Edge smoothing optimization method in DMD digital lithography system based on dynamic blur matching pixel overlap technique.

Due to digital micromirrors device (DMD) digital lithography limited by non-integer pixel errors, the edge smoothness of the exposed image is low and the sawtooth defects are obvious. To improve the image edge smoothness, an optimized pixel overlay method was proposed, which called the DMD digital lithography based on dynamic blur effect matching pixel overlay technology. The core of this method is that motion blur effect is cleverly introduced in the process of pixel overlap to carry out the lithography optimization experiment. The simulation and experimental results showed that the sawtooth edge was reduced from 1.666 µm to 0.27 µm by adopting the 1/2 dynamic blur effect to match pixel displacement superposition, which is far less than half of the sawtooth edge before optimization. The results indicated that the proposed method can efficiently improve the edge smoothness of lithographic patterns. We believe that the proposed optimization method can provide great help for high fidelity and efficient DMD digital lithography microfabrication.

High intraoperative fluid load associated with prolonged length of hospital stay and complications after non-cardiac surgery in neonates.

Inappropriate perioperative fluid load can lead to postoperative complications and death. This retrospective study was designed to investigate the association between intraoperative fluid load and outcomes in neonates undergoing non-cardiac surgery. From April 2020 to September 2022, 940 neonates who underwent non-cardiac surgery were retrospectively enrolled and their perioperative data were harvested for further analysis. According to recorded intraoperative fluid volumes defined as ml.kg-1 h-1, patients were mandatorily divided into quintile with fluid load as restrictive (quintile 1, Q1), moderately restrictive (Q2), moderate (Q3), moderately liberal (Q4), and liberal (Q5). The primary outcomes were defined as prolonged length of hospital stay (LOS) (postoperative LOS ≥ 14 days), complications beyond prolonged LOS, and 30-day mortality. Secondary outcomes included postoperative complications within 14 days of hospital stay. The intraoperative fluid load was in Q1 of 6.5 (5.3-7.3) (median and IQR); Q2: 9.2 (8.7-9.9); Q3: 12.2 (11.4-13.2); Q4: 16.5 (15.4-18.0); and Q5: 26.5 (22.3-32.2) ml.kg-1 h-1. The odd of prolonged LOS was positively correlated with an increase fluid volume (Q5 quintile: OR 2.602 [95% CI 1.444-4.690], P = 0.001), as well as complications beyond prolonged LOS (Q5: OR 3.322 [95% CI 1.656-6.275], P = 0.001). The overall 30-day mortality rate was increased with high intraoperative fluid load but did not reach to a statistical significance after adjusted with confounders. Furthermore, the highest quintile of fluid load (26.5 ml.kg-1 h-1, IQR [22.3-32.2]) (Q5 quintile) was significantly associated with longer postoperative mechanical ventilation time compared with Q1 (Q5: OR 2.212 [95% CI 1.101-4.445], P = 0.026).    Conclusion: Restrictive intraoperative fluid load had overall better outcomes, whilst high fluid load was significantly associated with prolonged LOS and complications after non-cardiac surgery in neonates.    Trial registration:  Chictr.org.cn Identifier: ChiCTR2200066823 (December 19, 2022). What is Known: • Inappropriate perioperative fluid load can lead to postoperative complications and even death. What is New: • High perioperative fluid load was significantly associated with an increased length of stay after non-cardiac surgery in neonates, whilst low fluid load was consistently related to better postoperative outcomes.

Technological innovations enhance postharvest fresh food resilience from a supply chain perspective.

Fresh food is rich in nutrients but is usually seasonal, perishable, and challenging to store without degradation of quality. The inherent limitations of various preservation technologies can result in losses in all stages of the supply chain. As consumers of fresh foods have become more health-conscious, new technologies for intelligent, energy-efficient, and nondestructive preservation and processing have emerged as a research priority in recent years. This review aims to summarize the quality change characteristics of postharvest fruits, vegetables, meats, and aquatic products. It critically analyzes research progress and applications of various emerging technologies, which include: the application of high-voltage electric field, magnetic field, electromagnetic field, plasma, electrolytic water, nanotechnology, modified atmosphere packaging, and composite bio-coated film preservation technologies. An evaluation is presented of the benefits and drawbacks of these technologies, as well as future development trends. Moreover, this review provides guidance for design of the food supply chain to take advantage of various technologies used to process food, reduce losses and waste of fresh food, and this improve the overall resilience of the supply chain.

Technological advances in protein extraction, structure improvement and assembly, digestibility and bioavailability of plant-based foods.

Plant-based foods are being considered seriously to replace traditional animal-origin foods for various reasons. It is well known that animals release large amounts of greenhouse gases into the environment during feeding, and eating animal-origin foods may also cause some health problems. Moreover, animal resources will likely be in short supply as the world population grows. It is highly likely that serious health problems ascribed to insufficient protein intake in some areas of the world will occur. Studies have shown that environmentally friendly, abundant, and customizable plant-based foods can be an effective alternative to animal-based foods. However, currently, available plant-based foods lack nutrients unique to animal-based foods. Innovative processing technologies are needed to improve the nutritional value and functionality of plant-based foods and make them acceptable to a wider range of consumers. Therefore, protein extraction technologies (e.g., high-pressure extraction, ultrasound extraction, enzyme extraction, etc.), structure improvement and assembly technologies (3D printing, micro-encapsulation, etc.), and technologies to improve digestibility and utilization of bioactive substances (microbial fermentation, physical, etc.) in the field of plant-based foods processing are reviewed. The challenges of plant-based food processing technologies are summarized. The advanced technologies aim to help the food industry solve production problems using efficient, environmentally friendly, and economical processing technologies and to guide the development of plant-based foods in the future.

Intraoperative hypothermia in the neonate population: risk factors, outcomes, and typical patterns.

The risk factors, outcomes, and typical patterns of intraoperative hypothermia were studied in neonates to better guide the application of insulation measures in the operating room. This retrospective study enrolled 401 neonates undergoing surgery under general anaesthesia with tracheal intubation, including abdominal surgery, thoracic surgery, brain surgery, and others. The study collected basic characteristics, such as age, sex, weight, birth weight, gestational week, primary diagnosis and American Society of Anaesthesiologists (ASA) grade. Perioperative data included preoperative body temperature, length of hospital stay, length of intensive care unit (ICU) stay, intubation time, postoperative bleeding, postoperative pneumonia, postoperative death, and total cost of hospitalization. Intraoperative data included surgical procedures, anaesthesia duration, operation duration, blood transfusion, fluid or albumin infusion, and application of vasoactive drugs. The incidence of intraoperative hypothermia (< 36 °C) was 81.05%. Compared to normothermic patients, gestational week (OR 0.717; 95% CI 0.577-0.890; P = 0.003), preoperative temperature (OR 0.228; 95% CI 0.091-0.571; P = 0.002), duration of anaesthesia (OR 1.052; 95% CI 1.027-1.077; P < 0.001), and type of surgery (OR 2.725; 95% CI 1.292-5.747; P = 0.008) were associated with the risk of intraoperative hypothermia. Patients with hypothermia had longer length of ICU stay (P = 0.001), longer length of hospital stay (P < 0.001), and higher hospital costs (P < 0.001). But there were no association between clinical outcomes and intraoperative hypothermia in the multivariable regression adjusted analysis. The lowest point of intraoperative body temperature was approximately 1 h 30 min. Then, the body temperature of patients successively entered a short plateau phase and a period of slow ascent. The greatest decrease in body temperatures occurred in preterm babies and neonates with preoperative hypothermia. The lowest core temperatures that occurred in neonates with preoperative hypothermia was lower than 35 °C. This study shows that there is a high incidence of intraoperative hypothermia in the neonate population. The intraoperative body temperature of neonates dropped to the lowest point in 1-1.5 h. The greatest decrease in core temperatures occurred in preterm babies and neonates with lower preoperative temperature.

The differences of hemogram, myelogram, and driver gene mutations in classic myeloproliferative neoplasms.

The aim of this study was to explore and compare routine blood features and pathological characteristics of bone marrow tissues in essential thrombocythemia (ET), polycythemia vera (PV), primary myelofibrosis, prefibrotic stage (prePMF) and overt fibrotic stage (overtPMF), and the correlation between common driver gene mutations and clinical manifestations of myeloproliferative neoplasms (MPN). Methods: We analyzed 259 MPN patients treated at Tongji Hospital of Huazhong University of Science and Technology from January 2016 to December 2020. Results: Among ET, PV, prePMF, and overtPMF, the median leukocyte counts of PV and prePMF were significantly higher than those of ET. The average hemoglobin level of overtPMF was significantly lower than that of ET, PV, and prePMF. ET and prePMF had higher platelet counts than PV and overtPMF, whereas ET had the lowest platelet distribution width. Regarding hematopoietic tissues in the bone marrow, enlarged megakaryocytes were easily found in ET, PV, and prePMF, whereas the average diameter of megakaryocytes in prePMF was smaller than in ET, and PV showed various sizes of megakaryocytes. An increased M/E ratio and dilation of sinus were seen more frequently in PMF. Additionally, JAK2-positive patients tended to have significantly higher leukocyte counts than CALR-positive patients in ET and PMF.

Small intestine duplication cyst with recurrent hematochezia: a case report and literature review.

BACKGROUND: Small intestine duplication cysts (SIDCs) are rare congenital anatomical abnormalities of the digestive tract and a rare cause of hematochezia. CASE PRESENTATION: We describe an adult female presented with recurrent hematochezia. The routine gastric endoscope and colonic endoscope showed no positive findings. Abdominal CT scan indicated intussusception due to the "doughnut" sign, but the patient had no typical symptoms. Two subsequent capsule endoscopes revealed a protruding lesion with bleeding in the distal ileum. Surgical resection was performed and revealed a case of SIDC measuring 6 * 2 cm located inside the ileum cavity. The patient remained symptom-free throughout a 7-year follow-up period. CONCLUSION: SIDCs located inside the enteric cavity can easily be misdiagnosed as intussusception by routine radiologic examinations.

Associations of immunological features with COVID-19 severity: a systematic review and meta-analysis.

BACKGROUND: COVID-19 has spread widely worldwide, causing millions of deaths. We aim to explore the association of immunological features with COVID-19 severity. METHODS: We conducted a meta-analysis to estimate mean difference (MD) of immune cells and cytokines levels with COVID-19 severity in PubMed, Web of Science, Scopus, the Cochrane Library and the grey literature. RESULTS: A total of 21 studies with 2033 COVID-19 patients were included. Compared with mild cases, severe cases showed significantly lower levels of immune cells including CD3+ T cell (× 106, MD, - 413.87; 95%CI, - 611.39 to - 216.34), CD4+ T cell (× 106, MD, - 203.56; 95%CI, - 277.94 to - 129.18), CD8+ T cell (× 106, MD, - 128.88; 95%CI, - 163.97 to - 93.79), B cell (× 106/L; MD, - 23.87; 95%CI, - 43.97 to - 3.78) and NK cell (× 106/L; MD, - 57.12; 95%CI, - 81.18 to - 33.06), and significantly higher levels of cytokines including TNF-α (pg/ml; MD, 0.34; 95%CI, 0.09 to 0.59), IL-5 (pg/ml; MD, 14.2; 95%CI, 3.99 to 24.4), IL-6 (pg/ml; MD, 13.07; 95%CI, 9.80 to 16.35), and IL-10 (pg/ml; MD, 2.04; 95%CI, 1.32 to 2.75), and significantly higher levels of chemokines as MCP-1 (SMD, 3.41; 95%CI, 2.42 to 4.40), IP-10 (SMD, 2.82; 95%CI, 1.20 to 4.45) and eotaxin (SMD, 1.55; 95%CI, 0.05 to 3.05). However, no significant difference was found in other indicators such as Treg cell (× 106, MD, - 0.13; 95%CI, - 1.40 to 1.14), CD4+/CD8+ ratio (MD, 0.26; 95%CI, - 0.02 to 0.55), IFN-γ (pg/ml; MD, 0.26; 95%CI, - 0.05 to 0.56), IL-2 (pg/ml; MD, 0.05; 95%CI, - 0.49 to 0.60), IL-4 (pg/ml; MD, - 0.03; 95%CI, - 0.68 to 0.62), GM-CSF (SMD, 0.44; 95%CI, - 0.46 to 1.35), and RANTES (SMD, 0.94; 95%CI, - 2.88 to 4.75). CONCLUSION: Our meta-analysis revealed significantly lower levels of immune cells (CD3+ T, CD4+ T, CD8+ T, B and NK cells), higher levels of cytokines (TNF-α, IL-5, IL-6 and IL-10) and higher levels of chemokines (MCP-1, IP-10 and eotaxin) in severe cases in comparison to mild cases of COVID-19. Measurement of immunological features could help assess disease severity for effective triage of COVID-19 patients.

Synthesis, characterization and application of magnetoferritin nanoparticle by using human H chain ferritin expressed by Pichia pastoris.

Protein-based nanoparticles have developed rapidly in areas such as drug delivery, biomedical imaging and biocatalysis. Ferritin possesses unique properties that make it attractive as a potential platform for a variety of nanobiotechnological applications. Here we synthesized magnetoferritin (P-MHFn) nanoparticles for the first time by using the human H chain of ferritin that was expressed by Pichia pastoris (P-HFn). Western blot results showed that recombinant P-HFn was successfully expressed after methanol induction. Transmission electron microscopy (TEM) showed the spherical cage-like shape and monodispersion of P-HFn. The synthesized magnetoferritin (P-MHFn) retained the properties of magnetoferritin nanoparticles synthesized using HFn expressed by E. coli (E-MHFn): superparamagnetism under ambient conditions and peroxidase-like activity. It is stable under a wider range of pH values (from 5.0 to 11.0), likely due to post-translational modifications such as N-glycosylation on P-HFn. In vivo near-infrared fluorescence imaging experiments revealed that P-MHFn nanoparticles can accumulate in tumors, which suggests that P-MHFn could be used in tumor imaging and therapy. An acute toxicity study of P-MHFn in Sprague Dawley rats showed no abnormalities at a dose up to 20 mg Fe Kg-1 body weight. Therefore, this study shed light on the development of magnetoferritin nanoparticles using therapeutic HFn expressed by Pichia pastoris for biomedical applications.

[Application of enhanced recovery after surgery in the treatment of children with congenital choledochal cyst].

OBJECTIVE: To explore the feasibility of enhanced recovery after surgery (ERAS) in treatment of children with congenital choledochal cyst. METHODS: One hundred and thirty children with congenital choledochal cysts admitted in the Children's Hospital of Zhejiang University from June 2017 to June 2019 were divided into ERAS group (n=65) and control group (n=65) according to admission order. The intestinal tract condition during operation, time of operation, surgical results, time for eating after operation, abdominal drainage after operation, length of hospital stay after operation, total hospital expenses and complications were compared between two groups. RESULTS: Compared with the control group, the satisfaction of intestinal operation field, recovery of gastrointestinal function after operation,time required for the volume of peritoneal drainage fluid to be less than 50 mL,time of abdominal drainage tube removal, and length of hospital stay were all improved in ERAS group (P<0.05 or P<0.01).ERAS group had more peritoneal effusion after removal of abdominal drainage tube (P<0.01), but the incidence of edema after operation was lower (P<0.05). The satisfaction of parents in the two groups was similar, but the cooperation of parents in the ERAS group was improved (P<0.05) and the total cost of hospitalization was reduced (P<0.01). CONCLUSIONS: ERAS has advantages over the traditional scheme and can be used in the clinical treatment of children with congenital choledochal cyst.

Production of a fungal furocoumarin by a polyketide synthase gene cluster confers the chemo-resistance of Neurospora crassa to the predation by fungivorous arthropods.

The formation of sexual fruiting bodies and production of polyketides are believed to be the most important strategies for fungal survival in environmental insults. In Neurospora crassa, the backbone gene of polyketide synthase gene cluster 6 (pks-6), which is expressed at lower level under vegetative growth, is highly expressed during perithecia development. Intriguingly, deletion of pks-6 does not affect perithecia maturation. How the expression of pks-6 correlates with fungal sexual development remains to be established. Here, we showed that overexpression of pks-6 results in an enhanced production of an insecticidal furocoumarin (neurosporin A). Deletion of pks-6, however, abolished neurosporin A biosynthesis. Moreover, the content of neurosporin A negatively associates with the food preference of fungivores, where the pks-6 knockout strain is more prone to be grazed by collembolans Sinella curviseta. Additionally, during vegetative growth, confrontation with Drosophila melanogaster also results in an enhanced expression of pks-6 and production of neurosporin A. Thus, high expression of pks-6 positively interrelates with the chemo-resistance of N. crassa to arthropod predation. Our findings suggest that pks-6 confers the production of insecticidal neurosporin A counteracting the feeding attack by arthropods during sexual development of N. crassa.

Towards Monodisperse Star-Shaped Ladder-Type Conjugated Systems: Design, Synthesis, Stabilized Blue Electroluminescence, and Amplified Spontaneous Emission.

A novel series of monodisperse star-shaped ladder-type oligo(p-phenylene)s, named as TrL-n (n=1-3), have been explored. Their thermal and electrochemical properties, fluorescence transients, photoluminescence quantum yields, density functional theory calculations, electroluminescence (EL) and amplified spontaneous emission (ASE) properties have been systematically investigated to unravel the molecular design on optoelectronic properties. The resulting materials showed excellent structural perfection, free of chemical defects, and exhibited great thermal stability (Td : 404-418 °C and Tg : 147-184 °C) and amorphous glassy morphologies. Compared with their corresponding linear counterparts FL-m (m=1-3), TrL-n showed only little bathochromic shifts (5-12 nm) for the absorption maxima λmax in both solution and films. The star-shaped ladder-type compounds exhibited enhanced optical stability and suppressed low-energy emission. Their EL spectra exhibited excellent stability with increasing the driving voltage from 6 to 12 V. Moreover, superior low ASE thresholds were recorded for TrL-n compared with FL-m. Rather low ASE threshold (29 nJ per pulse or 1.60 µJ cm-2 ) was recorded for TrL-3, demonstrating their promising potential as excellent gain media. This study provides a novel design concept to develop monodisperse star-shaped ladder-type materials with excellent structural perfection, which are vital for shedding light on exploring robust organic emitters for optoelectronic applications.

Elevated homocysteine levels contribute to larger hematoma volume in patients with intracerebral hemorrhage.

BACKGROUND: We investigate whether plasma homocysteine (HCY) levels are associated with hematoma volume and outcome in patients with intracerebral hemorrhage (ICH). METHODS: A total of 69 patients admitted within 24 hours after ICH onset was divided into 2 groups based on admission plasma HCY levels (low homocysteinemia [LHCY] group, plasma HCY concentrations ≤14.62 µmol/L, versus high homocysteinemia [HHCY] group, >14.62 µmol/L). RESULTS: Mean hematoma volumes for 2 groups (LHCY and HHCY) were 13.18 and 23.09 mL (P = .012), respectively, in patients with thalamoganglionic ICH, but hematoma volumes between 2 groups had no significant difference among patients with lobar or infratentorial ICH. On multivariate linear regression analysis, elevated HCY levels significantly correlated with larger hematoma volume in patients with thalamoganglionic ICH (B = .604, P = .004) after adjustment for confounding factors. Poor outcomes (6-month modified Rankin Scale scores ≥3) were not significantly different between 2 groups (low homocysteinemia group, 31.4%, versus high homocysteinemia group, 41.2%, P = .400). CONCLUSIONS: Elevated plasma HCY levels were associated with larger hematoma volume only in patients with thalamoganglionic ICH. HCY levels might not be predictors of the 6-month clinical outcome in patients with ICH.

Isolation of a novel alkaline-stable lipase from a metagenomic library and its specific application for milkfat flavor production.

BACKGROUND: Lipolytic enzymes are commonly used to produce desired flavors in lipolyzed milkfat (LMF) manufacturing processes. However, the choice of enzyme is critical because it determines the final profile of fatty acids released and the consequent flavor of the product. We previously constructed a metagenomic library from marine sediments, to explore the novel enzymes which have unique properties useful in flavor-enhancing LMF. RESULTS: A novel lipase Est_p6 was isolated from a metagenomic library and was expressed highly in E.coli. Bioinformatic analysis indicated that Est_p6 belongs to lipolytic enzyme family IV, the molecular weight of purified Est_p6 was estimated at 36 kDa by SDS-PAGE. The hydrolytic activity of the enzyme was stable under alkaline condition and the optimal temperature was 50°C. It had a high specific activity (2500 U/mg) toward pNP butyrate (pNP-C4), with K(m) and V(max) values of 1.148 mM and 3497 µmol∙min⁻¹âˆ™mg⁻¹, respectively. The enzyme activity was enhanced by DTT and was not significantly inhibited by PMSF, EDTA or SDS. This enzyme also showed high hydrolysis specificity for myristate (C14) and palmitate (C16). It seems that Est_p6 has safety for commercial LMF flavor production and food manufacturing processes. CONCLUSIONS: The ocean is a vast and largely unexplored resource for enzymes. According the outstanding alkaline-stability of Est_p6 and it produced myristic acid and palmitic acid more efficiently than other free fatty acids in lipolyzed milkfat. This novel lipase may be used to impart a distinctive and desirable flavor and odor in milkfat flavor production.

Modulation of starch structure, swallowability and digestibility of 3D-printed diabetic-friendly food for the elderly by dry heating.

Elderly people often experience difficulty in swallowing and have impaired regulation of the nervous system. Furthermore, their blood glucose level can rise easily after eating. Therefore, functional foods that are easy to swallow and can maintain blood glucose at a lower level have been an important research topic in recent years. In this study, 3D printing was combined with dry heating to modify the starch in white quinoa and brown rice to develop whole grain foods with Osmanthus flavor that meet the dietary habits of the elderly. The samples were tested for printability, swallowing performance, and in vitro digestion. The results showed that after dry heating, all samples had shear-thinning properties and could pass through the extrusion nozzle of the printer smoothly. Both white quinoa and brown rice showed improved printability and self-support compared to the control. B45 (white quinoa, dry heating for 45 min) and C45 (brown rice, dry heating for 45 min) had significant elasticity and greater internal interaction strength during swallowing to resist disintegration of food particles during chewing. B45, C30, and C45, conformed to class 4 consistency and were characterized by easy swallowing of the diet. Further, dry heating resulted in greater resistance to enzymatic degradation of white quinoa and brown rice starch, with overall in vitro digestibility lower than the control.

Comparison of volume-controlled ventilation, pressure-controlled ventilation and pressure-controlled ventilation-volume guaranteed in infants and young children in the prone position: A prospective randomized study.

STUDY OBJECTIVE: To explore if the pressure-controlled ventilation (PCV) and pressure-controlled ventilation-volume guaranteed (PCV-VG) modes are superior to volume-controlled ventilation (VCV) in optimizing intraoperative respiratory mechanics in infants and young children in the prone position. DESIGN: A single-center prospective randomized study. SETTING: Children's Hospital, Zhejiang University School of Medicine. PATIENTS: Pediatric patients aged 1 month to 3 years undergoing elective spinal cord detethering surgery. INTERVENTIONS: Patients were randomly allocated to the VCV group, PCV group and PCV-VG group. The target tidal volume (VT) was 8 mL/kg and the respiratory rate (RR) was adjusted to maintain a constant end tidal CO2. MEASUREMENTS: The primary outcome was intraoperative peak airway pressure (Ppeak). Secondary outcomes included other respiratory and ventilation variables, gas exchange values, serum lung injury biomarkers concentration, hemodynamic parameters and postoperative respiratory complications. MAIN RESULTS: A total of 120 patients were included in the final analysis (40 in each group). The VCV group showed higher Ppeak at T2 (10 min after prone positioning) and T3 (30 min after prone positioning) than the PCV and PCV-VG groups (T2: P = 0.015 and P = 0.002, respectively; T3: P = 0.007 and P = 0.009, respectively). The prone-related decrease in dynamic compliance was prevented by PCV and PCV-VG ventilation modalities at T2 and T3 than by VCV (T2: P = 0.008 and P = 0.015, respectively; T3: P = 0.015 and P = 0.014, respectively). Additionally, there were no significant differences in other secondary outcomes among the three groups. CONCLUSION: In infants and young children undergoing spinal cord detethering surgery in the prone position, PCV-VG may be a better ventilation mode due to its ability to mitigate the increase in Ppeak and decrease in Cdyn while maintaining consistent VT.

Frontline combination of dasatinib and low-intensity chemotherapy in adults with de novo Philadelphia chromosome-positive acute lymphoblastic leukemia.

BACKGROUND: Studies on dasatinib-based low-intensity induction regimens and post-remission strategies are limited in China. Therefore, we conducted a single-center phase 2 trial in newly diagnosed adult patients with Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL) to establish the efficacy and safety of this treatment approach. RESEARCH DESIGN AND METHODS: Patients received one month of dasatinib plus low-intensity chemotherapy and two months of dasatinib monotherapy for induction, followed by a single course of high-dose methotrexate for consolidation. Subsequently, they underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) or tyrosine kinase inhibitor (TKI)-based treatment for maintenance therapy between October 2015 and August 2022. RESULTS: Twenty-two patients were enrolled. Median age was 45 years (range, 20-71). The rates of major and complete molecular responses in the third month were 18.2% and 40.9% respectively. With a median follow-up of 15 months (range, 5-89), the estimated 3-year disease-free survival (DFS) and overall survival (OS) were 52.4% and 73.2%, respectively. The TKI-based cohort had a significantly poorer DFS (p = 0.014) and OS (p = 0.008) than the allo-HSCT cohort. CONCLUSIONS: Our results suggest that dasatinib-based low-intensity chemotherapy is safe and effective as an induction strategy in the Chinese population. Allo-HSCT plays a crucial role in the long-term outcomes of patients with Ph+ ALL. CLINICAL TRIAL REGISTRATION: The trial was registered at ClinicalTrials.gov as NCT02690922.

Perspectives on Novel Technologies of Processing and Monitoring the Safety and Quality of Prepared Food Products.

With the changes of lifestyles and rapid growth of prepared food industry, prepared fried rice that meets the consumption patterns of contemporary young people has become popular in China. Although prepared fried rice is convenient and nutritious, it has the following concerns in the supply chain: (1) susceptible to contamination by microorganisms; (2) rich in starch and prone to stall; and (3) vegetables in the ingredients have the issues of water loss and discoloration, and meat substances are vulnerable to oxidation and deterioration. As different ingredients are used in prepared fried rice, their food processing and quality monitoring techniques are also different. This paper reviews the key factors that cause changes in the quality of prepared fried rice, and the advantages and limitations of technologies in the processing and monitoring processes. The processing technologies for prepared fried rice include irradiation, high-voltage electric field, microwave, radio frequency, and ohmic heating, while the quality monitoring technologies include Raman spectral imaging, near-infrared spectral imaging, and low-field nuclear magnetic resonance technology. These technologies will serve as the foundation for enhancing the quality and safety of prepared fried rice and are essential to the further development of prepared fried rice in the emerging market.

Risk factors associated with prolonged intensive care unit stay following surgery for total anomalous pulmonary venous connection: a retrospective study.

BACKGROUND: Prolonged intensive care unit (ICU) stays consume medical resources and increase medical costs. This study identified risk factors associated with prolonged postoperative intensive care unit (ICU) stay in children with total anomalous pulmonary venous connection (TAPVC). METHODS: The medical records of 85 patients who underwent surgical repair of TAPVC were retrospectively analyzed. The patients were divided into prolonged-stay and standard-stay groups. The prolonged stay group included all patients who exceeded the 75th percentile of the ICU stay duration, and the standard stay group included all remaining patients. The effects of patient variables on ICU stay duration were investigated using univariate and logistic regression analyses. RESULTS: Patient median age was 41 (18-103) days, and median weight was 3.80 (3.30-5.35) kg.Postoperative duration of ICU stay was 11-68 days in the prolonged stay group (n = 23) and 2-10 days in the standard stay group (n = 62). Lower preoperative pulse oximetry saturation (SpO2), higher intraoperative plasma lactate levels, and prolonged postoperative mechanical ventilation were independent risk factors for prolonged ICU stay. Preoperative SpO2 < 88.5%, highest plasma lactate value > 4.15 mmol/L, and postoperative mechanical ventilation duration was longer than 53.5 h, were associated with increased risk of prolonged ICU stay. Young age, low body weight, subcardiac type, need for vasoactive drug support, emergency surgery, long anesthesia time, low SpO2 after anesthesia induction, long cardiopulmonary bypass (CPB) and aortic clamp times, high lactate level, low temperature, large volume of ultrafiltration during CPB, large amounts of chest drainage, large red blood cells (RBCs) and plasma transfusion, and postoperative cardiac dysfunction may be associated with prolonged ICU stay. CONCLUSIONS: Lower preoperative SpO2, higher intraoperative plasma lactate levels, and prolonged postoperative mechanical ventilation were independent risk factors for prolonged ICU stay in children with TAPVC. When SpO2 was lower than 88.5%, the highest plasma lactate value was more than 4.15 mmol/L, and the postoperative mechanical ventilator duration was longer than 53.5 h, the risk of prolonged ICU stay increased. Improved clinical management, including early diagnosis and timely surgical intervention to reduce hypoxia time and protect intraoperative cardiac function, may reduce ICU stay time.

Application of laryngeal mask airway anesthesia with preserved spontaneous breathing in children undergoing video-assisted thoracic surgery.

Purpose: To investigate the feasibility and safety of non-intubated general anesthesia with spontaneous breathing combined with paravertebral nerve blocks (PVNB) in young children undergoing video-assisted thoracic surgery (VATS) and to determine its significance for rapid recovery after pediatric thoracic surgery. Methods: The data of 46 children aged 6-36 months with an American Society of Anesthesiologists status of I-II who underwent elective VATS under general anesthesia were retrospectively analyzed. Of these patients, 25 underwent non-intubated general anesthesia with spontaneous breathing combined with PVNB (non-intubation group), and 21 received conventional intubated general anesthesia combined with local infiltration anesthesia (intubation group). The following perioperative parameters were compared between the two groups: heart rate (HR), mean arterial pressure, saturation of pulse oximetry (SpO2), partial pressure end-tidal carbon dioxide, time from the completion of the operation to extubation or removing laryngeal masks, time to first feeding after the operation, length of postoperative in-hospital stay, incidence of postoperative complications, and hospitalization expenses. Results: The operations were completed successfully in both groups. When the non-intubation group was compared with the intubation group, the minimal SpO2 level during the surgery was higher (93% vs. 88%, P < 0.001), which might indicate better oxygenation. There was no significant difference of the duration of surgery and intraoperative blood loss between two groups. Compared to the intubation group, the duration of anesthesia (P = 0.027), time from the completion of the operation to extubation (P < 0.001), time to the first feeding after surgery (P < 0.001), and length of postoperative in-hospital stay (P < 0.001) were significantly reduced in the non-intubation group. The incidence of postoperative complications was not significantly different. Conclusions: Non-intubated general anesthesia with spontaneous breathing combined with PVNB is safe and feasible in young children undergoing VATS and can promote rapid recovery in young children undergoing thoracoscopic surgery.