Synthetic minority over-sampling technique-enhanced machine learning models for predicting recurrence of postoperative chronic subdural hematoma.

Objective: Chronic subdural hematoma (CSDH) is a neurological condition with high recurrence rates, primarily observed in the elderly population. Although several risk factors have been identified, predicting CSDH recurrence remains a challenge. Given the potential of machine learning (ML) to extract meaningful insights from complex data sets, our study aims to develop and validate ML models capable of accurately predicting postoperative CSDH recurrence. Methods: Data from 447 CSDH patients treated with consecutive burr-hole irrigations at Wenzhou Medical University's First Affiliated Hospital (December 2014-April 2019) were studied. 312 patients formed the development cohort, while 135 comprised the test cohort. The Least Absolute Shrinkage and Selection Operator (LASSO) method was employed to select crucial features associated with recurrence. Eight machine learning algorithms were used to construct prediction models for hematoma recurrence, using demographic, laboratory, and radiological features. The Border-line Synthetic Minority Over-sampling Technique (SMOTE) was applied to address data imbalance, and Shapley Additive Explanation (SHAP) analysis was utilized to improve model visualization and interpretability. Model performance was assessed using metrics such as AUROC, sensitivity, specificity, F1 score, calibration plots, and decision curve analysis (DCA). Results: Our optimized ML models exhibited prediction accuracies ranging from 61.0% to 86.2% for hematoma recurrence in the validation set. Notably, the Random Forest (RF) model surpassed other algorithms, achieving an accuracy of 86.2%. SHAP analysis confirmed these results, highlighting key clinical predictors for CSDH recurrence risk, including age, alanine aminotransferase level, fibrinogen level, thrombin time, and maximum hematoma diameter. The RF model yielded an accuracy of 92.6% with an AUC value of 0.834 in the test dataset. Conclusion: Our findings underscore the efficacy of machine learning algorithms, notably the integration of the RF model with SMOTE, in forecasting the recurrence of postoperative chronic subdural hematoma. Leveraging the RF model, we devised an online calculator that may serve as a pivotal instrument in tailoring therapeutic strategies and implementing timely preventive interventions for high-risk patients.

Recent Advances of Ti/Zr-Substituted Polyoxometalates: From Structural Diversity to Functional Applications.

Polyoxometalates (POMs), a large family of anionic polynuclear metal-oxo clusters, have received considerable research attention due to their structural versatility and diverse physicochemical properties. Lacunary POMs are key building blocks for the syntheses of functional POMs due to their highly active multidentate O-donor sites. In this review, we have addressed the structural diversities of Ti/Zr-substituted POMs based on the polymerization number of POM building blocks and the number of Ti and Zr centers. The synthetic strategies and relevant catalytic applications of some representative Ti/Zr-substituted POMs have been discussed in detail. Finally, the outlook on the future development of this area is also prospected.

Synthesis of CuO and PAA-Regulated Silver-Carried CuO Nanosheet Composites and Their Antibacterial Properties.

With the aid of a facile and green aqueous solution approach, a variety of copper oxide (CuO) with different shapes and polyacrylic-acid (PAA)-regulated silver-carried CuO (CuO@Ag) nanosheet composites have been successfully produced. The point of this article was to propose a common synergy using Ag-carried CuO nanosheet composites for their potential antibacterial efficiency against three types of bacteria such as E. coli, P. aeruginosa, and S. aureus. By using various technical means such as XRD, SEM, and TEM, the morphology and composition of CuO and CuO@Ag were characterized. It was shown that both CuO and CuO@Ag have a laminar structure and exhibit good crystallization, and that the copper source and reaction duration have a sizable impact on the morphology and size distribution of the product. In the process of synthesizing CuO@Ag, the appropriate amount of polyacrylic acid (PAA) can inhibit the agglomeration of Ag NPs and regulate the size of Ag at about ten nanometers. In addition, broth dilution, optical density (OD 600), and electron microscopy analysis were used to assess the antimicrobial activity of CuO@Ag against the above three types of bacteria. CuO@Ag exhibits excellent synergistic and antibacterial action, particularly against S. aureus. The antimicrobial mechanism of the CuO@Ag nanosheet composites can be attributed to the destruction of the bacterial cell membrane and the consequent leakage of the cytoplasm by the release of Ag+ and Cu2+. The breakdown of the bacterial cell membrane and subsequent leakage of cytoplasm caused by Ag+ and Cu2+ released from antimicrobial agents may be the cause of the CuO@Ag nanosheet composites' antibacterial action. This study shows that CuO@Ag nanosheet composites have good antibacterial properties, which also provides the basis and ideas for the application research of other silver nanocomposites.

Fluorinated covalent organic frameworks for efficient drug delivery.

In this study, two novel fluorine-functionalized crystalline covalent organic frameworks (COFs), namely DF-TAPB-COF and DF-TATB-COF, were synthesized, and their ordered structure, porosity, suitable pore size, and abundant fluorine groups were expected to serve as effective carriers in drug delivery. The excellent cell viability of DF-TAPB-COF and DF-TATB-COF was verified using MTT assays. Both COFs exhibited very high loading capacities in terms of drug loading performance, in particular the drug loading rate of DF-TAPB-COF for 5-fluorouracil (5-FU) was up to 69%. They also exhibited efficient drug release performance in a simulated body fluid environment. Cell endocytosis experiments demonstrated that DF-TAPB-COF and DF-TATB-COF could be effectively endocytosed by cells. Hence, this study offers new insight into the design and development of COF-based drug carrier systems.

Association between Serum Calcium Level and Hemorrhagic Progression in Patients with Traumatic Intraparenchymal Hemorrhage: Investigating the Mediation and Interaction Effects of Coagulopathy.

In this study, we investigate the association of serum calcium with coagulopathy and hemorrhagic progression contusion (HPC) in patients with traumatic intraparenchymal hemorrhage (tIPH), and further explore the interaction and mediation effect between serum calcium and coagulopathy on HPC. We conducted retrospective analyses of patients with tIPH admitted to the First Affiliated Hospital of Wenzhou Medical University between January 2016 to December 2019. The clinical data, coagulation parameters, and serum calcium levels were collected for further analysis. Multi-variate logistic regression analysis was applied to identify the association of serum calcium level with coagulopathy and HPC. Causal mediation analysis (CMA) and additive interaction model were used to estimate the interaction and mediation effect between serum calcium as well as coagulopathy on HPC. Additionally, we repeated the analysis using corrected calcium. A total of 473 patients were included in this study. Of these, 54 (11.4%) patients had hypocalcemia at admission, 105 (22.2%) presented with coagulopathy, and 187 (39.5%) experienced HPC. Admission serum calcium level in patients presented with coagulopathy and HPC were 8.84 (interquartile range [IQR]: 8.44-9.40] and 8.92 (IQR: 8.48-9.40) mg/dL respectively, which were significantly lower than that of patients without coagulopathy (9.10 [IQR: 8.68-9.88] and 9.12 [IQR: 8.72-9.89] mg/dL; all p < 0.001). Multi-variate logistic regression analysis identified that hypocalcemia emerged as an independent risk factor for coagulopathy and HPC. However, no significant interaction was detected between hypocalcemia and coagulopathy. CMA showed that the mediator coagulopathy explained 24.4% (95% confidence interval: 4.7-65.0%; p = 0.006) of the association between hypocalcemia and HPC. Moreover, comparable results were held using corrected calcium, as well. Admission serum calcium level is associated with the HPC for patients with tIPH and this relationship is partially mediated by coagulopathy, but no significant interaction is detected. Further studies are needed to validate the findings and explore its mechanisms.

Ubiquitination of p21 by E3 Ligase TRIM21 Promotes the Proliferation of Human Neuroblastoma Cells.

Neuroblastoma (NB) is the most common extracranial solid tumor in childhood, which shows great clinical and biomolecule heterogeneity. Currently, surgery is still the main method of neuroblastoma treatment and specific therapeutic drugs are lacking, so useful targets are urgently needed. TRIM21 is a RING-type E3 ligase that its overexpression promotes the progression of human glioma, while whose effects on neuroblastoma have not been illustrated. Firstly, the shRNAs targeting TRIM21 were designed and found that the ablation of TRIM21 inhibits the proliferation of human neuroblastoma cells. Then the molecular mechanism study indicated that TRIM21 interacts with, and mediates p21 degradation by ubiquitination modification. Further study demonstrates that TRIM21 regulates the proliferation of neuroblastoma cells in a p21-dependent manner. These results suggest that TRIM21 might be a potential therapeutic target for neuroblastoma.

Construction of Covalent Organic Frameworks with Crown Ether Struts.

Crown ethers are a class of macrocyclic molecules with unique flexible structures but they are rarely integrated in covalent organic frameworks (COFs). To date, employing flexible organic units such as crown ethers to construct COFs with high crystallinity and surface area are still a challenge. In this work, two new COFs with different flexible crown ethers as backbone rather than side chains are synthesized and further employed for alkali metal ions separation. Both of COFs possess high surface areas, good crystallinity, and excellent chemical stability. Interestingly, these two new COFs with 18-crown-6 or 24-crown-8 units showed remarkable binding ability of K+ or Cs+ owing to the size-fit effect. This work demonstrated that the unique structural features of crown ethers will lead to increase interest in fabricating COFs with crown ethers.

Distribution pattern of invasion-related bio-markers in head Marjolin's ulcer.

Marjolin's ulcer (MU) is a rare and aggressive cutaneous malignancy that typically presented in an area of traumatized or chronically inflamed skin and particularly in burn scars. Among them, the MU in the scalp with extensive invasion of the skull is exceptional and severe. The principle of management for MU is to obtain an early diagnosis and perform prompt surgical interventions. The invasive capacity of MU may vary among different sites of the scalp, which may require different therapeutic strategies for surgical excision. However, no clear evidence has been provided to determine the invasion ability of MU at different regions of the lesion as a surgical guidance. In present study, a 41-year-old female with a 40-year history of scalp ulceration has been examined. After resection of the MU lesion, hematoxylin and eosin (H&E) staining was performed to confirm the pathology of the cutaneous malignancy after surgical excision. Furthermore, reverse transcription-quantitative PCR experiment was performed out to determine the expression levels of invasion-associated biomarkers at different sites of the scalp affected by MU. Pathological analysis with H&E staining indicated a differentiated squamous cell carcinoma with invasion of the skull. The invasion-associated biomarkers were highly expressed in the core region compared to the middle region as well as the edge of MU tissue. Taken together, the present study suggests that the expression pattern of invasion-associated biomarkers varies between different regions of the MU lesion. High expression levels in the core region of MU indicates that the resection of the center area may be critical for the successful surgical treatment of MU.

NT3P75-2 gene-modified bone mesenchymal stem cells improve neurological function recovery in mouse TBI model.

BACKGROUND: The attainment of extensive neurological function recovery remains the key challenge for the treatment of traumatic brain injury (TBI). Transplantation of bone marrow-derived mesenchymal stem cells (BMSCs) has been shown to improve neurological function recovery after TBI. However, the survival of BMSCs after transplantation in early-stage TBI is limited, and much is unknown about the mechanisms mediating this neurological function recovery. Secretion of neurotrophic factors, including neurotrophin 3 (NT3), is one of the critical factors mediating BMSC neurological function recovery. Gene mutation of NT3 (NT3P75-2) has been shown to enhance the biological function of NT3 via the reduction of the activation of the P75 signal pathway. Thus, we investigated whether NT3P75-2 gene-modified BMSCs could enhance the survival of BMSCs and further improve neurological function recovery after TBI. METHODS: The ability of NT3P75-2 induction to improve cell growth rate of NSC-34 and PC12 cells in vitro was first determined. BMSCs were then infected with three different lentiviruses (green fluorescent protein (GFP), GFP-NT3, or GFP-NT3P75-2), which stably express GFP, GFP-NT3, or GFP-NT3P75-2. At 24 h post-TBI induction in mice, GFP-labeled BMSCs were locally transplanted into the lesion site. Immunofluorescence and histopathology were performed at 1, 3, and/or 7 days after transplantation to evaluate the survival of BMSCs as well as the lesion volume. A modified neurological severity scoring system and the rotarod test were chosen to evaluate the functional recovery of the mice. Cell growth rate, glial activation, and signaling pathway analyses were performed to determine the potential mechanisms of NT3P75-2 in functional recovery after TBI. RESULTS: Overall, NT3P75-2 improved cell growth rate of NSC-34 and PC12 cells in vitro. In addition, NT3P75-2 significantly improved the survival of transplanted BMSCs and neurological function recovery after TBI. Overexpression of NT3P75-2 led to a significant reduction in the activation of glial cells, brain water content, and brain lesion volume after TBI. This was associated with a reduced activation of the p75 neurotrophin receptor (P75NTR) and the c-Jun N-terminal kinase (JNK) signal pathway due to the low affinity of NT3P75-2 for the receptor. CONCLUSIONS: Taken together, our results demonstrate that administration of NT3P75-2 gene-modified BMSCs dramatically improves neurological function recovery after TBI by increasing the survival of BMSCs and ameliorating the inflammatory environment, providing a new promising treatment strategy for TBI.

Dopamine Burden Triggers Cholesterol Overload Following Disruption of Synaptogenesis in Minimal Hepatic Encephalopathy.

The contribution of Dopamine (DA) to minimal hepatic encephalopathy (MHE) has been demonstrated. However, recent studies have revealed that cholesterol (CHO) treatment substantially increased the risk of dementia. The objectives of this study were to investigate whether CHO was induced by DA overload and its involvement in DA-induced cognitive impairment in MHE. Our study showed that DA treatment triggered CHO biosynthesis via the activation of JNK3/SREBP2 signaling pathway in primary cultured astrocytes. Conditioned media from DA-treated astrocytes increased CHO uptake by primary cultured neurons and disrupted synaptic formations; at the same time, inhibition of CHO synthesis and transportation from astrocytes diminished the disruption of synaptogenesis, which indicates the involvement of CHO in the perturbation of neural synaptogenesis in vitro. Secondary secretion of DA from primary cultured neurons was stimulated by CHO secreted from astrocytes. DA induced synergistic decreases of PPARγ/pERK/pCREB expressions in the presence of CHO in neurons, leading to synergistic synaptic impairment. Memory impairments were observed in MHE/DA-treated rats, which were partially rescued by atorvastatin (ATVS) treatment, confirming the involvement of CHO burden in vivo. Overall, our study suggests that DA overload triggers obvious CHO production from astrocytes. Excessive CHO in turn triggered neurons to secrete abundant DA and DA burden in combination with CHO overload elicit the cognitive decline and memory loss via PPARγ/ERK/CREB pathway in MHE.

Synthesis of silver nanoparticle-decorated hydroxyapatite (HA@Ag) poriferous nanocomposites and the study of their antibacterial activities.

Herein, we demonstrate a facile and green rapid approach for the synthesis of uniform poriferous hydroxylapatite [Ca10(PO4)6(OH)2, HA] and poriferous silver nanoparticle (Ag NPs)-decorated hydroxylapatite (HA@Ag) nanocomposites with excellent antibacterial properties. All the nanocomposites were fully characterized in the solid state via various techniques such as X-ray powder diffraction (XRD), transmission electron microscopy (TEM), Fourier transform infrared spectroscopy (FTIR), automatic specific surface area and porosity analysis (BET) and field emission scanning electron microscopy (FESEM). The results show that HA has a porous rod-like structure, which the HA@Ag nanocomposites retained, and the surface of HA was loaded with globular-like Ag NPs with an average diameter of about 5.8 nm, which exhibit a well-crystalline state. The experimental parameters such as pH, the molar ratio of HA and Tollens' reagent, and reductant have a significant effect on the size and distribution of the Ag NPs. Moreover, the antimicrobial activities of HA and HA@Ag against Escherichia coli (E. coli), Pseudomonas aeruginosa (P. aeruginosa) and Staphylococcus aureus (S. aureus) were evaluated via broth dilution, filter paper diffusion, optical density (OD600) and electron microscopy observation. The as-prepared HA@Ag nanocomposites exhibit excellent antibacterial activities, especially for S. aureus. The minimum inhibition concentration (MIC) of HA@Ag is only 3.9 µg mL-1.

Determination of the sediment carrying capacity based on perturbed theory.

According to the previous studies of sediment carrying capacity, a new method of sediment carrying capacity on perturbed theory was proposed. By taking into account the average water depth, average flow velocity, settling velocity, and other influencing factors and introducing the median grain size as one main influencing factor in deriving the new formula, we established a new sediment carrying capacity formula. The coefficients were determined by the principle of dimensional analysis, multiple linear regression method, and the least square method. After that, the new formula was verified through measuring data of natural rivers and flume tests and comparing the verified results calculated by Cao Formula, Zhang Formula, Li Formula, Engelung-Hansen Formula, Ackers-White Formula, and Yang Formula. According to the compared results, it can be seen that the new method is of high accuracy. It could be a useful reference for the determination of sediment carrying capacity.

Synthesis of poly acrylic acid modified silver nanoparticles and their antimicrobial activities.

Poly acrylic acid modified silver (Ag/PAA) nanoparticles (NPs) have been successfully synthesized in the aqueous solution by using tannic acid as a reductant. The structure, morphology and composition of Ag/PAA NPs were characterized by various techniques such as X-ray powder diffraction (XRD), transmission electron microscopy (TEM), Fourier transform infrared spectroscopy (FTIR), ultraviolet-visible absorption spectroscopy (UV-vis) and thermogravimetry analysis (TGA). The results show that PAA/Ag NPs have a quasi-ball shape with an average diameter of 10 nm and exhibit well crystalline, and the reaction conditions have some effect on products morphology and size distribution. In addition, the as-synthesized Ag/PAA NPs antimicrobial activities against Escherichia coli (E. coli), Pseudomonas aeruginosa (P. aeruginosa) and Staphylococcus aureus (S. aureus) were evaluated by the methods of broth dilution, cup diffusion, optical density (OD600) and electron microscopy observation. The as-synthesized Ag/PAA NPs exhibit excellent antibacterial activity. The antimicrobial mechanism may be attributed to the damaging of bacterial cell membrane and causing leakage of cytoplasm.

Ground movement analysis based on stochastic medium theory.

In order to calculate the ground movement induced by displacement piles driven into horizontal layered strata, an axisymmetric model was built and then the vertical and horizontal ground movement functions were deduced using stochastic medium theory. Results show that the vertical ground movement obeys normal distribution function, while the horizontal ground movement is an exponential function. Utilizing field measured data, parameters of these functions can be obtained by back analysis, and an example was employed to verify this model. Result shows that stochastic medium theory is suitable for calculating the ground movement in pile driving, and there is no need to consider the constitutive model of soil or contact between pile and soil. This method is applicable in practice.