Novel anthropometric indicators of visceral obesity predict the severity of hyperlipidemic acute pancreatitis.

BACKGROUND: Obesity substantially contributes to the onset of acute pancreatitis (AP) and influences its progression to severe AP. Although body mass index (BMI) is a widely used anthropometric parameter, it fails to delineate the distribution pattern of adipose tissue. To circumvent this shortcoming, the predictive efficacies of novel anthropometric indicators of visceral obesity, such as lipid accumulation products (LAP), cardiometabolic index (CMI), body roundness index (BRI), visceral adiposity index (VAI), A Body Shape Index (ABSI), and Chinese visceral adiposity index (CVAI) were examined to assess the severity of AP. METHOD: The body parameters and laboratory indices of 283 patients with hyperlipidemic acute pancreatitis (HLAP) were retrospectively analysed, and the six novel anthropometric indicators of visceral obesity were calculated. The severity of HLAP was determined using the revised Atlanta classification. The correlation between the six indicators and HLAP severity was evaluated, and the predictive efficacy of the indicators was assessed using area under the curve (AUC). The differences in diagnostic values of the six indicators were also compared using the DeLong test. RESULTS: Patients with moderate to severe AP had higher VAI, CMI, and LAP than patients with mild AP (all P < 0.001). The highest AUC in predicting HLAP severity was observed for VAI, with a value of 0.733 and 95% confidence interval of 0.678-0.784. CONCLUSIONS: This study demonstrated significant correlations between HLAP severity and VAI, CMI, and LAP indicators. These indicators, particularly VAI, which displayed the highest predictive power, were instrumental in forecasting and evaluating the severity of HLAP.

Rational Design of Full-Color Fluorescent C3N Quantum Dots.

Carbon-based quantum dots (QDs) exhibit unique photoluminescence due to size-dependent quantum confinement, giving rise to fascinating full-color emission properties. Accurate emission calculations using time-dependent density functional theory are a time-costing and expensive process. Herein, we employed an artificial neural network (ANN) combined with statistical learning to establish the relationship between geometrical/electronic structures of ground states and emission wavelength for C3N QDs. The emission energy of these QDs can be doubly modulated by size and edge effects, which are governed by the number of C4N2 rings and the CH group, respectively. Moreover, these two structural characteristics also determine the phonon vibration mode of C3N QDs to harmonize the emission intensity and lifetime of hot electrons in the electron-hole recombination process, as indicated by nonadiabatic molecular dynamics simulation. These computational results provide a general approach to atomically precise design the full-color fluorescent carbon-based QDs with targeted functions and high performance.

Solar driven CO2 hydrogenation to HCOOH on (TiO2)n (n = 1-6) atomic clusters.

Artificial photosynthesis is a crucial reaction that addresses energy and environmental challenges by converting CO2 into fuels and value-added chemicals. However, efficient catalytic activity using earth-abundant materials can be challenging due to intrinsic limitations. Herein, we explore neutral (TiO2)n (n = 1-6) atomic clusters for CO2 hydrogenation via comprehensive ab initio calculations combined with time-dependent functional theory. Our results show that these (TiO2)n clusters exhibit outstanding thermodynamic stabilities and decent surficial activities for CO2 activation and H2 dissociation, both of which possess kinetic barriers down to 0-0.74 eV. We establish a relationship between the binding strength of *CO2 species and electron characterization for these (TiO2)n clusters. These clusters, which have a wide energy gap between the highest occupied molecular orbital (HOMO) and the lowest unoccpied molecular orbital (LUMO) that allows them to harvest the solar light in the ultraviolet regime, enabling efficient catalysis for driving the catalysis of CO2 conversion. They provide exclusive reaction channels and high selectivity for yielding HCOOH products via the carboxyl mechanism, involving the kinetic barrier of the limiting step of 0.74-1.25 eV. We also investigated the substrate effect on supported (TiO2)n clusters, with non-metallic substrates featuring inert surfaces serving as suitable options for anchoring (TiO2)n clusters while preserving their intrinsic activity and selectivity. These computational results have significant implications not only for meeting energy demands but also for mitigating carbon emissions by utilizing CO2 as an alternative feedstock rather than considering it solely as a greenhouse gas.

Triglycerides to high-density lipoprotein cholesterol (TG/HDL-C) ratio is an independent predictor of the severity of hyperlipidaemic acute pancreatitis.

BACKGROUND: The incidence of acute pancreatitis caused by hyperlipidaemia is increasing. A quick and easy diagnosis of the severity of hyperlipidaemic acute pancreatitis (HTGP) is important to improve patient prognosis and reduce mortality. Previous studies reported that insulin resistance (IR) is associated with acute pancreatitis. Our study aimed to investigate the correlation between the triglycerides to high-density lipoprotein cholesterol (TG/HDL-C) ratio and HTGP. METHODS: Patients' laboratory and clinical parameters were obtained from the institutional pancreatitis database. Univariate and multivariate logistic regression analyses were applied to evaluate the risk factors for the severity of HTGP and the efficacy of four clinical scoring systems: Ranson's Criteria, Acute Physiology and Chronic Health Evaluation II (APACHE II), the Bedside Index for Severity in Acute Pancreatitis (BISAP), and Marshall. RESULTS: Of 290 patients, 134 (46.2%) were diagnosed with moderately severe to severe HTGP. The TG/HDL-C ratio was higher in the moderately severe to severe HTGP subgroup than in the mild HTGP subgroup. Among the independent risk factors, such as amylase, albumin, aspartate transaminase (AST), systemic inflammatory response syndrome (SIRS), and TG/HDL-C ratio, the TG/HDL-C ratio had the highest area under the curve (AUC) (0.727, 95% CI, 0.571-0.701). In comparison with other clinical scoring systems, the TG/HDL-C ratio has a relatively preferable predictive ability. CONCLUSION: Our findings suggest that the TG/HDL-C ratio is positively correlated with HTGP severity and could be used as a simple indicator of severe HTGP.

The modified computed tomography severity index combined with low skeletal muscle mass can better predict the severity of hypertriglyceridemia-induced pancreatitis.

BACKGROUND: Body composition parameters are associated with hypertriglyceridemia-induced pancreatitis (HTGP). This study investigated the association between the quantity of muscle assessed using computed tomography (CT) and the severity of HTGP. METHODS: The modified CT severity index (MCTSI) was calculated from admission examination data. Patients' characteristics and body composition parameters were collected. Univariate and multivariate logistic regression analyses were also performed. The receiver operating characteristic curves and corresponding area under the curves (AUC) were calculated to test the efficiency of the model. A nomogram was then constructed. RESULTS: Of the 175 included patients, 138 were male, of which 85 had moderately severe to severe HTGP. Patients with low skeletal muscle mass (LSMM) and high MCTSI were significantly more likely to have moderately severe to severe HTGP. Patients with LSMM had lower body mass index, lower HDL-C level, higher amylase level, prevalence of surgery, shorter umbilical waist circumference, and longer length of hospital stay. Univariate and multivariate logistic regression analyses confirmed that female sex, lipase, total cholesterol, LSMM-MCTSI (P = .004, odds ratio = 23.105), and albumin were risk factors. The TOTAL model that combined LSMM-MCTSI and clinical risk parameters performed best (AUCs = 0.875), followed by other models (LSMM-MCTSI: AUCs = 0.762, MCTSI: AUCs = 0.728). The Delong test revealed significant difference. Finally, a nomogram was developed to predict the severity of HTGP. CONCLUSION: The performance of MCTSI in predicting severity can be improved by considering LSMM, which is a promising strategy for the treatment of HTGP.

The visceral adiposity index predicts the severity of hyperlipidaemic acute pancreatitis.

It is important to clarify the severity of acute pancreatitis (AP) in the early stages of the disease. The visceral adiposity index (VAI), calculated using the waist circumference (WC), body mass index (BMI), triglyceride (TG) levels, and high-density lipoprotein cholesterol (HDL-c), indirectly reflects visceral adiposity function and can be used to explore its value in evaluating and predicting the severity of hyperlipidaemic acute pancreatitis (HLAP). The VAIs of 227 patients with HLAP were calculated by retrospective analysis of body parameters and laboratory indicators. The correlation between the VAI and HLAP severity, local complications, and systemic inflammatory response syndrome (SIRS) response was analysed. The VAI was significantly higher in patients with severe and moderately severe AP than in patients with mild AP (both p < 0.05). Length of hospital stay (LOS), AP severity, systemic complications, Acute Physiology and Chronic Health Evaluation II (APACHE-II) score, and SIRS score were significantly correlated with the VAI in HLAP patients. The VAI had the highest area under the curve of receiver operating characteristics (ROC) (0.755, 95% confidence interval [CI], 0.691-0.819) for predicting AP severity. The multivariate-adjusted odds ratio (HR) for the VAI in the relationship of body parameters and the severity of HLAP was 3.818 (95% CI, 1.395-10.452). Our study shows that the VAI is a valuable indicator for predicting and assessing the severity of hyperlipidaemic acute pancreatitis. Its increase is closely related to poor prognosis in patients with HLAP.

A Radiological Nomogram to Predict 30-day Mortality in Patients with Acute Pulmonary Embolism.

RATIONALE AND OBJECTIVES: Acute pulmonary embolism (APE) is a common disease with a high mortality, especially in the short term. Computed tomographic pulmonary angiography (CTPA) is a recommended method in the diagnostic workup for APE; thus, this study aimed to establish a CTPA-based radiological nomogram to predict the 30-day mortality in patients with APE, and to further compare this model with the pulmonary embolism severity index (PESI) and simplified pulmonary embolism severity index (SPESI). MATERIALS AND METHODS: We retrospectively recruited 158 adults with confirmed APE who underwent CTPA from August 1, 2017, to August 1, 2020. These adults were stratified into two groups according to their 30-day mortality. CTPA-based variables were analyzed using univariate and multivariate analyses, independent risk factors for 30-day mortality were established, and a radiological nomogram was constructed. Subsequently, PESI and SPESI were calculated. The performance of the radiological nomogram model was compared to that of the PESI and SPESI using decision curve analysis and receiver-operating characteristic curve analysis. RESULTS: Thirty-three patients died within 30 days (30-day mortality rate, 20.9%). On logistic regression analysis, the right and left ventricular diameter ratio (odds ratio [OR] = 8.709, 95% confidence interval [CI]: 1.085-69.903, p = 0.042), ventricular septal bowing (OR = 8.085, 95% CI: 1.947-33.567, p = 0.004), chronic bronchitis (OR = 4.383, 95% CI: 1.025-18.740, p = 0.046), malignant lung lesions (OR = 17.530, 95% CI: 2.408-127.636, p = 0.005), and pneumonia (OR = 3.477, 95% CI: 1.123-10.766, p = 0.031) were identified as the independent predictors of 30-day mortality. The area under the curve of the radiological nomogram, PESI, and SPESI were 0.900 (95% CI: 0.828-0.971), 0.729 (95% CI: 0.642-0.815), and 0.718 (95% CI: 0.621-0.815), respectively. CONCLUSION: The CTPA-based radiological nomogram appeared valuable for the prediction of 30-day mortality in patients with APE, and was superior to both PESI and SPESI.

Assessment of Computed Tomography-Defined Muscle and Adipose Tissue Features in Relation to Length of Hospital Stay and Recurrence of Hypertriglyceridemic Pancreatitis.

BACKGROUND: Analytic morphometric assessment has recently been proposed to be applied to the study of acute pancreatitis (AP). However, the relationship between body composition and the outcomes of hypertriglyceridemic pancreatitis (HTGP) is still unclear. The aim of this study was to evaluate body composition in relation to the length of hospital stay (LOS) and recurrence of HTGP. METHODS: Patient characteristics, admission examination data, body composition parameters, LOS, and recurrence within 1 year were collected from the institutional pancreatitis database and follow-up records. Logistic regression analysis was used to identify risk factors for LOS and recurrence of HTGP. RESULTS: Of the 196 included patients, 158 (80.6%) were men and 53 (27.0%) were sarcopenic. The average LOS was 15.83±10.02 days. The recurrence rate of HTGP was 36.7%. Multivariate analysis with multiple linear regression suggested that subcutaneous adipose tissue (SAT) area (p=0.019) and high-density lipoprotein-cholesterol (HDL-C) (p=0.001) were independently associated with the LOS for HTGP after adjusting for age and sex. The multivariate adjusted hazard ratios for SAT area and HDL-C, with respect to the relationship between body parameters and LOS, were 1.008 (95% confidence interval [CI], 1.001-1.015) and 0.090 (95% CI, 0.022-0.361), respectively. No significant differences were observed between the AP and recurrent AP (RAP) groups in terms of characteristics, admission examination data, and body composition parameters. CONCLUSION: SAT area and HDL-C are associated with LOS in patients with HTGP. The body composition of patients at the first symptom onset of HTGP cannot predict recurrence.

Imaging Features of Sclerosing Epithelioid Fibrosarcoma of the Pancreas: A Case Report.

Background: Sclerosing epithelioid fibrosarcoma (SEF) is an extremely rare fibrosarcoma variant. There is no complete imaging data on SEF involving the pancreas. Herein we report the computed tomography (CT) and magnetic resonance imaging (MRI) data of a patient with SEF that primarily involved the pancreas. Case Presentation: A 64-year-old man was found to have a solid mass in the tail of the pancreas on unenhanced CT. He had no constitutional symptoms. Contrast-enhanced abdominal CT and MRI were performed, and the results of the latter provided the diagnosis of a pancreatic neuroendocrine tumor. Laparoscopic distal pancreatectomy and splenectomy were performed. Anatomopathological examination and immunohistochemistry confirmed that the tumor was a SEF of the pancreas. The patient had no signs of recurrence or metastasis during a 12-months follow-up. Conclusion: We report an extremely rare case of SEF in the pancreas and its characterization with CT and MRI.

Comparative Decellularization and Recellularization of Normal Versus Streptozotocin-Induced Diabetes Mellitus Rat Pancreas.

Decellularized (DC) organs/tissues offer a promising scaffold for regenerative bioengineering. However, it is not clear whether the diabetic mellitus (DM) pancreas can be used in decellularized and recellularized bioengineering. For assessment of these questions, murine pancreatic scaffolds of normal, type 1DM (T1DM) and type 2 DM (T2DM) pancreas were generated using a perfusion decellularization technique and assessed by histology, scanning electron microscopy, immunohistochemistry, and enzyme-linked immunosorbent assay (ELISA). The capacity of DC pancreatic scaffolds to support attachment and proliferation of human umbilical vein endothelial cells (HUVECs) and MIN-6 ß cells was also assessed. Our results showed that DC pancreatic scaffolds were successfully produced from T1DM and T2DM pancreas and maintained their extracellular matrix (ECM) composition, 3D ultrastructure, and various cytokines. All of the pancreatic scaffolds were sufficiently cytocompatible and were able to support proliferation and adhesion of HUVECs and MIN-6 ß cells. The preliminary results support the biological utility of diabetes mellitus pancreatic scaffolds and pave the way for further investigations to assess the potential ability of using diabetes mellitus pancreas as scaffolds for recellularization and eventual medical applications.

[Localization of perforators in the lower leg by digital antomy imaging methods].

OBJECTIVE: To offer both the accurate three-dimensional anatomical information and algorithmic morphology of perforators in the lower leg for perforator flaps design. METHODS: The cadaver was injected with a modified lead oxide-gelatin mixture. Radiography was first performed and the images were analyzed using the software Photoshop and Scion Image. Then spiral CT scan was also performed and 3-dimensional images were reconstructed with MIMICS 10.01 software. RESULTS: There are (27 +/- 4) perforators whose outer diameter > or = 0.5 mm ( average, 0.8 +/- 0.2 mm). The average pedicle length within the superficial fascia is (37.3 +/- 18.6) mm. The average supplied area of each perforator is (49.5 +/- 25.5) cm2. The three-dimensional model displayed accurate morphology structure and three-dimensional distribution of the perforator-to- perforator and perforator-to-source artery. CONCLUSIONS: The 3D reconstruction model can clearly show the geometric, local details and three-dimensional distribution. It is a considerable method for the study of morphological characteristics of the individual perforators in human calf and preoperative planning of the perforator flap.