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This study investigated the impact of 24-h urinary calcium excretion (UCaE) on renal function decline in hospitalized patients with and without chronic kidney disease (CKD). This study enrolled 3815 CKD patients in stages 1–4 and 1133 non-CKD patients admitted to the First Center of the Chinese PLA General Hospital between January 2014 and July 2022. The primary outcome for CKD patients was a composite of CKD progression, defined as a 40% decline in estimated glomerular filtration rate (eGFR) or end-stage kidney disease. Annual eGFR change was the secondary outcome. For non-CKD patients, the primary outcome was an eGFR decline of ≥20% or CKD incidence, while annual eGFR change was the secondary outcome. The association between UCaE and kidney function decline was assessed using Cox proportional hazards and generalized linear models. Primary outcomes were observed in 813 CKD patients and 109 non-CKD patients over a median follow-up of 3.0 and 4.1 years, respectively. For CKD patients, every 1-mmol/d increase in UCaE was associated with a 15% decreased risk of CKD progression. The hazard ratio (HR) was 0.85, with a 95% confidence interval (CI) of 0.77–0.93. For non-CKD patients, the risk of renal function decline decreased by 11%. The multivariate models indicated that there was an annual decrease in eGFR in both CKD and non-CKD patients, with a reduction of 0.122 mL/min/1.73 m2/year (p < 0.001) and 0.046 mL/min/1.73 m2/year (p = 0.004), respectively, for every 1-mmol/d increase in UCaE. CKD experiences a decrease in 24-h UCaE as early as stage 1, with a significant decline in stage 4. CKD and non-CKD patients with lower UCaE levels are at an increased risk of renal decline, regardless of other variables. [ABSTRACT FROM AUTHOR]

Simple Summary: The ammonia content in aquaculture waterbodies can easily achieve a relatively high level, largely due to the excretion of intensively farmed aquatic animals and the decomposition of residual food particles. Excess ammonia may exert prominent toxicities to all aquatic species. Many freshwater turtles have become economically important aquaculture species in some countries. The evaluation of the toxic effects of ammonia on these cultured turtle species is rarely considered, despite having been extensively conducted in many invertebrates and fish. Various omics techniques can be applied to comprehensively analyze diverse biological responses at different levels in pollutant-exposed individuals. In order to increase our understanding of the physiological changes under ammonia stress in cultured turtle species, we exposed juveniles of the red-eared slider turtle (Trachemys scripta elegans) to different concentrations (0, 0.3, 3.0, and 20.0 mg/L) of ammonium chloride solution for 30 days, and then measured their swimming performance, growth rate, gut microbial composition, and liver metabolic profiling. No significant change in swimming ability was found in ammonia-exposed turtles, but a relatively low growth rate was exhibited in the 20.0 mg/L ammonia-exposed turtles. Although no significant differences in the alpha and beta diversity measures of the gut microbial community were observed, the microbial composition seemed to be different among different treatment groups. Some pathogenic bacteria were found to increase in ammonia-exposed turtles. Liver metabolic profiling based on liquid chromatography–mass spectrometry showed that a series of metabolites (such as leucine, valine, arginine, glutamine, adenosine diphosphate, glyceric acid, myo-inositol, gamma-aminobutyric acid, etc.) were significantly altered in ammonia-exposed turtles. Accordingly, ammonia exposure might alter the health status of guts due to increased pathogenic bacteria, and disturb multiple metabolic pathways (such as amino acid, nucleotide, lipid metabolism, energy metabolism, etc.) in juveniles of T. scripta elegans. As the most common pollutant in aquaculture systems, the toxic effects of ammonia have been extensively explored in cultured fish, molluscs, and crustaceans, but have rarely been considered in turtle species. In this study, juveniles of the invasive turtle, Trachemys scripta elegans, were exposed to different ammonia levels (0, 0.3, 3.0, and 20.0 mg/L) for 30 days to evaluate the physiological, gut microbiomic, and liver metabolomic responses to ammonia in this turtle species. Except for a relatively low growth rate of turtles exposed to the highest concentration, ammonia exposure had no significant impact on the locomotor ability and gut microbial diversity of turtles. However, the composition of the microbial community could be altered, with some pathogenic bacteria being increased in ammonia-exposed turtles, which might indicate the change in their health status. Furthermore, hepatic metabolite profiles via liquid chromatography–mass spectrometry revealed extensive metabolic perturbations, despite being primarily involved in amino acid biosynthesis and metabolism. Overall, our results show that ammonia exposure causes gut dysbacteriosis and disturbs various metabolic pathways in aquatic turtle species. Considering discrepant defense mechanisms, the toxic impacts of ammonia at environmentally relevant concentrations on physiological performance might be less pronounced in turtles compared with fish and other invertebrates. [ABSTRACT FROM AUTHOR]

This research examines the association between the platelet-derived growth factor/platelet-derived growth factor receptor (PDGF/PDGFR) system and rheumatoid arthritis (RA) susceptibility through a comprehensive search of the PubMed database to study the expression of the PDGF/PDGFR system in RA. Review Manager software version 5.3 was used for statistical analysis. Six eligible studies published in the English language were included, including 108 rheumatoid arthritis cases and 85 controls with the corresponding 126 and 97 tests, respectively, relating the expression of the PDGF/PDGFR system to the risk of RA. The overall results indicated a significant association between the PDGF/PDGFR system expression and RA (OR = 5.25 , 95% CI: 3.00-9.18, p < 00001), RA patients in Asian countries (OR = 4.13 , 95% CI = 2.04 -8.39, p < 0.0001) and in Western countries (OR = 9.18 , 95% CI = 2.04 -8.39, p = 0.03), and only PDGF expression in RA patients (OR = 5.28 , 95% CI = 2.73 -10.21, p < 0.00001). Thus, only the PDGFR expression was insignificantly associated with RA susceptibility (OR = 9.25 , 95% CI = 0.63 -136.30, p = 0.11). Hence, the PDGF/PDGFR system most likely contributes to susceptibility to RA. [ABSTRACT FROM AUTHOR]

We theoretically and experimentally study the optical trapping of two different microparticles by a double-tapered optical fiber probe (DOFP) which is fabricated by the interfacial etching method. A SiO 2 microsphere and a yeast, or two SiO 2 microspheres with different diameters, are trapped. We calculate and measure the trapping forces on the two microparticles, discuss the impacts of the geometrical size and refractive index on the trapping forces. Both the theoretical calculation and experimental measurements indicate that if the two particles have the same refractive index, the larger the second particle is, the larger the trapping force is. Whereas, if the two particles have the same geometrical size, the smaller the refractive index is, the lager trapping force is. Trapping and manipulation of different multiple microparticles by a DOFP enhance the application of optical tweezers, especially in biomedical engineering and material science.

Background: Colon adenocarcinoma (COAD) is a highly heterogeneous disease, which makes its prognostic prediction challenging. The purpose of this study was to investigate the clinical epidemiological characteristics, prognostic factors, and survival outcomes of patients with COAD in order to establish and validate a predictive clinical model (nomogram) for these patients., Methods: Using the SEER (Surveillance, Epidemiology, and End Results) database, we identified patients diagnosed with COAD between 1983 and 2015. Disease-specific survival (DSS) and overall survival (OS) were assessed using the log-rank test and Kaplan-Meier approach. Univariate and multivariate analyses were performed using Cox regression, which identified the independent prognostic factors for OS and DSS. The nomograms constructed to predict OS were based on these independent prognostic factors. The predictive ability of the nomograms was assessed using receiver operating characteristic (ROC) curves and calibration plots, while accuracy was assessed using decision curve analysis (DCA). Clinical utility was evaluated with a clinical impact curve (CIC)., Results: A total of 104,933 patients were identified to have COAD, including 31,479 women and 73,454 men. The follow-up study duration ranged from 22 to 88 months, with an average of 46 months. Multivariate Cox regression analysis revealed that age, gender, race, site&#95;recode&#95;ICD, grade, CS&#95;tumor&#95;size, CS&#95;extension, and metastasis were independent prognostic factors. Nomograms were constructed to predict the probability of 1-, 3-, and 5-year OS and DSS. The concordance index (C-index) and calibration plots showed that the established nomograms had robust predictive ability. The clinical decision chart (from the DCA) and the clinical impact chart (from the CIC) showed good predictive accuracy and clinical utility., Conclusion: In this study, a nomogram model for predicting the individualized survival probability of patients with COAD was constructed and validated. The nomograms of patients with COAD were accurate for predicting the 1-, 3-, and 5-year DSS. This study has great significance for clinical treatments. It also provides guidance for further prospective follow-up studies., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Yin, Wang, Cao, Chen, Sun and He.)

BACKGROUND In this study, we aimed to compare the effectiveness of transnasal humidified rapid insufflation ventilator exchange (THRIVE) with facemask pre-oxygenation in 40 patients ≥65 years of age undergoing general anesthesia during gastrointestinal surgery for intestinal obstruction. MATERIAL AND METHODS Patients with gastrointestinal obstruction were randomized to either a facemask group (group M, n=20) or THRIVE group (group T, n=20). During pre-oxygenation, the 2 groups used a facemask (100% oxygen, 6 L/min) and THRIVE (100% oxygen, 40 L/min) to supply oxygen, respectively. Induction of anesthesia was performed in both groups using facemasks and without mechanical or assisted ventilation. The intubation occurred after myorelaxant action began. When the peripheral oxygen saturation (SpO₂) dropped below 95%, or 480 s after administration of muscle relaxants, mechanical ventilation was initiated immediately. The primary outcome was arterial partial pressure of oxygen (PaO₂) at 5 min after pre-oxygenation. A secondary outcome was time to SpO₂ of 95% during apnea, with a cut-off time of 480 s. RESULTS PaO₂ at 5 min after pre-oxygenation was (261.5±30.9) mmHg for group M and (446.1±84.4) mmHg for group T (P<0.001). Based on survival analysis, the median time-to-event in group T was 480 s (95% CI 415.7 s - upper limit unknown) and 240 s (95% CI 225.9-254.1 s) in group M (P<0.001). CONCLUSIONS In elderly patients undergoing rapid sequence induction, pre-oxygenation with THRIVE could improve oxygenation and extend safe apnea time, compared with facemask pre-oxygenation.