Association of preoperative coronavirus disease 2019 with mortality, respiratory morbidity and extrapulmonary complications after elective, noncardiac surgery: An observational cohort study.

STUDY OBJECTIVE: To assess the impact of preoperative infection with the contemporary strain of severe acute respiratory coronavirus 2 (SARS-CoV-2) on postoperative mortality, respiratory morbidity and extrapulmonary complications after elective, noncardiac surgery. DESIGN: An ambidirectional observational cohort study. SETTING: A tertiary and teaching hospital in Shanghai, China. PATIENTS: All adult patients (≥ 18 years of age) who underwent elective, noncardiac surgery under general anesthesia at Huashan Hospital of Fudan University from January until March 2023 were screened for eligibility. A total of 2907 patients were included. EXPOSURE: Preoperative coronavirus disease 2019 (COVID-19) positivity. MEASUREMENTS: The primary outcome was 30-day postoperative mortality. The secondary outcomes included postoperative pulmonary complications (PPCs), myocardial injury after noncardiac surgery (MINS), acute kidney injury (AKI), postoperative delirium (POD) and postoperative sleep quality. Multivariable logistic regression was used to assess the risk of postoperative mortality and morbidity imposed by preoperative COVID-19. MAIN RESULTS: The risk of 30-day postoperative mortality was not associated with preoperative COVID-19 [adjusted odds ratio (aOR), 95% confidence interval (CI): 0.40, 0.13-1.28, P = 0.123] or operation timing relative to diagnosis. Preoperative COVID-19 did not increase the risk of PPCs (aOR, 95% CI: 0.99, 0.71-1.38, P = 0.944), MINS (aOR, 95% CI: 0.54, 0.22-1.30; P = 0.168), or AKI (aOR, 95% CI: 0.34, 0.10-1.09; P = 0.070) or affect postoperative sleep quality. Patients who underwent surgery within 7 weeks after COVID-19 had increased odds of developing delirium (aOR, 95% CI: 2.26, 1.05-4.86, P = 0.036). CONCLUSIONS: Preoperative COVID-19 or timing of surgery relative to diagnosis did not confer any added risk of 30-day postoperative mortality, PPCs, MINS or AKI. However, recent COVID-19 increased the risk of POD. Perioperative brain health should be considered during preoperative risk assessment for COVID-19 survivors.

[Deposition Characteristics of Water-soluble Inorganic Nitrogen and Organic Nitrogen in Atmospheric Precipitation in the Northern Suburbs of Nanjing].

Based on atmospheric precipitation collected in the northern suburbs of Nanjing from 2019 to 2020, the pH, conductivity, and chemical components of precipitation were analyzed. The seasonal variation in pH and conductivity of atmospheric precipitation in the northern suburbs of Nanjing were studied. The pollution levels and deposition characteristics of water-soluble inorganic nitrogen (WSIN) and organic nitrogen (WSON) in precipitation were also analyzed. The frequency of acid rain (pH<5.6) in atmospheric precipitation in the northern suburbs of Nanjing reached 37.18% during the observation period. Precipitation acidification was more serious in autumn and winter, and the pH value showed a variation trend of spring>summer>autumn>winter. The average conductivity of precipitation was 29.49 µS·cm-1; high pH and conductivity in spring were related to the high dust content in the atmosphere. The seasonal difference between WSIN and WSON in precipitation was significant. The highest and lowest concentrations of NO3--N and NH4+-N appeared in spring and summer, respectively. The concentration of WSON was the highest in autumn (2.63 mg·L-1). The average concentration ratio of WSON to water-soluble total nitrogen (WSTN) in precipitation was approximately 0.47, indicating that WSON played an important role in the study of total nitrogen. The average wet deposition fluxes of WSIN and WSON were 12.10 kg·(hm2·a)-1 and 11.13 kg·(hm2·a)-1, respectively, in which the inorganic nitrogen deposition was mainly NH4+-N.

Soft tissue facial changes among adult females during alignment stage of orthodontic treatment: a 3D geometric morphometric study.

BACKGROUND: To investigate changes in facial morphology during the first six months of orthodontic treatment among adult females receiving orthodontic treatment. METHODS: 43 adult females receiving orthodontic treatment were randomly recruited. 3D facial images were taken at baseline (T0), three months (T1), and six months (T2) after treatment initiation. Spatially dense facial landmarks were digitized to allow for sufficient details in characterization of facial features. 3D geometric morphometrics and multivariate statistics were used to investigate changes in mean and variance of facial shape and facial form associated with treatment. RESULTS: We observed statistically significant changes in facial shape across the three treatment stages (p = 0.0022). Pairwise comparisons suggested significant changes from T0 to T1 (p = 0.0045) and from T0 to T2 (p = 0.0072). Heatmap visualization indicated that the buccal and temporal region were invaginated while the labial region became protruded with treatment. The magnitude of shape change was 0.009, 0.004, and 0.010 from T0 to T1, T1 to T2, and T0 to T2, respectively, in unit of Procrustes distance. The average magnitude of change per-landmark was 1.32 mm, 0.21 mm, and 1.34 mm, respectively. Changes in mean facial form were not statistically significant (p = 0.1143). No changes in variance of facial shape were observed across treatment stages (p > 0.05). CONCLUSION: Rate of facial changes was twice as fast during the first three months as that during fourth to sixth month. Buccal and temporal region became invaginated while labial region became protruded with treatment.

[Characteristics and Sources of Water-soluble Ion Pollution in PM2.5 in Winter in Shenyang].

In order to explore the characteristics of PM2.5 and water-soluble ions in Shenyang in winter, the URG-9000D online monitoring system was used to continuously sample PM2.5 and gas components during 2018. The results indicated that the average concentration of PM2.5 in Shenyang during the sampling period was 80.67 µg·m-3, and the total water-soluble ion concentration ranged from 2.68 to 132.79 µg·m-3. Compared with clean days, the proportion of NO3-, SO42-, and NH4+ (SNA) in polluted days increased significantly, reached 43.7% of PM2.5. The rapid accumulation of SO2 in a short period of time made atmospheric PM2.5 explosively increase in Shenyang in winter. A Pearson correlation analysis showed that the correlation coefficients of SNA, Cl-, and PM2.5 were all above 0.78, indicating that the main contribution components of winter PM2.5 in Shenyang were SNA and Cl-. The apportionment of PMF sources indicated that the sources of pollutants in winter in Shenyang mainly included secondary reaction sources, coal and biomass combustion sources, and dust sources.

[Diurnal Variations and Source Apportionment of Water-soluble Ions in PM2.5During Winter in Nanjing Jiangbei New Area].

To gain a better understanding of the day-night variation characteristics of water-soluble ions, PM2.5 samples were continuously collected for two months in the Nanjing Jiangbei New Area during winter. The diurnal variation and sources of water-soluble ions were studied. Results showed that the mass concentration of water-soluble ions ranged from 17.07 µg·m-3 to 168.43 µg·m-3 with a mean value of (59.01±30.75) µg·m-3. The average mass concentration of water-soluble ions in daytime was higher than that in the nighttime. The concentration ratio of NO3- and NH4+ to total ion concentrations was higher at night, while SO42- and Cl- were higher during daytime. SO42-, NO3-, and NH4+ (SNA) were the dominant species of water-soluble ions in PM2.5 in Nanjing. The mass concentration of SNA on polluted days was higher than that on clean days. The ratio of the anion-cation balance (AE/CE) was larger than 1, indicating that the PM2.5 was acidic. There was a significant linear correlation between NH4+ with NO3- and SO42-, indicating that it occurred mainly in the form of NH4NO3 and (NH4)2SO4 in PM2.5. The PMF source apportionment indicated that water-soluble ions of PM2.5 were mainly derived from motor vehicle emissions, fossil fuel combustion, biomass burning, and dust in the Nanjing Jiangbei New Area.

[Pollution and Deposition Characteristics of Precipitation and Its Source Apportionment in Xi'an City].

Chemical and deposition characteristics as well as potential sources of precipitation in Xi'an from 2000 to 2017 were analyzed based on the acid deposition monitoring network in East Asia (EANET). The pH of precipitation showed increasing trends, whereas the conductivity of precipitation showed decreasing trends between 2000 and 2017 in Xi'an. The decreasing order of ion concentration in precipitation was as follows:SO42- > Ca2+ > NH4+ > NO3- > Na+ > Cl- > Mg2+ > K+. The percentage of SO42- in the total ion concentration decreased from 38.6% in 2000 to 27.9% in 2017. The ratio of SO42- to NO3- in recent years indicated that the type of pollutant in Xi'an changed from the coal-burning type to the mixed type. The deposition of SO42- in precipitation had a declining trend, which was consistent with the results of the Mann-Kendall test. Nitrogen and sulphur depositions in precipitation were 16.89 kg·(hm2·a)-1 and 33.52 kg·(hm2·a)-1, respectively, and ammonium nitrogen (NH4+-N) was the main deposition component of atmospheric active nitrogen in the precipitation of Xi'an. Vehicle emissions were the major contributors to SO42- (15.43%) and NO3- (72.99%). NH4+ originated mainly from agriculture sources, and the percentage reached up to 75.47%.

Serine-threonine protein kinase activation may be an effective target for reducing neuronal apoptosis after spinal cord injury.

The signaling mechanisms underlying ischemia-induced nerve cell apoptosis are poorly understood. We investigated the effects of apoptosis-related signal transduction pathways following ischemic spinal cord injury, including extracellular signal-regulated kinase (ERK), serine-threonine protein kinase (Akt) and c-Jun N-terminal kinase (JNK) signaling pathways. We established a rat model of acute spinal cord injury by inserting a catheter balloon in the left subclavian artery for 25 minutes. Rat models exhibited notable hindlimb dysfunction. Apoptotic cells were abundant in the anterior horn and central canal of the spinal cord. The number of apoptotic neurons was highest 48 hours post injury. The expression of phosphorylated Akt (p-Akt) and phosphorylated ERK (p-ERK) increased immediately after reperfusion, peaked at 4 hours (p-Akt) or 2 hours (p-ERK), decreased at 12 hours, and then increased at 24 hours. Phosphorylated JNK expression reduced after reperfusion, increased at 12 hours to near normal levels, and then showed a downward trend at 24 hours. Pearson linear correlation analysis also demonstrated that the number of apoptotic cells negatively correlated with p-Akt expression. These findings suggest that activation of Akt may be a key contributing factor in the delay of neuronal apoptosis after spinal cord ischemia, particularly at the stage of reperfusion, and thus may be a target for neuronal protection and reduction of neuronal apoptosis after spinal cord injury.