Clinical significance of the advanced lung cancer inflammation index in gastrointestinal cancer patients: a systematic review and meta-analysis.

Background: The advanced lung cancer inflammation index (ALI) has been identified as a scientific and clinical priority in multiple malignancies. The aim of this study is to investigate the value of the ALI before treatment in evaluating postoperative complications (POCs) and survival outcomes in patients with gastrointestinal (GI) cancer. Methods: Electronic databases including PubMed, Embase and Web of Science were comprehensively reviewed up to June 2022. The endpoints were POCs and survival outcomes. Subgroup analyses and sensitivity analyses were also performed. Results: Eleven studies including 4417 participants were included. A significant heterogeneity in the ALI cut-off value among studies was observed. Patients in the low ALI group showed increased incidence of POCs (OR=2.02; 95%CI:1.60-2.57; P<0.001; I2 = 0%). In addition, a low ALI was also significantly associated with worse overall survival (HR=1.96; 95%CI: 1.58-2.43; P<0.001; I2 = 64%), which remained consistent in all subgroups based on country, sample size, tumor site, tumor stage, selection method and Newcastle Ottawa Scale score. Moreover, patients in the low ALI group had an obviously decreased disease-free survival compared to these in the high ALI group (HR=1.47; 95%CI: 1.28-1.68; P<0.001; I2 = 0%). Conclusion: Based on existing evidence, the ALI could act as a valuable predictor of POCs and long-term outcomes in patients with GI cancer. However, the heterogeneity in the ALI cut-off value among studies should be considered when interpreting these findings.

Comparisons of perioperative and long-term outcomes of laparoscopic versus open gastrectomy for advanced gastric cancer after neoadjuvant therapy: an updated pooled analysis of eighteen studies.

BACKGROUND: Outcomes of laparoscopic surgery in advanced gastric cancer patients who received neoadjuvant therapy represent a controversial issue. We performed an updated meta-analysis to evaluate the perioperative and long-term survival outcomes of laparoscopic gastrectomy (LG) versus conventional open gastrectomy (OG) in this subset of patients. METHODS: Electronic databases including PubMed, Embase, Web of Science, the Cochrane Central Register of Controlled Trials and China National Knowledge Infrastructure were comprehensively searched up to May 2023. The short-term and long-term outcomes of LG versus OG in advanced gastric cancer patients undergoing neoadjuvant therapy were evaluated. Effect sizes with 95% confidence intervals were always assessed using random-effects model. The prospective protocol was registered with PROSPERO (CRD42022359126). RESULTS: Eighteen studies (2 randomized controlled trials and 16 cohort studies) involving 2096 patients were included. In total, 933 patients were treated with LG and 1163 patients were treated with OG. In perioperative outcomes, LG was associated with less estimated blood loss (MD = - 65.15; P < 0.0001), faster time to flatus (MD = - 0.56; P < 0.0001) and liquid intake (MD = - 0.42; P = 0.02), reduced hospital stay (MD = - 2.26; P < 0.0001), lower overall complication rate (OR = 0.70; P = 0.002) and lower minor complication rate (OR = 0.69; P = 0.006), while longer operative time (MD = 25.98; P < 0.0001). There were no significant differences between the two groups in terms of proximal margin, distal margin, R1/R2 resection rate, retrieved lymph nodes, time to remove gastric tube and drainage tube, major complications and other specific complications. In survival outcomes, LG and OG were not significantly different in overall survival, disease-free survival and recurrence-free survival. CONCLUSION: LG can be a safe and feasible technique for the treatment of advanced gastric cancer patients receiving neoadjuvant therapy. However, more high-quality randomized controlled trials are still needed to further validate the results of our study.

Prophylactic drainage versus non-drainage following gastric cancer surgery: a meta-analysis of randomized controlled trials and observational studies.

BACKGROUND: The role of prophylactic drainage (PD) in gastrectomy for gastric cancer (GC) is not well-established. The purpose of this study is to compare the perioperative outcomes between the PD and non-drainage (ND) in GC patients undergoing gastrectomy. METHODS: A systematic review of electronic databases including PubMed, Embase, Web of Science, the Cochrane Library, and China National Knowledge Infrastructure was performed up to December 2022. All eligible randomized controlled trials (RCTs) and observational studies were included and meta-analyzed separately. The registration number of this protocol is PROSPERO CRD42022371102. RESULTS: Overall, 7 RCTs (783 patients) and 14 observational studies (4359 patients) were ultimately included. Data from RCTs indicated that patients in the ND group had a lower total complications rate (OR = 0.68; 95%CI:0.47-0.98; P = 0.04; I2 = 0%), earlier time to soft diet (MD = - 0.27; 95%CI: - 0.55 to 0.00; P = 0.05; I2 = 0%) and shorter length of hospital stay (MD = - 0.98; 95%CI: - 1.71 to - 0.26; P = 0.007; I2 = 40%). While other outcomes including anastomotic leakage, duodenal stump leakage, pancreatic leakage, intra-abdominal abscess, surgical-site infection, pulmonary infection, need for additional drainage, reoperation rate, readmission rate, and mortality were not significantly different between the two groups. Meta-analyses on observational studies showed good agreement with the pooled results from RCTs, with higher statistical power. CONCLUSION: The present meta-analysis suggests that routine use of PD may not be necessary and even harmful in GC patients following gastrectomy. However, well-designed RCTs with risk-stratified randomization are still needed to validate the results of our study.

Catechol exerts an in situ surface oxygen vacancy effect on BiOI: an innovative signal transduction mode for cathodic photoelectrochemistry.

Cathodic photoelectrochemistry, a research hotspot in state-of-art bioassays, is generally circumscribed by its monotonous signal transduction tactic of photoinduced electron transfer (PET) mechanism, which significantly narrows the scope of its applications. In this study, we reveal the surface oxygen vacancy (VO) formation elicited by the spontaneous coordination of catechol (CA) onto the surface of BiOI nanoplates for the innovative operation of the cathodic PEC signal transduction tactic. The in situ-generated VO functions as a carrier separation center to efficiently promote photocurrent generation. Taking tyrosinase (TYR) and Escherichia coli O157:H7 (E. coli O157:H7) as model targets, the established signal transduction tactic was validated as efficient and sensitive for the detection of the two targets with linear ranges from 1.0 × 10-4 to 1.0 U mL-1 and 5.0 to 1.0 × 106 CFU mL-1, respectively. Low-detection limits of 1.0 × 10-4 U mL-1 and 3.0 CFU mL-1 were achieved for TYR and E. coli O157:H7, respectively. This study opens up a new perspective of in situ generated surface VO on semiconductors, which underlies an innovative PEC signal transduction mechanism with convincing analytical performance. Hopefully, it might encourage more explorations of new methodologies for introducing surface vacancies with exquisite applications.

Sensitive colorimetric assay of T4 DNA ligase by the oxidase nanozyme of LaMnO3.26 coupled with a hyperbranched amplification reaction.

The development of efficient methods for the detection of T4 DNA ligase is extremely important for public health. The present work demonstrates the integration of engineerable oxidase nanozyme of LaMnO3.26 nanomaterials for the colorimetric detection of T4 DNA ligase. Specifically, the LaMnO3.26 nanomaterials exhibited oxidase-like activity, oxidizing o-phenylenediamine (OPD), 2,2'-azino-bis(3-ethylbenzthiazoline-6-sulfonic acid) (ABTS), and 3,3',5,5'-tetramethylbenzidine (TMB) to their corresponding oxidation products, which featured maximum absorption wavelengths at 450, 417 and 650 nm, respectively, while pyrophosphate ion (PPi) caused an obvious decrease in the oxidase-like activity of LaMnO3.26 through its surface coordination with the surface-exposed Mn element and induced aggregation of the nanozyme. Attributed to the PPi regulated oxidase nanozyme activity, LaMnO3.26 served as a colorimetric probe for the quantitative detection of T4 DNA ligase assisted by a hyperbranched amplification reaction for signal amplification. The T4 DNA ligase was detected with a linear range of 4.8 × 10-3 to 6.0 U mL-1, achieving a detection limit of 1.6 × 10-3 U mL-1. The outcome indicated that the developed nanozyme might be extended to a broad range of practical applications.

2,3-Dihydroxynaphthalene invoked surface oxygen vacancy effect on Fe2O3 nanorods for photoanodic signal transduction tactic.

The state-of-art signal transduction mechanism of anodic photoelectrochemistry is constrained to the hole oxidation reaction, which greatly hinders its application for prospective biosensing applications. Herein, we present an innovative strategy for signal transduction by exploiting the in situ formation of surface oxygen vacancies (VOs) on Fe2O3 nanorods (NRs) through the self-coordination of 2,3-dihydroxynaphthalene (2,3-DHN) on their surfaces. The 2,3-DHN was connected with Fe(Ⅲ) on the surface of Fe2O3 NRs vis the formation of the five-membered ring structures accompanied by the generation of VOs. And the generated VOs introduced a new defect energy level for trapping the photogenerated holes, which enhanced the charge separation and realized the enhancement of photocurrent signal. The developed signal transduction strategy was validated by the first photoelectrochemical (PEC) sensing platform for ß-glucoside (ß-Glu) and lipase (LPS), which can catalyze the hydrolysis of 3-hydroxy-2-naphthalenyl-ß-D-glucoside and naphthalene-2,3-diol diacetate, respectively, to produce 2,3-DHN for signal stimuli. The ß-Glu and LPS were detected with linear ranges of 0.01-10.0 U/mL and 0.001-5.0 mg/mL, respectively. Detection limits of 3.3 × 10-3 U/mL and 0.32 µg/mL (S/N = 3) were achieved, for ß-Glu and LPS, respectively. The present study not only provides a new strategy for spontaneous induction of VOs in situ for n-type semiconductors, but also innovates the anodic PEC signal transduction strategy with broadened biosensing applications.

Kanamycin triggered nanozyme for homogeneous and amplified colorimetric detection of T4 polynucleotide kinase.

It is of significance to develop efficient methods for detecting the activity of T4 polynucleotide kinase (T4 PNK) due to its essential role in the modulation of different life activities. In this work, we constructed a novel nanozyme using Kanamycin (KANA) as a trigger for the [Fe(CN)6]3- coordinated Cu2(OH)3NO3 (Cu2(OH)3NO3/[Fe(CN)6]3-) nanorods, and designed an amplified colorimetric method to detect T4 PNK. That was, the free KANA efficiently triggered the peroxidase-like activity of Cu2(OH)3NO3/[Fe(CN)6]3-, while the bound KANA by its aptamer lost the stimulative capability for the nanomaterials. On the basis of the bioreaction regulated generation of the KANA aptamer, a highly sensitive colorimetric assay aided by the rolling circle amplification (RCA) reaction for the detection of T4 PNK was realized. Results showed that this assay can detect T4 PNK from 1.0 × 10-3 to 10.0 U/mL, with a limit of detection (LOD) of 1.42 × 10-4 U/mL. The assay also showed acceptable performance in the detection of T4 PNK in serum samples. In addition to the satisfactory sensitivity and selectivity, the displayed T4 PNK assay also presented merits of operational convenience, without labeling or immobilization process and did not require costly instrument. It is expected that the KANA as a stimulator would have extended biosensing applications by coupling various bioreactions that can produce the KANA aptamer.

Detection of asymptomatic recurrence following curative surgery improves survival in patients with gastric cancer: A systematic review and meta-analysis.

Background: To date, there is no evidence that intensive follow-up provides survival benefit in gastric cancer patients undergoing curative gastrectomy. The aim of this study is to investigate the efficacy of detection of asymptomatic recurrence using intensive surveillance strategy in long-term survival after curative gastric cancer surgery. Methods: A systematic review of electronic databases including PubMed, Embase, Web of Science, the Cochrane Library and China National Knowledge Infrastructure, Clinical Trials Registry and Google Scholar was performed up to April 2022. The primary outcomes were survival outcomes: overall survival, recurrence-free survival and post-recurrence survival. The secondary endpoints were clinicopathological features, recurrence patterns and treatment after recurrence. The registration number of this protocol is PROSPERO CRD42022327370. Results: A total of 11 studies including 1898 participants were included. In the pooled analysis, the detection of asymptomatic recurrence was significantly associated with an improved overall survival compared to patients showing symptoms of recurrence (HR=0.67; 95%CI: 0.57-0.79; P<0.001), which was primarily driven by the prolongation of post-recurrence survival (HR=0.51; 95%CI: 0.42-0.61; P<0.001), since there was no significant difference observed in recurrence-free survival (HR=1.12; 95%CI: 0.81-1.55; P=0.48) between the two groups. Meanwhile, male sex and advanced T stage were more frequently observed in the symptomatic recurrence group. Furthermore, patients in the symptomatic recurrence group had a higher proportion of peritoneal relapse but lower proportion of distant lymph node metastasis. Additionally, patients in the symptomatic recurrence group were less likely to receive surgery treatment and post-recurrence chemotherapy. Conclusion: The detection of asymptomatic recurrence using intensive follow-up was associated with an appreciable improvement in overall survival. However, more robust data from high-quality studies are still required to verify this issue. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=327370, identifier CRD42022327370.

Using multiple linear regression and BP neural network to predict critical meteorological conditions of expressway bridge pavement icing.

Icy bridge deck in winter has tremendous consequences for expressway traffic safety, which is closely related to the bridge pavement temperature. In this paper, the critical meteorological conditions of icy bridge deck were predicted by multiple linear regression and BP neural network respectively. Firstly, the main parameters affecting the bridge pavement temperature were determined by Pearson partial correlation analysis based on the three-year winter meteorological data of the traffic meteorological monitoring station on the bridge in Shandong province. Secondly, the bridge pavement temperature is selected as the dependent variable, while air temperature, wind speed, relative humidity, dew point temperature, wet bulb temperature and wind cold temperature were selected as independent variables, and the bridge pavement temperature prediction models of linear regression and 5-layer hidden layer classical BP neural network regression were established respectively based on whether the variables are linear or not. Finally, the prediction accuracy of the above models was compared by using the measured data. The results show that the linear regression model could be established only with air temperature, relative humidity and wind speed, owing to collinearity problem. Compared with multiple linear regression model, the predicted value of the BP neural network has a higher degree of fitting with the measured data, and the coefficient of determination reaches 0.7929. Using multiple linear regression and BP neural network, the critical meteorological conditions of bridge deck icing in winter can be effectively predicted even when the sample size is insufficient.

Permitted speed decision of single-unit trucks with emergency braking maneuver on horizontal curves under rainy weather.

Under adverse weather conditions, visibility and the available pavement friction are reduced. The improper selection of speed on curved road sections leads to an unreasonable distribution of longitudinal and lateral friction, which is likely to cause rear-end collisions and lateral instability accidents. This study considers the combined braking and turning maneuvers to obtain the permitted vehicle speed under rainy conditions. First, a braking distance computation model was established by simplifying the relationship curve between brake pedal force, vehicle braking deceleration, and braking time. Different from the visibility commonly used in the meteorological field, this paper defines "driver's sight distance based on real road scenarios" as a threshold to measure the longitudinal safety of the vehicle. Furthermore, the lateral friction and rollover margin is defined to characterize the vehicle's lateral stability. The corresponding relationship between rainfall intensity-water film thickness-road friction is established to better predict the safe speed based on the information issued by the weather station. It should be noted that since the road friction factor of the wet pavement not only determined the safe vehicle speed but also be determined by the vehicle speed, so we adopt Ferrari's method to solve the quartic equation about permitted vehicle speed. Finally, the braking and turning maneuvers are considered comprehensively based on the principle of friction ellipse. The results of the TruckSim simulation show that for a single-unit truck, running at the computed permitted speed, both lateral and longitudinal stability meet the requirements. The proposed permitted vehicle speed model on horizontal curves can provide driving guidance for drivers on curves under rainy weather or as a decision-making basis for road managers.

Intercalated doxorubicin acting as stimulator of PbS photocathode for probing DNA-protein interactions.

Label-free and turn-on DNA-binding protein detection based on the doxorubicin (Dox)-intercalated DNA as a signal stimulator in cathodic photoelectrochemistry is reported. The double-stranded DNA (dsDNA) acted as the matrix accommodating the intercalative Dox and allowed its effective photoelectrochemical (PEC) communication with the PbS quantum dots (QDs) for realizing cathodic photocurrent readout. In the presence of the target of the vascular endothelial growth factor (VEGF), the dsDNA was prevented from being digested by the exonuclease III (Exo III), allowing the anchor of Dox to perform as activation stimuli of the photocurrent. The VEGF can be detected in the linear range from 1.5 pM to 100 nM, with an impressively low detection limit of 0.49 pM. This study hints the prospect of DNA intercalated architectures as innovative signaling transduction elements for wide and versatile cathodic PEC bioassays. Effective signaling molecules that are conducive to probe-related cathodic PEC bioassays using DNA as the recognition or signification elements are scarce but very demanding. Herein, the doxorubicin intercalated in duplex DNA functions as an efficient signal stimulator of PbS-consisted photocathode, and thus hints the versatility of the strategy for various targets through cathodic photoelectrochemistry.

Predicting the water film depth: A model based on the geometric features of road and capacity of drainage facilities.

The water film depth is a key variable that affects traffic safety under rainfall conditions. According to the Federal Highway Administration, approximately 5700 people are killed and more than 544 700 people are injured in crashes on wet pavements annually. While several studies have attempted to address water film depth issues by establishing prediction models, a few focused on the relationship among road geometric features, capacity of drainage facilities and water film depth. To ascertain the influence of the geometric features of road and facility drainage capacities on the water film depth, the road geometry features were first classified into four types, and the facility drainage capacities were considered from three aspects in this study. Furthermore, the concept of short-time rainfall grade was proposed according to the results of the field test. Finally, the theoretical prediction model for the water film depth was conceived, based on the geometric features of road and facility drainage capacities with different rainfall intensities. Compared with the traditional regression prediction models, the theoretical prediction model clearly shows the effects of the geometric features of road and facility drainage capacities. When the road drainage facilities have no drainage capacity, the water film depth increases rapidly with the rainfall intensity. This model can be used to predict the water film depth of road surfaces on rainy days, evaluate the effect of rainfall on the driving environment, and provide guidance for determining safety control measures on rainy days.

Nomogram to Predict Intensive Care Following Gastrectomy for Gastric Cancer: A Useful Clinical Tool to Guide the Decision-Making of Intensive Care Unit Admission.

BACKGROUND: We aimed to generate and validate a nomogram to predict patients most likely to require intensive care unit (ICU) admission following gastric cancer surgery to improve postoperative outcomes and optimize the allocation of medical resources. METHODS: We retrospectively analyzed 3,468 patients who underwent gastrectomy for gastric cancer from January 2009 to June 2018. Here, 70.0% of the patients were randomly assigned to the training cohort, and 30.0% were assigned to the validation cohort. Least absolute shrinkage and selection operator (LASSO) method was performed to screen out risk factors for ICU-specific care using the training cohort. Then, based on the results of LASSO regression analysis, multivariable logistic regression analysis was performed to establish the prediction nomogram. The calibration and discrimination of the nomogram were evaluated in the training cohort and validated in the validation cohort. Finally, the clinical usefulness was determined by decision curve analysis (DCA). RESULTS: Age, the American Society of Anesthesiologists (ASA) score, chronic pulmonary disease, heart disease, hypertension, combined organ resection, and preoperative and/or intraoperative blood transfusions were selected for the model. The concordance index (C-index) of the model was 0.843 in the training cohort and 0.831 in the validation cohort. The calibration curves of the ICU-specific care risk nomogram suggested great agreement in both training and validation cohorts. The DCA showed that the nomogram was clinically useful. CONCLUSIONS: Age, ASA score, chronic pulmonary disease, heart disease, hypertension, combined organ resection, and preoperative and/or intraoperative blood transfusions were identified as risk factors for ICU-specific care after gastric surgery. A clinically friendly model was generated to identify those most likely to require intensive care.