Construction of sensitive quality indicators for rapid rehabilitation care of patients after combined pancreaticoduodenectomy.

AIM: To construct evidence-based sensitive quality indicators for patients' rapid rehabilitation care after combined pancreaticoduodenectomy (PD) and to provide a reference for clinical nursing professionals to scientifically evaluate the quality of patients' rehabilitation post-PD. BACKGROUND: Since PD is associated with higher surgical risk and anastomotic complications, it leads to higher complication rates and longer postoperative recovery cycles. This reiterates the need for rapid recovery of patients after PD; however, the evaluation of sensitive nursing care indicators regarding rapid recovery post-PD has not yet been established to date. METHODS: Based on the Donabedian structure-process-result theory model, we used available literature, semi-structured interviews, the Delphi method, and hierarchical analysis to establish a sensitive indicator system for patients' rapid rehabilitation after PD and evaluate the importance of such indicators. RESULTS: There were two rounds of expert correspondence, and the effective recovery rate of the questionnaires of these rounds was 100%. The expert authority coefficients, as well as the Kendall coordination coefficients of the expert opinions, were 0.859 and 0.872 as well as 0.423 and 0.431, with statistically significant differences (p < 0.05), respectively. Consequently, we developed a sensitive quality index system for patients' rapid rehabilitation care after combined PD, including 3 first-level, 12 s-level, and 23 third-level indexes, respectively. CONCLUSION: The constructed sensitive quality index system developed for patients' rapid rehabilitation nursing care after combined PD is standardized, practical, and aligned with the specialty characteristics. Furthermore, this might help greatly in improving the quality and safety of patients' rapid rehabilitation nursing care after combined PD, standardizing nursing management skills, and enhancing nursing quality.

Fluorination Strategy Towards Symmetry Breaking of Boron-centered Tetrahedron for Poly-fluorinated Optical Crystals.

Borate crystals can be chemically and functionally modified by the fluorination strategy, which encourages the identification of emerging fluorooxoborates with a structure and set of characteristics not seen in any other oxide parents. However, the bulk of fluorooxoborates have been found accidentally, rational methods of synthesis are required, particularly for the infrequently occurring poly-fluorinated components. Herein, we reported the use of bifluoride salts as a potent source of fluorine to prepare fluorooxoborates that contain rarely tri-fluorinated [BF3 X] (X=O and CH3 ) tetrahedra and eleven compounds were found. We identified the optical properties of the organofluorinated group [CH3 BF3 ] and their potential for nonlinear optics for the first time. Among these, two non-centrosymmetric components hold potential for the production of 266 nm harmonic coherent light for nonlinear optics, and more crucially, have the benefit of growing large size single crystals. Our study establishes experimental conditions for the coexistence of the diverse functional groups, enabling the production of poly-fluorinated optical crystals.

Synthesis of Urchin-like Ni@NP@NCP Composites with Three Solvothermal Systems for Highly Efficient Overall Seawater Splitting.

In this work, an urchin-like Ni@Ni2P@NiCoP (Ni@NP@NCP) composite was prepared on nickel foam by a simple hydrothermal treatment process. Using the prepared NiO nanosheets as templates, the NiCo precursor was prepared in the presence of three solvothermal systems of water/dimethylformamide (DMF)/dimethyl sulfoxide (DMSO) by the hydrothermal process. After mixing and calcining with sodium hypophosphite under a nitrogen atmosphere at a high temperature for phosphating, an urchin-like Ni@NP@NCP(F/SO/H) nanostructured catalyst was obtained with superior hydrogen evolution and oxygen evolution performance. To further explore their efficiency in seawater splitting. Ni@NP@NCP(F/SO/H) composites were used as the cathode and anode of an electrolytic cell, which delivered 1.822 V potential at 300 mA cm-2 in simulated seawater (1 M KOH and 0.5 M NaCl). This may provide an effective way of developing clean energy.

Agonist long protocol improves outcomes of vitrified-warmed embryo transfer in repeatedly thin endometrium.

RESEARCH QUESTION: Does follicular stimulation using human menopausal gonadotrophin (HMG) after pituitary down-regulation by a GnRH agonist improve endometrial thickness (EMT) and clinical outcomes of frozen-thawed embryo transfer (FET; using vitrified-warmed embryos) in women with thin endometrium after intensified oestrogen administration (IOA)? DESIGN: This was a retrospective study. A total of 627 patients attempted 683 FET cycles with at least one previous history of thin endometrium. None of the cycles reached over 7 mm EMT after using oral and vaginal oestradiol for more than 21 days (IOA protocol). A total of 129 cycles proceeded with FET, 305 cycles were cancelled, and 249 cycles involved administration of HMG following GnRH agonist pituitary down-regulation (GnRH agonist + HMG protocol) for further endometrial preparation. RESULTS: EMT became significantly greater (7.18 ± 1.14 mm versus 6.13 ± 0.63 mm, P < 0.001) using GnRH agonist + HMG compared with previous IOA cycles, but this was not related to serum oestrogen concentrations. A total of 213 cycles after the GnRH agonist + HMG protocol proceeded with FET, showing a significantly increased clinical pregnancy rate, implantation rate and live birth rate compared with those after IOA. CONCLUSIONS: The GnRH agonist + HMG protocol for endometrial preparation in FET cycles improves EMT in women with a thin endometrium after IOA and showed significantly better clinical outcomes than IOA. The authors suggest that the GnRH agonist + HMG protocol should be used for EMT that is less than 7 mm after there has been no optimal response to IOA.

Comparative analysis of the vaginal microbiome of healthy and polycystic ovary syndrome women: a large cross-sectional study.

RESEARCH QUESTION: What are the different features of the vaginal microbiome (VMB) between patients with polycystic ovary syndrome (PCOS) and healthy women? DESIGN: A cross-sectional study was conducted at a single academic university-affiliated centre. A total of 1446 participants were recruited (PCOS group, n =713, control group, n = 733). Vaginal swabs were analysed using 16S rRNA gene sequencing. The diversity and composition of the microbiome were compared between the PCOS group and the control group. Microbial interaction networks and functional prediction were investigated. RESULTS: The PCOS group had a higher alpha diversity than the control group (Shannon P = 0.03, Simpson P = 0.02), and higher intra-group variability was observed in PCOS group (P < 2.2E-16). At the genus level, the proportion of Lactobacillus decreased (85.1% versus 89.3%, false discovery rate [FDR] = 0.02), whereas the proportion of Gardnerella vaginalis and Ureaplasma increased in the PCOS group (5.1% versus 3.3%, FDR = 0.006; 1.2% versus 0.6%, FDR = 0.002, respectively). Lactobacillus acidophilus, Prevotella buccalis and G. vaginalis were identified as the main differential species. L. acidophilus was positively correlated with serum levels of anti-Müllerian hormone (AMH), and triglyceride (P = 2.01E-05, P = 0.004, respectively). P. buccalis was negatively correlated with serum levels of AMH and testosterone (P = 0.002, P = 0.003, respectively). G. vaginalis was positively correlated with serum levels of AMH, oestradiol and progesterone (P = 0.004, P = 0.005, P = 0.03, respectively). The VMB interaction network indicated that Lactobacillus crispus, Prevotella timonensis, and P. buccalis could be key drivers in the PCOS group. Overall, 55 predicted genes were found to be differentially abundant between PCOS and the control (FDRs < 0.25). CONCLUSIONS: The PCOS group had a higher diversity of vaginal microbiome and showed an enhanced level of heterogeneity. The proportion of Lactobacillus in the PCOS group decreased, whereas the proportions of Gardnerella and Ureaplasma increased. These results warrant further research that can validate the correlation between PCOS and VMB.

Target-Oriented Synthesis of Borate Derivatives Featuring Isolated [B3O3] Six-Membered Rings as Structural Features.

Borates provide an excellent platform for investigating the optical nonlinearity and linearity of crystals as photoelectric functional materials. In our work, borate derivatives with isolated [B3O3] six-membered rings as structural features are the preferred system due to their simple functional units and excellent properties. Herein, by utilizing the target-oriented synthesis, a series of borate derivatives, A2[B3O3F4(OH)] (A= NH4, Rb, Cs) (ABOFH), K2.3Cs0.7B3O3F6 (KCsBOF), and Cs3[B3O3(OH)3]Cl3 (CsBOHCl), with novel heteroanionic groups containing [BOxF4-x] (x = 0-3) and/or [BO2(OH)] units were obtained. ABOFH, KCsBOF, and CsBOHCl construct different two-dimensional pesudolayers featuring [B3O3F4(OH)], [B3O3F6], and [B3O3(OH)3] units, respectively. Also, the optical properties and the arrangement information of these anionic groups were studied. Among the total five compounds, (NH4)2[B3O3F4(OH)] and Cs3[B3O3(OH)3]Cl3 with enlarged birefringence and sufficient band gaps were screened out as promising birefringent crystals due to the optimally aligned configuration of birefringence-active heteroanionic units. The successful results of target-oriented synthesis indicate a more profound conclusion that the borate system now has more diversified structural chemistry, and an effective strategy was proposed to modify the arrangement and species of anionic units to optimize the performance of optical crystals.

Screening the predictors for live birth failure in women after the first frozen embryo transfer based on the Lasso algorithm: a retrospective study.

This study aimed to screen factors related to live birth outcomes of women with first frozen embryo transfer (FET). The enrolled women were divided into training and validation cohorts. The least absolute shrinkage and selection operator (Lasso) regression algorithm of machine learning and the multiple regression model were then used to screen factors relevant to live birth failure (LBF) for the training dataset. A nomogram risk prediction model was established on the basis of the screened factors, and the consistency index (C-index) and calibration curve were derived for evaluating the model. The validation cohort was utilized to validate the nomogram model further. In total, 2083 women who accepted the first FET in our hospital were included and 44 factors were initially screened in this study. On the basis of the training cohort, the screened risk factors via multiple regression analysis with odds ratio (OR) values were female age (OR: 3.092, 95%CI: 1.065-4.852), body mass index (BMI; OR: 1.106, 95%CI: 1.015-1.546), caesarean section (OR: 1.909, 95%CI: 1.318-2.814), number of high-quality embryos (OR: 0.698, 95%CI: 0.599-0.812), and endometrial thickness (OR: 0.957, CI: 0.904-0.980). The nomogram model was generated based on five predictors. Furthermore, favourable results with C-indexes and calibration curves close to ideal curves indicated the accurate predictive ability of the nomogram. Female age, BMI, caesarean section, number of high-quality embryos, and endometrial thickness were independent predictors for LBF. The five factors of the risk assessment model may help to identify LBF with high accuracy in women who accept FET.

Giant Mid-Infrared Second-Harmonic Generation Response in a Densely-Stacked Van Der Waals Transition-Metal Oxychloride.

Second-harmonic generation (SHG) is a fundamental optical property of nonlinear optical (NLO) crystals. Thus far, it has proved difficult to engineer large SHG responses, particularly in the mid-infrared region, owing to the difficulty in simultaneously controlling the arrangement and density of functional NLO-active units. Herein, a new assembly strategy employing functional modules only, and aimed at maximizing the density and optimizing the spatial arrangement of highly efficient functional modules, has been applied to the preparation of NLO crystals, affording the van der Waals crystal MoO2 Cl2 . This exhibits the strongest powder SHG response (2.1×KTiOPO4 (KTP) @ 2100 nm) for a transition-metal oxyhalide, a wide optical transparency window, and a sufficient birefringence. MoO2 Cl2 is the first SHG-active transition-metal oxyhalide effective in the infrared region. Theoretical studies and crystal structure analysis suggest that the densely packed, optimally-aligned [MoO4 Cl2 ] modules within the two-dimensional van der Waals layers are responsible for the giant SHG response.

K6(IO6H4)(HI2O6)(HIO3)2(IO3)4·2H2O: A Case of Iodate with Coexisting [I5+O3] and [I7+O6] Units.

A new alkali-metal iodate, K6(IO6H4)(HI2O6)(HIO3)2(IO3)4·2H2O (KIOH), was successfully grown at room temperature by a slow evaporation method. To our knowledge, the title compound is the first alkali-metal iodate containing isolated [I5+O3] and [I7+O6] units in one structure. Both the bond valence sum and X-ray photoelectron spectroscopy confirmed this phenomenon, which is consistent with the single-crystal data. Also, the theoretical calculation results showed that the title compound is a potential birefringent material. What is more, the low-cost growth of centimeter-sized crystals for the title compound greatly enriches the structural chemistry of the iodate system.

Strong Nonlinearity Induced by Coaxial Alignment of Polar Chain and Dense [BO3 ] Units in CaZn2 (BO3 )2.

Discovery of new efficient nonlinear optical (NLO) materials with large second-order nonlinearity for the short-wave ultraviolet spectral region (λPM ≤266 nm, PM=phase-matching) is still very challenging. Herein, a new beryllium-free borate CaZn2 (BO3 )2 with Sr2 Be2 B2 O7 (SBBO) double-layered like configuration was rationally designed, which not only preserves the structural merits but also eliminates the limitations of the SBBO crystal. CaZn2 (BO3 )2 shows a large PM second harmonic generation (SHG) reponse of 3.8×KDP, which is 38 times higher than that of its barium analogue. This enhancement mainly originates from the 1 [Zn2 O6 ]∞ polar chains with a large net dipole moment and [BO3 ] units with a high NLO active density. Our findings show the great significance of the [ZnO4 ] tetrahedra introduced strategy to design beryllium-free SBBO-type NLO crystals and also verify the feasibility of using simple non-isomorphic substitution to induce giant second-order nonlinearity enhancement.