Establishing and clinically validating a machine learning model for predicting unplanned reoperation risk in colorectal cancer.

BACKGROUND: Colorectal cancer significantly impacts global health, with unplanned reoperations post-surgery being key determinants of patient outcomes. Existing predictive models for these reoperations lack precision in integrating complex clinical data. AIM: To develop and validate a machine learning model for predicting unplanned reoperation risk in colorectal cancer patients. METHODS: Data of patients treated for colorectal cancer (n = 2044) at the First Affiliated Hospital of Wenzhou Medical University and Wenzhou Central Hospital from March 2020 to March 2022 were retrospectively collected. Patients were divided into an experimental group (n = 60) and a control group (n = 1984) according to unplanned reoperation occurrence. Patients were also divided into a training group and a validation group (7:3 ratio). We used three different machine learning methods to screen characteristic variables. A nomogram was created based on multifactor logistic regression, and the model performance was assessed using receiver operating characteristic curve, calibration curve, Hosmer-Lemeshow test, and decision curve analysis. The risk scores of the two groups were calculated and compared to validate the model. RESULTS: More patients in the experimental group were ≥ 60 years old, male, and had a history of hypertension, laparotomy, and hypoproteinemia, compared to the control group. Multiple logistic regression analysis confirmed the following as independent risk factors for unplanned reoperation (P < 0.05): Prognostic Nutritional Index value, history of laparotomy, hypertension, or stroke, hypoproteinemia, age, tumor-node-metastasis staging, surgical time, gender, and American Society of Anesthesiologists classification. Receiver operating characteristic curve analysis showed that the model had good discrimination and clinical utility. CONCLUSION: This study used a machine learning approach to build a model that accurately predicts the risk of postoperative unplanned reoperation in patients with colorectal cancer, which can improve treatment decisions and prognosis.

Comparative study of immune response to local tumor destruction modalities in a murine breast cancer model.

Introduction: Immunotherapy is revolutionizing the management of multiple cancer types. However, only a subset of patients responds to immunotherapy. One mechanism of resistance is the absence of immune infiltrates within the tumor. In situ vaccine with local means of tumor destruction that can induce immunogenic cell death have been shown to enhance tumor T cell infiltration and increase efficacy of immune checkpoint blockade. Methods: Here, we compare three different forms of localize tumor destruction therapies: radiation therapy (RT), vascular targeted photodynamic therapy (VTP) and cryoablation (Cryo), which are known to induce immunogenic cell death, with their ability to induce local and systemic immune responses in a mouse 4T1 breast cancer model. The effects of combining RT, VTP, Cryo with anti-PD1 was also assessed. Results: We observed that RT, VTP and Cryo significantly delayed tumor growth and extended overall survival. In addition, they also induced regression of non-treated distant tumors in a bilateral model suggesting a systemic immune response. Flow cytometry showed that VTP and Cryo are associated with a reduction in CD11b+ myeloid cells (granulocytes, monocytes, and macrophages) in tumor and periphery. An increase in CD8+ T cell infiltration into tumors was observed only in the RT group. VTP and Cryo were associated with an increase in CD4+ and CD8+ cells in the periphery. Conclusion: These data suggest that cell death induced by VTP and Cryo elicit similar immune responses that differ from local RT.

Bacterial community succession in aerobic-anaerobic-coupled and aerobic composting with mown hay affected C and N losses.

The primary objective of this work was to investigate how the dominant microbial species change and affect C and N losses under aerobic and aerobic-anaerobic-coupled composting of mown hay (MH, ryegrass) and corn stover (CS) mix. Results showed that C and N losses in aerobic compost of MH-CS were significantly decreased by 19.57-31.47% and 29.04-41.18%, respectively. 16S rRNA gene sequencing indicated that the bacterial microbiota showed significant differences in aerobic and aerobic-anaerobic-coupled composting. LEfSe analyses showed that aerobic composting promoted the growth of bacteria related to lignocellulosic degradation and nitrogen fixation, while aerobic-anaerobic-coupled composting promoted the growth of bacteria related to denitrification. Correlation analysis between bacterial community and environmental factors indicated that moisture content (MC) was the most important environmental factor influencing the differentiation of bacterial growth. KEGG analysis showed that aerobic composting enhanced the amino acid, carbohydrate, and other advantageous metabolic functions compared to that of aerobic-anaerobic-coupled composting. As a conclusion, the addition of 10-20% corn stover (w/w) to new-mown hay (ryegrass) appeared to inhibit anaerobic composting and prompt aerobic composting in MH-CS mix, which led to the effective utilization of mown hay as a resource for composting.

Nano zero-valent iron loaded corn-straw biochar for efficient removal of hexavalent chromium: remediation performance and interfacial chemical behaviour.

To improve the poor stability of nano zero-valent iron (nZVI), corn-straw biochar (BC) was used as a support for the synthesis of composites of nZVI-biochar (nZVI/BC) in different mass ratios. After a thorough characterization, the obtained nZVI/BC composite was used to remove hexavalent chromium [Cr(vi)] in an aquatic system under varying conditions including composite amount, Cr(vi) concentration, and pH. The obtained results show that the treatment efficiency varied in the following order: nZVI-BC (1 : 3) > nZVI-BC (1 : 5) > nZVI alone > BC alone. This order indicates the higher efficiency of composite material and the positive effect of nZVI content in the composite. Similarly, the composite dosage and Cr(vi) concentration had significant effects on the removal performance and 2 g L-1 and 6 g L-1 were considered to be the optimum dose at a Cr(vi) concentration of 20 mg L-1 and 100 mg L-1, respectively. The removal efficiency was maximum (100%) at pH 2 whereas solution pH increased significantly after the reaction (from 2 to 4.13). The removal kinetics of Cr(vi) was described by a pseudo-second-order model which indicated that the removal process was mainly controlled by the rate of chemical adsorption. The thermodynamics was more in line with the Freundlich model which indicated that the removal was multi-molecular layer adsorption. TEM-EDS, XRD, and XPS were applied to characterize the crystal lattice and structural changes of the material to specify the interfacial chemical behaviour on the agent surface. These techniques demonstrate that the underlying mechanisms of Cr(vi) removal include adsorption, chemical reduction-oxidation reaction, and co-precipitation on the surface of the nZVI-BC composite. The results indicated that the corn-straw BC as a carrier material highly improved Cr(vi) removal performance of nZVI and offered better utilization of the corn straw.

[Soil nematode community characteristics of alfalfa field with different growing ages in the semi-arid Loess Plateau of Central Gansu, Northwest China]. / 陇中黄土高原半干旱区不同种植年限紫花苜蓿土壤线虫群落分布特征.

To clarify the impacts of long-term alfalfa plantation on the soil nematode community, soil samples were collected from different alfalfa growing ages (2 a, 9 a, 18 a) in the semi-arid area of Loess Plateau in Central Gansu by Illumina Miseq sequencing technology. The main controlling factors affecting its community change were also explored. The results showed that soil nematode belongs to 2 classes, 7 orders, 16 families and 21 genera. Among them, Chromadorea was the dominant group (44.6%-81.4%), the relative abundance of which decreased with alfalfa growing ages. Paratylenchus, Helicotylenchus, Xiphinema, Pristionchus, Ditylenchus, Panagrolaimus, Longidorus, Aprutides, Isolaimium and Aglenchus were the special nematode species of alfalfa, among which Paratylenchus (54.1%), Helicotylenchus (23.9%) and Xiphinema (21.9%) were the dominant nematodes in 2 a, 9 a and 18 a alfalfa soil respectively. Plant-parasitic nematode was the dominant group in alfalfa soil (31.8%-67.1%), and its relative abundance decreased at first and then increased with alfalfa growing ages. Results of redundancy analysis showed that soil available phosphorus and total nitrogen were the dominant environmental factors affecting community structure of soil nematodes in the region.

Bacterial Diversity and Potential Functions in Response to Long-Term Nitrogen Fertilizer on the Semiarid Loess Plateau.

Bacterial diversity and its functions are essential to soil health. N fertilization changes bacterial communities and interferes with the soil biogeochemical N cycle. In this study, bacterial community and soil physicochemical properties were studied in 2018 after applying N fertilizers (0, 52.5, 105, 157.5, and 210 kg N ha-1) for a long (2003-2018) and a short (2003-2004) duration in a wheat field on the Loess Plateau of China. Soil bacteria were determined using 16S rRNA Illumina-MiSeq®, and the prediction function was analyzed through PICRUSt. The study showed that N fertilizer significantly changed the diversity and abundance of bacterial communities. The phyla Proteobacteria, Actinobacteria, Acidobacteria, and Chloroflexi were most abundant, accounting for 74-80% of the bacterial community abundance. The optimum rates of N fertilizer application (N105) maintain soil health by promoting soil microbial diversity and abundance. The bacterial population abundance was higher after short-term N application than after N application for a long duration and lowest with the high N-fertilizer treatment (N210). High N enrichment led to more heterotrophic N-fixing microorganisms (Alphaproteobacteria), in which metabolism and genetic information processing dominated, while cellular processes, genetic information processing, metabolism, and organismal systems were the main functional categories under low N. The phyla Gemmatimonadetes, Actinobacteria, Bacteroidetes, and Chloroflexi were the key bacteria in the co-occurrence network. The genus Saccharimonadales of the superphylum Patescibacteria has a more significant impact under low N treatment. Long-term N fertilization affected the soil pH, NO3-N, and other physicochemical properties, and soil NO3-N was the highest indicator, contributing 81% of the bacterial community function under different N fertilizer treatments.

A comparative study of Cd(ii) adsorption on calcined raw attapulgite and calcined aluminium hydroxide-modified attapulgites in aqueous solution.

In this study, raw attapulgite and two aluminium hydroxide-modified attapulgites prepared using different aluminium salts were calcined at 600 °C to successfully prepare three novel adsorbents (C-ATP, C-ATP-SO4 2- and C-ATP-Cl-). The three adsorbents were characterized by transmission electron microscopy (TEM), Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), Brunauer-Emmett-Teller (BET) analysis and X-ray photoelectron spectroscopy (XPS). Batch experiments revealed that the Cd(ii) adsorption capacity of the three adsorbents increased with increasing pH, increasing the initial concentration of Cd(ii) in solution, and with longer adsorption times. The order of adsorption capacity was always C-ATP > C-ATP-Cl- > C-ATP-SO4 2-. C-ATP and C-ATP-Cl- were better described by the Langmuir model, while C-ATP-SO4 2- was better described by the Freundlich model. The three adsorbents reached adsorption equilibrium within 2 h, and all followed pseudo-second order kinetics. The adsorption of Cd(ii) onto the three adsorbents was physisorption, as suggested by the calculated thermodynamic parameters. Although the adsorption of Cd(ii) on C-ATP and C-ATP-Cl- was exothermic, the adsorption on C-ATP-SO4 2- was endothermic. Ion exchange and cadmium precipitation were the primary mechanisms of cadmium adsorption on the three adsorbents analysed by XPS. The presence of SO4 2- in C-ATP-SO4 2- may result in weaker binding of Cd(ii) by the adsorbent than C-ATP-Cl-.

Changes in Ammonia-Oxidizing Archaea and Bacterial Communities and Soil Nitrogen Dynamics in Response to Long-Term Nitrogen Fertilization.

Ammonia oxidizing archaea (AOA) and bacteria (AOB) mediate a crucial step in nitrogen (N) metabolism. The effect of N fertilizer rates on AOA and AOB communities is less studied in the wheat-fallow system from semi-arid areas. Based on a 17-year wheat field experiment, we explored the effect of five N fertilizer rates (0, 52.5, 105, 157.5, and 210 kg ha-1 yr-1) on the AOA and AOB community composition. This study showed that the grain yield of wheat reached the maximum at 105 kg N ha-1 (49% higher than control), and no further significant increase was observed at higher N rates. With the increase of N, AOA abundance decreased in a regular trend from 4.88 × 107 to 1.05 × 107 copies g-1 dry soil, while AOB abundance increased from 3.63 × 107 up to a maximum of 8.24 × 107 copies g-1 dry soil with the N105 treatment (105 kg N ha-1 yr-1). Application rates of N fertilizer had a more significant impact on the AOB diversity than on AOA diversity, and the highest AOB diversity was found under the N105 treatment in this weak alkaline soil. The predominant phyla of AOA and AOB were Thaumarchaeota and Proteobacteria, respectively, and higher N treatment (N210) resulted in a significant decrease in the relative abundance of genus Nitrosospira. In addition, AOA and AOB communities were significantly associated with grain yield of wheat, soil potential nitrification activity (PNA), and some soil physicochemical parameters such as pH, NH4-N, and NO3-N. Among them, soil moisture was the most influential edaphic factor for structuring the AOA community and NH4-N for the AOB community. Overall, 105 kg N ha-1 yr-1 was optimum for the AOB community and wheat yield in the semi-arid area.

Managing the trade-offs among yield, economic benefits and carbon and nitrogen footprints of wheat cropping in a semi-arid region of China.

It is critical to understand how farming practices affect the carbon and nitrogen footprints of agricultural production. Grain yield, economic return, and carbon and nitrogen footprints of spring wheat (Triticum aestivum L.) were examined under different tillage-mulch practices. Wheat was grown over 15 years (2002-2016) in the semi-arid region of the western Loess Plateau of China under six tillage-mulch practices: traditional plough with no straw mulching (T), no-till without straw mulching (NT), traditional plough with straw mulching (TS), no-till without straw mulching (NTS), traditional plough with plastic mulching (TP), no-till with plastic mulching (NTP). Average wheat yield over 15 years under NTS, NTP, TP and TS was increased by 28, 24, 22, and 13%, respectively, compared to T. Average net return was greatest under NTS and lowest under TP. The soils under all six tillage-mulch practices gained a considerably large amount of soil organic carbon (SOC) over the 15 yr. The increase in SOC in the 0-30 cm soil layer was greatest under NTS and lowest under T. When changes in soil C were included in the calculations, treatments of NT, TS, NTS, and NTP sharply reduced total greenhouse gas (GHG) emission compared to T. Compared to T, the carbon footprint was decreased by 180, 44, and 123% under NTS, NT, and TS, respectively, but was increased by 153% under TP. Compared to T, the nitrogen footprint was 24-26% lower in TP and NTP, but was not significantly different under NTS, NT, and TS. Therefore, NTS enhanced yield and net return, and reduced GHG and the carbon footprint without increasing the nitrogen footprint, and should be adopted to mitigate the environmental impacts of wheat production in the semiarid Loess Plateau.

NRF2 Dysregulation in Hepatocellular Carcinoma and Ischemia: A Cohort Study and Laboratory Investigation.

Background Intermediate stage hepatocellular carcinomas (HCCs) are treated by inducing ischemic cell death with transarterial embolization (TAE) or transarterial chemoembolization (TACE). A subset of HCCs harbor nuclear factor E2-related factor 2 (NRF2), a major regulator of the oxidative stress response implicated in cell survival after ischemia. NRF2-mutated HCC response to TAE and/or TACE is unknown. Purpose To test whether ischemia resistance is present in individuals with NRF2-mutated HCC and if this resistance can be overcome by means of NRF2 inhibition in HCC cell lines. Materials and Methods This was a combined retrospective review of an institutional database (from January 2011 to December 2018) and prospective study (from January 2014 to December 2018) of participants with HCC who underwent TAE and a laboratory investigation of HCC cell lines. Imaging follow-up included liver CT or MRI at 1 month after the procedure followed by 3-month interval scans. Tumor radiologic response was assessed on the basis of follow-up imaging. The time to local progression after TAE for individuals with and individuals without NRF2 pathway alterations was estimated by using competing risk analysis (Gray test). The in vitro response to ischemia in four HCC cell lines with and without NRF2 overexpression was evaluated, and the combination of ischemia with NRF2 knockdown by means of short hairpin RNA or an NRF2 inhibitor was tested. Doubling time estimates, dose response curve regression, and comparison analyses were performed. Results Sixty-five individuals (median age, 69 years [range, 19-84 years]; 53 men) were evaluated. HCCs with NRF2 pathway mutation had a shorter time to local progression after TAE compared to those without mutation (6-month cumulative incidence of local progression, 56% [range, 19%-91%] vs 22% [range, 12%-34%], respectively; P < .001) and confirmed ischemia resistance in NRF2-overexpressing HCC cell lines. However, ischemia and NRF2 knock-down worked synergistically to decrease proliferation of NRF2-overexpressing HCC cell lines. Dose response curves of ML385, an NRF2 inhibitor, showed that ischemia induces addiction to NRF2 in cells with NRF2 alterations. Conclusion Hepatocellular carcinoma with nuclear factor E2-related factor 2 (NRF2) alterations showed resistance to ischemia, but ischemia simultaneously induced sensitivity to NRF2 inhibition. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Weiss and Nezami in this issue.