Phage therapy: A renewed approach against oral diseases caused by Enterococcus faecalis infections.

Antibiotics play an important role in the treatment of infectious diseases. Long-term overuse or misuse of antibiotics, however, has triggered the global crisis of antibiotic resistance, bringing challenges to treating clinical infection. Bacteriophages (phages) are the viruses infecting bacterial cells. Due to high host specificity, high bactericidal activity, and good biosafety, phages have been used as natural alternative antibacterial agents to fight against multiple drug-resistant bacteria. Enterococcus faecalis is the main species detected in secondary persistent infection caused by failure of root canal therapy. Due to strong tolerance and the formation of biofilm, E. faecalis can survive the changes in pH, temperature, and osmotic pressure in the mouth and thus is one of the main causes of periapical lesions. This paper summarizes the advantages of phage therapy, its applications in treating oral diseases caused by E. faecalis infections, and the challenges it faces. It offers a new perspective on phage therapy in oral diseases.

Effects of Oxygenation Targets on Mortality in Critically Ill Patients in Intensive Care Units: A Systematic Review and Meta-Analysis.

BACKGROUND: The effects of oxygenation targets (partial pressure of arterial oxygen [Pao2], arterial oxygen saturation [Sao2]/peripheral oxygen saturation [Spo2], or inspiratory oxygen concentration [Fio2] on clinical outcomes in critically ill patients remains controversial. We reviewed the existing literature to assess the effects of lower and higher oxygenation targets on the mortality rates of critically ill intensive care unit (ICU) patients. METHODS: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science databases were searched from their dates of inception to December 31, 2022, for randomized controlled trials (RCTs) comparing lower and higher oxygenation targets for critically ill patients ≥18 years of age undergoing mechanical ventilation, nasal cannula, oxygen mask, or high-flow oxygen therapy in the ICU. Data extraction was conducted independently, and RoB 2.0 software was used to evaluate the quality of each RCT. A random-effects model was used for the meta-analysis to calculate the relative risk (RR). We used the I2 statistic as a measure of statistical heterogeneity. Certainty of evidence was assessed according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines. RESULTS: We included 12 studies with a total of 7416 patients participating in RCTs. Oxygenation targets were extremely heterogeneous between studies. The meta-analysis found no differences in mortality between lower and higher oxygenation targets for critically ill ICU patients (relative risk [RR], 1.00; 95% confidence interval [CI], 0.93-1.09; moderate certainty). The incidence of serious adverse events (RR, 0.93; 95% CI, 0.85-1.00; high certainty), mechanical ventilation-free days through day 28 (mean difference [MD], -0.05; 95%CI, -1.23 to 1.13; low certainty), the number of patients requiring renal replacement therapy (RRT) (RR, 0.96; 95% CI, 0.84-1.10; low certainty), and ICU length of stay (MD, 1.05; 95% CI, -0.04 to 2.13; very low certainty) also did not differ among patients with lower or higher oxygenation targets. CONCLUSIONS: Critically ill ICU patients ≥18 years of age managed with lower and higher oxygenation targets did not differ in terms of mortality, RRT need, mechanical ventilation-free days through day 28, or ICU length of stay. However, due to considerable heterogeneity between specific targets in individual studies, no conclusion can be drawn regarding the effect of oxygenation targets on ICU outcomes.

Improving Cardiorespiratory and Muscular Function of Korean Firefighters: A Kinect-Based Mixed Reality Device Exercise Intervention Randomized Control Trial.

OBJECTIVE: This study addresses declining physical fitness among Korean firefighters due to a low exercise participation rate caused by the absence of exercise instructors. The research explores Virtual Mate (VM), a Kinect-based mixed reality device, as a potential solution, but its capacity to replace training instructors in enhancing physical fitness remains uncertain. METHODS: Twenty Korean male firefighters were divided into two groups: the exercise group received an 8-week intervention using VM, while the control group maintained regular physical activity. Cardiopulmonary function and muscle function were measured. RESULTS: After 8 weeks, the exercise group demonstrated a significant improvement in VO 2peak . Furthermore, there were notable enhancements in the strength and endurance of most knee, shoulder, and trunk flexors and extensors. CONCLUSIONS: Integrating VM into an exercise program can effectively improve cardiorespiratory and muscular function in Korean firefighters.

A novel holin from an Enterococcus faecalis phage and application in vitro and in vivo.

Enterococcus faecalis, a conditional pathogenic bacterium, is prevalent in the intestinal, oral, and reproductive tracts of humans and animals, causing a variety of infectious diseases. E. faecalis is the main species detected in secondary persistent infection from root canal therapy failure. Due to the abuse of antibacterial agents, E. faecalis has evolved its resistant ability. Therefore, it is difficult to treat clinical diseases infected by E. faecalis. Exploring new alternative drugs for treating E. faecalis infection is urgent. We cloned and expressed the gene of phage holin, purified the recombinant protein, and analyzed the antibacterial activity, lysis profile, and ability to remove bacterial biofilm. It showed that the crude enzyme of phage holin pEF191 exhibited superior bacterial inhibiting activity and a broader lysis host range compared to the parent phage PEf771. In addition, pEF191 demonstrated high efficacy in eliminating E. faecalis biofilm. The therapeutic results of the Sprague-Dawley (SD) rats model infected showed that pEf191 did not affect SD rats, indicating that pEF191 provided greater protection against E. faecalis infection in SD rats. Based on the 16 S rDNA data of SD rats intestinal microorganism population, holin pEF191 exhibited no impact on the diversity of intestinal microorganisms at the phylum and genus levels and improved the relative abundance of favorable bacteria. Thus, pEF191 may serve as a promising alternative to antibiotics in the management of E. faecalis infection.

Exercise intensity impacts the improvement of metabolic dysfunction-associated steatotic liver disease via variations of monoacylglycerol O-acyltransferase 1 expression.

BACKGROUND: The involvement of monoacylglycerol O-acyltransferase 1 (MOGAT1) in the pathogenesis of metabolic dysfunction-associated steatotic liver disease (MASLD) has been recognized. While exercise is recommended for the improvement of obesity and MASLD, the impact of exercise intensity remains unclear. This study aimed to examine the influence of exercise intensity on MOGAT1 expression in high-fat diet (HFD)-induced obese mice with MASLD. METHOD: Male C57BL/6 mice aged 6 weeks were subjected to either a regular or HFD with 60 % fat content for 8 weeks. The mice were categorized into 5 groups based on their diet and exercise intensity: normal diet group (ND), HFD group, low-intensity exercise with HFD group (HFD+LIE), moderate-intensity exercise with HFD group (HFD+MIE), and high-intensity exercise (HIE) with HFD group (HFD+HIE). The duration of running was adjusted to ensure uniform exercise load across groups (total distance = 900 m): HFD+LIE at 12 m/min for 75 min, HFD+MIE at 15 m/min for 60 min, and HFD+HIE at 18 m/min for 50 min. RESULTS: Lipid droplet size and MASLD activity score were significantly lower in the HFD+HIE group compared to other exercise-intensity groups (p < 0.05). Among the 3 intensity exercise groups, the lowest MOGAT1 protein expression was found in the HFD+HIE group (p < 0.05). CONCLUSION: This study reveals that high-intensity exercise has the potential to mitigate MASLD development, partly attributed to the downregulation of MOGAT1 expression.

Management of a nursing unit in a COVID-19 shelter hospital in China: A case study.

OBJECTIVE: Fangcang shelter hospital is a form of large temporary hospital developed in China to tackle public health events. Through the case study and analysis of managing a nursing unit in a huge Fangcang shelter hospital transformed from the National Exhibition and Convention Center during the Omicron wave in Shanghai, China between April 9, 2022 and May 24, 2022, this paper aimed to highlight critical implications of public health nurses in health emergencies. DESIGN: A case study was conducted using data collected from a nursing unit with 570 beds. The five characteristics of management were organized as follows: human resource management, establishment and optimization of the core workflow, safety management of high-risk patients, the grid cooperation mechanism with patient volunteers, as well as humanistic nursing. RESULTS: Analysis of the data of the nursing unit indicated close team cooperation, efficient and orderly process scheduling, good outcomes of patients, and the indispensable role of volunteers. CONCLUSION: Practice indicated that nursing unit management in a large Fangcang shelter hospital is important to ensure medical order and efficiency. This practical experience can provide valuable reference and data to support for the nursing management of large-scale public health events, such as infectious disease epidemics.

Generation of Reactive Nitrogen Species in UV Photolysis of Dichloramine and Their Incorporation into Nitrogenous Byproducts.

Dichloramine (NHCl2) often coexists with monochloramine (NH2Cl) in reverse osmosis (RO) permeate in potable reuse scenarios when NH2Cl is added upstream of RO for membrane fouling control such that UV photolysis of NHCl2 occurs during the downstream UV/chloramine process. However, the formation of reactive nitrogen species (RNS) and their incorporation into byproducts during the UV/NHCl2 process are largely unknown. This study quantitatively evaluated the generation of RNS in the UV/NHCl2 process and investigated the role of RNS in micropollutant transformation. UV photolysis of NHCl2 produced comparable RNS concentration to that of NH2Cl at the same oxidant dosage (100 µM) at pH 5.5. Under the experimental conditions, the RNS contributed greatly (40.6%) to N,N-diethyl-3-methylbenzamide (DEET) degradation. By using 15N-labeling and mass spectrometry methods, seven nitrogenous byproducts of DEET degradation with the incorporation of nitrogen originating from the RNS were detected. Among these seven byproducts, six were identified to contain a nitro group (-NO2). While the UV/NHCl2 process formed comparable intensities of -NO-containing products to those in the UV/NH2Cl process, the later process formed 3-91% higher intensities of -NO2-containing products. These findings are essential in furthering our understanding of the contribution of the UV/NHCl2 process in potable reuse scenarios.

Facile hydrothermal synthesis of N-doped fluorescent carbon dots for selective detection of insecticide parathion.

Pesticides are enormously important to industry requirements and in agriculture for improving yields. Parathion is widely used to control pests in vegetables, fruits, and flowers. However, excessive use of parathion poses a threat to food safety, the environment, and human health. Due to low cost, ease to use, and high selectivity and sensitivity, a fluorescent nanoprobe is a candidate for parathion detection. Blue fluorescent carbon dots were prepared by a hydrothermal method with rutinum and o-phenylenediamine as precursors. The Rut-CDs were purified by using dialysis, thin layer chromatography, and a chromatographic column. Excellent linear ranges of 0-7.5 µg L-1 and 12.5-62.5 µg L-1 parathion were obtained with a low detection limit of 0.11 ng mL-1. In addition, the quenching mechanism of parathion to the fluorescence of Rut-CDs was illuminated. Furthermore, the nanoprobe was efficiently applied to determine the parathion content in Chinese cabbage, cantaloupe, and cowpea samples. It shows great potential to detect parathion.

Reactions of Monobromamine and Dibromamine with Phenolic Compounds and Organic Matter: Kinetics and Formation of Bromophenols and Bromoform.

Monobromamine (NH2Br) and dibromamine (NHBr2) produced from reactions of hypobromous acid (HOBr) with ammonia can react with phenolic structures of natural organic matter (NOM) to produce disinfection byproducts such as bromoform (CHBr3). The reactivity of NH2Br was controlled by the reaction of the bromoammonium ion (NH3Br+) with phenolate species, with specific rate constants ranging from 6.32 × 102 for 2,4,6-tribromophenol to 1.22 × 108 M-1 s-1 for phenol. Reactions of NHBr2 with phenol and bromophenols were negligible compared to its self-decomposition; rate constants could be determined only with resorcinol for pH > 7. At pH 8.1-8.2, no formation of CHBr3 was observed from the reaction of NH2Br with phenol while the reaction of NH2Br with resorcinol produced a significant concentration of CHBr3. In contrast to NH2Br, a significant amount of CHBr3 produced with an excess of NHBr2 over phenol was explained by the reactions of HOBr produced from NHBr2 decomposition. A comprehensive kinetic model including the formation and decomposition of bromamines and the reactivity of HOBr and NH2Br with phenolic compounds was developed at pH 8.0-8.3. Furthermore, the kinetic model was used to evaluate the significance of the NH2Br and NHBr2 reactions with the phenolic structures of two NOM isolates.

Evaluating UV254 absorbance reductions in landfill leachate for municipal sewage co-treatment through timed UV/electrooxidation.

Landfill leachate contains dissolved organic matter (DOM) exhibiting high ultraviolet absorbance at 254 nm (UVA254). The UVA254 limits leachate co-treatment with municipal sewage by hindering the downstream UV disinfection efficiency at wastewater treatment plants. Here, we alleviated the UVA254 by timing the radiation in a UV/electrooxidation (UV/EO) process to accelerate reactive species formation. At 200 A·m-2, the UV radiation was delayed by 10 min to accumulate 21 mg·L-1 as Cl2, which enhanced the initial radical formation rate by 5.25 times compared with a simultaneous UV/EO. The timed operation increased the steady-state concentrations of ClO• by 700 times to 4.11 × 10-14 M and reduced the leachate UVA254 by 78.2% after 60 min. We identified that aromatic formulas with low oxygen content were susceptible to UV/EO from Fourier-transform ion cyclotron resonance mass spectrometry analysis. The toxicity of the treated leachate and generated byproducts was assessed through specific oxygen uptake rates (SOUR) and developmental assays with Platynereis dumerilii. After quenching the residual chlorine, leachate co-treatment at 3.5% v/v presented minimal toxicological risk. Our findings provide operational insights for applying UV/EO in high UVA254 matrices such as landfill leachate.

Emerging roles of histone deacetylases in adaptive thermogenesis.

Brown and beige adipose tissues regulate body energy expenditure through adaptive thermogenesis, which converts energy into heat by oxidative phosphorylation uncoupling. Although promoting adaptive thermogenesis has been demonstrated to be a prospective strategy for obesity control, there are few methods for increasing adipose tissue thermogenesis in a safe and effective way. Histone deacetylase (HDAC) is a category of epigenetic modifying enzymes that catalyzes deacetylation on both histone and non-histone proteins. Recent studies illustrated that HDACs play an important role in adipose tissue thermogenesis through modulating gene transcription and chromatin structure as well as cellular signals transduction in both deacetylation dependent or independent manners. Given that different classes and subtypes of HDACs show diversity in the mechanisms of adaptive thermogenesis regulation, we systematically summarized the effects of different HDACs on adaptive thermogenesis and their underlying mechanisms in this review. We also emphasized the differences among HDACs in thermogenesis regulation, which will help to find new efficient anti-obesity drugs targeting specific HDAC subtypes.

Development of the Korean Firefighter Performance Battery: Job-Related Physical Fitness Assessment.

OBJECTIVE: The Candidate Physical Capability Test (CPAT) has been used in many countries to assess the fitness levels of firefighters, but it requires a special facility with a space of at least 900 square m 2 and expensive equipment. Because it can be difficult to have both money and space at smaller gas stations, we have developed the Korean Firefighter Performance Battery (KFPB). METHODS: To verify the validity and reliability of the developed KFPB, this study consists of three parts, a validation test, reliability test, and evaluation criterion. RESULTS: As a result of the analysis, the KFPB met all of the criteria as a valid evaluation. Furthermore, the KFPB seems to compensate for the shortcomings of CPAT. CONCLUSIONS: In locations where the CPAT is difficult to administer, the KFPB is expected to be used as a firefighting job-related physical fitness evaluation.

Biogeochemical sulfur cycling of virus auxiliary metabolic genes involved in Napahai plateau wetland.

Virus plays important roles in regulating microbial community structure, horizontal gene transfer, and promoting biological evolution, also augmenting host metabolism during infection via the expression of auxiliary metabolic genes (AMGs), and thus affect biogeochemical cycling in the oceans. As the "kidney of the earth," wetlands have rich biodiversity and abundant resources. Based on metagenomic data, 10 AMGs associated with sulfur cycling, i.e., tusA, moaD, dsrE, soxA, soxB, soxC, soxD, soxX, soxY, and soxZ, were analyzed in Napahai plateau wetland. The phylogenetic trees of AMGs involved in sulfur metabolism from different habitats and host origins were constructed. Combined with principal coordinate analysis, it revealed that most AMGs associated with sulfur metabolism clustered separately, indicating the abundance and uniqueness in this region. The sulfur metabolism pathways involved by AMGs were mainly SOX systems, among which sulfur oxidation was associated with moaD and dsrE genes, while sulfur transport was related to tusA genes. It provides an insight into the biogeochemical sulfur cycling in plateau wetlands and lays the foundation for further study on the co-evolution of virus and host.

UV/chlorine and chlorination of effluent organic matter fractions: Tracing nitrogenous DBPs using FT-ICR mass spectrometry.

UV/chlorine process is a promising advanced treatment to eliminate pathogen and remove refractory micropollutants for reclamation of municipal secondary effluent. However, effluent organic matter (EfOM) featuring high organic nitrogen content serves as a potential precursor for nitrogenous disinfection byproducts (N-DBPs) of health concern. The molecular-level alteration of a hydrophobic (HPO) EfOM fraction and a transphilic (TPI) EfOM fraction isolated from the same municipal effluent and the formation of N-DBPs in the UV/chlorine were tracked by ultrahigh-resolution mass spectrometry. Compared with chlorination, UV/chlorine induced a significantly greater modification on the molecular composition of EfOM and resulted in formation of unique formulae and chlorinated molecules with higher degree of oxidation, lower aromaticity, and less carbon number due to the involvement of reactive radical species. For both EfOM fractions, UV/chlorine formed more diverse DBPs with higher intensity and Cl-incorporation than chlorination. The TPI fraction of EfOM characterized by higher O/C and N/C ratios generated more N-DBPs with higher intensity clustered in the high O/C region than the HPO fraction of EfOM by both UV/chlorine and chlorination. Totally, 207 and 117 nitrogen-containing chlorinated formulae were recorded after UV/chlorine treatment of TPI and HPO, respectively. Precursor tracking found a greater number of DBPs were originated from raw EfOM through electrophilic substitution pathway rather than chlorine addition. Toxicity bioassays demonstrated that DBPs can trigger oxidative stress-induced DNA damage, while HPO fraction of EfOM dominated the induction of cytotoxicity. However, no correlation could be established between the diversity/abundance of N-DBPs and the level of DNA damage. A total of 22 DBPs with a significant rank correlation with DNA damage were identified, while C8H6O5NCl was found as the N-DBP with the strongest correlation. The potential toxic chlorine-containing formula with the most abundant intensity was assigned to C5HO3Cl3. This study suggests that the character and transformation of EfOM and associated toxicity is critical to evaluate the UV/chlorine process toward practical application.

Role of UV-based advanced oxidation processes on NOM alteration and DBP formation in drinking water treatment: A state-of-the-art review.

Oxidative treatment of drinking water has been practiced for more than a century. UV-based advanced oxidation processes (UV-AOPs) have emerged as promising oxidative treatment technologies to eliminate recalcitrant chemicals and biological contaminants in drinking water. UV-AOPs inevitably alter the properties of natural organic matter (NOM) and affect the disinfection byproduct (DBP) formation in the post-disinfection. This paper provides a state-of-the-art review on the effects of UV-AOPs on the changes of NOM properties and the consequent impacts on DBP formation in the post-chlorination process. A tutorial review to the connotations of NOM properties (e.g., bulk properties, fractional constituents, and molecular structures) and the associated state-of-the-art analytical methods are firstly presented. The impacts of different radical-based AOPs on the changes of NOM properties together with the underlying NOM-radical reaction mechanisms are discussed. The impacts of alteration of NOM properties on DBP formation in the post-chlorination process are then reviewed. The current knowledge gaps and future research needs are finally presented, with emphases on the needs to strengthen the comparability of research data in literature, the accuracy in quantifying the reactive moieties of NOM, and the awareness of unknown DBPs in oxidative water treatment processes. The review and discussion improve the fundamental understanding of NOM-radical and NOM-chlorine chemistry. They also provide useful implications on the engineering design and operation of next-generation drinking water treatment plants.

Dominant Dissolved Oxygen-Independent Pathway to Form Hydroxyl Radicals and the Generation of Reactive Chlorine and Nitrogen Species in Breakpoint Chlorination.

Due to the complexities of the interactions between ammonia, chlor(am)ine, and intermediate species such as ONOOH, the radical formation in breakpoint chlorination and the consequential removal of micropollutants remain largely unexplored. In this study, the dominant generation pathway of HO•, as a primary radical in breakpoint chlorination, was examined, and the generations of HO•, reactive chlorine species (RCS), and reactive nitrogen species (RNS) were quantitatively evaluated. A dissolved oxygen (DO)-independent pathway was verified by 18O labeling and contributed over 90% to HO• generation. The commonly believed pathway, the decomposition of ONOOH involving DO, contributed only 7% to HO• formation in breakpoint chlorination. The chlorine to nitrogen (Cl/N) ratio and pH greatly affected the generations and speciations of the reactive species. An optimum Cl/N mass ratio for HO•, Cl2•-, and RNS generations occurred at the breakpoint (i.e., Cl/N mass ratio = 9), whereas excessive free chlorine shifted the radical speciation toward ClO• at Cl/N mass ratios above the breakpoint. Basic conditions inhibited the generations of HO• and RNS but significantly promoted that of ClO•. These findings improved the fundamental understanding of the radical chemistry of breakpoint chlorination, which can be extended to estimate the degradations of micropollutants of known rate constants toward the reactive species with influences from the Cl/N ratio and pH in real-world applications.

Facile hydrothermal synthesis and purification of fluorescent carbon dots for food colorant tartrazine detection based on a dual-mode nanosensor.

Colorant tartrazine is widely used in the food industry, but its long-term and excessive consumption is harmful to human health. Therefore, it is necessary to establish a sensitive detection method for tartrazine. Blue fluorescent carbon dots with L-arginine and o-phenylenediamine as precursors, namely L-Arg/oPD-CDs, were prepared via the hydrothermal method. Then, L-Arg/oPD-CDs were further purified by dialysis, thin layer chromatography and column chromatography. A dual-mode nanosensor based on fluorescent and UV absorption was successfully developed. Excellent linear ranges of 0-5 µM and 10-50 µM were obtained with a low detection limit of 42.3 nM based on fluorescence. A good linear range of 0-50 µM was obtained with a low detection limit of 130.15 nM based on UV absorption. The quenching mechanism of tartrazine towards L-Arg/oPD-CDs fluorescence was the inner filter effect. In addition, a dual-mode nanosensor was used for tartrazine determination in millet, maize flour, carbonated drink, and sugar samples. This study provides new insight into the detection of tartrazine by applying a dual-mode nanosensor.

Comparison of the effect of double-lumen endotracheal tubes and bronchial blockers on lung collapse in video-assisted thoracoscopic surgery: a systematic review and meta-analysis.

OBJECTIVE: This meta-analysis compared the quality of lung collapse and the resultant adverse reactions between the use of double-lumen endotracheal tubes (DLT) and bronchial blockers (BB) in minimally invasive thoracic surgery. METHODS: A search was performed in five bibliographic databases, namely PubMed, Springer, Medline, EMBASE, and Cochrane Library ignoring the original language, which identified five randomized controlled trials (RCTs) published on or before December 31, 2021. These studies were subsequently analyzed. All included studies compared the efficacy and safety of DLT and BB as a lung isolation technique in surgery. The methodological quality of each study was assessed by the Cochrane Collaboration's risk of bias tool. The quality of lung collapse and the malposition rate were adopted as the main outcome indicators. Alternatively, the intubation time and the incidence of postoperative sore throat were adopted as secondary indicators. RESULTS: When either DLT or BB were utilized in minimally invasive thoracic surgery, no differences were observed in the quality of lung collapse (odds ratio [OR], 1.00; 95% confidence interval [CI], 0.63 to 1.58), the intubation time (mean difference [MD], 0.06; 95% CI, -1.02 to 1.14), or the malposition rate (OR, 0.88; 95% CI, 0.37 to 2.06). However, the incidence of postoperative sore throat among patients treated with BB was significantly lower than that among patients treated with DLT (OR, 5.25; 95% CI, 2.55 to 10.75). CONCLUSION: When utilized in minimally invasive thoracic surgery, the quality of lung collapse with DLT was identical to that with BB. However, patients treated with the latter demonstrated a significantly lower incidence of postoperative sore throat.

Development and Validation of a Nomogram for Predicting Postoperative Pulmonary Infection in Patients Undergoing Lung Surgery.

OBJECTIVES: To develop and validate a nomogram for predicting postoperative pulmonary infection (PPI) in patients undergoing lung surgery. DESIGN: Single-center retrospective cohort analysis. SETTING: A university-affiliated cancer hospital PARTICIPANTS: A total of 1,501 adult patients who underwent lung surgery from January 2018 to December 2020. INTERVENTIONS: Observation for PPI within 7 days after lung surgery. MEASUREMENTS AND MAIN RESULTS: A complete set of demographics, preoperative variables, and postoperative follow-up data was recorded. The primary outcome was PPI; a total of 125 (8.3%) out of 1,501 patients developed PPI. The variables with p < 0.1 in univariate logistic regression were included in the multivariate regression, and multivariate logistic regression analysis showed that surgical procedure, surgical duration, the inspired fraction of oxygen in one-lung ventilation, and postoperative pain were independent risk factors for PPI. A nomogram based on these factors was constructed in the development cohort (area under the curve: 0.794, 95% CI 0.744-0.845) and validated in the validation cohort (area under the curve: 0.849, 95% CI 0.786-0.912). The calibration slope was 1 in the development and validation cohorts. Decision curve analysis indicated that when the threshold probability was within a range of 0.02-to-0.58 and 0.02-to-0.42 for the development and validation cohorts, respectively, the nomogram model could provide a clinical net benefit. CONCLUSIONS: The authors developed and validated a nomogram for predicting PPI in patients undergoing lung surgery. The prediction model can predict the development of PPI and identify high-risk groups.

Increased Serum VEGF-B Level Is Associated With Renal Function Impairment in Patients With Type 2 Diabetes.

Aims/Introduction: Renal function impairment related to type 2 diabetes (T2DM) presents serious threat to public health. Previous studies suggest that vascular endothelial growth factor-B (VEGF-B) might contribute to renal injury. Therefore, this study investigated the association of serum VEGF-B level with the risk of renal function impairment in T2DM patients. Materials and Methods: Serum VEGF-B levels were measured in 213 patients with type 2 diabetes and 31 healthy participants. Participants with type 2 diabetes were further divided into a group of 112 participants with eGFR<90 mL/min/1.73m2 and 101 participants with eGFR≥ 90 mL/min/1.73m2. Clinical data were collected, and a binary logistic regression model was employed to test the association between potential predictors and eGFR. Results: Serum VEGF-B levels evaluated in type 2 diabetes patients compared with healthy controls. In patients with type 2 diabetes, serum VEGF-B level was positively correlated with triglyceride, serum creatinine and cystatin C while negatively correlated with HDL-C and eGFR. Binary logistic regression showed that serum VEGF-B level was an independent risk factor of eGFR<90 mL/min/1.73m2. Conclusions: Serum VEGF-B level is associated with renal function impairment in patients with type 2 diabetes and may be a potential drug target for diabetic kidney disease.