Nomogram for predicting major bleeding after off-pump coronary artery bypass grafting.

OBJECTIVE: The purpose of this investigation is to develop a novel nomogram for predicting major bleeding following off-pump coronary artery bypass grafting (CABG). METHODS: Between January 2012 and December 2022, 541 patients who underwent off-pump isolated primary CABG were included in a retrospective analysis. The primary outcome measure after off-pump CABG was major bleeding. Based on the outcomes of a multivariate analysis, nomograms were constructed. Using receiver operating characteristic analysis and calibration, the predictive accuracy of the nomograms was assessed. Using decision curve analysis (DCA), the clinical benefit of the nomograms was determined. RESULTS: We categorized 399 and 142 patients in the "no major bleeding group" and "major bleeding group", respectively. Age (odds ratio (OR) 1.038; 95% confidence interval (CI) 1.009-1.068; p = 0.009), body mass index (OR 0.913; 95% CI 0.849-0.982; p = 0.014), hemoglobin (OR 0.958; 95% CI 0.945-0.971; p < 0.001), sodium (OR 0.873; 95% CI 0.807-0.945; p = 0.001), blood urea nitrogen (OR 1.198; 95% CI 1.073-1.338; p = 0.001), and operation time (OR 1.012; 95% CI 1.008-1.017; p < 0.001) were independent predictors for major bleeding after off-pump CABG. The model based on independent predictors exhibited excellent discrimination and calibration, with good agreement between actual and nomogram-estimated probabilities of generalization. DCA demonstrated that nomogram-assisted decisions have a greater positive benefit than treating all patients or none. CONCLUSIONS: The plotted nomogram accurately predicted major bleeding outcomes following off-pump CABG and may therefore contribute to clinical decision-making, patient treatment, and consultation services.

Soil nitrogen availability and microbial carbon use efficiency are dependent more on chemical fertilization than winter drought in a maize-soybean rotation system.

Soil nitrogen (N) availability is one of the limiting factors of crop productivity, and it is strongly influenced by global change and agricultural management practices. However, very few studies have assessed how the winter drought affected soil N availability during the subsequent growing season under chemical fertilization. We conducted a field investigation involving snow removal to simulate winter drought conditions in a Mollisol cropland in Northeast China as part of a 6-year fertilization experiment, and we examined soil physicochemical properties, microbial characteristics, and N availability. Our results demonstrated that chemical fertilization significantly increased soil ammonium and total N availability by 42.9 and 90.3%, respectively; a combined winter drought and fertilization treatment exhibited the highest soil N availability at the end of the growing season. As the growing season continued, the variation in soil N availability was explained more by fertilization than by winter drought. The Mantel test further indicated that soil Olsen-P content and microbial carbon use efficiency (CUE) were significantly related to soil ammonium availability. A microbial community structure explained the largest fraction of the variation in soil nitrate availability. Microbial CUE showed the strongest correlation with soil N availability, followed by soil available C:P and bacteria:fungi ratios under winter drought and chemical fertilization conditions. Overall, we clarified that, despite the weak effect of the winter drought on soil N availability, it cannot be ignored. Our study also identified the important role of soil microorganisms in soil N transformations, even in seasonally snow-covered northern croplands.

Effect of Erector Spinae Plane Block in Terms of Analgesic Efficacy in Elderly Patients Undergoing Posterior Lumbar Spine Surgery: A Retrospective, Propensity-Score Matched Study.

INTRODUCTION: For preoperative analgesia during a variety of operations, the erector spinae plane block (ESPB) has grown in popularity. However, its effectiveness in lumbar surgery is still unknown. The purpose of this study was to investigate the potential benefits of ESPB in enhancing analgesic efficacy in elderly individuals following posterior lumbar spine surgery. METHODS: Patients aged 65 years or older who underwent elective posterior lumbar instrumented fusion (with or without decompression) at our institution between January 2019 and June 2022 were included. Demographic data, comorbidities, and results of preoperative screening were retrospectively collected. Propensity score matching (PSM) was performed in a ratio of 1:1 for control and ESPB groups. The primary outcome was opioid consumption at 24 h after surgery. Secondary outcomes was visual analog scale (VAS) pain scores at rest in the first 24 h. Additional secondary outcomes included number of patients requesting rescue analgesia, incidence of nausea and vomiting, time to the first request for analgesia via patient-controlled analgesia, and length of stay. RESULTS: A total of 382 patients were included, of whom 119 received ESPB. The mean age of the study patients was 70.6 years old, and 254 (66.5%) were male. After PSM, each group comprised 115 patients. Patients in the ESPB group showed a significantly lower opioid consumption at 24 h after surgery. Compared with the control group, VAS pain scores at rest in the first 24 h, number of patient-controlled intravenous analgesia (PCIA) pump compressions, ratio of patients requesting rescue analgesia, incidence of nausea and vomiting, and length of stay were significantly reduced in the ESPB group. There were no significant differences between the two groups regarding safety outcomes. CONCLUSIONS: ESPB reduces short-term opioid consumption while providing safe and effective analgesia in elderly patients undergoing posterior lumbar surgery.

DPHL v.2: An updated and comprehensive DIA pan-human assay library for quantifying more than 14,000 proteins.

A comprehensive pan-human spectral library is critical for biomarker discovery using mass spectrometry (MS)-based proteomics. DPHL v.1, a previous pan-human library built from 1,096 data-dependent acquisition (DDA) MS data of 16 human tissue types, allows quantifying of 10,943 proteins. Here, we generated DPHL v.2 from 1,608 DDA-MS data. The data included 586 DDA-MS data acquired from 18 tissue types, while 1,022 files were derived from DPHL v.1. DPHL v.2 thus comprises data from 24 sample types, including several cancer types (lung, breast, kidney, and prostate cancer, among others). We generated four variants of DPHL v.2 to include semi-tryptic peptides and protein isoforms. DPHL v.2 was then applied to two colorectal cancer cohorts. The numbers of identified and significantly dysregulated proteins increased by at least 21.7% and 14.2%, respectively, compared with DPHL v.1. Our findings show that the increased human proteome coverage of DPHL v.2 provides larger pools of potential protein biomarkers.

Evaluating sample sizes and design for monitoring and characterizing the spatial variations of potentially toxic elements in the soil.

Cost-effective, representative and spatial coverage sampling designs are required to monitor the effects of potentially toxic elements (PTEs) in the soil. This study aims to evaluate the minimum sample sizes and placement of soil sampling designs to monitor and characterize the spatial variation of the PTEs (Cu, Zn, Cd, Cr, Pb, and Ni) in the soils. However, there is no standardized approach for evaluating the optimum soil sample size and monitoring location because of the spatial heterogeneity of PTEs in the soil. As a result, three broad techniques were applied. The first step was to use Global Moran's I and q-statistic values to describe the variability of soil PTEs and select appropriate evaluation methods. Second, using simple random sampling (SRS), ordinary kriging (OK), and Mean of Surface with Non-homogeneity (MSN), we estimated and evaluated soil PTEs in the current soil sampling schemes. Finally, MSN and spatial simulated annealing (SSA) optimization techniques were used to assess the required sample sizes and placements in the existing designs. Method performance was evaluated using a standard error (SE) and a relative standard error of the mean (RSE). Except for Zn and Cd, all PTEs tested showed heterogeneous distributions over the area. The MSN lowered the predicted SE by 79-86 % compared with SRS. The OK approach also outperformed the SRS method regarding mean estimated values of soil PTEs by 42-57 %. After SSA refined the initial design, the predicted SE by MSN of Cr and Zn was lowered by 13 % and 39 %, respectively. The MSN was effective with small sample sizes, reducing sample sizes and surveying costs by 39 % after SSA optimized the existing sample numbers. Thus, integrating various sampling strategies may be efficient for building optimal sample designs to monitor PTEs in the soil.

[Responses of subalpine meadow to climatic factors and the time lag effects in Wuyi Mountains from 2000 to 2019]. / 2000­2019å¹´æ­¦å¤·å±±äºšé«˜å±±è‰ç”¸å¯¹æ°”å€™å› å­çš„å“åº”åŠå ¶æ—¶æ»žæ•ˆåº”.

Subalpine meadow is extremely sensitive to climate change. Few studies, however, focused on the responses of subalpine meadow to climatic factors in subtropical regions. It is still a challenge to extract the biophysical parameters from optical remote sensing imagery during the growing season. Based on the normalized difference vegetation index (NDVI) time series dataset from the MOD13Q1 vegetation index products and meteorological data, we analyzed the changes of vegetation growth of subalpine meadow at Huanggang Mountain in the top of Wuyishan National Park from 2000 to 2019, its responses to climate factors and the time lag effects. The results showed that NDVI in summer increased insignificantly during 2000-2019, and that NDVI in the growing season, spring, and autumn increased significantly. The enhancement of NDVI was mainly contributed by the increasing temperature (0.026 ℃·a-1) from 2000 to 2019. The increasing temperature in spring and autumn influenced meadow growth more than that in summer and growing season. NDVI of the growing season in subalpine meadow was sensitive to precipitation,indicating that the growth of subalpine meadow was strongly affected by precipitation even in the subtropical region with sufficient precipitation. Temperature and precipitation in different growth periods had different time lag effects on the NDVI of subalpine meadowo. The time lag effects of temperature on subalpine meadow were 0-1 month, and that of precipitation were 2-3 month.

Investigation of Shear-Driven and Pressure-Driven Liquid Crystal Flow at Microscale: A Quantitative Approach for the Flow Measurement.

The liquid crystal-based method is a new technology developed for flow visualizations and measurements at microscale with great potentials. It is the priority to study the flow characteristics before implementation of such a technology. A numerical analysis has been applied to solve the simplified dimensionless two-dimensional Leslie-Ericksen liquid crystal dynamic equation. This allows us to analyze the coupling effect of the LC's director orientation and flow field. We will be discussing two classic shear flow cases at microscale, namely Couette and Poiseuille flow. In both cases, the plate drag speed in the state of Couette flow are varied as well as the pressure gradients in Poiseuille flow state are changed to study their effects on the flow field distributions. In Poiseuille flow, with the increase of applied pressure gradient, the influence of backflow significantly affects the flow field. Results show that the proposed method has great advantages on measurement near the wall boundaries which could complement to the current adopted flow measurement technique. The mathematical model proposed in this article could be of great potentials in the development of the quantitatively flow measurement technology.

Acute promyelocytic leukemia with a STAT5b-RARα fusion transcript defined by array-CGH, FISH, and RT-PCR.

Acute promyelocytic leukemia (APL) is characterized by the generation of the PML-RARα fusion transcript as a result of a reciprocal chromosomal rearrangement, t(15;17)(q22;q12), with breakpoints within the PML gene and the RARα gene. In a small proportion of APL cases, RARα is fused with a number of alternative partner genes. The signal transducer and activator of transcription 5 beta (STAT5b) is one of the variant partners. Here, we describe one rare case with all-trans retinoic acid (ATRA) -unresponsive APL characterized by the STAT5b-RARα fusion transcript. Morphology and immunophenotypic analyses indicated the typical features of APL; however, cytogenetic analysis exhibited a normal karyotype, and importantly, results of interphase fluorescence in situ hybridization (FISH) or reverse transcriptase-polymerase chain reaction (RT-PCR) analysis indicated that PML-RARα expression was negative. FISH analysis with the RARα dual-color break-apart rearrangement probe indicated a submicroscopic deletion of the 3' end of one RARA gene. Indeed, the STAT5b-RARα fusion transcript was found in this case by array-based comparative genomic hybridization and nested RT-PCR. To the best of our knowledge, we report here only the sixth APL patient in the world with the STAT5b-RARα fusion transcript. Additional clinical studies concerning the prognosis, response to therapy, and pathogenesis of APL patients with STAT5b-RARα fusion are necessary.