Sildenafil improves hemodynamic changes caused by acute pulmonary embolism by inhibiting Rho kinase activity.

OBJECTIVE: This study examined the effects of sildenafil on acute pulmonary embolism (APE) using a rat model. METHODS: Sprague-Dawley rats were randomly divided into the sham, pulmonary thromboembolism (PTE), and sildenafil groups. The sham and PTE groups received normal saline once daily via gavage for 14 consecutive days, whereas the sildenafil group received sildenafil (0.5 mg/kg/day) once daily via gavage for 14 consecutive days. Autologous emboli were prepared from blood samples collected from the left femoral artery of rats in each group on day 13, and autologous emboli were injected into the jugular vein cannula of rats in the PTE and sildenafil groups on day 14. Sham-treated rats received the same volume of saline. Right systolic ventricular pressure (RVSP) and mean pulmonary arterial pressure (MPAP) were used to assess pulmonary embolism, and western blotting and enzyme-linked immunosorbent assay were used to detect relevant markers. RESULTS: The Rho kinase signaling pathway was significantly activated in rats with APE, and sildenafil significantly inhibited this activation. CONCLUSIONS: Sildenafil protected against APE through inhibiting Rho kinase activity, thereby reducing pulmonary vasoconstriction and decreasing elevated pulmonary arterial pressure. These findings might provide new ideas for the clinical treatment of acute pulmonary thromboembolism.

UniChest: Conquer-and-Divide Pre-training for Multi-Source Chest X-Ray Classification.

Vision-Language Pre-training (VLP) that utilizes the multi-modal information to promote the training efficiency and effectiveness, has achieved great success in vision recognition of natural domains and shown promise in medical imaging diagnosis for the Chest X-Rays (CXRs). However, current works mainly pay attention to the exploration on single dataset of CXRs, which locks the potential of this powerful paradigm on larger hybrid of multi-source CXRs datasets. We identify that although blending samples from the diverse sources offers the advantages to improve the model generalization, it is still challenging to maintain the consistent superiority for the task of each source due to the existing heterogeneity among sources. To handle this dilemma, we design a Conquer-and-Divide pre-training framework, termed as UniChest, aiming to make full use of the collaboration benefit of multiple sources of CXRs while reducing the negative influence of the source heterogeneity. Specially, the "Conquer" stage in UniChest encourages the model to sufficiently capture multi-source common patterns, and the "Divide" stage helps squeeze personalized patterns into different small experts (query networks). We conduct thorough experiments on many benchmarks, e.g., ChestX-ray14, CheXpert, Vindr-CXR, Shenzhen, Open-I and SIIM-ACR Pneumothorax, verifying the effectiveness of UniChest over a range of baselines, and release our codes and pre-training models at https://github.com/Elfenreigen/UniChest.

The proliferation of beneficial bacteria influences the soil C, N, and P cycling in the soybean-maize intercropping system.

Soybean-maize intercropping system can improve the utilization rate of farmland and the sustainability of crop production systems. However, there is a significant gap in understanding the interaction mechanisms between soil carbon (C), nitrogen (N), and phosphorus (P) cycling functional genes, rhizosphere microorganisms, and nutrient availability. To reveal the key microorganisms associated with soil nutrient utilization and C, N, and P cycling function in the soybean-maize intercropping system, we investigated the changes in soil properties, microbial community structure, and abundance of functional genes for C, N, and P cycling under soybean-maize intercropping and monocropping at different fertility stages in a pot experiment. We found that there was no significant difference in the rhizosphere microbial community between soybean-maize intercropping and monocropping at the seeding stage. As the reproductive period progressed, differences in microbial community structure between intercropping and monocropping gradually became significant, manifesting the advantages of intercropping. During the intercropping process of soybean and maize, the relative abundance of beneficial bacteria in soil rhizosphere significantly increased, particularly Streptomycetaceae and Pseudomonadaceae. Moreover, the abundances of C, N, and P cycling functional genes, such as abfA, mnp, rbcL, pmoA (C cycling), nifH, nirS-3, nosZ-2, amoB (N cycling), phoD, and ppx (P cycling), also increased significantly. Redundancy analysis and correlation analysis showed that Streptomycetaceae and Pseudomonadaceae were significantly correlated with soil properties and C, N, and P cycling functional genes. In brief, soybean and maize intercropping can change the structure of microbial community and promote the proliferation of beneficial bacteria in the soil rhizosphere. The accumulation of these beneficial bacteria increased the abundance of C, N, and P cycling functional genes in soil and enhanced the ability of plants to fully utilize environmental nutrients and promoted growth.

Locating X-Ray Coronary Angiogram Keyframes via Long Short-Term Spatiotemporal Attention With Image-to-Patch Contrastive Learning.

Locating the start, apex and end keyframes of moving contrast agents for keyframe counting in X-ray coronary angiography (XCA) is very important for the diagnosis and treatment of cardiovascular diseases. To locate these keyframes from the class-imbalanced and boundary-agnostic foreground vessel actions that overlap complex backgrounds, we propose long short-term spatiotemporal attention by integrating a convolutional long short-term memory (CLSTM) network into a multiscale Transformer to learn the segment- and sequence-level dependencies in the consecutive-frame-based deep features. Image-to-patch contrastive learning is further embedded between the CLSTM-based long-term spatiotemporal attention and Transformer-based short-term attention modules. The imagewise contrastive module reuses the long-term attention to contrast image-level foreground/background of XCA sequence, while patchwise contrastive projection selects the random patches of backgrounds as convolution kernels to project foreground/background frames into different latent spaces. A new XCA video dataset is collected to evaluate the proposed method. The experimental results show that the proposed method achieves a mAP (mean average precision) of 72.45% and a F-score of 0.8296, considerably outperforming the state-of-the-art methods. The source code is available at https://github.com/Binjie-Qin/STA-IPCon.

Specifying the Starting Point for S1 Iliosacral Screw Placement in the Dysmorphic Sacrum.

BACKGROUND: Sacral dysmorphism is not uncommon and complicates S1 iliosacral screw placement partially because of the difficulty of determining the starting point accurately on the sacral lateral view. We propose a method of specifying the starting point. METHODS: The starting point for the S1 iliosacral screw into the dysmorphic sacrum was specifically set at a point where the ossification of the S1/S2 intervertebral disc (OSID) intersected the posterior vertebral cortical line (PVCL) on the sacral lateral view, followed by guidewire manipulation and screw placement on the pelvic outlet and inlet views. Computer-simulated virtual surgical procedures based on pelvic computed tomography (CT) data on 95 dysmorphic sacra were performed to determine whether the starting point was below the iliac cortical density (ICD) and in the S1 oblique osseous corridor and to evaluate the accuracy of screw placement (with 1 screw being used, in the left hemipelvis). Surgical procedures on 17 patients were performed to verify the visibility of the OSID and PVCL, to check the location of the starting point relative to the ICD, and to validate the screw placement safety as demonstrated with postoperative CT scans. RESULTS: In the virtual surgical procedures, the starting point was consistently below the ICD and in the oblique osseous corridor in all patients and all screws were Grade 1. In the clinical surgical procedures, the OSID and PVCL were consistently visible and the starting point was always below the ICD in all patients; overall, 21 S1 iliosacral screws were placed in these 17 patients without malpositioning or iatrogenic injury. CONCLUSIONS: On the lateral view of the dysmorphic sacrum, the OSID and PVCL are visible and intersect at a point that is consistently below the ICD and in the oblique osseous corridor, and thus they can be used to identify the starting point. LEVEL OF EVIDENCE: Therapeutic Level III . See Instructions for Authors for a complete description of levels of evidence.

Effect of miR-206 on lower limb ischemia-reperfusion injury in rat and its mechanism.

Lower limb ischemia-reperfusion is a common pathological process during clinical surgery. Because lower limb ischemia-reperfusion usually aggravates ischemia-induced skeletal muscle tissue injury after lower limb ischemia-reperfusion, it also causes remote organ heart, intestine, liver, lung and other injuries, and there is no effective clinical treatment for lower limb ischemia-reperfusion injury, so it is urgent to study its injury mechanism. In this study, the rat model of lower limb ischemia-reperfusion was established by clamping the femoral artery with microarterial clips, and the wall destruction such as intimal injury, cell edema, collagen degeneration, neutrophil infiltration, and elastic fiberboard injury of the femoral artery wall was detected. The expression of inflammatory factors was detected by immunohistochemistry. miR-206 preconditioning was used to observe the expression of inflammatory factors, redox status and apoptosis in the vascular wall of rats after acute limb ischemia-reperfusion. Our findings suggest that vascular endothelial cell edema increases, wall thickening, neutrophil infiltration, and elastic fiber layer damage during IRI. Inflammatory factor expression was increased in femoral artery tissue, and miR-206 expression levels were significantly down-regulated. Further studies have found that miR-206 attenuates lower limb IRI by regulating the effects of phase inflammatory factors. In this study, we investigated the effect of miR-206 on inflammatory factors and its possible role in the development of lower limb IRI, providing new research ideas for the regulatory mechanism of lower limb IRI, and providing a certain theoretical basis for the treatment of lower limb ischemia-reperfusion injury after surgery or endovascular intervention.

Optogenetic induction of caspase-8 mediated apoptosis by employing Arabidopsis cryptochrome 2.

Apoptosis, a programmed cell death mechanism, is a regulatory process controlling cell proliferation as cells undergo demise. Caspase-8 serves as a pivotal apoptosis-inducing factor that initiates the death receptor-mediated apoptosis pathway. In this investigation, we have devised an optogenetic method to swiftly modulate caspase-8 activation in response to blue light. The cornerstone of our optogenetic tool relies on the PHR domain of Arabidopsis thaliana cryptochrome 2, which self-oligomerizes upon exposure to blue light. In this study, we have developed two optogenetic approaches for rapidly controlling caspase-8 activation in response to blue light in cellular systems. The first strategy, denoted as Opto-Casp8-V1, entails the fusion expression of the Arabidopsis blue light receptor CRY2 N-terminal PHR domain with caspase-8. The second strategy, referred to as Opto-Casp8-V2, involves the independent fusion expression of caspase-8 with the PHR domain and the CRY2 blue light-interacting protein CIB1 N-terminal CIB1N. Upon induction with blue light, PHR undergoes aggregation, leading to caspase-8 aggregation. Additionally, the blue light-dependent interaction between PHR and CIB1N also results in caspase-8 aggregation. We have validated these strategies in both HEK293T and HeLa cells. The findings reveal that both strategies are capable of inducing apoptosis, with Opto-Casp8-V2 demonstrating significantly superior efficiency compared to Opto-Casp8-V1.

Research progress in biological control of tomato bacterial wilt.

Bacterial wilt caused by the infection of Ralstonia solanacearum, is one of the most harmful diseases to tomatoes, one of the most important greenhouse vegetables in China. R. solanacearum can survive and remain active in the deep soil for a long time, and the chemical control of tomato bacterial wilt is consequently limited. In this study, we introduced the characteristics of tomato bacterial wilt disease and the types of R. solanacearum, and systematically reviewed the research progresses of biological control methods from the aspects of botanical insecticides, agricultural antibiotics, biocontrol bacteria. We emphatically introduced the principle and current status of these methods, discussed the limitations and the improvement strategies, and prospected a new environmental protection and efficient biological control system based on micro-ecological regulation would be the development direction of biological control of tomato bacterial wilt.

Simulation and Experimentation of a Grounding Network Detection Scheme Based on a Low-Frequency Electromagnetic Method.

The grounding network is a significant component of substations, and the corrosion of its ground resistance is predominantly detected using the electromagnetic method. However, the application of electromagnetic methods for detecting corrosion within earthing networks has received relatively limited attention in research. Currently, the prevailing method utilizes electromagnetic techniques to identify the breakage points within the given earthing network. In this study, we propose a corrosion detection method for grounding networks based on the low-frequency electromagnetic method, which measures the resistance value between individual nodes of the network. Specifically, an excitation source signal of a predetermined frequency was transmitted to the measurement segment of the grounding network, which facilitated the direct measurement of the strength of the induced magnetic field above the center of the measuring conductor. The recorded electromagnetic data were subsequently uploaded to the host computer for data processing, and the computer interface was constructed based on a LABVIEW design. By leveraging the relationship between the induced electric potential, current strength, excitation source strength, and additional voltage detection devices, the resistance of the conductor under examination could be determined. Furthermore, the proposed method was tested under suitable conditions, and it demonstrated favorable results. Thus, the proposed method can serve as a foundation for developing electromagnetic testing instruments tailored to the investigated grounding network.

Enhanced Thermoelectric Properties of Nb-Doped Ti(FeCoNi)Sb Pseudo-Ternary Half-Heusler Alloys Prepared Using the Microwave Method.

Pseudo-ternary half-Heusler thermoelectric materials, which are formed by filling the B sites of traditional ternary half-Heusler thermoelectric materials of ABX with equal atomic proportions of various elements, have attracted more and more attention due to their lower intrinsic lattice thermal conductivity. High-purity and relatively dense Ti1-xNbx(FeCoNi)Sb (x = 0, 0.01, 0.03, 0.05, 0.07 and 0.1) alloys were prepared via microwave synthesis combined with rapid hot-pressing sintering, and their thermoelectric properties are investigated in this work. The Seebeck coefficient was markedly increased via Nb substitution at Ti sites, which resulted in the optimized power factor of 1.45 µWcm-1K-2 for n-type Ti0.93Nb0.07(FeCoNi)Sb at 750 K. In addition, the lattice thermal conductivity was largely decreased due to the increase in phonon scattering caused by point defects, mass fluctuation and strain fluctuation introduced by Nb-doping. At 750 K, the lattice thermal conductivity of Ti0.97Nb0.03(FeCoNi)Sb is 2.37 Wm-1K-1, which is 55% and 23% lower than that of TiCoSb and Ti(FeCoNi)Sb, respectively. Compared with TiCoSb, the ZT of the Ti1-xNbx(FeCoNi)Sb samples were significantly increased. The average ZT values of the Nb-doped pseudo-ternary half-Heusler samples were dozens of times that of the TiCoSb prepared using the same process.

Treatment of Anterior Dislocation of the Sacroiliac Joint via the Lateral-rectus Approach: Surgical Techniques and Preliminary Outcomes.

OBJECTIVE: Anterior dislocation of the sacroiliac joint (ADSIJ) is caused by strong violence, and because of its low morbidity, there are no standardized diagnostic and therapeutical guidelines at this moment. This study aims to explore the surgical techniques and preliminary outcomes of the lateral-rectus approach (LRA) for treating ADSIJ. METHODS: A retrospective study was conducted of 15 patients with ADSIJ from January 2016 to January 2021. The patients' age ranged from 1.8 years old to 57 years old (37 ± 18 years old). All patients underwent open reduction and internal fixation (ORIF) through the LRA. Eight patients were combined with lumbosacral plexus injury and underwent neurolysis during operation. Patients' fracture type, mechanism of injury, associated injuries, operation time and intraoperative bleeding volume were accessed by reviewing medical history. Quality of fracture reduction was evaluated with the Matta score. At 1-year follow-up, the functional rehabilitation was evaluated by the Majeed rehabilitation criteria. For those with lumbosacral plexus injury, the neuromotor function was evaluated using muscle strength grading proposed by the British Medical Research Council (BMRC) and recovery was recorded. RESULTS: All 15 patients underwent the operation successfully. The surgical time ranged from 70 to 220 min (126 ± 42 min), and the intraoperative blood loss ranged from 180 to 2000 mL (816 ± 560 mL). Eighty percent of the cohort (12/15) were rated as excellent and good in the Matta score for fracture reduction quality after operation without surgical incision-related complications. At 1-year follow-up, the overall excellent and good rate was 73.3% (11/15) according to the Majeed criteria, the neuromotor function recovered completely in six cases and partially in two cases according to the BMRC muscle strength grading, and the recovery of sensory function was evaluated as excellent in six cases, good in one case and poor in one case, with an overall excellent and good rate of 87.5%. CONCLUSION: The LRA can well expose the surrounding structures of the sacroiliac joint from the front, which helps surgeons reduce and fix the anterior dislocation of the sacroiliac joint under direct vision and effectively decompress the entrapment of the lumbosacral plexus to achieve better clinical efficacy.

Optimizing enteral nutrition delivery by implementing volume-based feeding protocol for critically ill patients: an updated meta-analysis and systematic review.

BACKGROUND: This study aims to provide an updated assessment of the efficacy of optimized enteral nutrition (EN) delivery by implementing the volume-based feeding (VBF) protocol in critically ill patients. METHODS: We updated our previous literature retrieval with no language restrictions. The inclusion criteria were:1) Participants: Critically ill patients (Patients who was admitted in ICU; 2) Intervention: The VBF protocol was adopted for EN administration; 3) Comparison: The rate-based feeding (RBF) protocol was adopted for EN administration; 4) Major outcomes: EN nutrition delivery. The exclusion criteria included participants aged < 18 years, duplicated literature, animal and cellular experiments, and studies lacking any of the outcomes mentioned in the inclusion criteria. The databases included MEDLINE (through PubMed), Web of Science, Cochrane Library, Chinese Biomedical Literature Service System (SinoMed), Wanfang Data Knowledge Service Platform, and China National Knowledge Infrastructure. RESULT: Sixteen studies involving a total of 2896 critically ill patients are included in the updated meta-analysis. Compared with the previous meta-analysis, nine new studies were added that included 2205 more patients. The VBF protocol significantly improved energy (MD = 15.41%, 95% CI: [10.68, 20.14], p < 0.00001) and protein (MD = 22.05%, 95% CI: [10.89, 33.22], p = 0.0001) delivery. The patients in the VBF group stayed in the ICU for a shorter time (MD = 0.78, 95% CI: [0.01, 1.56], p = 0.05). The VBF protocol did not increase the risk of death (RR = 1.03, 95% CI: [0.85, 1.24], p = 0.76) or prolong the mechanical ventilation duration (MD = 0.81, 95% CI: [-0.30,1.92], p = 0.15). In addition, the VBF protocol did not affect EN complications, such as diarrhea (RR = 0.91, 95% CI: [0.73, 1.15], p = 0.43), emesis (RR = 1.23, 95% CI: [0.76, 1.99], p = 0.41), feeding intolerance (RR = 1.14, 95% CI: [0.63, 2.09], p = 0.66), and gastric retention (RR = 0.45, 95% CI: [0.16, 1.30], p = 0.14). CONCLUSION: Our study revealed that the VBF protocol significantly improved calorie and protein delivery in critically ill patients with no additional risk.

Moist dressings in the treatment of pressure injuries: A network meta-analysis.

AIMS: The aim of this network meta-analysis is to analyze the difference in therapeutic effects between moist dressings and traditional dressings in the treatment of pressure injury (PI), explore the healing, healing time, direct cost, and number of dressing changes of different moist dressings for the management of pressure injuries. BACKGROUND: The incidence of pressure injury is high and the burden of disease is high, but there is no consensus on how to choose moist dressing treatment. DESIGN: A systematic review with network meta-analysis was performed. DATA SOURCES: We searched the Chinese Biomedicine Literature Database and China National Knowledge Infrastructure, Wanfang Database, VIP database, PubMed, Web of Science, EMBASE.com, CENTRAL (Cochrane Central Register of Controlled Trials) and CINAHL to obtain randomized controlled trials (RCTs) on the treatment of PI with moist dressings. REVIEW METHODS: R studio software and Stata 16.0 software were used to compare different moist dressings and traditional dressings. RESULTS: 41 RCTs of moist dressings in the treatment of PI were included. A total of seven kinds of moist dressings, Vaseline gauze and traditional gauze dressing were involved. All RCTs were at a medium to high risk of bias. Overall, moist dressings had more advantages than traditional dressings in terms of various outcome indicators. CONCLUSION: The effect of moist dressings in treating PI is more advantageous than traditional dressings. However, in terms of direct cost and the number of dressings changes, more research is needed to improve the credibility of the network meta-analysis. The results of the network meta-analysis show that the silver ion dressing and alginate dressing are the best choices in the treatment of PI. NO PATIENT OR PUBLIC CONTRIBUTION: This study is a network meta-analysis, which does not require the participation of patients and the public.

Proximal tibia osteotomy with absorbable spacer combined with fibular osteotomy versus high tibial osteotomy for medial compartmental knee osteoarthritis.

PURPOSE: The study aimed to compare the perioperative complications, short-term clinical outcomes, patient-reported outcomes, and radiographic parameters of tibiofibular proximal osteotomy combined with absorbable spacer insertion (TPOASI) and open-wedge high tibial osteotomy (OWHTO) in a two year postoperative time period. METHODS: A total of 160 patients with Kellgren-Lawrence classification grade 3 medial compartmental knee OA were randomized to receive either TPOASI (n = 82) or OWHTO (n = 78). The primary and secondary outcomes were measured preoperatively, postoperatively, and at each follow-up examination. The primary outcomes were the between-group change in the Western Ontario and McMaster Universities Global score (WOMAC). Secondary measures included visual analog scale (VAS), radiographic parameters, American Knee Society Score (KSS), operation time, blood loss, length of incision, hospital stay, and relevant complications. Postoperative radiographic parameters, including the femorotibial angle (FTA), varus angle (VA), and joint line convergence angle (JLCA), were measured to evaluate the correction of varus deformity. RESULTS: No significant differences were found in the baseline data between the two groups. Both methods improved functional status and pain postoperatively. For primary outcomes of both groups, statistical difference was observed in WOMAC scores at the 6-month follow-up (P < 0.001). For secondary outcomes, no statistical difference was observed between the groups during the 2-year follow-up (P > 0.05). For TPOASI vs. OWHTO, the mean hospital stay (6.6 ± 1.3 days vs. 7.8 ± 2.1 days) was shorter (P < 0.001), and both blood loss (70.56 ± 35.58 vs. 174.00 ± 66.33 mL) and complication rate (3.7% vs. 12.8%) were significantly lower (P < 0.005 for both). CONCLUSIONS: Both approaches showed satisfactory functional outcomes and alleviated pain. However, TPOASI is a simple, feasible method with few complications, and it could be widely used.

Efficacy of intraosseous access for trauma resuscitation: a systematic review and meta-analysis.

BACKGROUND: During medical emergencies, intraosseous (IO) access and intravenous (IV) access are methods of administering therapies and medications to patients. Treating patients in emergency medical situations is a highly time sensitive practice; however, research into the optimal access method is limited and existing systematic reviews have only considered out-of-hospital cardiac arrest (OHCA) patients. We focused on severe trauma patients and conducted a systematic review to evaluate the efficacy and efficiency of intraosseous (IO) access compared to intravenous (IV) access for trauma resuscitation in prehospital care. MATERIALS AND METHOD: PubMed, Web of Science, Cochrane Library, EMBASE, ScienceDirect, banque de données en santé publique and CNKI databases were searched for articles published between January 1, 2000, and January 31, 2023. Adult trauma patients were included, regardless of race, nationality, and region. OHCA patients and other types of patients were excluded. The experimental and control groups received IO and IV access, respectively, in the pre-hospital and emergency departments for salvage. The primary outcome was success rate on first attempt, which was defined as secure needle position in the marrow cavity or a peripheral vein, with normal fluid flow. Secondary outcomes included mean time to resuscitation, mean procedure time, and complications. RESULTS: Three reviewers independently screened the literature, extracted the data, and assessed the risk of bias in the included studies; meta-analyses were then performed using Review Manager (Version 5.4; Cochrane, Oxford, UK). The success rate on first attempt was significant higher for IO access than for IV access (RR = 1.46, 95% CI [1.16, 1.85], P = 0.001). The mean procedure time was significantly reduced (MD = - 5.67, 95% CI [- 9.26, - 2.07], P = 0.002). There was no significant difference in mean time to resuscitation (MD = - 1.00, 95% CI [- 3.18, 1.17], P = 0.37) and complications (RR = 1.22, 95% CI [0.14, 10.62], P = 0.86) between the IO and IV groups. CONCLUSION: The success rate on first attempt of IO access was much higher than that of IV access for trauma patients, and the mean procedure time of IO access was significantly less when compared to IV access. Therefore, IO access should be suggested as an urgent vascular access for hypotensive trauma patients, especially those who are under severe shock.

Early versus late drain removal in patients after pancreatoduodenectomy: A systematic review and meta-analysis.

Whether early or late drain removal (EDR/LDR) is better for patients after pancreatic resection remains controversial. We aim to systematically evaluate the safety and efficacy of early or late drain removal in patients who undergo pancreatic resection. We searched seven databases from January 1, 2000, through September 2021, and included randomized controlled trials (RCTs) or observational studies comparing EDR vs. LDR in patients after pancreatic resection. We separately pooled effect estimates across RCTs and observational studies. Finally, we included 4 RCTs with 711 patients and 8 nonRCTs with 7207 patients. Based on the pooled RCT data, compared to LDR, EDR reduced hospital length of stay (LOS) (RR: -2.59, 95% CI: -4.13 to -1.06) and hospital cost (RR: -1022.27, 95% CI: -1990.39 to -54.19). Based on the pooled nonRCT data, EDR may reduce the incidence of all complications (OR: 0.45, 95% CI: 0.32 to 0.63), pancreatic fistula (OR: 0.26, 95% CI: 0.15 to 0.45), wound infection (RR: 0.59, 95% CI: 0.06 to 5.45)), reoperation (OR: 0.62, 95% CI: 0.40 to 0.96) and hospital readmission (OR: 0.57, 95% CI: 0.47 to 0.69). There was an uncertain effect on mortality (OR from pooled nonRCTs: 1.02, 95% CI: 0.41 to 2.53) and delayed gastric emptying (RR from pooled RCTs: 0.76, 95% CI: 0.41 to 1.41). The findings of this meta-analysis suggest that early drain removal is associated with lower hospital cost, is safe and may reduce the incidence of complications compared to late drain removal in patients after pancreaticoduodenectomy.

Secure Decentralized IoT Service Platform Using Consortium Blockchain.

Although many studies have been devoted to integrating blockchain into IoT device management, access control, data integrity, security, and privacy, blockchain-facilitated IoT communication is still much less studied. Blockchain has great potential in decentralizing and securing IoT communications. In this paper, we propose an innovative IoT service platform powered by the consortium blockchain technology. The proposed platform abstracts machine-to-machine (M2M) and human-to-machine (H2M) communications into services provided by IoT devices. Then, it materializes the data exchange of the IoT network through smart contracts and blockchain transactions. Additionally, we introduce the auxiliary storage layer to the proposed platform to address various off-chain data storage needs. Our proof-of-concept implementation was tested against various workloads and connection sizes under different block configurations to evaluate the platform's transaction throughput, latency, and hardware utilization. The experimental results demonstrate that our solution can maintain high performance with a throughput of approximately 800 reads per second (RPS), 50-80 transactions per second (TPS), and a latency of 50 ms-2 s under light to moderate workloads. Our extensive evaluation of the performance impact of batch size, batch timeout, and connection size also provides valuable insights into the optimization of blockchain configuration for achieving high performance.

Determination of the Metabolites and Metabolic Pathways for Three ß-Receptor Agonists in Rats Based on LC-MS/MS.

This paper developed a universal detection method by high-performance liquid chromatography-tandem mass spectrometry to detect three typical clenbuterols, CLB, SAL, and RAC, and to investigate the metabolism of ß-agonists in vivo. The parent ions and daughter ions of the three ß-receptor agonist standards and the residues in the muscle, liver, and blood samples of rats were obtained by Total Ions Scan mode. The metabolites produced in different tissues at a specific time were qualitatively and quantitatively analyzed, and the corresponding metabolic pathways were inferred. The results showed that the three ß-receptor agonists mainly existed in the form of prototype drugs in rats, with a small amount of clenbuterol methyl compound and albuterol methyl compound. There were significant differences in residual metabolism between different tissues of the same species. In addition, different ß-receptor agonists have different absorption and utilization rates in rats.

Plaque removal efficacy of a compacted dual-head power toothbrush: A split-mouth randomized clinical trial.

PURPOSE: To evaluate the plaque removal efficacy of a compacted dual-head power toothbrush (DH) in comparison with a single-head power toothbrush (SH). METHODS: 24 healthy university students were included in this split-mouth and single-center clinical trial. The DH and SH were randomly assigned to brush the left/right half mouth in the first visit. Testing time points were 30 and 60 seconds. Additionally, 15 and 45 seconds were set for the DH period. The overall, buccal, lingual, gingival marginal, and proximal plaque scores at different time points were recorded and determined by Rustogi Modification of the Navy Plaque Index. To avoid the influence of the right handedness, subjects were brushed in the second visit after 4 weeks, and the SH and the DH were assigned to the right/left half mouth in an opposite period to that of the first visit. RESULTS: 21 participants completed this study. Overall plaque score reductions of the SH and DH were 29% and 59% (P< 0.05) at 30 seconds, and the reductions were 47% and 77% respectively (P< 0.05) at 60 seconds. Using the DH for 45 seconds reduced significantly more overall, buccal, lingual, and gingival marginal plaque than that of using SH for 60 seconds (P< 0.05). The SH reduced plaque scores significantly less in the right and lower dentitions than left and upper dentitions respectively, while DH reduced comparable plaque scores between these dentitions. The DH is more effective in removing overall, buccal, lingual, gingival marginal, and proximal plaque in healthy university students than the SH, meanwhile DH showed comparable overall plaque reduction rates between different regions of the dentitions. CLINICAL SIGNIFICANCE: This compact dual-head power toothbrush provides a new option to carry out daily plaque control effectively.

Enhanced Thermoelectric Properties of Te Doped Polycrystalline Sn0.94Pb0.01Se.

Thermoelectric materials can directly convert heat and electricity, which is a kind of promising energy material. In view of cost and mechanical properties, polycrystalline SnSe material with high zT value is greatly desired. In this study, polycrystalline Sn0.94Pb0.01Se1-xTex samples were prepared by the vacuum melting-hot pressing sintering method. Sn vacancies, Pb and Te atoms were simultaneously introduced into the polycrystalline SnSe. The power factor of Sn0.94Pb0.01Se1-xTex samples was decreased, which could be attributed to the generation of n-type semiconductor SnSe2. In addition, the phonons were strongly scattered by point defects and dislocations, which led to the decrease of thermal conductivity-from 0.43 Wm-1K-1 to 0.29 Wm-1K-1 at 750 K. Finally, the polycrystalline Sn0.94Pb0.01Se0.96Te0.04 sample achieved the maximum zT value of 0.60 at 750 K.