchus lymph nodes were independent prognosticators for OS and DFS, respectively.

Assessment of Quality of Reporting in Randomized Controlled Trials of Moxibustion for Chronic Diseases Using the Consolidated Standards of Reporting Trials and Standards for Reporting Interventions in Clinical Trials of Moxibustion Statements.

INTRODUCTION: Moxibustion is clinically used for treating various chronic diseases; however, the reporting quality of current published RCTs of moxibustion is unclear. The objective of this study was to assess the reporting quality of RCTs focusing on moxibustion as a treatment for chronic diseases. METHODS: Seven databases were searched to identify relevant RCTs. Criteria for evaluating the reporting quality of standard RCT elements and moxibustion intervention-related information were developed based on the CONSORT statement and its STRICTOM extension, respectively. Multivariate regression models were used to investigate factors impacting reporting quality. RESULTS: A total of 310 RCTs were included, with 41 (7.6%) published in English journals and 269 (92.4%) in Chinese journals. The median CONSORT and STRICTOM scores of these RCTs, with a maximum score of 100, were 41.2 and 62.9, respectively. RCTs with a later publication year and protocol registration or ethical approval exhibited significantly higher CONSORT and STRICTOM scores. Higher CONSORT scores were also significantly associated with English language publication, funding support, and inclusion of a safety evaluation, while higher STRICTOM scores were additionally associated with an active control design. CONCLUSION: The reporting quality of RCTs focusing on moxibustion treatment for chronic diseases is subpar, with gradual but limited improvement over the last 25 years. To enhance the reporting quality of moxibustion RCTs, researchers should develop a comprehensive study protocol and standardize result reporting based on CONSORT and STRICTOM statements. Registration platforms, ethical approval organizations, funders, and journals can also contribute to this improvement by bolstering structured information reporting in the review process.

[Advances in mechanisms of biofilm formation and drug resistance of Staphylococcus aureus].

Staphylococcus aureus is a common pathogenic bacterium. However, due to the abuse of antibiotics, multiple drug-resistant S. aureus (DR S. aureus) has emerged in a large number, which seriously threatens human health. DR S. aureus usually forms biofilms by attaching on contact surfaces and secreting macromolecules including polysaccharides, proteins, and lipids, thus encasing themselves in a self-generated polymeric matrix. A biofilm provides an efficacious barrier that protects bacteria from detrimental environmental factors. Simultaneously, it protects DR S. aureus from the host immune system and attenuates the penetration and killing effects of drugs, serving as a key structure for the development of drug resistance. Therefore, gaining an in-depth understanding of the DR S. aureus biofilm is crucial for treating related infectious diseases. In this paper, we summarize recent research progress in the biofilm formation mechanism, drug resistance mechanism, and measures for inhibition and clearance of DR S. aureus and provide an outlook on the future research directions.

Safety of medicinal and edible herbs from fruit sources for human consumption: A systematic review.

ETHNOPHARMACOLOGICAL RELEVANCE: Medicinal and edible herbs from fruit sources have been increasingly used in traditional Chinese medicine dietotherapy. There are no restrictions on who could consume the medicinal and edible fruits or on the dosage of consumption. However, their safety for human consumption has yet to be established. AIM OF THE STUDY: This systematic review aimed to assess the safety of human consumption of 30 medicinal and edible fruits. MATERIALS AND METHODS: Seven English and Chinese databases were searched up to May 31, 2023, to collect AE reports following human consumption of medicinal and edible fruits. Eligible reports should include details on the occurrence, symptoms, treatments, and outcomes of AEs. AEs that were life-threatening or caused death, permanent or severe disability/functional loss, or congenital abnormality/birth defects were classified as serious AEs (SAEs). The causality between the consumption of fruits and AEs was graded as one of four ranks: "certain", "probable", "possible", or "unlikely". RESULTS: Thirty AE reports related to the consumption of medicinal and edible fruits were included, involving 12 species of fruits: Crataegi fructus, Gardeniae fructus, Mori fructus, Hippophae fructus, Cannabis fructus, Siraitiae fructus, Perillae fructus, Rubi fructus, Longan arillus, Anisi stellati fructus, Zanthoxyli pericarpium, and Lycii fructus. No AE reports were found for the remaining 18 species. A total of 97 AEs, featuring predominantly gastrointestinal symptoms, followed by allergic reactions and neuropsychiatric symptoms, were recorded. Thirty SAEs were noted, with Zanthoxyli pericarpium accounting for the most (14 cases), followed by Perillae fructus (7 cases), Anisi stellati fructus (6 cases), and Gardeniae fructus, Rubi fructus, and Mori fructus (1 case each). Mori fructus was associated with one death. All AEs were concordant with a causality to fruit consumption, judged to be "certain" for 37 cases, "probable" for 53 cases, and "possible" for 7 cases. CONCLUSIONS: Our findings suggest that among medicinal and edible fruits, 12 species have AE reports with a causality ranging from "possible" to "definite". SAEs were not scarce. Most AEs may be associated with an excessive dose, prolonged consumption, or usage among infants or young children. No AE reports were found for the remaining 18 species.

Risk of Asthma and Allergies in Children Delivered by Cesarean Section: A Comprehensive Systematic Review.

BACKGROUND: It is unclear whether cesarean delivery increases the risk of allergic diseases in offspring. OBJECTIVE: To investigate the association between cesarean delivery and the risk of allergic diseases in offspring. METHODS: We searched PubMed, Embase, and the Cochrane Library for relevant studies up to October 12, 2023. Observational studies comparing the risk of allergic diseases in offspring delivered by cesarean section versus those delivered vaginally were included. Most-adjusted estimates from individual studies were synthesized by meta-analysis. RESULTS: A total of 113 studies were included, 70 of which had a low risk of bias. Compared with offspring delivered vaginally, offspring delivered by cesarean section had significantly greater risks of asthma (odds ratio [OR] = 1.20; 95% CI, 1.16-1.25), allergic rhinitis or conjunctivitis (OR = 1.15' CI 1.09-1.22), atopic dermatitis or eczema (OR = 1.08; CI, 1.04-1.13), food allergies (OR = 1.35; CI, 1.18-1.54), and allergic sensitization (OR = 1.19; CI, 1.10-1.28). Cesarean delivery did not significantly increase urticaria risk. Sensitivity analyses including only studies with a low risk of bias, adjusted estimates, prospective data collection, large sample sizes, or outcomes from medical records generally supported these findings. Offspring age, study region latitude, economy type, and cesarean delivery rate accounted for some of the clinical heterogeneity. We found no data on allergic purpura. CONCLUSIONS: Most-adjusted estimates suggest that cesarean delivery is associated with increased risks of asthma, allergic rhinitis or conjunctivitis, atopic dermatitis or eczema, food allergies, and allergic sensitization in offspring. The impact of cesarean delivery on urticaria and purpura remains uncertain.

Clinical relevance of somatic mutations in Chinese lung adenocarcinoma and their prognostic implications for survival.

BACKGROUND: To comprehensively elucidate the genomic and mutational features of lung cancer cases, and lung adenocarcinoma (LUAD), it is imperative to conduct ongoing investigations into the genomic landscape. In this study, we aim to analyze the somatic mutation profile and assessed the significance of these informative genes utilizing a retrospective LUAD cohort. METHODS: A total of 247 Chinese samples were analyzed to exhibit the tumor somatic genomic alterations in patients with LUAD. The Cox regression analysis was employed to identify prognosis-related genes and establish a predictive model for stratifying patients with LUAD. RESULTS: In the Dianjiang People's Hospital (DPH) cohort, the top five frequent mutated genes were (Epidermal growth factor receptor) EGFR (68%), TP53 (30%), RBM10 (13%), LRP1B (9%), and KRAS (9%). Of which, EGFR is a mostly altered driver gene, and most mutation sites are located in tyrosine kinase regions. Oncogene pathway alteration and mutation signature analysis demonstrated the RTK-RAS pathway alteration, and smoking was the main carcinogenic factor of the DPH cohort. Furthermore, we identified 34 driver genes in the DPH cohort, including EGFR (68%), TP53 (30.4%), RBM10 (12.6%), KRAS (8.5%), LRP1B (8.5%), and so on, and 45 Clinical Characteristic-Related Genes (CCRGs) were found to closely related to the clinical high-risk factors. We developed a Multiple Parameter Gene Mutation (MPGM) risk model by integrating critical genes and oncogenic pathway alterations in LUAD patients from the DPH cohort. Based on publicly available LUAD datasets, we identified five genes, including BRCA2, Anaplastic lymphoma kinase (ALK), BRAF, EGFR, and Platelet-Derived Growth Factor Receptor Alpha (PDGFRA), according to the multivariable Cox regression analysis. The MPGM-low group showed significantly better overall survival (OS) compared to the MPGM-high group (p < 0.0001, area under the curve (AUC) = 0.754). The robust performance was validated in 55 LUAD patients from the DPH cohort and another LUAD dataset. Immune characteristics analysis revealed a higher proportion of primarily DCs and mononuclear cells in the MPGM-low risk group, while the MPGM-high risk group showed lower immune cells and higher tumor cell infiltration. CONCLUSION: This study provides a comprehensive genomic landscape of Chinese LUAD patients and develops an MPGM risk model for LUAD prognosis stratification. Further follow-up will be performed for the patients in the DPH cohort consistently to explore the resistance and prognosis genetic features.

Sublobectomy and lymph node sampling are adequate for patients with invasive lung adenocarcinoma presenting as pure ground glass nodules.

PURPOSE: In this study, we aimed to investigate the prognosis of invasive lung adenocarcinoma that manifests as pure ground glass nodules (pGGNs) and confirm the effectiveness of sublobectomy and lymph node sampling in patients with pGGN-featured invasive adenocarcinoma (IAC). MATERIALS AND METHODS: We retrospectively enrolled 139 patients with pGGN-featured IAC, who underwent complete resection in two medical institutions between January 2011 and May 2022. Stratification analysis was conducted to ensure balanced baseline characteristics among the patients. The 5-year overall survival (OS) and disease-free survival (DFS) rates were compared between the groups using Kaplan-Meier survival curves and log-rank test. RESULTS: The 5-year OS and DFS rates for patients with IAC presenting as pGGNs after surgery were 96.5% and 100%, respectively. No lymph node metastasis or recurrence was observed in any of the enrolled patients. There was no statistically significant difference in the 5-year OS between patients who underwent lobectomy or sublobectomy, along with lymph node resection or sampling. CONCLUSION: IAC presented as pGGNs exhibited low-grade malignancy and had a relatively good prognosis. Therefore, these patients may be treated with sublobectomy and lymph node sampling.

Targeting the aryl hydrocarbon receptor with FICZ regulates IL-2 and immune infiltration to alleviate Hashimoto's thyroiditis in mice.

Hashimoto's thyroiditis (HT) is the most frequent autoimmune disorder. Growing work points to the involvement of aryl hydrocarbon receptor (AhR), a ligand-dependent transcription factor, in the regulation of immune homeostasis. However, the roles of AhR and its ligands in HT remains unclear. In this study, we leveraged public human database analyses to postulate that the AhR expression was predominantly in thyroid follicular cells, correlating significantly with the thyroid infiltration levels of multiple immune cells in HT patients. Using a thyroglobulin-induced HT mouse model and in vitro thyroid follicular epithelial cell cultures, we found a significant downregulation of AhR expression in thyrocytes both in vivo and in vitro. Conversely, activating AhR by FICZ, a natural AhR ligand, mitigated inflammation and apoptosis in thyrocytes in vitro and conferred protection against HT in mice. RNA sequencing (RNA-seq) of thyroid tissues indicated that AhR activation moderated HT-associated immune or inflammatory signatures. Further, immunoinfiltration analysis indicated that AhR activation regulated immune cell infiltration in the thyroid of HT mice, such as suppressing cytotoxic CD8+ T cell infiltration and promoting anti-inflammatory M2 macrophage polarization. Concomitantly, the expression levels of interleukin-2 (IL-2), a lymphokine that downregulates immune responses, were typically decreased in HT but restored upon AhR activation. In silico validation substantiated the binding interaction between AhR and IL-2. In conclusion, targeting the AhR with FICZ regulates IL-2 and immune infiltration to alleviate experimental HT, shedding new light on the therapeutic intervention of this prevalent disease.

Giant cell tumor of soft tissue involving thyroid gland: a case report and review of the literature.

BACKGROUND: Giant cell tumor of soft tissue is a low malignant uncommon neoplasm, with histologic features and immunophenotype similar to its bone counterpart. Primary giant cell tumor of soft tissue in the thyroid gland is considered an exceedingly rare entity. CASE PRESENTATION: We describe a case of primary thyroid giant cell tumor of soft tissue in a 69-year-old Chinese female patient. Neck ultrasonography showed a 19 mm × 12 mm × 5 mm nodule with heterogeneous echo and clear boundary located within the left thyroid. Histopathological examination revealed that the neoplasm was composed of two morphological components, mononuclear cells admixed with multinucleated osteoclast-like giant cells. Immunohistochemically, the tumor cells were positive for CD68 and vimentin, but were negative for epithelial membrane antigen, cytokeratin, and additional muscle markers. She underwent left unilateral thyroidectomy, and total thyroidectomy was performed for local recurrence 3 months later. The patient remained well without recurrence or metastasis following up for 12 months. CONCLUSION: The significance of this case lies in its rarity, the challenge of preoperative clinical diagnosis, and the differential diagnosis with other malignancies.

Transforming electrochemical hydrogen Production: Tannic Acid-Boosted CoNi alloy integration with Multi-Walled carbon nanotubes for advanced bifunctional catalysis.

The dimensions of alloy nanoparticles or nanosheets have emerged as a critical determinant for their prowess as outstanding electrocatalysts in water decomposition. Remarkably, the reduction in nanoparticle size results in an expanded active specific surface area, elevating reaction kinetics and showcasing groundbreaking potential. In a significant leap towards innovation, we introduced tannic acid (TA) to modify multi-walled carbon nanotubes (MWCNTs) and CoNi alloys. This ingenious strategy not only finely tuned the size of CoNi alloys but also securely anchored them to the MWCNTs substrate. The resulting synergistic "carbon transportation network" accelerated electron transfer during the reaction, markedly enhancing efficiency. Furthermore, the exceptional synergy of Co and Ni elements establishes Co0.84Ni1.69/MWCNTs as highly efficient electrocatalysts. Experimental findings unequivocally demonstrate that TA-Co0.84Ni1.69/MWCNTs require minimal overpotentials of 171 and 294 mV to achieve a current density of ± 10 mA cm-2. Serving as both anode and cathode for overall water splitting, TA-Co0.84Ni1.69/MWCNTs demand a low voltage of 1.66 V at 10 mA cm-2, maintaining structural integrity throughout extensive cyclic stability testing. These results propel TA-Co0.84Ni1.69/MWCNTs as promising candidates for future electrocatalytic advancements.

Paint sludge derived activated carbon encapsulating with cobalt nanoparticles for non-radical activation of peroxymonosulfate.

Industrial solid waste management and recycling are important to environmental sustainability. In this study, cobalt (Co) nanoparticles encapsulated in paint sludge-derived activated carbon (AC) were fabricated. The Co-AC possessed high conductivity, magnetic properties and abundant metal oxide impurities (TiAlSiOx), which was applied as multifunctional catalyst for peroxymonosulfate (PMS) activation. Compared to pure AC, the Co-AC exhibited significant enhanced performance for degradation of tetracycline hydrochloride (TCH) via PMS activation. Mechanism studies by in situ Raman spectroscopy, Fourier infrared spectroscopy, electrochemical analysis and electron paramagnetic resonance suggested that surface-bonded PMS (PMS*) and singlet oxygen (1O2) are the dominant reactive species for TCH oxidation. The non-radical species can efficiently oxidize electron-rich pollutants with high efficiency, which minimized the consumption of PMS and the catalyst. The removal percentages of TCH reached 97 % within 5 min and âˆ¼ 99 % within 15 min in the Co-AC/PMS system. The Co active sites facilitated PMS adsorption to form the PMS* and the TiAlSiOx impurities provided abundant oxygen vacancy for generation of the 1O2. In addition, the Co-AC/PMS system achieved high efficiency and stability for oxidation of the target pollutants over a long-term continuous operation. This work not only offers a cost-effective approach for recycling industrial waste but also provides new insights into the application of waste-derived catalyst for environmental remediation.

Role of the tripartite motif-containing (TRIM) family of proteins in insulin resistance and related disorders.

Emerging evidence suggests that the ubiquitin-mediated degradation of insulin-signalling-related proteins may be involved in the development of insulin resistance and its related disorders. Tripartite motif-containing (TRIM) proteins, a superfamily belonging to the E3 ubiquitin ligases, are capable of controlling protein levels and function by ubiquitination, which is essential for the modulation of insulin sensitivity. Recent research has indicated that some of these TRIMs act as key regulatory factors of metabolic disorders such as type 2 diabetes mellitus, obesity, nonalcoholic fatty liver disease, and atherosclerosis. This review provides a comprehensive overview of the latest evidence linking TRIMs to the regulation of insulin resistance and its related disorders, their roles in regulating multiple signalling pathways or cellular processes, such as insulin signalling pathways, peroxisome proliferator-activated receptor signalling pathways, glucose and lipid metabolism, the inflammatory response, and cell cycle control, as well as recent advances in the development of TRIM-targeted drugs.

A novel bi-functional cold-adaptive chitinase from Chitinilyticum aquatile CSC-1 for efficient synthesis of N-acetyl-D-glucosaminidase.

In order to better utilize chitinolytic enzymes to produce high-value N-acetyl-D-glucosamine (GlcNAc) from chitinous waste, there is an urgent need to explore bi-functional chitinases with exceptional properties of temperature, pH and metal tolerance. In this study, we cloned and characterized a novel bi-functional cold-adaptive chitinase called CaChi18A from a newly isolated strain, Chitinilyticum aquatile CSC-1, in Bama longevity village of Guangxi Province, China. The activity of CaChi18A at 50 °C was 4.07 U/mg. However, it exhibited significant catalytic activity even at 5 °C. Its truncated variant CaChi18A_ΔChBDs, containing only catalytic domain, demonstrated significant activity levels, exceeding 40 %, over a temperature range of 5-60 °C and a pH range of 3 to 10. It was noteworthy that it displayed tolerance towards most metal ions at a final concentration of 0.1 mM, including Fe3+ and Cu2+ ions, retaining 122.52 ± 0.17 % and 116.42 ± 1.52 % activity, respectively. Additionally, it exhibited favorable tolerance towards organic solvents with the exception of formic acid. Interestedly, CaChi18A and CaChi18A_ΔChBDs had a low Km value towards colloidal chitin (CC), 0.94 mg mL-1 and 2.13 mg mL-1, respectively. Both enzymes exhibited chitobiosidase and N-acetyl-D-glucosaminidase activities, producing GlcNAc as the primary product when hydrolyzing CC. The high activities across a broader temperature and pH range, strong environmental adaptability, and hydrolytic properties of CaChi18A_ΔChBDs suggested that it could be a promising candidate for GlcNAc production.

Multi-omics analysis reveals the molecular basis of flavonoid accumulation in fructus of Gardenia (Gardenia jasminoides Ellis).

BACKGROUND: The fruits of Gardenia are rich in flavonoids and geniposides, which have various pharmacological effects such as antioxidant, anti-inflammatory and anticancer. In this study, we analyzed the transcriptome and metabolome of gardenia peel and kernel at different growth stages, revealed the regulatory network related to flavonoid synthesis, and identified the key regulatory genes. RESULTS: The results showed that in terms of flavonoid metabolic pathways, gardenia fruits mainly synthesized cinnamic acid through the phenylpropanoid pathway, and then synthesized flavonoids through the action of catalytic enzymes such as 4-coumaroyl-CoA ligase, chalcone synthase, chalcone isomerase and flavanol synthase, respectively. In addition, we found that the metabolomics data showed a certain spatial and temporal pattern in the expression of genes related to the flavonoid metabolism pathway and the relative content of metabolites, which was related to the development and ripening process of the fruit. CONCLUSIONS: In summary, this study successfully screened out the key genes related to the biosynthesis metabolism of flavonoids in gardenia through the joint analysis of transcriptome and metabolome. This is of certain significance to the in-depth study of the formation mechanism of gardenia efficacy components and the improvement of quality.