Targeting DNA junction sites by bis-intercalators induces topological changes with potent antitumor effects.

Targeting inter-duplex junctions in catenated DNA with bidirectional bis-intercalators is a potential strategy for enhancing anticancer effects. In this study, we used d(CGTATACG)2, which forms a tetraplex base-pair junction that resembles the DNA-DNA contact structure, as a model target for two alkyl-linked diaminoacridine bis-intercalators, DA4 and DA5. Cross-linking of the junction site by the bis-intercalators induced substantial structural changes in the DNA, transforming it from a B-form helical end-to-end junction to an over-wounded side-by-side inter-duplex conformation with A-DNA characteristics and curvature. These structural perturbations facilitated the angled intercalation of DA4 and DA5 with propeller geometry into two adjacent duplexes. The addition of a single carbon to the DA5 linker caused a bend that aligned its chromophores with CpG sites, enabling continuous stacking and specific water-mediated interactions at the inter-duplex contacts. Furthermore, we have shown that the different topological changes induced by DA4 and DA5 lead to the inhibition of topoisomerase 2 activities, which may account for their antitumor effects. Thus, this study lays the foundations for bis-intercalators targeting biologically relevant DNA-DNA contact structures for anticancer drug development.

Regulating cathode surface hydroxyl chemistry enables superior potassium storage.

Potassium vanadium fluorophosphate (KVPO4F) is regarded as a promising cathode candidate for potassium-ion batteries due to its high working voltage and satisfactory theoretical capacity. However, the usage of electrochemically inactive binders and redundant current collectors typically results in inferior electrochemical performance and low energy density, thus implying the important role of rational electrode structure design. Herein, we have reported a scalable and cost-effective synthesis of a cellulose-derived KVPO4F self-supporting electrode, which features a special surface hydroxyl chemistry, three-dimensional porous and conductive framework, as well as super flexible and stable architecture. The cellulose not only serves as a flexible substrate, a pore-forming agent, and a versatile binder for KVPO4F/conductive carbon but also enhances the K-ion migration ability. Benefiting from the special hydroxyl chemistry-induced storage mechanism and electrode structural stability, the flexible freestanding KVPO4F cathode exhibits high-rate performance (53.0% capacity retention with current densities increased 50-fold, from 0.2 C to 10 C) and impressive cycling stability (capacity retention up to 74.9% can be achieved over 1,000 cycles at a rate of 5 C). Such electrode design and surface engineering strategies, along with a deeper understanding of potassium storage mechanisms, provide invaluable guidance for better electrode design to boost the performance of potassium-ion energy storage systems.

Synergistic Gas Therapy and Targeted Interventional Ablation With Size-Controllable Arsenic Sulfide (As2S3) Nanoparticles for Effective Elimination of Localized Cancer Pain.

The elimination of localized cancer pain remains a globally neglected challenge. A potential solution lies in combining gas therapy with targeted interventional ablation therapy. In this study, HA-As2S3 nanoparticles with controlled sizes are synthesized using different molecular weights of sodium hyaluronate (HA) as a supramolecular scaffold. Initially, HA co-assembles with arsenic ions (As3+) via coordinate bonds, forming HA-As3+ scaffold intermediates. These intermediates, varying in size, then react with sulfur ions to produce size-controlled HA-As2S3 particles. This approach demonstrates that different molecular weights of HA enable precise control over the particle size of arsenic sulfide, offering a straightforward and environmentally friendly method for synthesizing metal sulfide particles. In an acidic environment, HA-As2S3 nanoparticles release hydrogen sulfide(H2S) gas and As3+. The released As3+ directly damage tumor mitochondria, leading to substantial reactive oxygen species (ROS) production from mitochondria. Concurrently, the H2S gas inhibits the activity of catalase (CAT) and complex IV, preventing the beneficial decomposition of ROS and disrupting electron transfer in the mitochondrial respiratory chain. Consequently, it is found that H2S gas significantly enhances the mitochondrial damage induced by arsenic nanodrugs, effectively killing local tumors and ultimately eliminating cancer pain in mice.

Effect of continuous hypertonic saline infusion on clinical outcomes in patients with traumatic brain injury.

Osmotic therapy has been recognized as an important treatment option for patients with traumatic brain injury (TBI). Nevertheless, the effect of hypertonic saline (HTS) remains unknown, as findings are primarily based on a large database. This study aimed to elucidate the effect of HTS on the clinical outcomes of patients with TBI admitted to the intensive care unit (ICU). We retrospectively identified patients with moderate-to-severe TBI from two public databases: Medical Information Mart for Intensive Care (MIMIC)-IV and eICU Collaborative Research Database (eICU-CRD). A marginal structural Cox model (MSCM) was used, with time-dependent variates designed to reflect exposure over time during ICU stay. Trajectory modeling based on the intracranial pressure evolution pattern allowed for the identification of subgroups. Overall, 130 (6.65%) of 1955 eligible patients underwent HTS. MSCM indicated that the HTS significantly associated with higher infection complications (e.g., urinary tract infection (HR 1.88, 95% CI 1.26-2.81, p = 0.002)) and increased ICU LOS (HR 2.02, 95% CI 1.71-2.40, p < 0.001). A protective effect of HTS on GCS was found in subgroups with medium and low intracranial pressure. Our study revealed no significant difference in mortality between patients who underwent HTS and those who did not. Increased occurrence rates of infection and electrolyte imbalance are inevitable outcomes of continuous HTS infusion. Although the study suggests slight beneficial effects, including better neurological outcomes, these results warrant further validation.

Efficacy of a Wearable Activity Tracker With Step-by-Step Goal-Setting on Older Adults' Physical Activity and Sarcopenia Indicators: Clustered Trial.

BACKGROUND: Smart wearable technology has potential benefits for promoting physical activity and preventing sarcopenia. OBJECTIVE: The purpose of this study was to explore the efficacy of a wearable activity tracker with 2-stage goal-setting for daily steps on older adults' physical activity and sarcopenia indicators. METHODS: The study used a clustered trial design and was conducted in March to June 2022. Participants were community-dwelling adults older than 60 years who were recruited from 4 community centers in Taipei City. The intervention was designed with 2-stage goals set to 5000 steps/day in the first 4 weeks and 7500 steps/day in the final 4 weeks while wearing a commercial wearable activity tracker. Data were collected by self-reported questionnaires, a body composition analyzer, a handle grip tester, and 5 sit-to-stand tests. RESULTS: All 27 participants in the experimental group and 31 participants in the control group completed the 8-week intervention. Total and light-intensity physical activities, skeletal muscle index, and muscle strength increased, while sedentary time, BMI, and the waist circumference of participants decreased in the experimental group, with significant group-by-time interactions compared to the control group. CONCLUSIONS: A wearable activity tracker with gradual goal-setting is an efficient approach to improve older adults' physical activity and sarcopenia indicators. Smart wearable products with behavioral change techniques are recommended to prevent sarcopenia in older adult populations.

"Submarine-Shaped" Radial Forearm Flap for Simultaneous Reconstruction of Oral and Lower Lip Defects".

BACKGROUND: Reconstruction of the oral cavity commonly results in trismus and lip incompetence. AIM AND OBJECTIVES: In this study, we aim to describe an innovative design of a radial forearm free flap for resurfacing bilateral buccal defects and simultaneous functional lower lip reconstruction in a single stage. MATERIALS AND METHODS: Between January 2010 and December 2019, 6 males underwent simultaneous buccal and lower lip reconstruction with a radial forearm free flap. The mean age of the patients was 57.3 years (range, 50-68 years). The defects were caused by trismus release and due to previous treatments. The mean size of the defects was 17.9 cm in length and 3.25 cm in width. Flaps were harvested, including the proximal perforators of the radial vessels, and the inset began in the buccal area opposite the anastomosis side. RESULTS: Flap size ranged from 16 to 21 × 2 to 4 cm. The recipient vessels used were the superficial temporal (4) and facial (2). All flaps survived. Lip infection was seen in 2 cases and managed conservatively. The mean follow-up was 19.2 months (range, 12-28 months). The mean increase in the interincisal distance was 10.7 mm. Oral continence was good in all patients. Speech intelligibility was considered total in 4 patients and partial in the remaining 2. CONCLUSION: The radial forearm flap constitutes an option for simultaneous lower lip reconstruction and resurfacing of bilateral buccal areas after trismus release. The procedure provides a thin and pliable reconstruction using only 1 donor site and 1 set of recipient vessels.

Temporal trends and outcomes in acute ischaemic stroke patients with a current or historical diagnosis of cancer.

BACKGROUND AND PURPOSE: The aim was to evaluate the temporal trends, characteristics and in-hospital outcomes of patients hospitalized with acute ischaemic stroke (AIS) between those with and without current or historical malignancies. METHODS: Adult hospitalizations with a primary diagnosis of AIS were identified from the National Inpatient Sample database 2007-2017. Logistic regression was used to compare the differences in the utilization of AIS interventions and in-hospital outcomes. For further analysis, subgroup analyses were performed stratified by cancer subtypes. RESULTS: There were 892,862 hospitalizations due to AIS, of which 108,357 (12.14%) had a concurrent diagnosis of current cancer (3.41%) or historical cancer (8.72%). After adjustment for confounders, patients with current malignancy were more likely to have worse clinical outcomes. The presence of historical cancers was not associated with an increase in poor clinical outcomes. Additionally, AIS patients with current malignancy were less likely to receive intravenous thrombolysis (adjusted odds ratio 0.66, 95% confidence interval 0.63-0.71). Amongst the subgroups of AIS patients treated with intravenous thrombolysis or mechanical thrombectomy, outcomes varied by cancer types. Notably, despite these acute stroke interventions, outcome remains poor in AIS patients with lung cancer. CONCLUSIONS: Although AIS patients with malignancy generally have worse in-hospital outcomes versus those without, there were considerable variations in these outcomes according to different cancer types and the use of AIS interventions. Finally, treatment of these AIS patients with a current or historical cancer diagnosis should be individualized.

Deep learning, 3D ultrastructural analysis reveals quantitative differences in platelet and organelle packing in COVID-19/SARSCoV2 patient-derived platelets.

Platelets contribute to COVID-19 clinical manifestations, of which microclotting in the pulmonary vasculature has been a prominent symptom. To investigate the potential diagnostic contributions of overall platelet morphology and their α-granules and mitochondria to the understanding of platelet hyperactivation and micro-clotting, we undertook a 3D ultrastructural approach. Because differences might be small, we used the high-contrast, high-resolution technique of focused ion beam scanning EM (FIB-SEM) and employed deep learning computational methods to evaluate nearly 600 individual platelets and 30 000 included organelles within three healthy controls and three severely ill COVID-19 patients. Statistical analysis reveals that the α-granule/mitochondrion-to-plateletvolume ratio is significantly greater in COVID-19 patient platelets indicating a denser packing of organelles, and a more compact platelet. The COVID-19 patient platelets were significantly smaller -by 35% in volume - with most of the difference in organelle packing density being due to decreased platelet size. There was little to no 3D ultrastructural evidence for differential activation of the platelets from COVID-19 patients. Though limited by sample size, our studies suggest that factors outside of the platelets themselves are likely responsible for COVID-19 complications. Our studies show how deep learning 3D methodology can become the gold standard for 3D ultrastructural studies of platelets.

COVID-19 patients exhibit a range of symptoms including microclotting. Clotting is a complex process involving both circulating proteins and platelets, a cell within the blood. Increased clotting is suggestive of an increased level of platelet activation. If this were true, we reasoned that parts of the platelet involved in the release of platelet contents during clotting would have lost their content and appear as expanded, empty "ghosts." To test this, we drew blood from severely ill COVID-19 patients and compared the platelets within the blood draws to those from healthy volunteers. All procedures were done under careful attention to biosafety and approved by health authorities. We looked within the platelets for empty ghosts by the high magnification technique of electron microscopy. To count the ghosts, we developed new computer software. In the end, we found little difference between the COVID patient platelets and the healthy donor platelets. The results suggest that circulating proteins outside of the platelet are more important to the strong clotting response. The software developed will be used to analyze other disease states.

Metabolism, pharmacokinetics and excretion of [14C]dimethyl fumarate in healthy volunteers: an example of xenobiotic biotransformation following endogenous metabolic pathways.

Delayed-release dimethyl fumarate (DMF), Tecfidera®, is approved globally for treating relapsing-remitting multiple sclerosis. The disposition of DMF was determined in humans after administration of a single oral dose of [14C]DMF, and the total recovery was estimated to be between 58.4% to 75.0%, primarily through expired air.The absorption of [14C]DMF-derived radioactivity was rapid, with Tmax at 1h postdose. Glucose was the predominant circulating metabolite, accounting for ∼60% of the total extractable radioactivity. Cysteine and N-acetylcysteine conjugates of mono- or di-methyl succinate were found to be the major urinary metabolites.In vitro studies showed that [14C]DMF was mainly metabolised to MMF, and fumarase exclusively converted fumaric acid to malic acid and did not catalyse the conversion of fumaric acid esters to malic acid. DMF was observed to bind with human serum albumin through Michael addition to the Cys-34 residue when exposed to human plasma.These findings indicate that DMF undergoes metabolism via hydrolysis, GSH conjugation, and the TCA cycle, leading to the formation of citric acid, CO2, and water. These ubiquitous and well-conserved metabolism pathways minimise the risk of drug-drug interactions and reduce variability related to pharmacogenetics and ethnicity.

Impact of Early Tracheostomy on Clinical Outcomes in Trauma Patients Admitted to the Intensive Care Unit: A Retrospective Causal Analysis.

OBJECTIVES: To assess the indications, timing, and clinical outcomes that result from the early tracheostomy (ET) administration, by causal inference models. DESIGN: A retrospective observational study. SETTING: Multiinstitutional intensive care unit in the United States PARTICIPANTS: The study comprised 626 trauma patients. INTERVENTIONS: An ET versus late tracheostomy (LT). MEASUREMENTS AND MAIN RESULTS: Trauma patients with tracheostomy were identified from 2 public databases named Medical Information Mart for the Intensive Care-IV and eICU Collaborative Research Database. Tracheostomy was defined as early (≤7 days) or late (>7 days) from intensive care unit admission. A marginal structural Cox model (MSCM) with inverse probability weighting was employed. For comparison, the authors also used time-dependent propensity-score matching (PSM) to account for differences in the probability of receiving an ET or LT. A total of 626 eligible patients were enrolled in the study, of whom 321 (51%) received a ET. The MSCM and time-dependent PSM indicated that the ET group was associated with reduced ventilation-associated pneumonia (VAP) and a shorter mechanical ventilation (MV) duration than the LT group. Yet, mortality did not show any difference between the two groups. CONCLUSIONS: The authors' study observed that ET was not associated with reduced mortality in trauma patients, but it was associated with reduced VAP risk and MV duration. The results warrant further validation in randomized controlled trials.

A Machine Learning Approach for the Prediction of Severe Acute Kidney Injury Following Traumatic Brain Injury.

BACKGROUND: Acute kidney injury (AKI), a prevalent non-neurological complication following traumatic brain injury (TBI), is a major clinical issue with an unfavorable prognosis. This study aimed to develop and validate machine learning models to predict severe AKI (stage 3 or greater) incidence in patients with TBI. METHODS: A retrospective cohort study was conducted by using two public databases: the Medical Information Mart for Intensive Care IV (MIMIC)-IV and the eICU Collaborative Research Database (eICU-CRD). Recursive feature elimination was used to select candidate predictors obtained within 24 h of intensive care unit admission. The area under the curve and decision curve analysis curves were used to determine the discriminatory ability. On the other hand, the calibration curve was employed to evaluate the calibrated performance of the newly developed machine learning models. RESULTS: In the MIMIC-IV database, there were 808 patients diagnosed with moderate and severe TBI (msTBI) (msTBI is defined as Glasgow Coma Score < 12). Of these, 60 (7.43%) patients experienced severe AKI. External validation in the eICU-CRD indicated that the random forest (RF) model had the highest area under the curve of 0.819 (95% confidence interval 0.783-0.851). Furthermore, in the calibration curve, the RF model was well calibrated (P = 0.795). CONCLUSIONS: In this study, the RF model demonstrated better discrimination in predicting severe AKI than other models. An online calculator could facilitate its application, potentially improving the early detection of severe AKI and subsequently improving the clinical outcomes among patients with msTBI.

Microsurgical Reconstruction of Extensive Lower Lip Defects: An Algorithm for Free Flap Selection and Functional Outcomes.

BACKGROUND: Large defects of the lower lip pose a difficult challenge for any reconstructive surgeon. When there is limited local tissue available to resurface the defects, free flaps are the preferred option. AIM AND OBJECTIVES: We reported our experience in the reconstruction of extensive lower lip defects. The authors propose a new algorithm for microsurgical technique selection and assessment of the functional outcomes obtained. MATERIALS AND METHODS: A retrospective review of all microsurgical reconstructions of extensive lower lip defects by the senior author for 10 years was performed. The functional outcomes assessed included speech, feeding, and oral continence. Patients were stratified according to their status of simultaneous mandible resection (none, marginal, segmental). RESULTS: Fifty-one patients were included in this study. Almost all patients (96.1%) achieved intelligible speech. Only 1 patient experienced severe drooling. Most patients could eat a solid or soft diet (72.5%). Mandible resection was associated with the worst feeding outcomes. CONCLUSIONS: Microsurgical reconstruction of extensive lip defects is safe and provides good results. Free flap selection should take into account the location of the defect, the resected structures, and the body mass index of the patient. Feeding status seems to be inversely correlated with the amount of mandibular resection.

Impacts of land use/cover and slope on the spatial distribution and ecological risk of trace metals in soils affected by smelting emissions.

The soil contamination around smelting sites shows high spatial heterogeneity. This study investigated the impacts of distance, land use/cover types, land slopes, wind direction, and soil properties on the distribution and ecological risk of trace metals in the soil around a copper smelter. The results demonstrated that the average concentrations of As, Cd, Cu, Pb, and Zn were 248.0, 16.8, 502.4, 885.6, and 250.2 g mg kg-1, respectively, higher than their background values. The hotspots of trace metals were primarily distributed in the soil of smelting production areas, runoff pollution areas, and areas in the dominant wind direction. The concentrations of trace metals decreased with the distance to the smelting production area. An exponential decay regression revealed that, depending on the metal species, the influence distances of smelting emissions on trace metals in soil ranged from 450 to 1000 m. Land use/cover types and land slopes significantly affected trace element concentrations in the soil around the smelter. High concentrations of trace metals were observed in farmland, grassland, and flatland areas. The average concentrations of trace metals in the soil decreased in the order of flat land > gentle slope > steep slope. Soil pH values were significantly positively correlated with Cd, Cu, Pb, Zn, and As, and SOM was significantly positively correlated with Cd, Pb, and Zn in the soil. Trace metals in the soil of the study area posed a significant ecological risk. The primary factors influencing the distribution of ecological risk, as determined by the Ctree analysis, were land slope, soil pH, and distance to the source. These results can support the rapid identification of high-risk sites and facilitate risk prevention and control around smelting sites.

Release characteristics of heavy metals from electrolytic manganese residue under varying environmental factors.

High levels of manganese (Mn) and other heavy metals from electrolytic manganese residue (EMR) stockpiled would be released into the environment under natural conditions. A batch-leaching test was carried out to investigate the release characteristics of heavy metals from EMR with different storage times under simulated environmental conditions such as acid rain with different pH (3.0, 4.5, 5.6, and 7.0) at contact times of 1, 2, 4, 6, and 12 h; liquid to solid ratio (L/S) (5:1, 10:1, 20:1, and 30:1); and temperature (15, 25, 35, and 45 °C). The results showed that low pH (3.0 and 4.5) and high temperature (35 and 45 °C) could significantly promote heavy metal leaching from EMRs and increasing the L/S ratio above 20:1 mL/g significantly decreased heavy metal leachate concentrations due to dilution effect. Cr, Mn, and Pb concentrations in leachate increased almost continuously throughout the leaching process, while Zn decreased slightly at the 12th hour. Meanwhile, heavy metal concentrations in EMR1 (fresh EMR) were higher than in EMR2 (out stockpiled for more than 3 months). The concentrations of Mn, Pb, and Zn in leachates from EMRs at pH 3.0 and 4.5 leaching far exceeded the allowable maximum discharge concentrations for pollutants of the integrated wastewater discharge standard in China (GB8978-1996) by 57.5-59.0, 1.3-4.3, and 1.1-1.8 and 53.5-56.0, 3.04-7.25, and 1.0-1.91 times, respectively. Additionally, the Mn concentrations from both EMR leachates at pH 7.0 were above the national safe emission threshold. The morphological structure of EMRs changed after leaching, and XRD analysis showed the disappearance of MnO2, SiO2, FeS2, and CaSO4. The XPS revealed that Cr, Mn, Pb, and Zn existed as Cr3+, MnO, PbSO4, and ZnSiO3, respectively, after leaching. The study concluded that Mn, Pb, and Zn from EMRS leached by acid rain might pose a high potential environmental risk. Therefore, developing appropriate disposal techniques for EMR is necessary to prevent heavy metal pollution.

Effects of Simulated Reclaimed Water on Soil Particle Sizes and Cd Adsorption and Migration in Soils at Smelting Sites.

This work studied the vertical migration characteristics of Cd in soil profiles from a zinc smelting site under the influence of simulated reclaimed water containing NaCl and Na2SO4. The isothermal adsorption curves of Cd in the soils of miscellaneous fill and weathered slate well fitted the Freundlich and Langmuir models, with R2 ranging from 0.991 to 0.998. The maximum adsorption capacity of Cd in the soils decreased significantly under the salt ion treatments with NaCl and Na2SO4. After leaching, the Cd concentrations in the leachates and Cd contents in the subsoil layers of 10-60 cm followed the order NaCl treatment > Na2SO4 treatment > CK (p < 0.05), suggesting that the salt ions promoted the vertical migration of exogenous Cd. The proportion of coarse particles (> 0.02 mm) decreased, while that of fine particles (< 0.02 mm) increased under salt ion treatments (p < 0.05). The morphological characterization indicated that salt ions accelerated the erosion and fragmentation of coarse particles to form fine particles. The use of reclaimed water to flush smelting sites may increase the risk of Cd migration with small-sized soil particles from the soil to groundwater.

Temporal trends, predictors of blood transfusion and in-hospital outcomes among patients with severe burn injury in the United States-A national database-based analysis.

BACKGROUND: Severe burn can be accompanied by life-threatening bleeding on some occasions, thus, blood transfusion is often required in these patients during their hospitalization. Therefore, we aimed to examine temporal trends, predictors, and in-hospital outcomes of blood transfusion in these patients in the United States. METHODS: The National Inpatient Sample was used to identify severe burn patients between January 2010 and September 2017 in the United States. Trends in the utilization of blood transfusion were analyzed using the Cochran-Armitage trend test. Moreover, propensity score matching (PSM) was employed, and then in-hospital outcomes were compared between these two groups in the matched cohort. Multivariable logistic regressions were further used to validate the results of PSM. RESULTS: Among 27,260 severe burn patients identified during the study period, 2120 patients (7.18%) received blood transfusion. Blood transfusion rates decreased significantly from 9.52% in 2010 to 5.02% in 2017 (p for trend <.001). In the propensity-matched cohort (2120 pairs with and without transfusion), patients transfused were at increased risk of in-hospital mortality (13.3% vs 8.77%, p < .001), overall postoperative complications (88.3% vs 72.59%, p < .001), longer hospital stays (defined as > median hospital stays = 5 d) (73.8% vs 50.6%, p < .001) and increased overall cost (defined as > median overall costs = 30,746) (81.6% vs 57.3%, p < .001). This was also the case for the multivariable analysis. CONCLUSIONS: Blood transfusion following severe burn injury may be associated with worse clinical outcomes. The utility for blood transfusion in burn patients warrants further prospective exploration.

Machine learning approach for the prediction of 30-day mortality in patients with sepsis-associated encephalopathy.

OBJECTIVE: Our study aimed to identify predictors as well as develop machine learning (ML) models to predict the risk of 30-day mortality in patients with sepsis-associated encephalopathy (SAE). MATERIALS AND METHODS: ML models were developed and validated based on a public database named Medical Information Mart for Intensive Care (MIMIC)-IV. Models were compared by the area under the curve (AUC), accuracy, sensitivity, specificity, positive and negative predictive values, and Hosmer-Lemeshow good of fit test. RESULTS: Of 6994 patients in MIMIC-IV included in the final cohort, a total of 1232 (17.62%) patients died following SAE. Recursive feature elimination (RFE) selected 15 variables, including acute physiology score III (APSIII), Glasgow coma score (GCS), sepsis related organ failure assessment (SOFA), Charlson comorbidity index (CCI), red blood cell volume distribution width (RDW), blood urea nitrogen (BUN), age, respiratory rate, PaO2, temperature, lactate, creatinine (CRE), malignant cancer, metastatic solid tumor, and platelet (PLT). The validation cohort demonstrated all ML approaches had higher discriminative ability compared with the bagged trees (BT) model, although the difference was not statistically significant. Furthermore, in terms of the calibration performance, the artificial neural network (NNET), logistic regression (LR), and adapting boosting (Ada) models had a good calibration-namely, a high accuracy of prediction, with P-values of 0.831, 0.119, and 0.129, respectively. CONCLUSIONS: The ML models, as demonstrated by our study, can be used to evaluate the prognosis of SAE patients in the intensive care unit (ICU). Online calculator could facilitate the sharing of predictive models.

Estimating accumulation rates and health risks of PAHs in residential soils of metropolitan cities.

Predicting temporal changes in PAH concentrations in urban soils and their corresponding health risk is essential for developing appropriate management measures to prevent those risks. Concentrations of PAHs in soils of residential areas with different building ages in three metropolitan cities were determined to estimate the accumulation rates of PAHs in soil. The mean concentrations of total PAHs (∑PAHs) were 1297 ng/g in Shanghai, 865 ng/g in Beijing, and 228 ng/g in Shenzhen. The primary sources of the PAHs were traffic and coal combustion for industrial activity and space heating. The high PAH concentrations in Shanghai were attributed to the relatively high average building age of the sampled residential areas and the low annual temperature in the city. The overall annual accumulation rates of PAHs in the soils were estimated from linear regressions between the PAH concentrations and building age of the residential areas. The annual accumulation rate of PAHs in the soils was 64.7 ng/g in Beijing, 24.2 ng/g in Shanghai, and 3.3 ng/g in Shenzhen. The higher rate in Beijing was due to the higher intensity of PAH emissions and the lower temperature. The regression estimations suggest that health risks posed by PAHs in residential soils of the metropolitan cities increase considerably with time.

Effect of harvest time span on physicochemical properties, antioxidant, antimicrobial, and anti-inflammatory activities of Meliponinae honey.

BACKGROUND: The maturity of honey has a great impact on its quality and contents. Additionally, stingless bee honey contains high moisture, which allows microorganisms to survive and ferment, contributing to honey's variable flavor and physicochemical properties. Therefore, there is a need for better quality control of the honey process, especially the harvest time of honey. RESULTS: We gathered honey from the nest of stingless bees Heterotrigona itama and Tetrigona binghami over different time periods, i.e. 15, 30, and 45 days. The results show harvest time considerably affects the physicochemical properties, antioxidant activity, and antimicrobial activity of honey. Good antioxidant activity and antimicrobial activity can be found in honey produced from a longer harvest time. Compared with 15-day harvest time, at 30- or 45-day harvest time water, trehalulose, and protein content and total acidity increased, and the content of reducing sugars, fructose and glucose, and pH values, decreased in both types of honey. Moreover, compared with 15-day harvest time, the sum of six organic acids in the 45-day honey of H. itama fluctuated between 2.78 to 4.12 g 100 g-1 and in the 45-day honey of T. binghami increased from 1.66 to 3.61 g 100 g-1 , respectively. CONCLUSION: Honey harvest time had a significant effect on the physicochemical properties, antioxidant activity, and antimicrobial activity of stingless bee honey (H. itama or T. binghami). This study provides a reference for beekeepers to adjust harvest time to obtain honey with suitable physicochemical parameters. © 2022 Society of Chemical Industry.

Venous Size Discrepancy Is a Critical Factor When Using Superficial Temporal Vessels as Recipient Vessels for Free Flaps.

BACKGROUND: Superficial temporal vessels have been used successfully as recipient vessels for head and neck reconstruction. This study evaluates the impact of several treatment variables on flap failure and take-back rate when using these recipient vessels. METHODS: We conducted a retrospective study of all microsurgical reconstructions using superficial temporal vessels as recipient vessels in a period of 10 years. Variables collected included previous treatments (radiotherapy, chemotherapy, neck dissection, free flap reconstruction), type of flaps used (soft tissue, osteocutaneous), and vessel size discrepancy between donor and recipient vessels. RESULTS: A total of 132 patients were included in the study. The flap success rate was 98.5%. The take-back rate was 10.6%. The most frequent reason for take-back was venous congestion secondary to thrombosis. None of the studied variables was associated with flap failure. Reconstructions using osteocutaneous flaps and vein diameter discrepancy (ratio ≥ 2:1) had significantly higher take-back rates. CONCLUSION: Flaps with a significant size discrepancy between donor and recipient veins (ratio ≥ 2:1) and fibula flaps (compared with soft tissue flaps) were associated with a higher risk of take-back. It is crucial to minimize venous engorgement during flap harvest and anastomosis, and limit vein redundancy during flap in-setting.