A preliminary study on the normal value of the thoracic haller index in children.

BACKGROUND AND OBJECTIVE: The Haller index (HI) is widely utilized as a quantitative indicator to assess the extent of pectus excavatum (PE) deformity, which is the most common chest wall abnormality in children. Both preoperative correction planning and postoperative follow-up need to be based on the standard of normal thoracic growth and development. However, there is currently no established reference range for the HI in children. Consequently, the aim of this study was to conduct a preliminary investigation of normal HI values among children to understand thoracic developmental characteristics. METHODS: Chest CT images obtained from January 2012 to March 2022 were randomly selected from the imaging system of the Children's Hospital of Chongqing Medical University. We divided the images of children into a total of 19 groups: aged 0-3 months (1 group), 4-12 months (1 group), and 1 year to 17 years (17 groups), with 50 males and 50 females, totaling 100 children in each group. HI was measured in the plane where the lowest point of the anterior thoracic wall was located and statistically analyzed using SPSS 26.0 software. RESULTS: A total of 1900 patients were included in the study. Our results showed that HI, transverse diameter, and anterior-posterior diameter were positively correlated with age (P < 0.05). Using age as the independent variable and HI as the dependent variable, the best-fit regression equations were HI-male = 2.047 * Age0.054(R2 = 0.276, P＜0.0001), HI-female = 2.045 * Age0.067(R2 = 0.398, P＜0.0001). Males had significantly larger thoracic diameters than females, and there was little difference in the HI between the two sexes. CONCLUSIONS: The HI rapidly increases during the neonatal period, slowly increases during infancy, and stops increasing during puberty, with no significant differences between sexes.

No prognostic impact of staging bone scan in patients with stage IA non-small cell lung cancer.

OBJECTIVE: To investigate the survival benefit of preoperative bone scan in asymptomatic patients with early-stage non-small cell lung cancer (NSCLC). METHODS: This retrospective study included patients with radical resection for stage T1N0M0 NSCLC between March 2013 and December 2018. During postoperative follow-up, we monitored patient survival and the development of bone metastasis. We compared overall survival, bone metastasis-free survival, and recurrence-free survival in patients with or without preoperative bone scan. Propensity score matching and inverse probability of treatment weighting were used to minimize election bias. RESULTS: A total of 868 patients (58.19 ± 9.69 years; 415 men) were included in the study. Of 87.7% (761 of 868) underwent preoperative bone scan. In the multivariable analyses, bone scan did not improve overall survival (hazard ratio [HR] 1.49; 95% confidence intervals [CI] 0.91-2.42; p = 0.113), bone metastasis-free survival (HR 1.18; 95% CI 0.73-1.90; p = 0.551), and recurrence-free survival (HR 0.89; 95% CI 0.58-1.39; p = 0.618). Similar results were obtained after propensity score matching (overall survival [HR 1.28; 95% CI 0.74-2.23; p = 0.379], bone metastasis-free survival [HR 1.00; 95% CI 0.58-1.72; p = 0.997], and recurrence-free survival [HR 0.76; 95% CI 0.46-1.24; p = 0.270]) and inverse probability of treatment weighting. CONCLUSION: There were no significant differences in overall survival, bone metastasis-free survival, and recurrence-free survival between asymptomatic patients with clinical stage IA NSCLC with or without preoperative bone scan.

Characterization of a Novel Hyperthermophilic GH1 ß-Glucosidase from Acidilobus sp. and Its Application in the Hydrolysis of Soybean Isoflavone Glycosides.

A putative ß-glucosidase gene, BglAc, was amplified from Acidilobus sp. through metagenome database sampling from a hot spring in Yellowstone National Park. BglAc is composed of 485 amino acid residues and bioinformatics analysis showed that it belongs to the GH1 family of ß-glucosidases. The gene was successfully expressed in Escherichia coli with a molecular weight of approximately 55.3 kDa. The purified recombinant enzyme showed the maximum activity using p-nitrophenyl-ß-D-glucopyranoside (pNPG) as the substrate at optimal pH 5.0 and 100 °C. BglAc exhibited extraordinary thermostability, and its half-life at 90 °C was 6 h. The specific activity, Km, Vmax, and Kcat/Km of BglAc toward pNPG were 357.62 U mg-1, 3.41 mM, 474.0 µmol min-1·mg-1, and 122.7 s-1mM-1. BglAc exhibited the characteristic of glucose tolerance, and the inhibition constant Ki was 180.0 mM. Furthermore, a significant ethanol tolerance was observed, retaining 96% relative activity at 10% ethanol, and even 78% at 20% ethanol, suggesting BglAc as a promising enzyme for cellulose saccharification. BglAc also had a strong ability to convert the major soybean isoflavone glycosides (daidzin, genistin, and glycitin) into their corresponding aglycones. Overall, BglAc was actually a new ß-glucosidase with excellent thermostability, ethanol tolerance, and glycoside hydrolysis ability, indicating its wide prospects for applications in the food industry, animal feed, and lignocellulosic biomass degradation.

Efficacy of ceftazidime-avibactam in the treatment of carbapenem-resistant Klebsiella pneumoniae infections: Focus on solid organ transplantation recipients.

INTRODUCTION: Ceftazidime-avibactam (CAZ-AVI) is a new option to treat KPC- and OXA-48 carbapenem-resistant Klebsiella pneumoniae (CRKP) infections. However, clinical evidence is limited regarding its use in treating CRKP infections, especially in solid organ transplantation (SOT) recipients. In this study, we assessed the efficacy of CAZ-AVI in treating CRKP infections in both the general population and the SOT recipients in comparison with other antibiotic regimens. METHODS: This is a single-centre retrospective cohort study of patients admitted between January 1, 2018 and June 30, 2021 with the diagnosis of CRKP infections receiving either CAZ-AVI or other regimens ≥ 72 hours and clinical outcomes were analysed. RESULTS: Of 200 patients with CRKP infections, 67 received CAZ-AVI, 133 received other regimens, and 50 were SOT recipients. In the SOT cohort, 30 patients received CAZ-AVI, and 20 received other regimens. The overall 30-day mortality was 38% in the SOT cohort. Compared with patients receiving other regimens, CAZ-AVI therapy resulted in lower 30-day mortality (23.3% vs. 60%, P = 0.014) and 90-day mortality (35.7% vs. 86.7%, P = 0.003), higher clinical cure (93.3% vs. 40%, P < 0.001) and microbiological clearance. Similar promising results of CAZ-AVI were also shown in the whole population cohort. Moreover, clinical outcomes of SOT recipients receiving CAZ-AVI were not inferior to those without SOT. CONCLUSIONS: CAZ-AVI therapy was associated with better clinical outcomes in CRKP infections in both the general population and SOT recipients. Considering the limitations of the present study, well-conducted RCTs are still warranted to confirm these findings.

Characterization of bacterial diversity and screening of cellulose-degrading bacteria in the gut system of Glenea cantor (Fabricius) larvae.

The intestinal bacteria of longhorn beetles would be ideal targets for pest control and lignocellulosic resources by destroying or exploiting their cellulose-degrading function. This article aims to investigate the diversity and community structure of intestinal bacteria the oligophagous longhorn beetle Glenea cantor. Additionally, it seeks to identify the presence of lignocellulose-degrading bacteria in the gut, and explore their role in consuming host kapok trees Bombax malabaricum. In this study, the bacterial community from G. cantor was examined by Illumina sequencing of 16S ribosomal RNA (rRNA) targeting the V3 and V4 regions. A total of 563,201 valid sequences and 814 OTUs were obtained. The dominant phyla were Proteobacteria, and the dominant genera were Acinetobacter and Lactococcus. The analysis of microbial diversity revealed a high bacterial diversity in the samples, with the gut bacteria playing a crucial role in the physiological activities of the host, particularly, 9 genera of intestinal bacteria with cellulose degradation function were found, highlighting their vital role in cellulose degradation. Five strains of cellulose-degrading bacteria, belonging to the genus Pseudomonas, were obtained from the intestinal tract of G. cantor larvae using traditional isolation and culture techniques as well as 16S rDNA sequencing. Among these strains, A4 exhibited a cellulase activity of 94.42 ± 0.42 U/mL, while A5 displayed the highest filter paper enzyme activity of 127.46 ± 3.54 U/mL. These results offered valuable insights into potential targets for pest control through internal attack digestion and cellulose-degrading bacteria in longhorn beetles.

Chirality-selective topological magnon phase transition induced by interplay of anisotropic exchange interactions in honeycomb ferromagnet.

A variety of distinct anisotropic exchange interactions commonly exist in one magnetic material due to complex crystal, magnetic and orbital symmetries. Here we investigate the effects of multiple anisotropic exchange interactions on topological magnon in a honeycomb ferromagnet, and find a chirality-selective topological magnon phase transition induced by a complicated interplay of Dzyaloshinsky-Moriya interaction and pseudo-dipolar interaction, accompanied by the bulk gap close and reopen with chiral inversion. Moreover, this novel topological phase transition involves band inversion at high symmetry pointsKandK', which can be regarded as a pseudo-orbital reversal, i.e. magnon valley degree of freedom, implying a new manipulation corresponding to a sign change of the magnon thermal Hall conductivity. Indeed, it can be realized in 4dor 5dcorrelated materials with both spin-orbit coupling and orbital localized states, such as iridates and ruthenates,etc.This novel regulation may have potential applications on magnon devices and topological magnonics.

Moisture content online detection system based on multi-sensor fusion and convolutional neural network.

To monitor the moisture content of agricultural products in the drying process in real time, this study applied a model combining multi-sensor fusion and convolutional neural network (CNN) to moisture content online detection. This study built a multi-sensor data acquisition platform and established a CNN prediction model with the raw monitoring data of load sensor, air velocity sensor, temperature sensor, and the tray position as input and the weight of the material as output. The model's predictive performance was compared with that of the linear partial least squares regression (PLSR) and nonlinear support vector machine (SVM) models. A moisture content online detection system was established based on this model. Results of the model performance comparison showed that the CNN prediction model had the optimal prediction effect, with the determination coefficient (R2) and root mean square error (RMSE) of 0.9989 and 6.9, respectively, which were significantly better than those of the other two models. Results of validation experiments showed that the detection system met the requirements of moisture content online detection in the drying process of agricultural products. The R2 and RMSE were 0.9901 and 1.47, respectively, indicating the good performance of the model combining multi-sensor fusion and CNN in moisture content online detection for agricultural products in the drying process. The moisture content online detection system established in this study is of great significance for researching new drying processes and realizing the intelligent development of drying equipment. It also provides a reference for online detection of other indexes in the drying process of agricultural products.

Risk factor and correlation between postoperative serum myoglobin and acute kidney injury after pulmonary endarterectomy.

Background: Acute kidney injury (AKI) is a common and life-threatening complication following pulmonary endarterectomy (PEA). Our study aimed to investigate the risk factors associated with AKI and evaluate the correlation between serum myoglobin (sMb) levels and postoperative AKI. Methods: We conducted a retrospective study involving 134 patients who underwent PEA at China-Japan Friendship Hospital. AKI was defined and staged according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria. Results: During the study period, the incidence of postoperative AKI was 57.5%, and the associated mortality rate was 6.0%. Severe AKI was found to be significantly associated with worse short-term outcomes (P<0.05). Logarithmically transformed postoperative day (POD) 0 sMb levels were significantly associated with AKI [odds ratio (OR) =5.174; 95% confidence interval (CI), 2.307-11.603; P<0.001] and severe AKI (OR =4.605; 95% CI, 1.510-14.048; P=0.007), also had independent predictive value [area under the curve (AUC) =0.776 in AKI and AUC =0.737 in severe AKI]. The optimal cut-off values were 370.544 ng/mL for AKI and 419.473 ng/mL for severe AKI. Furthermore, albumin concentration was found to play a protective role in the development of severe AKI (OR =0.838; 95% CI, 0.716-0.980; P=0.027) when higher than 40.350 g/L. Conclusions: Our findings suggest that a high concentration of POD0 sMb may increase the risk of developing AKI following PEA surgery. Increasing albumin concentration could serve as an effective preventive measure against AKI.

Plasma campesterol and ABCG5/ABCG8 gene loci on the risk of cholelithiasis and cholecystitis: evidence from Mendelian randomization and colocalization analyses.

The causal relationships between plasma metabolites and cholelithiasis/cholecystitis risks remain elusive. Using two-sample Mendelian randomization, we found that genetic proxied plasma campesterol level showed negative correlation with the risk of both cholelithiasis and cholecystitis. Furthermore, the increased risk of cholelithiasis is correlating with the increased level of plasma campesterol. Lastly, genetic colocalization study showed that the leading SNP, rs4299376, which residing at the ABCG5/ABCG8 gene loci, was shared by plasma campesterol level and cholelithiasis, indicating that the aberrant transportation of plant sterol/cholesterol from the blood stream to the bile duct/gut lumen might be the key in preventing cholesterol gallstone formation.

Quality and Process Optimization of Infrared Combined Hot Air Drying of Yam Slices Based on BP Neural Network and Gray Wolf Algorithm.

In this paper, the effects on drying time (Y1), the color difference (Y2), unit energy consumption (Y3), polysaccharide content (Y4), rehydration ratio (Y5), and allantoin content (Y6) of yam slices were investigated under different drying temperatures (50-70 °C), slice thicknesses (2-10 mm), and radiation distances (80-160 mm). The optimal drying conditions were determined by applying the BP neural network wolf algorithm (GWO) model based on response surface methodology (RMS). All the above indices were significantly affected by drying conditions (p < 0.05). The drying rate and effective water diffusion coefficient of yam slices accelerated with increasing temperature and decreasing slice thickness and radiation distance. The selection of lower temperature and slice thickness helped reduce the energy consumption and color difference. The polysaccharide content increased and then decreased with drying temperature, slice thickness, and radiation distance, and it was highest at 60 °C, 6 mm, and 120 mm. At 60 °C, lower slice thickness and radiation distance favored the retention of allantoin content. Under the given constraints (minimization of drying time, unit energy consumption, color difference, and maximization of rehydration ratio, polysaccharide content, and allantoin content), BP-GWO was found to have higher coefficients of determination (R2 = 0.9919 to 0.9983) and lower RMSEs (reduced by 61.34% to 80.03%) than RMS. Multi-objective optimization of BP-GWO was carried out to obtain the optimal drying conditions, as follows: temperature 63.57 °C, slice thickness 4.27 mm, radiation distance 91.39 mm, corresponding to the optimal indices, as follows: Y1 = 133.71 min, Y2 = 7.26, Y3 = 8.54 kJ·h·kg-1, Y4 = 20.73 mg/g, Y5 = 2.84 kg/kg, and Y6 = 3.69 µg/g. In the experimental verification of the prediction results, the relative error between the actual and predicted values was less than 5%, proving the model's reliability for other materials in the drying technology process research to provide a reference.

Electrochemical Redox Conversion of Formate to CO via Coupling Fe-Co Layered Double Hydroxides and Au Catalysts.

Formate has been considered an inactive molecule and thus cannot be further reduced under CO2 reduction conditions, which limits its widespread application as feedstock. Here we present an electrochemical redox conversion of formate to CO through the potential-dependent generation of carbon dioxide radical anions (CO2 ⋅- ) on Fe-Co layered double hydroxides (Fe-Co LDHs) and the subsequent reduction of CO2 ⋅- to CO on Au catalysts. We present an electrodeposition protocol for the synthesis of Fe-Co LDHs with precise composition control and find that Fe1 Co4 exhibits a promising potential window for CO2 ⋅- formation between 1.14 and 1.4 V and an optimized potential at 1.24 V at a neutral pH condition. We further determined the formation of CO2 ⋅- at 1.24 V via electron paramagnetic resonance and CO2 at >1.4 V through differential electrochemical mass spectrometry. This work provides a redox chemistry route for converting formate into CO through a coupled slit parallel-plate electrode system.

Increased Segregation in Functional Connectivity Networks When Watching Unpleasant Arousing Videos: A Generalized Psychophysiological Interaction Analysis.

Background: Properties of functional connectivity (FC), such as network integration and segregation, are shown to be associated with various human behaviors. For example, Godwin et al. and Sun et al. found increased integration with attention allocation, whereas Cohen and D'Esposito and Shine et al. observed increased segregation with simple motor tasks. The current study investigated how viewing video clips with different valence and arousal influenced integration-segregation properties in task-based FC networks. Methods: We analyzed an open dataset collected by Kim et al. We performed a generalized psychophysiological interaction (gPPI) analysis paired with network analysis and community detection to investigate changes in brain network dynamics when people watched four types of videos that differed by affective valence (unpleasant or pleasant) and arousal (arousing or calm). Results: Results showed that unpleasant arousing videos produced greater FC deviation from the baseline (task-induced FC deviation [tiFCd]) and perturbed the brain into a more segregated state than other kinds of video. Increased segregation was only observed in association systems, not sensorimotor systems. Discussion: Unpleasant arousing content perturbed the brain to a functionally distinct state from the other three types of affective videos. We suggest that the change in brain state was related to people disengaging from the unpleasant arousing content or, alternatively, staying alert while exposed to unpleasant arousing stimuli. The study also added to our understanding of how combining task-based gPPI analysis with community detection methods and network segregation measures can advance our knowledge of the links between behavior and brain state changes. Impact statement Network integration and segregation is an important property of the human brain. We address the question of how affective stimuli influence brain dynamics from a functional connectivity (FC) network integration-segregation perspective. By conducting a whole-brain generalized psychophysiological interaction (gPPI) analysis paired with community detection methods, we found that highly aversive video content induced significant FC changes and perturbed the brain to a more segregated state.

Coupling analysis of crane accident risks based on Bayesian network and the N-K model.

Crane usage is pervasive on construction sites, however, it is associated with a notably high accident rate. The analyzing of crane accident risks is essential for accident prevention, control, and ensuring the safety of lifting operations. Hence, significant emphasis should be placed on understanding the interaction among various risk factors. This paper proposes a quantitative coupling method for human, machine, management, and environmental risk factors in crane accidents, leveraging Bayesian networks (BN) and the N-K model. Firstly, text mining technology and fault tree analysis are employed to analyze the causes of crane accidents and categorize the associate risk factors. Secondly, the types of risk coupling resulting from human, machine, management, and environmental risk factors are defined. Thirdly, the BN model is developed based on the analysis of crane accident risksand its N-K model. Fourthly, the parameters of the risk coupling nodes in the developed BN are determined based on the calculation results of the N-K model. Finally, for the risk coupling types with high coupling values and the first-level node and second-level node, the failure probability is analyzed through posterior probability and sensitivity analysis. The results indicate that factors related to man and management significantly impact crane accidents and warrant enhanced attention. The interplay among multiple risk factors significantly influences the probability of crane accidents, necessitating careful attention.

Prognostic significance of 18F-Fluorodeoxyglucose positron-emission tomography parameters in patients with biliary tract cancers: a meta-analysis.

BACKGROUND AND OBJECTIVE: Numerous previous studies have assessed the prognostic role of 18F-fluorodeoxyglucose positron-emission tomography (18F FDG PET) in patients with biliary tract cancer (BTC), but those results were inconsistent. The present study aims to determine the predictive value of 18F FDG PET in BTC patients via a meta-analysis. METHODS: The underlying studies related to 18F FDG PET and BTC patients` outcomes were searched and identified in the online databases. The interested parameters include total lesion glycolysis (TLG), metabolic tumor volume (MTV), primary tumor and metastatic lymph node (LN) maximum standardized uptake value (SUVmax), as well as change of SUVmax (ΔSUVmax) during treatment. Overall survival (OS), disease-free survival (DFS), and progression-free survival (PFS) were considered as the primary endpoints. Hazard ratio (HR) and corresponding 95% confidence intervals (CIs) were defined as the effective measure and calculated by a pooled analysis. Publication bias was assessed by funnel plot, Bagg's and Egger's tests. RESULTS: Totally, 23 studies involving 1478 patients were included in the present meta-analysis. After a pooled analysis, it revealed that a high SUVmax was significantly associated with a poor OS (HR:2.07, 95%CI: 1.74-2.46, P = 0.000) and DFS (HR: 2.28, 95%CI: 1.53-3.41, P = 0.000). In addition, an increased TLG level contributed to a shorter OS (HR:1.91, 95%CI: 1.26-2.90, P = 0.002) and DFS (HR: 4.34, 95%CI: 1.42-13.27, P = 0.01). Moreover, we confirmed that an elevated MTV was significantly associated with increased mortality (HR:2.04, 95%CI:1.26-3.31, P = 0.004) and disease relapse (HR: 3.88, 95%CI:1.25-12.09, P = 0.019) risks. Besides, the present study uncovered that increased ΔSUVmax could predict poor OS (HR:1.26, 95%CI:1.06-1.50, P = 0.008) instead of PFS (HR: 1.96, 95%CI: 0.82-4.72, P = 0.280). Lastly, we found that LN SUVmax did not link to OS (HR: 1.49, 95%CI: 0.83-2.68, P = 0.178). No obvious publication bias was detected in the present study. CONCLUSION: 18F FDG PET parameters, including SUVmax, TLG, MTV, and ΔSUVmax, could be applied as convenient and reliable factors for predicting BTC patients` outcomes.

The mediating roles of mental health problems and racial differences in the linkage between social media use and E-cigarette use among American youth.

OBJECTIVE: Social media use is shown to be linked to youth's e-cigarette use. However, less is known about the underlying mechanisms. This study examined the mediating roles of internalizing and externalizing problems in the association between youth's social media use and e-cigarette use, and the racial differences in the mediation association. METHODS: The study sample included 4913 U.S. youth from the Population Assessment of Tobacco and Health Study Waves 3-5 (2015-2019). Two weighted generalized structural equation models were conducted to examine the mediation pathways between youth's social media use (Wave 3) and past-30-day e-cigarette use (Wave 5) through internalizing and externalizing problems (Wave 4), respectively. Invariance tests were conducted to examine racial group differences. RESULTS: Youth with high social media use frequency were more likely to use e-cigarettes (total effect: OR = 1.20, p < 0.001 in both internalizing and externalizing models). Internalizing and externalizing problems mediated the aforementioned associations (mediation proportions: 5.05% and 5.66%, respectively). The invariance tests indicated a significant difference between White and non-White groups (both ps < 0.001), where a larger proportion of mediation was found in the non-White group (12.22% for internalizing and 11.99% for externalizing) compared to their White counterparts (2.46% for internalizing and 3.17% for externalizing). CONCLUSIONS: Mental health problems following social media use served as a risk factor for e-cigarette use among youth. Interventions aiming to improve youth's mental health could in turn temper e-cigarette use among youth social media users, and implementing tailored interventions in response to racial differences is warranted.

Kernel Cox partially linear regression: Building predictive models for cancer patients' survival.

Wide heterogeneity exists in cancer patients' survival, ranging from a few months to several decades. To accurately predict clinical outcomes, it is vital to build an accurate predictive model that relates the patients' molecular profiles with the patients' survival. With complex relationships between survival and high-dimensional molecular predictors, it is challenging to conduct nonparametric modeling and irrelevant predictors removing simultaneously. In this article, we build a kernel Cox proportional hazards semi-parametric model and propose a novel regularized garrotized kernel machine (RegGKM) method to fit the model. We use the kernel machine method to describe the complex relationship between survival and predictors, while automatically removing irrelevant parametric and nonparametric predictors through a LASSO penalty. An efficient high-dimensional algorithm is developed for the proposed method. Comparison with other competing methods in simulation shows that the proposed method always has better predictive accuracy. We apply this method to analyze a multiple myeloma dataset and predict the patients' death burden based on their gene expressions. Our results can help classify patients into groups with different death risks, facilitating treatment for better clinical outcomes.

Trimethylamine-N-oxide (TMAO) and predicted risk of cardiovascular events after partial nephrectomy.

INTRODUCTION: Emerging evidence suggests that uremic toxins, in particular trimethylamine-N-oxide(TMAO), indoxyl-sulfate(IS), and p-cresyl-sulfate(PCS), may associate with increased risk of cardiovascular events(CVe). However, whether uremic toxins increase after partial nephrectomy(PN) and their correlation with risk for CVe remains unknown. METHODS: 100 patients managed with PN were retrospectively reviewed. TMAO/IS/PCS levels were examined by liquid chromatography-mass-spectrometry. Renal-parenchymal-volume-preservation(RPVP) was estimated from CT scans. Predicted risks for CVe were obtained using the Framingham score. Linear regression assessed association between uremic toxins, GFR and risk of CVe. Logistic regression evaluated factors associated with post-PN TMAO. RESULTS: TMAO, IS and PCS increased from 1.7, 3.7 and 3.5 µmol/L before PN to 3.6, 5.4 and 7.4 µmol/L at latest follow-up, respectively, while GFR declined from 102 to 93 ml/min/1.73 m2 (all p<0.001). TMAO, IS and PCS levels all negatively correlated with GFR(all p<0.001). Predicted 10-year risk of CVe increased from 1.1% pre-PN to 1.7% post-PN(p<0.001), primarily due to increased age(p<0.001), blood pressure(p = 0.002) and total cholesterol(p = 0.003). TMAO(ß = 0.038) and GFR (ß = -0.02) were independent predictors for predicted 10-year CVe risk on multivariable-analysis. Increased TMAO was an early and sustained finding maintained through 5 years, unlike IS, PCS and eGFR. On multivariable analysis, increased pre-PN TMAO(OR = 2.79) and decreased RPVP(OR = 3.23) were identified as independent risk factors for higher post-PN TMAO, while ischemia type/duration failed to correlate. CONCLUSION: Uremic toxin levels increased after PN correlating with reduced GFR. Higher TMAO independently associated with greater predicted 10-year CVe risk. Parenchymal mass preserved rather than ischemia time or type associated with increased TMAO.

Case Report: Non-negligible Epstein-Barr virus-associated posttransplant lymphoproliferative disorders in a lung transplant recipient.

Background: Posttransplant lymphoproliferative disorders (PTLDs) are uncommon but serious complications in patients following solid organ transplantation. Primary Epstein-Barr virus (EBV) infection is a risk factor for the development of PTLD, especially early-onset PTLD, in EBV-negative recipients. To date, however, there are no specific guidelines on the threshold of EBV-DNA load for therapeutic intervention, the source for measurement (e.g., blood, bronchoalveolar fluid), or the use of antiviral agents as prophylaxis for early PTLD prevention in EBV-mismatched patients. Methods: The present study describes a 56-year-old male lung transplant recipient diagnosed with EBV-associated PTLD. Results: This patient had a history of invasive fungal disease and Mucor and Aspergillus fumigatus infections in the early post-transplant period, necessitating antifungal therapy throughout the course of the disease. The patient was EBV-positive 15 days after transplantation, with lung CT showing multiple bilateral nodules of varying sizes beginning 98 days after transplantation. A lung biopsy showed PTLD, and next-generation sequencing (NGS) revealed EBV. This patient, however, did not receive any antiviral therapy for early PTLD prevention or any PTLD-related treatment. He died 204 days after lung transplantation. Conclusion: The present study describes a lung transplant recipient who developed EBV-associated PTLD, a non-negligible disease, after solid organ transplantation. Monitoring EBV-DNA load is important, as a sudden increase may be a sensitive indicator of PTLD. An earlier diagnosis may increase the likelihood of successful treatment.

Electron Paramagnetic Resonance Tracks Condition-Sensitive Water Radical Cation.

Oxidizing species or radicals generated in water are of vital importance in catalysis, the environment, and biology. In addition to several related reactive oxygen species, using electron paramagnetic resonance (EPR), we present a nontrapping chemical transformation pathway to track water radical cation (H2O+•) species, whose formation is very sensitive to the conditioning environments, such as light irradiation, mechanical action, and gas/chemical introduction. We reveal that H2O+• can oxidize the 5,5-dimethyl-1-pyrroline N-oxide (DMPO) to the crucial epoxy hydroxylamine (HDMP=O) intermediate, which further reacts with the hydroxyl radical (•OH) for the formation of the EPR-active sextet radical (DMPO=O•). Interestingly, we uncover that H2O+• can react with dimethyl methylphosphonate (DMMP), 2-methyl-2-nitrosopropane (MNP), 5-tert-butoxycarbonyl-5-methyl-1-pyrroline N-oxide (BMPO), and α-phenyl-N-tert-butylnitrone (PBN) which contain a double-bond structure to produce corresponding derivatives as well. It is thus expected that both H2O+• and •OH are ubiquitous in nature and in various water-containing experimental systems. These findings provide a novel perspective on radicals for water redox chemistry.