Modeling of the synergistic anti-reflection effect in gradient refractive index films integrated with subwavelength structures for photothermal conversion.

Photothermal materials generally suffer from challenges such as low photothermal conversion efficiency and inefficient full-spectrum utilization of solar energy. This paper proposes gradient refractive index transparent ceramics (GRITCs) integrated with subwavelength nanostructure arrays and simulates the synergistic anti-reflection effect by an admittance recursive model. An innovative subwavelength structure, possessing a superior light-trapping capability, is initially crafted based on this model. Subsequently, various intelligent optimization algorithms including genetic algorithm, particle swarm optimization, and simulated annealing are employed to optimize the structure of gradient refractive index films respectively. Finally, the photothermal conversion efficiencies of devices based on different photothermal materials are calculated. The simulations and finite-difference time-domain calculations demonstrate that the three-layer GRITCs integrated with an optimal SNA exhibit outstanding full-spectrum and omnidirectional anti-reflection performance. The solar transmittance of the devices can exceed 97% for light wavelengths ranging from 300 to 2500 nm over the full angle of incidence. Our results reveal that the synergistic anti-reflection effect in the SNAs and GRITCs can enhance the photothermal conversion efficiency by more than 20%.

Nanosphere-reinforced polysaccharide self-healing hydrogels for infected wound healing.

Bacterial infection remarkably impedes wound healing, with antibiotics traditionally serving as the primary therapeutic intervention. However, the escalating misuse of antibiotics and the emergence of bacterial resistance present substantial treatment challenges for infected wounds. Consequently, the development of antibiotic-free antimicrobial dressings holds pertinent research and clinical relevance. To this end, this study aimed to introduce an all-natural hydrogel dressing, amalgamating polyphenols and polysaccharides, exhibiting pronounced antibacterial and antioxidant properties without relying on antibiotics. First, we constructed curcumin-tannic acid­zinc ion nanospheres (CTZN) through self-assembly. Our experimental results showed that the nanospheres had excellent biocompatibility, antioxidant, and antimicrobial abilities. Subsequently, we prepared carboxymethylated chitosan/oxidized sodium alginate hydrogels via Schiff base reactions. Incorporation of CTZN into the hydrogel system not only improves the inherent qualities of the hydrogel but also confers multifunctional properties, including antimicrobial, antioxidant, and anti-inflammatory abilities. In this study, we enhanced the physicochemical properties and biological activity of hydrogels by introducing natural material nanospheres, offering a novel approach that could pave the way for the development of purely natural biomaterial dressings.

Risk factors and survival analysis of human leukocyte antigen loss in relapsed acute myeloid leukaemia/myelodysplastic syndrome patients after allogeneic haematopoietic stem cell transplantation.

To investigate the clinical characteristics and risk factors of specific human leukocyte antigen loss (HLA loss) in relapsed acute myeloid leukaemia (AML)/myelodysplastic syndrome (MDS) patients after allogeneic haematopoietic stem cell transplantation (allo-HSCT), and compare the responses of patients with HLA loss relapse with those without HLA loss (non-HLA loss) to different treatment regimens. Clinical data of traceable patients with AML/MDS after myeloablative allo-HSCT in our centre between January 2010 and June 2021, who experienced disease relapse after the transplantation, were collected. The patients were divided into the HLA loss relapse group and the non-HLA loss relapsed group based on HLA loss gene test findings by next-generation sequencing. The patients' median overall survival (OS) after the relapse were compared, and univariate and multivariate analyses were performed using the Kaplan-Meier survival curve and Cox proportional hazard model to explore the responses to different treatments after relapse. A total of 2359 patients were selected. Retrospective HLA gene loss gene detection was performed for the deoxyribonucleic acid in 179 relapsed patients, including 47 patients in the HLA loss group (27.2%), 126 patients in the non-HLA loss group (72.8%) and 6 patients were excluded due to a lack of confirmed results. There was no significant statistical difference in the baseline characteristics of patients between the two groups, but as to transplantation-related characteristics, the donor-recipient relationship and HLA mismatched loci were statistically different between the two groups (both p < 0.001). Multivariate Cox analysis showed that more HLA mismatched loci ≥3 (HR = 3.66; 95% CI: 1.61-8.31; p = 0.002), time (≤6 months) from HSCT to relapse (HR = 7.92; 95% CI: 3.35-18.74; p < 0.001) and donor chimerism (CD3) in bone marrow at relapse (HR = 1.02; 95% CI: 1.00-1.03; p = 0.036) were independent factors affecting HLA loss relapse. The ratio of negative conversion of FLT3-ITD or CEBPA mutation was significantly lower in patients with post-transplantation HLA loss relapse than in the non-HLA loss group (0.0% vs. 45.5%, p = 0.003; 0.0% vs. 80.0%, p = 0.035), with none of the patients with FLT3-ITD or CEBPA mutation turned negative in the HLA loss group. The number of gene mutations turned negative when relapse in the non-HLA loss group was remarkably higher than that in the HLA loss group (p = 0.001). Using donor lymphocyte infusion (DLI) could not prolong OS for the HLA loss group (p = 0.42). Nevertheless, second transplantation had a significant positive impact on OS in the HLA loss group (p = 0.017), although only five patients in the HLA loss group underwent second transplantation. However, patients in the non-HLA loss group using DLI had a relatively longer OS time than those without DLI (p = 0.017). Second transplantation could also prolong OS in the non-HLA loss group, but the effect was not as significant as in the HLA loss group (p = 0.053). In summary, HLA loss detection is essential for patients with recurrence after transplantation, especially for those with more HLA mismatched loci and non-sibling donor. Furthermore, the detection of HLA loss has a guiding role in choosing subsequent therapy when relapsed, as secondary transplantation is more suitable than DLI for those with HLA loss.

Effects of Wheat Oligopeptide on the Baking and Retrogradation Properties of Bread Rolls: Evaluation of Crumb Hardness, Moisture Content, and Starch Crystallization.

Delaying the deterioration of bakery goods is necessary in the food industry. The objective of this study was to determine the effects of wheat oligopeptide (WOP) on the qualities of bread rolls. The effects of WOP on the baking properties, moisture content, and starch crystallization of rolls during the storage process were investigated in this study. The results showed that WOP effectively improved the degree of gluten cross-linking, thereby improving the specific volume and the internal structure of rolls. The FTIR and XRD results showed that the addition of WOP hindered the formation of the starch double helix structure and decreased its relative crystallinity. The DSC results revealed a decrease in the enthalpy change (ΔH) from 0.812 to 0.608 J/g after 7 days of storage with 1.0% WOP addition, further indicating that WOP reduced the availability of water for crystal lattice formation and hindered the rearrangement of starch molecules. The addition of WOP also improved the microstructure of the rolls that were observed using SEM analysis. In summary, WOP is expected to be an effective natural additive to inhibit starch staling and provide new insights into starchy food products.

Phonon dynamic behaviors induced by amorphous layers at heterointerfaces.

An amorphous layer is commonly found at the interfaces of heterostructures due to lattice and thermal mismatch between dissimilar materials. While existing research has explored the impact of these layers on interfacial thermal transport, a comprehensive understanding of the underlying microscopic mechanisms remains essential for advancing thermal nanodevice development. Through phonon wave packet simulations, we investigated the dynamic behaviors of phonons crossing the amorphous interlayer at the GaN/AlN interface from the mode level. Our results highlight the amorphous layer's capability to notably adjust the polarization properties of incoming phonons, culminating in phonon localization. By examining transmission outcomes on a per-mode basis, we demonstrate the amorphous layer's impediment on phonon transport. Notably, this resistance escalates with an increase in the amorphous layer thickness (L), with certain high-frequency TA phonons showing unexpectedly high transmissivity due to polarization conversion and inelastic scattering at the amorphous interface. In addition, we observe that the amorphous layer prompts multiple reflections of incident phonons, instigating discernible from the two-beam interference equation. Finally, in pursuit of enhanced phonon transport, we employ annealing techniques to optimize the interface morphology, leading to the recrystallization of the amorphous layer. This optimization yields a substantial enhancement of interfacial thermal conductance by up to 38% for L = 3 nm.

Microenvironment Remodeling Self-Healing Hydrogel for Promoting Flap Survival.

Random flap grafting is a routine procedure used in plastic and reconstructive surgery to repair and reconstruct large tissue defects. Flap necrosis is primarily caused by ischemia-reperfusion injury and inadequate blood supply to the distal flap. Ischemia-reperfusion injury leads to the production of excessive reactive oxygen species, creating a pathological microenvironment that impairs cellular function and angiogenesis. In this study, we developed a microenvironment remodeling self-healing hydrogel [laminarin-chitosan-based hydrogel-loaded extracellular vesicles and ceria nanozymes (LCH@EVs&CNZs)] to improve the flap microenvironment and synergistically promote flap regeneration and survival. The natural self-healing hydrogel (LCH) was created by the oxidation laminarin and carboxymethylated chitosan via a Schiff base reaction. We loaded this hydrogel with CNZs and EVs. CNZs are a class of nanomaterials with enzymatic activity known for their strong scavenging capacity for reactive oxygen species, thus alleviating oxidative stress. EVs are cell-secreted vesicular structures containing thousands of bioactive substances that can promote cell proliferation, migration, differentiation, and angiogenesis. The constructed LCH@EVs&CNZs demonstrated a robust capacity for scavenging excess reactive oxygen species, thereby conferring cellular protection in oxidative stress environments. Moreover, these constructs notably enhance cell migration and angiogenesis. Our results demonstrate that LCH@EVs&CNZs effectively remodel the pathological skin flap microenvironment and marked improve flap survival. This approach introduces a new therapeutic strategy combining microenvironmental remodeling with EV therapy, which holds promise for promoting flap survival.

Risk factors of first thrombosis in obstetric antiphospholipid syndrome.

OBJECTIVE: There is limited evidence on long-term thrombosis risk in patients with obstetric antiphospholipid syndrome (OAPS). This study aimed to investigate the clinical features and risk factors associated with the first thrombosis in patients with isolated OAPS. METHODS: Data from patients with isolated OAPS were collected. All patients were followed up until the first thrombotic event during or after delivery or until the end of the study. Logistic regression analysis identified independent risk factors associated with the first thrombosis in patients with isolated OAPS. RESULTS: The study enrolled 186 patients with OAPS. During a mean 5.4-year follow-up, 11 (5.9%) patients experienced thrombotic events. Multivariate binary logistic regression analysis revealed that triple-positive antiphospholipid antibodies (aPLs, OR=11.662, 95% CI=2.117 to 64.243, p=0.005) and hypocomplementemia (OR=9.047, 95% CI=1.530 to 53.495, p=0.015) were identified as independent risk factors for the first thrombosis in OAPS, after adjustment for low-dose aspirin and hydroxychloroquine. CONCLUSIONS: Triple-positive aPLs and hypocomplementemia are risk factors for the first thrombosis in patients with OAPS.

Radical Cations of Bilayer Nanographenes.

Chemical redox reactions of bilayer nanographene complexes, (C96H24Ar6)2 (Ar = 2,6-dimethylphenyl) (12) and (C42H12R6)2 (R = tBu) (22), were investigated. Upon two-electron oxidation reactions, 12 and 22 were transformed to radical cations 122•+ and 222•+, respectively. SQUID and EPR measurements on 122•+ and 222•+ indicate that they possess an open-shell singlet ground state with antiferromagnetic interactions between two layers. The shortest separation distance between bilayers in 222•+ (3.30 Å) is shorter than that in 22 (3.44 Å) and 22•+ (3.40 Å), illustrating stronger interaction upon loss of electrons.

Heptamethine Cyanine-Based Molecule Release Triggered by Mitochondrial ROS.

Conditionally activated molecule release in live cells would provide spatiotemporal control for the study and intervention of biological processes, e.g., bioactive molecule monitoring and controlled drug release. Mitochondria are the main sites of reactive oxygen species (ROS) production in cells. Here, we report an ROS-triggered molecule release strategy in mitochondria. A molecule IRTO with dual targeting groups was designed by covalently linking IR-780 (a mitochondrial targeted heptamethine cyanine) and 4-aminobutyl-thiazole orange (NH2-TO, a nuclear dye). IRTO diffused into live cells and first accumulated in mitochondria. As the cyanine moiety reacted with mitochondrial ROS directly or with the help of mitochondrial cytochromes, NH2-TO was released, escaped from mitochondria, and finally located in the nucleus. This process could be visualized by fluorescent imaging, i.e., red fluorescence (from the cyanine moiety of IRTO) first located in mitochondria, and green fluorescence (from NH2-TO) appeared and gradually enhanced in the nucleus with the increase of incubation time. The addition of H2O2 or lipopolysaccharide (LPS, an ROS accelerator) could accelerate the release of NH2-TO, whereas N-acetyl-l-cysteine (NAC, an ROS inhibitor) and mitoquinone mesylate (MitoQ, a mitochondrial ROS scavenger) could obviously decrease the release of NH2-TO. These results suggest that IRTO could serve as a fluorescent probe for monitoring ROS in mitochondria and that IR-780 might be a promising endogenous ROS-triggered molecule release platform.

Laparoscopic radical surgery for locally advanced T4 transverse colon cancer and prognostic factors analysis: Evidence from multi-center databases.

The safety and efficacies of laparoscopic radical procedures are still controversial for locally advanced pathological T4 (pT4) TCC (transverse colon cancer). Therefore, the aim of this study is to evaluate the oncologic and perioperative outcomes and to recognize the prognostic factors in radical resection for pT4 TCC derived from multi-center databases. 314 patients with TCC who underwent radical resection between January 2004 and May 2017, including 139 laparoscopic resections and 175 open resections, were extracted from multicenter databases. Oncological as well as perioperative outcomes were investigated. The baseline characteristics of the 2 groups did not differ significantly. Nevertheless, the laparoscopic technique was found to be linked with a significantly longer duration of surgery (208.96 vs 172.89 minutes, P = .044) and a significantly shorter postoperative hospital stay (12.23 vs 14.48 days, P = .014) when compared to the conventional open approach. In terms of oncological outcomes, lymph node resection (16.10 vs 13.66, P = .886), 5-year overall survival (84.7% vs 82.7%, P = .393), and disease-free survival (82.7% vs 83.9%, P = .803) were similar between the 2 approaches. Based on multivariate analysis, it was determined that differentiation and N classification were both independent prognostic factors for overall survival. However, it was found that only N classification was an independent prognostic factor for disease-free survival. These findings underscore the significance of differentiation and N classification as key determinants of patient outcomes in this context. Overall, the laparoscopic approach may offer advantages in terms of shorter hospital stays, while maintaining comparable oncological outcomes. Laparoscopic radical procedure can gain a couple of short-term benefits without reducing long-term oncological survival for patients with pT4 TCC.

DNA Aptamer Binding Octapeptide Repeat Region of Cellular Prion Protein.

Cellular prion protein (PrPC) is highly expressed in a variety of tumor cells and plays a crucial role in neurodegenerative diseases. Its N-terminal domain contains a conserved octapeptide (PHGGGWGQ) repeat sequence. The number of repeats has been correlated with the species as well as the development of associated diseases. Herein, PrPC was identified to be the molecular target of a high-affinity DNA aptamer HA5-68 obtained by cell-SELEX. Aptamer HA5-68 was further optimized to two short sequences (HA5-40-1 and HA5-40-2), and its binding site to PrPC was identified to be located in the loop-stem-loop region of the head of its secondary structure. HA5 series aptamers were demonstrated to bind the octapeptide repeat region of PrPC, as well as the synthesized peptides containing different numbers of octapeptide repeats. The PrPC expression on 42 cell lines was measured by using aptamer HA5-68 as a molecular probe. The clear understanding of the molecular structure and binding mechanism of this set of aptamers will provide information for the design of diagnostic methods and therapeutic drugs targeting PrPC.

Natural self-healing injectable hydrogels loaded with exosomes and berberine for infected wound healing.

Complete and rapid healing of infected skin wounds remains a challenge in current clinical treatment. In this study, we prepared a self-healing injectable CK hydrogel by crosslinking two natural polysaccharides, carboxymethyl chitosan and oxidized konjac glucomannan, based on the Schiff base bond. To enhance the biological function of the hydrogel, we multi-functionalized hydrogen by loading it with berberine (BBR) and stem cell-derived exosomes (Exo), forming a composite hydrogel, CK@BBR&Exo, which could be injected directly into the wound through a needle and adhered to the wound. Furthermore, the self-healing properties of CK@BBR&Exo increased its usefulness and service life. Additionally, the drug-loaded CK@BBR&Exo hydrogel was versatile, inhibiting bacterial growth, regulating the inflammatory response, and promoting neovascularization in infected skin wounds, thus achieving the rapid healing of infected skin wounds. These results suggest that the CK@BBR&Exo-injectable self-healing hydrogel is an ideal dressing for treating infected skin wounds.

The investigation on shale mechanical characteristics and brittleness evaluation.

Rock mechanical property is significant for shale gas development and exploitation. Shale compressive strength, tensile strength, elastic deformation and so on, are necessary parameters for drilling, completion and fracturing work in shale formation. Among all these shale mechanical parameters, brittleness is a tricky and significant rock property, which has been widely used to hydraulic fracturing design. Currently, although so many works have been conducted to investigate shale brittleness, there is no precise definition of brittleness. In particular, there is no consensus on which method is the most reliable for shale brittleness evaluation. It is vital to figure out how to evaluate shale brittleness in a reliable method. Thus, this paper presents an experimental study on shale mechanical properties, analyzing mechanical features in stress strain curve, relation between mineral content and strength, mechanical parameters at varying confined stress. Based on shale mechanical characteristics and its brittle exhibition, stress strain curve from triaxial compression test is divided into 3 stages, namely, elastic stage, plastic stage and post peak stage. In combined with brittle characteristics in 3 stages of axial and radial stress-strain curves, a new brittleness index has been established for assessing shale brittleness. In order to prove the applicability of new brittleness index, its result is compared with shale failure sample after triaxial test and existing brittleness indexes based on mineral content, elastic deformation, energy, stress and strain, showing a good consistency and proving its practicability. Based on this brittleness index, influence factors of shale brittleness have been discussed. It is shown that elastic module is the most important factor of shale brittleness. Bedding plane makes shale brittleness have strong anisotropy. Brittleness is not only relied on its structure and mineral (like bedding plane, silicate and clay mineral content), but is also highly affected by external stress. Large confined pressure is able to impair shale brittleness. Outcome in this study can offer theoretical guidance for shale exploitation.

Machine learning prediction of biochar yield based on biomass characteristics.

Slow pyrolysis is a widely used thermochemical pathway that can convert organic waste into biochar. We employed six machine learning models to predictively model 13 selected variables using pearson feature selection. Additionally, partial dependence analysis is used to reveal the deep relationship between feature variables. Both the gradient boosting decision tree and the Levenberg-Marquardt backpropagation neural network achieved training set R2 > 0.9 and testing set R2 > 0.8. But the other models displayed lower performance on the testing set, with R2 < 0.8. The partial dependence plot demonstrates that pyrolysis conditions have greater impact on biochar yield than biomass composition. Furthermore, the highest treatment temperature, being the sole consistently changing feature, can serve as a guiding factor for regulating biochar yield. This study highlights the immense potential of machine learning in experimental prediction, providing a scientific reference for reducing time and economic costs in pyrolysis experiments and process development.

Differential molecular programs of cutaneous anaplastic large cell lymphoma and CD30-positive transformed mycosis fungoides.

Background: Discriminating between cutaneous anaplastic large cell lymphoma (cALCL) and CD30-positive transformed mycosis fungoides (CD30+ TMF) is challenging, particularly when they arise in the context of pre-existing mycosis fungoides. The development of molecular diagnostic tools was hampered by the rarity of both diseases and the limited understanding of their pathogenesis. Methods: In this study, we established a cohort comprising 25 cALCL cases and 25 CD30+ TMF cases, with transcriptomic data obtained from 31 samples. We compared the clinicopathological information and investigated the gene expression profiling between these two entities. Furthermore, we developed an immunohistochemistry (IHC) algorithm to differentiate these two entities clinically. Results: Our investigation revealed distinct clinicopathological features and unique gene expression programs associated with cALCL and CD30+ TMF. cALCL and CD30+ TMF displayed marked differences in gene expression patterns. Notably, CD30+ TMF demonstrated enrichment of T cell receptor signaling pathways and an exhausted T cell phenotype, accompanied by infiltration of B cells, dendritic cells, and neurons. In contrast, cALCL cells expressed high levels of HLA class II genes, polarized towards a Th17 phenotype, and exhibited neutrophil infiltration. An IHC algorithm with BATF3 and TCF7 staining emerged as potential diagnostic markers for identifying these two entities. Conclusions: Our findings provide valuable insights into the differential molecular signatures associated with cALCL and CD30+ TMF, which contribute to their distinct clinicopathological behaviors. An appropriate IHC algorithm could be used as a potential diagnostic tool.

Optimization of construction safety resource allocation based on evolutionary game and genetic algorithm.

In the construction industry, ensuring the safety performance of a project relies heavily on the effective allocation of safety resources. As the importance of mental health in the construction industry increases, evolutionary game theory can be used to analyze the interaction mechanism of various factors affecting safety performance during the construction phase. The objective of this paper is to construct an analytical model that combines evolutionary game theory with genetic algorithms from the perspective of Leader-Member Exchange Ambivalence. The model aims to quantify and compare the various factors that influence achieving the expected safety state and identify the specific necessary constraints. Initially, we analyzed the relationships among construction site employees, divided them into superiors and subordinates, and established a game model and payoff matrix based on the research background. Next, we introduced genetic algorithms into the model via the replicator dynamic equation for optimization. We adjusted the coefficients of safety risk level, psychological expected return, moral identity, and other factors to simulate various construction site scenarios. Simulation and optimization results indicate that genetic algorithms provide more accurate reference values for safety resource allocation compared to preset or manually assigned values.

Self-supervised dual-head attentional bootstrap learning network for prostate cancer screening in transrectal ultrasound images.

Current convolutional neural network-based ultrasound automatic classification models for prostate cancer often rely on extensive manual labeling. Although Self-supervised Learning (SSL) have shown promise in addressing this problem, those data that from medical scenarios contains intra-class similarity conflicts, so using loss calculations directly that include positive and negative sample pairs can mislead training. SSL method tends to focus on global consistency at the image level and does not consider the internal informative relationships of the feature map. To improve the efficiency of prostate cancer diagnosis, using SSL method to learn key diagnostic information in ultrasound images, we proposed a self-supervised dual-head attentional bootstrap learning network (SDABL), including Online-Net and Target-Net. Self-Position Attention Module (SPAM) and adaptive maximum channel attention module (CAAM) are inserted in both paths simultaneously. They captures position and inter-channel attention and of the original feature map with a small number of parameters, solve the information optimization problem of feature maps in SSL. In loss calculations, we discard the construction of negative sample pairs, and instead guide the network to learn the consistency of the location space and channel space by drawing closer to the embedding representation of positive samples continuously. We conducted numerous experiments on the prostate Transrectal ultrasound (TRUS) dataset, experiments show that our SDABL pre-training method has significant advantages over both mainstream contrast learning methods and other attention-based methods. Specifically, the SDABL pre-trained backbone achieves 80.46% accuracy on our TRUS dataset after fine-tuning.

Association of preoperative frailty with pulmonary complications after cardiac surgery in elderly individuals: a prospective cohort study.

BACKGROUND: The relationship between preoperative frailty and pulmonary complications after cardiac surgery in elderly patients is unclear. This study was designed to evaluate the relationship between frailty and postoperative pulmonary complications (PPCs) in elderly patients undergoing cardiac surgery and to provide a basis for their prevention and treatment. AIMS: This study aimed to investigate the predictive value of preoperative frailty on pulmonary complications after cardiac surgery in elderly patients. METHODS: Frailty was assessed using the CAF. The diagnosis of PPCs was based on the criteria defined by Hulzebos et al., and patients were classified into a PPCs group and a non-PPCs group. Factors with clinical significance and P < 0.05 in univariate regression analysis were included in multivariate logistic regression analysis to determine the relationship between preoperative frailty and PPCs. The area under the receiver operating characteristic (ROC) curve (AUC) was used to compare the predictive effects of the CAF, EuroSCORE II, and ASA + age on the occurrence of PPCs. RESULTS: A total of 205 patients were enrolled in this study, 31.7% of whom developed PPCs. Univariate logistic regression analysis showed that frailty, ASA grade, EuroSCORE II, hemoglobin concentration, FVC, time of operation, and postoperative AKI were associated with the development of PPCs. However, after adjustments for all possible confounding factors, multivariate logistic regression results showed that frailty, prolonged operation time, and postoperative AKI were risk factors for PPCs, and the risk of postoperative PPCs in frail patients was approximately 4.37 times that in nonfrail patients (OR = 4.37, 95%CI: 1.6-11.94, P < 0.05). The predictive efficacy of the traditional perioperative risk assessment tools EuroSCORE II and ASA + age was lower than that of CAF. CONCLUSIONS: Frailty before surgery, prolonged operation time, and postoperative AKI were independent risk factors for pulmonary complications after heart surgery in elderly individuals, and CAF was more effective than the traditional risk predictors EuroSCORE II and ASA + age.

An update on the biologics for the treatment of antiphospholipid syndrome.

Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by thrombosis and pregnancy morbidity with the persistent presence of antiphospholipid antibodies (aPLs). Although anticoagulation is the primary treatment for APS, it fails in approximately 20-30% of obstetric APS cases and more than 30% of thrombotic APS cases. Therefore, there is a need for new, targeted treatments beyond anticoagulants. Biologics, such as rituximab and eculizumab, have been recommended for refractory catastrophic APS. This review focuses on the recent advancements in the pathogenesis of APS and explores the potential of targeted treatments, including eculizumab, rituximab, belimumab, daratumumab, obinutuzumab, and anti-TNF-α antibodies, for APS management.