The profound review of Fenton process: What's the next step?

Fenton and Fenton-like processes, which could produce highly reactive species to degrade organic contaminants, have been widely used in the field of wastewater treatment. Therein, the chemistry of Fenton process including the nature of active oxidants, the complicated reactions involved, and the behind reason for its strongly pH-dependent performance, is the basis for the application of Fenton and Fenton-like processes in wastewater treatment. Nevertheless, the conflicting views still exist about the mechanism of the Fenton process. For instance, reaching a unanimous consensus on the nature of active oxidants (hydroxyl radical or tetravalent iron) in this process remains challenging. This review comprehensively examined the mechanism of the Fenton process including the debate on the nature of active oxidants, reactions involved in the Fenton process, and the behind reason for the pH-dependent degradation of contaminants in the Fenton process. Then, we summarized several strategies that promote the Fe(II)/Fe(III) cycle, reduce the competitive consumption of active oxidants by side reactions, and replace the Fenton reagent, thus improving the performance of the Fenton process. Furthermore, advances for the future were proposed including the demand for the high-accuracy identification of active oxidants and taking advantages of the characteristic of target contaminants during the degradation of contaminants by the Fenton process.

Integrative approach to assessing bioactivity from hempseed protein isolate extracted and dehydrated by different methods: Synergising in silico prediction and in vitro validation.

This study demonstrated a comprehensive workflow combining in silico screening and prediction with in vitro validation to investigate the bioactivity of hempseed protein isolate (HPI) extracted and dehydrated using different methods. By adopting an in silico approach, 13 major proteins of HPI were hydrolysed by 20 selected enzymes, leading to the prediction of 20 potential bioactivities. With papain hydrolysis, dipeptidyl peptidase-IV (DPP4) and angiotensin-converting enzyme (ACE) inhibitory activities emerged as having the highest potential. In vitro experiments confirmed these predictions, with DPP4 and ACE inhibitory activities displaying IC50 values of 0.32-0.42 mg/mL and 6.8-9.17 µg/mL, respectively. A strong correlation (r2 = 0.96) was observed between in vitro protein inhibitory results and in silico predicted data. This study demonstrated an effective integrative approach for predicting bioactive peptides in food protein, providing valuable guidance on its processing to create value-added products.

Association between heart rate and mortality in patients with septic shock: an analysis revealed by time series data.

BACKGROUND: Heart rate is crucial for patients with septic shock, but there are few studies on the scope of heart rate. Therefore, we studied the relationship between different heart rates and mortality of critically ill patients with septic shock, and explored the optimal heart rate range, in order to provide new insights for clinical treatment of septic shock. METHODS: This retrospective study utilized time-series heart rate data from the Medical Information Mart for Intensive Care (MIMIC) IV database. Patients with septic shock were identified as the Sepsis 3.0 criteria and received vasopressor therapy in the first 24 h since ICU admission. We calculated the time-weighted average heart rate (TWA-HR) based on the time-series data. The restricted cubic spline (RCS) analysis was employed to investigate the nonlinear relationship between heart rate and 28-day mortality, aiming to explore the optimal heart rate control target for septic patients and using this target as the exposure factor. The primary outcome was 28-day mortality, and the secondary outcome were ICU and in-hospital mortality. For the original cohort, we applied the log-rank test to infer the relationship between heart rate and mortality. To control for bias introduced by confounders, we utilized propensity score matching (PSM) to reduce imbalances between normal TWA-HR and high TWA-HR groups, and we established a series of models [the multivariable Cox model, matching weight (MW)-adjusted Cox model, multivariable logistic regression, MW-adjusted logistic regression, and doubly robust model] as sensitivity analyses and subgroup analyses to demonstrate the robustness of our findings. RESULTS: A total of 13492 patients were included in our study. The RCS analysis based on Cox and logistic regression showed increased risk of mortality (P < 0.001, non-linear P < 0.001) when TWA-HR > 85 beats per minute (bpm). The log-rank test revealed in terms of the 28-day mortality, the hazard ratio (HR) (95% confidence interval [CI]) was 1.92 (1.78-2.06, P < 0.001) for patients with high TWA-HR compared to normal TWA-HR group. Similarly, for the ICU mortality, the HR (95% CI) was 1.64 (1.52-1.78, P < 0.001), and for the in-hospital mortality, the HR (95% CI) was 1.61 (1.48-1.76, P < 0.001). Collectively, the sensitivity analysis consistently demonstrated higher 28-day mortality, ICU mortality, and in-hospital mortality in patients with TWA-HR > 85 bpm. CONCLUSION: Patients with septic shock whose heart rate was controlled no more than 85 bpm during ICU stay received survival benefit in terms of 28-day, ICU and in-hospital mortality. .

Profiling the differential phosphoproteome between breast milk and infant formula through a titanium (IV)-immobilized magnetic nanoplatform.

Breast milk (BM) fulfills the nutritional needs of infants and sets the standard for infant formula (IF). However, profiling the differential phosphoproteome between BM and IF remains unclear. Herein, a titanium (IV) (Ti4+)-immobilized magnetic nanoplatform (Fe3O4@GO@PDA-Ti4+) was constructed by self-assembly polymerization of dopamine on magnetic graphene oxide, followed by immobilizing Ti4+ through chelation for phosphopeptide enrichment. Fe3O4@GO@PDA-Ti4+ possessed outstanding selectivity (1/1000, a molar ratio of ß-casein digests to bovine serum albumin digests) and favorable sensitivity (2.5 fmol/µL), along with rapid magnetic separation. Excellent phosphopeptide capture efficiencies were obtained for BM and IF using Fe3O4@GO@PDA-Ti4+ as an adsorbent coupled with liquid chromatography-mass spectrometry/mass spectrometry. There were 191 and 239 phosphopeptides found in BM and IF, respectively, with 36 phosphoproteins identified in both. However, BM and IF shared only 17 phosphopeptides and 4 phosphoproteins. The variation in the phosphoproteome between BM and IF provides valuable insights into the optimization of IF humanization.

Machine learning models for mortality prediction in critically ill patients with acute pancreatitis-associated acute kidney injury.

Background: The occurrence of acute kidney injury (AKI) was associated with an increased mortality rate among acute pancreatitis (AP) patients, indicating the importance of accurately predicting the mortality rate of critically ill patients with acute pancreatitis-associated acute kidney injury (AP-AKI) at an early stage. This study aimed to develop and validate machine learning-based predictive models for in-hospital mortality rate in critically ill patients with AP-AKI by comparing their performance with the traditional logistic regression (LR) model. Methods: This study used data from three clinical databases. The predictors were identified by the Recursive Feature Elimination algorithm. The LR and two machine learning models-random forest (RF) and eXtreme Gradient Boosting (XGBoost)-were developed using 10-fold cross-validation to predict in-hospital mortality rate in AP-AKI patients. Results: A total of 1089 patients from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) and eICU Collaborative Research Database (eICU-CRD) were included in the training set and 176 patients from Xiangya Hospital were included in the external validation set. The in-hospital mortality rates of the training and external validation sets were 13.77% and 54.55%, respectively. Compared with the area under the curve (AUC) values of the LR model and the RF model, the AUC value of the XGBoost model {0.941 [95% confidence interval (CI) 0.931-0.952]} was significantly higher (both P < .001) and the XGBoost model had the smallest Brier score of 0.039 in the training set. In the external validation set, the performance of the XGBoost model was acceptable, with an AUC value of 0.724 (95% CI 0.648-0.800). However, it did not differ significantly from the LR and RF models. Conclusions: The XGBoost model was superior to the LR and RF models in terms of both the discrimination and calibration in the training set. Whether the findings can be generalized needs to be further validated.

Saroglitazar suppresses KIM-1 and type IV collagen in high fat diet and low-dose streptozotocin-induced diabetic nephropathy in Wistar rats.

Objectives: Nephropathy is the most common comorbidity linked to T2D. The present study aimed to examine the potential of saroglitazar in the context of a high-fat diet and low-dose streptozotocin-induced diabetic nephropathy in Wistar rats. Materials and Methods: Molecular docking simulation investigations were conducted on the ligand-binding region of type IV collagen and Kidney injury molecule-1 (KIM-1), using saroglitazar and fenofibrate as the subjects. The rats were fed either a conventional rodent diet or a high-fat diet ad libitum for two weeks. Following a two-week period, the rats given an HFD were administered with a low-dose of STZ (35 mg/kg, IP). Rats with experimentally induced diabetes were categorized into five groups: normal control; diabetic control; HFD+STZ+saroglitazar (2 mg/kg); HFD+STZ+saroglitazar (4 mg/kg); HFD+STZ+fenofibrate (100 mg/kg) treated orally for 21 days with continuation on HFD. After 21 days, rats were kept on fasting overnight, blood and urine was acquired for various biochemical analysis. Animals were sacrificed, and kidney tissues were removed for histopathological studies. Results: In-silico investigation showed a substantial affinity between saroglitazar and fenofibrate with KIM-1 and type IV collagen. Saroglitazar produced a significant (P<0.01) reduction in weight of the body, serum blood sugar, albumin, creatinine, and BUN levels. Further, saroglitazar significantly (P<0.01) reduced the KIM-1 and type IV collagen levels in the urine of diabetic rats. Histopathological results showed improvement in tubular degeneration, necrosis, and dilatation of Bowman's space in kidney tissue. Conclusion: Saroglitazar attenuated renal injury by improving renal function in HFD+STZ-induced DN in Wistar rats.

Prognostic value of red blood cell distribution width-to-albumin ratio in ICU patients with coronary heart disease and diabetes mellitus.

Background: The red blood cell distribution width (RDW)-to-albumin ratio (RAR) has emerged as a potentially valuable prognostic indicator in diverse medical conditions. However, the prognostic significance of RAR in intensive care unit (ICU) patients with coronary heart disease (CHD) and diabetes mellitus (DM) remains uncertain and requires further investigation. Methods: This study aims to investigate the prognostic significance of RAR in ICU patients with coexisting CHD and DM through a retrospective cohort analysis using data from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database (version 2.2). The study population included patients aged 18 years or older who were diagnosed with both CHD and DM. The primary endpoint was 1-year mortality, and the secondary endpoints included 30-day mortality, 90-day mortality, hospital length of stay (LOS), and ICU LOS. Results: A total of 3416 patients, of whom 64.64% were male, were included in the study. The 30-day mortality, 90-day mortality, and 1-year mortality were 7.08%, 7.44%, and 7.49%, respectively. After adjusting for confounding factors, multivariate Cox proportional risk analysis demonstrated that high RAR levels were associated with an increased risk of 30-day mortality (HR, 1.53 [95% CI 1.17-2.07], P = 0.006), 90-day mortality (HR, 1.58 [95% CI 1.17-2.13], P = 0.003), and 1-year mortality (HR, 1.58 [95% CI 1.17-2.13], P = 0.003). Furthermore, the restricted cubic spline (RCS) model indicated a linear relationship between RAR and 1-year mortality. Conclusion: The results suggest that RAR holds potential as a valuable prognostic biomarker in ICU patients with both CHD and DM. Elevated RAR levels were found to be significantly associated with increased mortality during hospitalization, facilitating the identification of individuals at higher risk of adverse outcomes. These findings underscore the importance of incorporating RAR into risk stratification and overall management strategies for ICU patients with coexisting CHD and DM.

Association between red blood cells transfusion and 28-day mortality rate in septic patients with concomitant chronic kidney disease.

Patients with chronic kidney disease (CKD) often have impaired immune function, making them more prone to infections that can lead to sepsis. The coexistence of these conditions can result in decreased hemoglobin levels and is associated with a higher mortality rate. To investigate whether the transfusion of red blood cells (RBCs) improves the prognosis of septic patients with concomitant CKD and to explore the indications for red blood cell transfusion. This retrospective cohort study utilizes data from the MIMIC-IV (v2.0) database. The study enrolled 6,604 patients with sepsis and concomitant CKD admitted to the Intensive Care Unit (ICU). Propensity score matching (PSM) was applied to adjust for confounding factors. Multivariate Cox regression analysis revealed an association between RBC transfusion and a decreased risk of 28-day mortality (HR: 0.61, 95% CI: 0.54-0.70, P < 0.001). Following a meticulous 1:1 propensity score matching analysis between the two cohorts, the matched population revealed a notable decrease in 28-day mortality within the RBC transfusion group (HR: 0.60, 95% CI: 0.51-0.71; P < 0.001). Additionally, we observed that a SOFA score ≥ 5, a Base Excess (BE) value < 3, and an estimated Glomerular Filtration Rate (eGFR) < 30 may be considered when evaluating the potential need for RBC transfusion. This study demonstrated an association between RBC transfusion and decreased 28-day mortality in patients with sepsis accompanied by CKD. The patient's BE value, SOFA score, and eGFR are crucial factors influencing the treatment outcome and should be considered when deciding on RBC transfusion.

Zirconium(IV) coordination-mediated rapid and versatile post-modification of polydopamine coating as stationary phase for open-tubular capillary electrochromatography.

In recent years, mussel-inspired polydopamine (PDA)-based materials have attracted significant attention in the field of open-tubular capillary electrochromatography (OT-CEC) owing to their diverse and appealing properties. However, previously established functionalized PDA coating-based CEC stationary phases predominantly relied on the latent reactivity of PDA with amine/thiol-containing molecules, limiting the types of applicable modifiers and requiring time-consuming reaction processes. Herein, we presented a versatile and efficient method for the facile and rapid fabrication of diverse functionalized PDA coatings as OT-CEC stationary phases through a Zr(IV) coordination-mediated post-modification strategy. Different kinds of modifiers, including octadecylamine (ODA), lauric acid (LA), and perfluorooctanoic acid (PFOA), were rapidly and robustly grafted onto the PDA coating, verified through multiple characterization techniques. The influences of preparation parameters on the grafting efficiency of the functionalized PDA coating were systematically investigated. Utilizing the Zr(IV)-mediated ODA-, LA- and PFOA-functionalized PDA-based OT-CEC columns, we achieved high-efficiency baseline separation of a series of neutral analytes with excellent repeatability, good stability, and long lifetime. Given the strong universality of the Zr(IV) coordination-mediated post-modification approach, our study provides an effective pathway for advancing the development of a wider range of functional PDA-based chromatographic stationary phases.

Prognostic Nutritional Index is Related to All-Cause Mortality in Patients With Stage IV Colorectal Cancer Treated With Capecitabine: Single-Center 24-Month Observational Study in Vietnam.

AIM: To determine the mortality rate and the predictive value of the prognostic nutritional index (PNI) for all-cause mortality during the 24 months in patients with stage IV colorectal cancer treated with capecitabine. METHODS: We conducted a study on 87 stage IV colorectal cancer patients treated with capecitabine. Before the day of treatment, all patients were measured CEA and CRP-hs levels and calculated neutrophil/lympho ratio (NLR) and PNI. Patients were monitored and collected drug side effects and mortality for 24 months. RESULTS: The mortality rate of study subjects was 60.9%. CRP-hs, NLR, and PNI were independent factors associated with 24-month mortality in patients with stage IV colorectal cancer (p < 0.05 to p < 0.01). At a cut-off value of 38.51, PNI was a predictor for mortality, with the area under the curve (AUC) of 0.88 and p < 0.001. CONCLUSIONS: PNI was a good predictor of all-cause mortality in patients with stage IV colorectal cancer treated with capecitabine for 24 months.

Education and technological innovation in mitigating CO2 emissions and fostering green economic growth in China: Marginal effects and policy threshold analyses.

This study makes a significant contribution to China's ambitious goals of achieving carbon dioxide (CO2) neutrality and transitioning to green economic growth (GEG), and integrating the theoretical framework of the impact, population, affluence, and technology (IPAT) theory, with real-world application to reduce CO2 and promote GEG for sustainable development. Furthermore, the study examines the ongoing theoretical debate on whether an inverted U-shaped environmental Kuznets curve (EKC) exists between technological innovations (TI) in environment-related fields and CO2 emissions in China, using data from 1990 to 2020 and employing the threshold instrumental variable two-stage least-squares (Th-IV2SLS) model. The findings indicate that all the variables representing education contribute to reducing CO2 emissions. The cost-effective levels of these variables to achieve CO2 reduction are as follows: a 93% literacy rate index, 12% education expenditure as a percentage of GDP, and an average of 6 years of schooling. Furthermore, TI also contributes to CO2 reduction, with a cost-effective level of 10.16% of TI. Educational variables promote GEG, with their respective cost-effective levels being 84% of the literacy rate index, 11.9% of education expenditure as a percentage of GDP, and an average of 5.5 years of schooling. In addition, TI promotes GEG, with a cost-effectiveness level of 10.4%. Moreover, there is a synergistic effect between education and TI that reduces CO2 emissions; however, the synergy that promotes GEG is relatively weak. Based on these findings, policy recommendations are provided to enhance the effectiveness of education and TI in reducing CO2 emissions and promoting GEG.

Therapeutic efficacy of Genistein in activation of neuronal AC/cAMP/CREB/PKA and mitochondrial ETC-Complex pathways in experimental model of autism: Evidence from CSF, blood plasma and brain analysis.

Autism is a complex neurodevelopmental condition characterized by repetitive behaviors, impaired social communication, and various associated conditions such as depression and anxiety. Its multifactorial etiology includes genetic, environmental, dietary, and gastrointestinal contributions. Pathologically, Autism is linked to mitochondrial dysfunction, oxidative stress, neuroinflammation, and neurotransmitter imbalances involving GABA, glutamate, dopamine, and oxytocin. Propionic acid (PRPA) is a short-chain fatty acid produced by gut bacteria, influencing central nervous system functions. Elevated PRPA levels can exacerbate Autism-related symptoms by disrupting metabolic processes and crossing the blood-brain barrier. Our research investigates the neuroprotective potential of Genistein (GNT), an isoflavone compound with known benefits in neuropsychiatric and neurodegenerative disorders, through modulation of the AC/cAMP/CREB/PKA signaling pathway and mitochondrial ETC complex (I-IV) function. In silico analyses revealed GNT's high affinity for these targets. Subsequent in vitro and in vivo experiments using a PRPA-induced rat model of autism demonstrated that GNT (40 and 80 mg/kg., orally) significantly improves locomotion, neuromuscular coordination, and cognitive functions in PRPA-treated rodents. Behavioral assessments showed reduced immobility in the forced swim test, enhanced Morris water maze performance, and restored regular locomotor activity. On a molecular level, GNT restored levels of key signaling molecules (AC, cAMP, CREB, PKA) and mitochondrial complexes (I-V), disrupted by PRPA exposure. Additionally, GNT reduced neuroinflammation and apoptosis, normalized neurotransmitter levels, and improved the complete blood count profile. Histopathological analyses confirmed that GNT ameliorated PRPA-induced brain injuries, restored normal brain morphology, reduced demyelination, and promoted neurogenesis. The study supports GNT's potential in autism treatment by modulating neural pathways, reducing inflammation, and restoring neurotransmitter balance.

Effective synthesis and characterization of citric acid cross-linking of modified ferrous metal-organic framework and chitosan nanocomposite sponge for Th(IV) elimination: Adsorption isotherms, kinetic analysis, and optimization by Box-Behnken design.

This research presents a novel nanocomposite of ferrous metal-organic framework (Fe(II)-MOF) that has been encapsulated with chitosan matrix, leading to the development of a new adsorbent referred to as NH2-Fe(II)-MOF@CSC composite sponge. This composite sponge has shown effectiveness in removing radioactive thorium (IV) contamination from water sources. The adsorbent underwent characterization using techniques including FTIR, PXRD, BET analysis, and SEM. The adsorbent has a high surface area of 1360.8 m2/g. The most effective conditions for adsorbing Th(IV) were found to be a pH of 5, using 0.02 g of adsorbent dose per 25 mL, and maintaining a contact time of 100 min. The composite sponge demonstrated an impressive maximum adsorption capacity of 618.8 mg/g for Th(IV). The adsorption process was fitted to Langmuir isothermally and kinetically fitted to pseudo-second-order. Nonetheless, the relatively low adsorption energy of 6.22 kJ/mol suggests that the main adsorption mechanism is physisorption, which is marked by weaker van der Waals forces. This discovery could have implications for the material's potential for easy regeneration. In the analysis of the influence of temperature on the adsorption of Th(IV), it was discovered that the adsorption process is endothermic because the positive ΔHo value was 24.48 kJ.mol-1. Furthermore, a positive ΔSo value of 87.46 J.mol-1 K-1 suggests the existence of disorder at the solid-solution interface. Conversely, a temperature rise resulted in a higher negatively charged ΔGo, indicating that the adsorption process is spontaneous. The research also examined the mechanism of interaction, such as π-π interaction, hydrogen bonding, pore filling, and electrostatic interaction. It was noted that the adsorbent can be efficiently used for a maximum of six cycles, demonstrating its economic viability. The adsorption outcomes were optimized using the Box Behnken design (BBD).

Mechanism of collagen type IV regulation by focal adhesion kinase during retained fetal membranes in dairy cows.

Retained fetal membranes (RFM) is an important reproductive disease in dairy cows, caused by maternal and fetal placental tissue adhesion. The main collagen in maternal and fetal placenta tissues is collagen type IV (COL-IV) and its breakdown is the key to placental expulsion. Focal adhesion kinase (FAK) has been shown to regulate the hydrolysis of Col-IV by affecting the activity of MMP-2 and MMP-9 activity, but the regulation of the mechanisms involved in placenta expulsion in dairy cows after postpartum are still unclear. The aim of this study was to investigate the pathogenic mechanism of RFM by studying the relationship between the FAK signaling pathway and COL-IV regulation. Maternal placental tissues were collected from six healthy and six cows with RFM of similar age, parity, body condition and milk yield at 12 h postpartum. In vitro experiments were performed on bovine endometrial epithelial cells from three groups including a FAK inhibitor group, a FAK activator group and a control group without FAK inhibitor and activator. The abundance of molecules involved in the FAK signaling pathway and COL-IV was detected by immunohistochemistry, quantitative real-time polymerase chain reaction (qRT-PCR) and western blot. The immunohistochemical results showed that the key molecules of FAK signaling pathway FAK, Src, MMP-2 and MMP-9 and Col-IV were expressed in placental tissues. The expression level of FAK, Src, MMP-2, and MMP-9 were significantly down-regulated (P < 0.05) and the abundances of COL-IV were significantly up-regulated (P < 0.05) in maternal placental tissues of RFM cows compared with healthy cows. In the FAK inhibitor treatment group, the relative expression levels of FAK and other related proteins were significantly down-regulated (P < 0.05) and the relative expression levels of COL-IV were significantly up-regulated (P < 0.05) with the results of the FAK activation group the opposite. These results indicated that FAK in maternal endometrial epithelial cells could regulate the hydrolysis process of Col-IV through the expression of key factors of signaling pathways and promote collagen hydrolysis, which in turn facilitated the process of postpartum placenta expulsion in dairy cows.

Lisdexamfetamine's Efficacy in Treating Attention Deficit Hyperactivity Disorder (ADHD): A Meta-Analysis and Review.

Lisdexamfetamine dimesylate, a prodrug stimulant, appears to effectively treat Attention-Deficit/Hyperactivity Disorder (ADHD) in children and adults. However, an analysis of the treatment effects of the two subscales (inattentiveness and hyperactivity) within the ADHD Rating Scale-IV (ADHD-RS-IV) has not yet been done to determine if clinical significance may be attributed to either one. Nor has there been a meta-analysis of the individual doses of lisdexamfetamine dimesylate. The current meta-analysis utilizes MEDLINE, Embase, Cochrane, PubMed, and clinicaltrials.gov to identify peer-reviewed studies. Selected studies were eligible if they met the following criteria: English language, randomized-controlled trials, and utilized the ADHD-RS-IV scale to assess the efficacy of lisdexamfetamine on treating ADHD in either children or adults. The primary studies utilized were published between January 2007 and April 2024. Many of these studies calculate effect sizes based on several dosages pooled together rather than by individual dosages. We conducted a random-effects meta-analysis to estimate the effect sizes for these pooled dosages on the full ADHD-RS-IV scale and its subscales, as well as to calculate effect sizes on the same scales based on the individual dosages. Our main outcome measures are the ADHD-RS-IV scale and its subscales in individual doses and pooled results in both children and adults. Adverse events during treatment were also analyzed based on stratified dosages. Eleven publications met our inclusion criteria. The analyses indicate that compared to placebo, lisdexamfetamine effectively alleviates the symptoms outlined by the ADHD-RS-IV. Moreover, there are no differences in the individual subscales or in the safety profile. Lisdexamfetamine demonstrates efficacy in treating the symptoms of ADHD, but we report that differing dosages did not yield significant differences in ADHD symptom management.

Traumatic spine fractures and concomitant venous thromboembolism: A systematic review.

Objective: Venous thromboembolism (VTE) associated with bony fractures have been documented in the literature. However, the literature is not very exhaustive when it comes to VTE associated with traumatic spine fractures. Thus the purpose of this systematic review analyzing the incidence of VTE associated with spinal trauma. Methods: An electronic search strategy was elaborated in Pubmed, Cochrane Library and Google Scholar (page 1-20) since inception till November 2023. Results: Twelve studies were included with three prospective clinical studies, seven retrospective studies, one observational cohort study, and one propensity-matched analysis. These involved 256,107 subjects with 6039 concomitant VTE (2.4 %). Potential risk factors included age, D-dimer levels, length of hospital stay, associated spinal cord injury, location of the vertebral trauma and other baseline patient-dependent characteristics. Conclusion: This review found that the rate VTE in spinal trauma patients was 2.4 % (6039/256107). To optimize care, clinical decision making should be tailored to each patient using a combined approach of imaging, laboratory findings, and serial physical examinations.

The impact of statin use on short-term and long-term mortality in patients with heart failure.

Background: Heart failure (HF) is a complex disorder that has an association with increased morbidity and mortality rates globally. The association of statin use with mortality rate in individuals with HF remains unclear. Objectives: To examine the association of statin use with the short-term and long-term all-cause mortality rate in critically ill individuals with HF. Methods: We performed a retrospective cohort analysis based on the Medical Information Mart for Intensive Care (MIMIC)-IV database. The critically ill people with HF were assigned to a statin group and a non-statin group according to whether they had been treated with statin or not during hospitalization. The Kaplan-Meier (KM) method and Cox proportional hazard models were adopted to explore the link between statin administration and the 30-day, 90-day, as well as 1-year mortality rates. To ensure the robustness of the findings, a 1:1 nearest propensity-score matching (PSM) was also performed. Results: The current research included 11,381 patients for the final analysis, with 7,561 in the statin group and 3,820 in the non-statin group. After multiple confounders were adjusted, we found that the Cox regression models revealed great beneficial effects of statin therapy on the 30-day, 90-day, as well as 1-year mortality rates among critically ill individuals with HF in the fully adjusted model. PSM also achieved consistent results. After PSM, the risk of mortality reduced by 23% for the 30-day mortality (HR = 0.77, 95%CI: 0.68-0.88, p < 0.001), 16% for the 90-day mortality rate (HR = 0.84, 95%CI: 0.75-0.93, p < 0.001), and 12% for the 1-year mortality rate (HR = 0.88, 95%CI: 0.81-0.97, p = 0.007). Patients treated with rosuvastatin had the greatest reduction in mortality rate. The 30-day, 90-day, and 1-year all-cause mortality rates were remarkably lower in patients who were treated with low-dose statins. Conclusion: Our study unveiled that statin use was related to decreased short-term and long-term all-cause mortality rates in critically ill individuals with HF. Rosuvastatin was associated with the greatest reduction of all-cause mortality rates. Low-dose statins can significantly reduce short-term and long-term mortality, while high-dose statins are not significantly correlated with mortality. However, the results are not conclusive and should be interpreted with caution.

Thermal ablation for Bethesda III and IV thyroid nodules: current diagnosis and management.

The diagnosis and management of Bethesda III and IV thyroid nodules remain clinical dilemmas. Current guidelines from academic societies suggest active surveillance or diagnostic lobectomy. However, the extent of surgery is often inappropriate, and a considerable percentage of patients experience under- or over-treatment. Thermal ablation has gained popularity as a safe and effective alternative treatment option for benign thyroid nodules. This review explores the feasibility of thermal ablation for Bethesda III or IV thyroid nodules, aiming to preserve the thyroid organ and avoid unnecessary surgery. It emphasizes individualized management, the need to consider factors including malignancy risk, clinical characteristics, and sonographic features, and the importance of supplemental tests such as repeat fine needle aspiration cytology, core needle biopsy, molecular testing, and radioisotope imaging.