Incidence, Risk Factors, and Correlation with Caprini Score of Deep Vein Thrombosis After Colpocleisis with/without Concomitant Hysterectomy for Pelvic Organ Prolapse in Elderly Women.

INTRODUCTION AND HYPOTHESIS: The objective was to investigate the incidence and risk factors of lower extremity deep vein thrombosis (DVT) in elderly women undergoing colpocleisis for pelvic organ prolapse and to evaluate the predictive efficacy of the Caprini scores. METHODS: Data from patients who underwent colpocleisis from August 2019 to April 2024 were retrospectively analyzed. The primary endpoint was DVT detected by ultrasonography within 7 days of surgery. Univariate and multivariate logistic regression analyses were applied to identify independent risk factors. Efficacy parameters of the Caprini scores were analyzed and optimal cut-off values were selected. RESULTS: A total of 262 patients were enrolled in the study, of whom 8.4% (22 out of 262) developed DVT postoperatively. After statistical analysis, the duration of menopause, history of inflammatory bowel disease, as well as higher levels of preoperative cholesterol and preoperative D-dimer, were identified as independent risk factors. There was a significant difference in the Caprini scores between the DVT and non-DVT groups (7.27 ± 1.28 vs 6.15 ± 0.80, p < 0.001), and the risk of DVT tended to increase with higher Caprini scores. The best performance was achieved when the threshold for the Caprini score was set to 7, at which point the area under the receiver operating characteristic curve was 0.758, the sensitivity was 0.773, and the specificity was 0.662. CONCLUSION: There was a strong correlation between the occurrence of DVT after colpocleisis and the Caprini score, with higher Caprini scores indicating a higher risk of postoperative DVT. A significantly increased risk was suggested when this score was ≥ 7.

Prediction Model for Delayed Behavior of Early Ambulation After Surgery for Varicose Veins of the Lower Extremity: A Prospective Case-Control Study.

OBJECTIVE: To analyze influencing factors and establish a prediction model for delayed behavior of early ambulation after surgery for varicose veins of the lower extremity (VVLE). DESIGN: A prospective case-control study. SETTING: Patients with VVLE were recruited from 2 local hospitals. PARTICIPANTS: In total, 498 patients with VVLE were selected using convenience sampling and divided into a training set and a test set. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: We collected information from the selected participants before surgery and followed up until the day after surgery, then divided them into a normal and delayed ambulation group. Propensity score matching was applied to all participants by type of surgery and anesthesia. All the characteristics in the 2 groups were compared using logistic regression, back propagation neural network (BPNN), and decision tree models. The accuracy, sensitivity, specificity, and area under the curve (AUC) values of the 3 models were compared to determine the optimal model. RESULTS: A total of 406 participants were included after propensity score matching. The AUC values for the training sets of logistic regression, BPNN, and decision tree models were 0.850, 0.932, and 0.757, respectively. The AUC values for the test sets were 0.928, 0.984, and 0.776, respectively. A BPNN was the optimal model. Social Support Rating Scale score, preoperative 30-second sit-stand test score, Clinical-Etiology-Anatomy-Pathophysiology (CEAP) grade, Medical Coping Modes Questionnaire score, and whether you know the need for early ambulation, in descending order of the result of a BPNN model. A probability value greater than 0.56 indicated delayed behavior of early ambulation. CONCLUSIONS: Clinicians should pay more attention to those with lower Social Support Rating Scale scores, poor lower limb strength, a higher CEAP grade, and poor medical coping ability, and make patients aware of the necessity and importance of early ambulation, thereby assisting decision-making regarding postoperative rehabilitation. Further research is needed to improve the method, add more variables, and transform the model into a scale to screen and intervene in the delayed behavior of early ambulation of VVLE in advance.

Migration and transformation of phosphorus and toxic metals during sludge incineration with Ca additives.

The recycling and utilization of phosphorus resources in sludge is becoming increasingly important. In this study, we compared the conversion of phosphorus and toxic metal passivation effects of different Ca additives under oxygen-rich combustion conditions and elucidated their specific mechanisms of action. The experimental results indicated that four Ca-based additives improved the recovery rate of total phosphorus, and promoted the generation of stable apatite phosphorus (AP). The effect of CaCl2 and CaO was greater than that of Ca(OH)2 and CaSO4. CaCl2 promoted the formation of Ca3(PO4)2 and Ca2P2O7, and CaSO4 improved the conversion of AlPO4 to Ca(H2PO4)2 with increasing temperature. The conversion capacity of CaO on non-apatite inorganic phosphorus to AP was greater than that of Ca(OH)2, and more CaH2P2O7, Ca(PO3)2, and Ca-Al-P minerals were found. Toxic metal percentages decreased after sludge incineration with CaCl2. Compared with CaO and Ca(OH)2, the toxic metal adsorption effect of CaSO4 was more significant. The influence of Ca additives on the conversion of Zn into stable components was as follows: CaCl2 > Ca(OH)2 > CaO > CaSO4. Ca additives reduced the toxic metal contamination level and ecological risk index values, and the order of toxic metal contamination levels was Ni > Zn > Cr > Cu > Mn. The experiment confirmed the conversion of phosphorus and the toxic metal passivation effect of Ca additives during oxy-fuel combustion of sludge, which is beneficial for its resource utilization.

Towards biomass production and wastewater treatment by enhancing the microalgae-based nutrients recovery from liquid digestate in an innovative photobioreactor integrated with dialysis bag.

Microalgae-based nutrients recovery from liquid anaerobic digestate of swine manure has been a hotspot in recent decades. Nevertheless, in consideration of the high NH4+-N content and poor light penetrability exhibited by the original liquid digestate, uneconomical pretreatment on liquid digestate including centrifugation and dilution are indispensable before microalgae cells inoculation. Herein, aiming at eliminating the energy-intensive and freshwater-consuming pretreatment on liquid digestate and enhancing microalgae growth, the dialysis bag which permits nutrients transferring across its wall surface whereas retains almost all matters characterized by impeding light transmission within the raw liquid digestate was integrated into a column photobioreactor (DB-PBR). Consequently, light availability of microalgae cells in DB-PBR was elevated remarkably and thus contributed to a 357.58% improvement on microalgae biomass concentration in DB-PBR than the conventional PBR under 80 µmol m-2 s-1. Likewise, superior nutrients removal efficiencies from liquid digestate were obtained in DB-PBR (NH4+-N: 74.84%, TP: 63.75%) over the conventional PBR (NH4+-N: 30.27%, TP: 16.86%). Furthermore, higher microalgae biomass concentration (1.87 g L-1) and nutrients removal efficiencies (NH4+-N: 95.12%, TP: 76.87%) were achieved in the DB-PBR by increasing the light intensity to 140 µmol m-2 s-1. More importantly, the DB-PBR may provide a simple and greener solution to purify other kinds of wastewater.

Physical examination-indicated cerclage in twin pregnancy: a retrospective cohort study.

PURPOSE: This study aimed to evaluate the efficacy of physical examination-indicated cerclage in twin pregnancies and compare it with those that received conservative management. METHODS: We used a retrospective cohort study design of asymptomatic twin pregnancies identified with physical examination indications at 14-26 weeks from 2015 through 2019 at Fujian Maternity and Child Health Hospital. The primary outcomes were gestational age (GA) at delivery and the incidence of spontaneous preterm birth (SPTB) at < 34 weeks, < 32 weeks, < 28 weeks, and < 24 weeks. The main secondary outcomes were latency period from diagnosis to delivery, composite neonatal adverse outcome and neonatal survival at discharge. RESULTS: Thirty-one women with twin pregnancies were managed with physical examination-indicated cerclage, and another 31 received expectant management. The demographic characteristics of the two groups were not significantly different. GA at delivery was significantly later in the cerclage group than in the controls: 32.53 ± 4.78 vs. 27.53 ± 4.15 weeks, with a mean difference of 5.00 weeks [95% confidence interval (CI), 2.73-7.28]. There were significant decreases in the incidence of spontaneous preterm birth (SPTB) at < 34 weeks, < 32 weeks, < 28 weeks, and < 24 weeks in the cerclage group. The interval from diagnosis to delivery was increased with cerclage by a mean difference of 4.37 weeks (95% CI, 1.96-7.06). Regarding neonatal outcome, the perinatal mortality rate in the cerclage group was significantly reduced compared to that in the control group [8/62 (12.9%) vs. 26/62 (41.9%); P < 0001]. Likewise, the neonatal intensive care unit (NICU) admissions, length of stay in the NICU, and composite adverse neonatal outcome in the cerclage group were significantly reduced. CONCLUSION: Physical examination-indicated cerclage was associated with significantly later GA at delivery, longer latency period from diagnosis to delivery, decreased incidence of SPTB at any given GA, and improved perinatal outcome compared with the corresponding measures in controls treated conservatively.

Two-stage nomogram models in mid-gestation for predicting the risk of spontaneous preterm birth in twin pregnancy.

PURPOSE: This study aimed to develop two-stage nomogram models to predict individual risk of preterm birth at < 34 weeks of gestation in twin pregnancies by incorporating clinical characteristics at mid-gestation. METHODS: We used a case-control study design of women with twin pregnancies followed up in a tertiary medical centre from January 2018 to March 2019. Maternal demographic characteristics and transvaginal cervical length data were extracted. The nomogram models were constructed with independent variables determined by multivariate logistic regression analyses. The risk score was calculated based on the nomogram models. RESULTS: In total, 65 twin preterm birth cases (< 34 weeks) and 244 controls met the inclusion criteria. Based on univariate and multivariate logistic regression analyses, we built two-stage nomogram prediction models with satisfactory discrimination and calibration when applied to the validation sets (first-stage [22-24 weeks] prediction model, C-index: 0.805 and 0.870, respectively; second-stage [26-28 weeks] prediction model, C-index: 0.847 and 0.908, respectively). Restricted cubic splines graphically showed the risk of preterm birth among individuals with increased risk scores. Moreover, the decision curve analysis indicated that both prediction models show positive clinical benefit. CONCLUSION: We developed and validated two-stage nomogram models at mid-gestation to predict the individual probability of preterm birth at < 34 weeks in twin pregnancy.

Association of the vaginal microbiota with pregnancy outcomes in Chinese women after cervical cerclage.

RESEARCH QUESTION: The study aimed to investigate the relationship between risk factors associated with vaginal microbiota and outcomes of cervical cerclage. DESIGN: A retrospective cohort study of singleton pregnancies with cervical cerclage was conducted. Before cerclage, participants underwent a vaginal microbiota assay, including morphological examination and functional vaginal microecological analysis using a vaginitis multi-test kit. The chi-squared test and logistic and linear regression analyses were performed to evaluate the associations of various risk factors with maternal and neonatal outcomes. RESULTS: Eighty-five participants were included. The mean interval between cerclage and delivery was 69.4 ± 36.7 days, and 12 (14.1%) of newborns died. A higher grade of vaginal cleanliness, a higher pH, a lower abundance of Lactobacillus spp., a higher sialidase-positive percentage, a higher positive percentage of clue cells, a higher lactobacillary grade, a higher Nugent score and a higher rate of microecological dysbiosis were significantly associated with a poor neonatal outcome and shorter cerclage to delivery intervals (P < 0.001-0.041). Furthermore, sialidase positivity was associated with the highest risk of cervical cerclage failure (odds ratio [OR] 10.469; 95% confidence interval [CI] 1.096-36.087), followed by the presence of bulging membranes (OR 6.400; 95% CI 0.428-15.641) and vaginal microbiota dysbiosis (OR 6.038; 95% CI 0.173-17.072). CONCLUSIONS: An absence of Lactobacillus spp. and some functional factors of vaginal microbiota are potential risk factors that predict subsequent cerclage failure. These findings indicate the potential clinical utility of these factors to predict cervical cerclage failure for managing patient expectations and providing improved postoperative surveillance.

Development and Validation of a Risk Prediction Model for Female Stress Urinary Incontinence in Rural Fujian, China.

Purpose: With China's rapidly aging population and the rising proportion of obese people, an increase in the number of women suffering from urinary incontinence (UI) is to be expected. In order to identify high-risk groups before leakage occurs, we aimed to develop and validate a model to predict the risk of stress UI (SUI) in rural women. Patients and methods: This study included women aged 20-70 years in rural Fujian who participated in an epidemiologic survey of female UI conducted between June and October 2022. Subsequently the data was randomly divided into training and validation sets in a ratio of 7:3. Univariate and multivariate logistic regression analyses were used to identify independent risk factors as well as to further construct a nomogram for risk prediction. Finally, concordance index (C-index), calibration curve and decision curve analysis were applied to evaluate the performance of the predictive models. Results: A total of 5290 rural females were enrolled, of whom 771 (14.6%) had SUI. Age, body mass index (BMI), postmenopausal status, number of vaginal deliveries, vaginal delivery of large infant, constipation and family history of pelvic organ prolapse (POP) and SUI were included in the nomogram. C-index of this prediction model for the training and validation sets was 0.835 (95% confidence interval [CI] = 0.818-0.851) and 0.829 (95% CI = 0.796-0.858), respectively, and the calibration curves and decision analysis curves for both the training and validation sets showed that the model was well-calibrated and had a positive net benefit. Conclusion: This model accurately estimated the SUI risk of rural women in Fujian, which may serve as an effective primary screening tool for the early identification of SUI risk and provide a basis for further implementation of individualized early intervention. Moreover, the model is concise and intuitive, which makes it more operational for rural women with scarce medical resources.

Circularly polarized luminescence and tuning chromaticity of Eu(III)-grafting chiral polymer based on variable position of the substitution.

The novel chiral conjugated polymers P-1 and P-3 are prepared from the monomers S-M-2 and S-M-3 with (R,R)-1,2-aminocyclohexane (M-1) via a nucleophilic addition-elimination reaction, respectively. The Eu(III)-grafting chiral polymers P-2 and P-4 could be obtained by direct coordination reaction of Eu(TTA)3 ·2H2 O with P-1 and P-3, respectively. Photoexcitation of P-2 produces pink color emission as a result of the combination of partial blue self-emission chromophore of P-1 along with the red color from the Eu(TTA)3 moiety, whereas P-4 shows the exclusively red color emission from the Eu(III) ((5) D0 →(7) F2 ) transition due to almost complete excitation energy transfer from the macromolecular chain to the Eu(TTA)3 moiety. The choice substitution of phenyl derivative of the polymer plays a crucial role on the efficient energy transfer from the polymer chain to Eu(III) ion center. Meanwhile, the glum value of the dissymmetry factor of circularly polarized luminescence (CPL) for the (5) D0 →(7) F2 transition of Eu(III) for P-4 reaches as high as +0.0207, whereas P-2 exhibits the largest glum value about +0.0464 centered at 434 nm.

A nomogram model can predict the risk of venous thromboembolism in postoperative patients with gynecological malignancies.

OBJECTIVE: To explore independent factors influencing the risk of lower extremity deep vein thrombosis during the postoperative period in patients with gynecological malignancies by constructing a predictive model. METHODS: In our study, we collected 573 patients with gynecological malignancies in the postoperative period between September 2016 and September 2020, who were divided into a modeling (n = 402) and verification group (n = 171) according to a ratio of 7:3. Univariate and multivariate regression analyses were used to determine independent factors influencing deep vein thrombosis (DVT). A nomogram model was created and a risk score was calculated. RESULTS: Multivariate regression analysis showed that the independent factors affecting DVT among these patients included age, hyperlipidemia, abnormal uterine bleeding, degree of anemia, D-dimer, operation time, and intraoperative blood loss. By incorporating these factors into a nomogram, we determined that the C-index and calibration curve of the two groups both showed that the model distinguishes and fits well. Further comparing between the high- and low-risk groups, we found that the model has favorable predictive performance. CONCLUSION: The predictive nomogram for the risk of DVT in patients with gynecological malignancies in the postoperative period demonstrated good calibration and recognition accuracy. Further independent research is necessary to verify our results.

Enhancing CO2 photo-biochemical conversion in a newly-designed attached photobioreactor characterized by stacked horizontal planar waveguide modules.

Aiming at alleviating the adverse effects on attached microalgae biofilm growth caused by heterogeneous spatial light distributions within the attached cultivation photobioreactors (PBRs), an innovative PBR integrated with stacked horizontal planar waveguide modules (SHPW-PBR) was proposed in this work. Different from the conventional PBR, the emergent light from the external LED light bars were guided and evenly redistributed within the SHPW-PBR by the planar waveguides and hence provided light energy for microalgae cells photoautotrophic growth. In comparison with the control PBR, the average light intensity illuminating the attached Chlorella vulgaris biofilm in the SHPW-PBR was elevated by 204.11% and contributed to a 145.20% improvement on areal C. vulgaris biofilm production. Thereafter, responses of attached C. vulgaris biofilm growth in the SHPW-PBR to various light intensities were evaluated and the maximum areal C. vulgaris biofilm density reached 90.43 g m-2 under the light intensity of 136 µmol m-2 s-1 after 9 days cultivation. Furthermore, the SHPW-PBR can be easily scaled-up by increasing the quantity of the stacked planar waveguide modules and thus shows great potential in biofilm-based biomass production.

Physicochemical characteristics and pyrolysis performance of corn stalk torrefied in aqueous ammonia by microwave heating.

The physicochemical characteristics and pyrolysis performance of corn stalk (CS) torrefied in water and aqueous ammonia by microwave heating were investigated. Physicochemical characterization revealed that both microwave water torrefied CS (MCS) and microwave ammonia torrefied CS (MACS) showed low hemicellulose content, disrupted macrostructure, improved porous properties, and low ash content. MACS exhibited a significantly lower crystallinity degree of 44.34% than CS (79.55%) and MCS (89.50%). MACS also showed increased methyl/methylene groups intensity, and complete acetyl groups disrupture. Pyrolysis coupled with gas chromatography/mass spectrometry (Py-GC/MS) revealed that compared with CS and MCS, MACS exhibited higher peak areas for ketones, aldehydes, furans and esters, and significantly lower peak areas for acids and phenols. A possible mechanism was proposed for the effects of wet torrefaction with aqueous ammonia on changes in physicochemical structure and pyrolysis behavior of corn stalk.

Catalytic transfer hydrogenolysis of lignin into monophenols over platinum-rhenium supported on titanium dioxide using isopropanol as in situ hydrogen source.

Using isopropanol as an in situ hydrogen donor, catalytic transfer hydrogenolysis of lignin into monomeric phenols was studied at mild conditions. The performance of catalysts and the effects of H2, temperature, and time on depolymerization of acid extracted birch lignin (ABL) were extensively examined. Platinum-rhenium supported on titanium dioxide (PtRe/TiO2) exhibited much higher activity on disrupting CO bonds than Pd/C, HZSM-5, Pt/TiO2, and Re/TiO2. 18.71 wt% monophenols was achieved for depolymerization of ABL over PtRe/TiO2 at 240 °C for 12 h with He. 4-Propylsyringol had the highest yield of 7.48 wt%. 2D HSQC NMR analysis reveals that ß-O-4 bonds have been fully disrupted during depolymerization. Addition of H2 led to less monophenols, likely due to the competitive adsorption of active sites on catalysts. Structure-reactivity analysis based on six representative lignins shows that the total yields of monophenols were highly linearly correlated with the ß-O-4 contents (R2 = 0.97).

Solvolysis kinetics of three components of biomass using polyhydric alcohols as solvents.

The solvolysis behavior and reaction kinetics of the three components of biomass (cellulose, hemicelluloses and lignin) liquefied in polyhydric alcohols (PEG 400 or glycerol) were investigated in this paper. Three stages were observed during the solvolysis process and the main degradation stage could be further divided into two zones. The influences of solvents on the liquefaction process of three main components were compared. Based on Starink and Malek methods, kinetic parameters and mechanism functions were obtained. The derived average activation energy of cellulose, hemicellulose and lignin were 108.73, 95.66 and 94.13kJmol-1 in PEG 400, while the values were 102.16, 77.43 and 89.10kJmol-1 in glycerol, respectively. Higher efficiency was observed when using glycerol as solvent, which could be ascribed to the higher polarity value of glycerol. The conversion curves calculated with obtained mechanism models and kinetic parameters were in good agreement with the experimental data.

Kinetic and product composition study on the cellulose liquefaction in polyhydric alcohols.

The liquefaction process of cellulose in polyhydric alcohols (PEG 400 and glycerol) was studied by TG-FTIR. Three stages were observed during the solvolysis process and the main liquefaction stage could be further divided into two zones. The differences of liquefaction behavior of cellulose in the two solvents were compared, and the functional groups of volatiles produced by solvolysis were also evaluated. A step-wise procedure based on iso-conversional and Master-plots methods was used for the kinetic and mechanism analysis of the main liquefaction stage. The calculation results based on the kinetic model were in agreement with the experimental data of the conversion rate. The kinetic parameters and mechanism functions between cellulose liquefaction in PEG400 and in glycerol were quite different, which verified that solvolysis behavior and reaction process were seriously influenced by solvent species. Finally, the detailed types of volatiles and product distribution were measured by Py-GC-MS.

Chiral sensing for induced circularly polarized luminescence using an Eu(III)-containing polymer and D- or L-proline.

An Eu(III)-containing polymer can exhibit intense induced circularly polarized luminescence (CPL) in the presence of proline. In addition, the optical anisotropy factor (g(lum)) of the polymer for (5)D0 → (7)F1/(7)F2 transition was much higher than that of a single model molecule, which reveals the amplification effect of CPL arising from the conjugated polymer structure.

Na+ triggered fluorescence sensors for Mg2+ detection based on a coumarin salen moiety.

Two coumarin salen-based sensors CS1 and CS2 can exhibit a pronounced fluorescence enhancement response toward Mg(2+) as high as 36-fold (CS1) and 111-fold (CS2) in the presence of Na(+) as a synergic trigger. More importantly, the fluorescent color of CS1 was bright green instead of weak yellow after the addition of Mg(2+) and Na(+) together, which can be easily detected by the naked eye.

L-Proline promoted fluorescent sensor for Mg2+ detection in a multicomponent sensory system.

Mg(2+) can lead to the fluorescence enhancement of a dye molecule as high as 47.3-fold while L-proline acts as a promoter in this multicomponent sensory system. The fluorescence color could be easily detected by the naked eye under a UV-lamp.