Search

Ultrasound (US) is gaining acceptance for the evaluation of midgut volvulus in children. However, its impact on clinical outcomes is unknown. We aim to determine whether using US as a first-line modality changes imaging mobilization, time to surgery and re-feeding, length of stay, and frequency of bowel necrosis, short bowel syndrome, and death. An IRB-approved retrospective cohort study was performed at a tertiary pediatric institution. Eighty children with surgically confirmed midgut volvulus from 2014 to 2021 were compared before and after implementation of US as first-line imaging and based on the modality used to diagnose midgut volvulus. Outcomes were not statistically different pre- versus post-implementation. Compared with patients who had UGI only, those who had US only or both had significantly quicker imaging mobilization (median: −33 min; 95% CI: −61.2, −4.8; p = 0.023 and median: −31 min; 95% CI: −58.5, −3.6; p = 0.028 respectively). Patients with US only were less likely to have bowel necrosis compared with those who had UGI only (9.1% versus 43.8%, p = 0.042). Patients who had US only or both were less likely to develop short bowel syndrome compared to UGI only (4.8% US only, 0% both, 40% UGI only; p = 0.027 for US only, p = 0.005 for both). No statistically significant change in outcomes was found after implementation of US as first-line imaging for midgut volvulus. However, patients diagnosed with US only or US in combination with UGI had quicker imaging mobilization and decreased frequency of bowel necrosis and short bowel syndrome. Findings suggest that US has potential to improve patient outcomes. III. • What is currently known about this topic? US has higher sensitivity for midgut volvulus than UGI, with comparable specificity. US is both quicker and cheaper than UGI, even when a radiologist is involved in scanning. • What new information is contained in this article? This is the first study to evaluate clinical outcomes based on the type of imaging exam used to diagnose midgut volvulus. [ABSTRACT FROM AUTHOR]

A conservative hemoglobin transfusion threshold is noninferior to a liberal threshold in cardiac surgery. However, red blood cell (RBC) transfusion remains common during cardiac surgery. The authors' single-center, retrospective study aimed to decrease RBC transfusions for hemoglobin >7.5 g/dL in nonemergent cardiovascular surgeries utilizing cardiopulmonary bypass (CPB), by educating the anesthesiology and surgical staff on the benefits of a conservative threshold for transfusions, and incorporating the discussion and routine use of blood conservation methods for all nonemergent cardiac surgeries. This was a single-center, retrospective study that included all nonemergent coronary artery bypass grafting and single-valve cases utilizing CPB from January 2018 to December 2021 before and after the intervention in July 2019. The data involved a single community hospital. A total of 417 patients were included in the study. The authors adopted a conservative threshold for blood transfusion and implemented a collaborative multidisciplinary approach to blood conservation. Baseline patient characteristics were summarized, and the incidence of RBC transfusion before and after the intervention on July 26, 2019, were compared by Wilcoxon rank sum and chi-square tests. Multivariate logistic regression was used. The intervention was significantly associated with reduced RBC transfusion rate after adjusting for confounding variables (p < 0.05). The odds of receiving an RBC transfusion among patients after the intervention was 0.615 times the odds among patients before intervention (95% CI: 0.3913-0.9663). The authors' goal was to improve patient outcomes and the quality of perioperative care during cardiac surgery. By implementing a protocol and educating anesthesiologists, surgeons, and perfusionists, they successfully decreased the incidence of RBC transfusion above a hemoglobin of 7.5 g/dL. [ABSTRACT FROM AUTHOR]

[Display omitted] Current literature identifies mobile phones of staff as potential vectors for hospital-acquired infection. A pre-post, quasi-experimental study was conducted in a 20 bed intensive care unit (ICU). Surface bioburden of personal and shared mobile phones was estimated with a luminometer, expressed in Relative Light Units (RLU). Effects of a simple sanitizing wipe-based disinfection routine were measured at baseline, and at 1, 3, 6, and 12 months after implementation of the disinfection routine. Personal mobile phones and shared phones of 30 on-shift ICU nurses were analyzed at each collection. RLUs for personal phones decreased from baseline to 12 months post-intervention (Geometric mean 497.1 vs 63.36 RLU; adj P <.001), while shared unit phones also demonstrated a decrease from baseline to 12 months post-intervention (Geometric mean 417.4 vs 45.90 RLU; adj P <.001). No recommended practice yet exists for disinfection of mobile phones in the acute care setting. The disinfection method and routine used in this study may have implications for use in acute care settings to reduce opportunities for infectious disease transmission. • Mobile phones have become an extension of our hands; why don't we disinfect phones more often? • Mobile phones have been cited as a risk for infectious disease transmission in patient care areas. • Nurses' mobile phones enter patient care areas, but routine disinfection protocols do not exist. • This article describes a multimodal intervention to reduce infectious disease transmission. • The intervention achieved low-level disinfection of mobile phones in a critical care unit. [ABSTRACT FROM AUTHOR]

There is a limited body of research on the recovery of soluble salts from municipal solid waste incineration fly ash (MSWI-FA), with challenges stemming from the effective management of residual heavy metals and dioxins. In this investigation, we propose using water-washing treatment for fly ash dechlorination and using CO 2 aeration carbonation combined with ceramic membrane filtration to recover soluble salt resources from fly ash. This study investigated the impact of combined processes on fly ash soluble salt recovery, carbon dioxide capture and sequestration, heavy metal removal, and dioxin diffusion reduction. The findings revealed that the combined process can significantly enhance the rate of carbonation and the removal of heavy metals. Specifically, the removal rates of Pb and Zn reach 100%. The resulting CaCO 3 precipitation particle size is smaller, averaging only approximately 4 μm, with greater surface porosity, higher heavy metal and dioxin content, and dioxin toxic equivalents as high as 8.11 ng TEQ/kg. Moreover, the dioxin content in the recovered mixed salt decreased, and its dioxin toxic equivalent was only 3.228.11 ng TEQ/kg. Consequently, the combined process of CO 2 aeration combined with ceramic membrane filtration was used in conjunction to significantly reduce pollutants (heavy metals and dioxins) in the MSWI-FA recovered salt. This approach enhances the recyclable resource utilization of MSWI-FA and reduces the risk of pollution dispersal during MSWI-FA disposal and resource utilization. [Display omitted] • Removal of heavy metals from MSWI-FA water washing solution by CO 2 carbonation. • Ceramic membrane interception to control the diffusion of dioxin pollution. • The combined process improves the efficiency of pollutant removal. • Recovering low pollutant soluble salts from MSWI-FA. • Sustainable development through the technology of treating waste with waste. [ABSTRACT FROM AUTHOR]

• This study established a preoperative risk prediction model for acute kidney injury after cardiac surgery. • Intraoperative hypotension is a significant independent risk factor for acute kidney injury after cardiac surgery. • The association between hypotension during cardiac surgery and postoperative acute kidney injury varies by preoperative risk. Acute kidney injury (AKI), a common and severe complication after cardiac surgery, has been demonstrated to be associated with intraoperative hypotension (IOH). The reproducibility of this finding and whether preoperative risk modifies the association remain unclear. We hypothesised that the relationship between IOH and AKI after cardiac surgery varies by preoperative risk. We conducted a single-centre, retrospective cohort study to analyse the association between IOH and postoperative AKI by stratifying patients using preoperative risk factors. IOH was defined as a mean arterial pressure (MAP) of less than 65 mmHg and characterised by the cumulative duration and area under the curve (AUC). Ten variables could be identified as risk factors: age, smoking status, NYHA III/Ⅳ, emergency surgery, peripheral vascular disease, cerebrovascular disease, heart failure, hypertension, previous cardiac surgery, and NT-proBNP concentration. The risk prediction model divided the patients into three equal-sized preoperative risk groups. Low-risk patients demonstrated no association between AKI and IOH of any severity, while high-risk patients demonstrated a statistically significant association between AKI and IOH with a cumulative duration greater than 104 min (adjusted odds ratio [OR]: 2.27, 95% confidence interval [CI]: 1.10−4.74; and adjusted OR: 3.63, 95% CI: 1.77−7.58) and an AUC greater than 905 mmHg min (adjusted OR: 2.08, 95% CI: 1.01−4.36; and adjusted OR: 4.00, 95% CI: 1.95−8.43). IOH is a significant independent risk factor for AKI after cardiac surgery. Patients with higher baseline risk showed a more prominent relationship between IOH and postoperative AKI than low-risk patients. [ABSTRACT FROM AUTHOR]

Single screen barriers are widely used in open-plan offices as a means of improving acoustical privacy. However, the insertion loss of an indoor barrier is limited in low frequency range. Active control systems have been shown to be able to enhance the insertion loss of outdoors noise barrier in low frequency range, so its feasibility for improving the performance of indoor barriers is investigated in this paper. The simulation results show that about 10 dB extra insertion loss below 500 Hz can be obtained with the active control system when the squared sound pressure inside the entire observation area is minimized. The performance of the active noise barrier deteriorated significantly due to the reflecting ceiling, and the performance is hardly improved by increasing the ceiling height or the ceiling absorption coefficient. Finally, the effects of the sensing strategy on the control performance and the impacts of the active control system on the source side are discussed. [ABSTRACT FROM AUTHOR]

Copper ion (Cu2+) is an important cofactor for many enzymes in human body. Either excessive or deficient Cu2+ in the body may cause serious dysfunctions and diseases. So sensitive determination of Cu2+ in environmental samples is of more significance for evaluation and control of Cu2+ intake. Based on a low-cost gold-plated coplanar electrode array, a disposable aptasensor is developed with an ultra-sensitive indicator of interfacial capacitance. Modified with a specially isolated DNA aptamer for Cu2+, this sensor achieves a high selectivity of 1207: 1 against non-target ions. To realize real-time response, alternating-current electrothermal effect is integrated into the capacitance measuring process to efficiently enrich the trace Cu2+. This sensor reaches a limit of detection of 2.97 fM, with a linear range from 5.0 fM to 50 pM. The response time is only 15 s, which can meet the real-time detection requirement. On-site test of practical samples is also realized using the disposable sensor combined with a handheld inductance/capacitance/resistance meter. This sensor with its portable test system provides a cost-efficient solution for on-site, real-time and sensitive detection of Cu2+, showing great application value in environment monitoring. [Display omitted] • A disposable aptasensor is developed for Cu2+ with a coplanar electrode array. • The sensor has advantages on the limit of detection, linear range and selectivity. • On-site and real-time detection of practical Cu2+ samples is achieved. • The determination is label-free, without signal amplification or enrichment steps. [ABSTRACT FROM AUTHOR]

Polycyclic aromatic hydrocarbons (PAHs) are chemicals that cause serious concerns because of their carcinogenicity and endocrine disrupting ability. In the current study, we studied how urinary PAH metabolites are related with the dose-effects of hormone levels and birth outcomes. 163 pregnant women without health problems and 163 newborns were enrolled in hospitals in Guiyu (e-waste-exposed area) and Haojiang (reference area) from May 2016 to May 2017. Urine samples were collected to measure hydroxylated PAH (OH-PAH) metabolite levels. Umbilical cord blood was used for measurement of hormone levels. Anthropometric parameters of newborns, such as anogenital distance (AGD), were also measured. Eight of ten urinary PAH metabolites in the exposed group were significantly higher than in the reference group. Levels of umbilical cord serum estradiol (E2) and testosterone (T) in the exposed group were significantly lower than those in the reference group. Birth weight was positively correlated with 2-OHFlu (2-hydroxyfluorene). Head circumference was negatively correlated with 9-OHFlu, 3-OHPhe (3-hydroxyphenanthrene), 9-OHPhe, and ƩOHFlu (sum of 2-OHFlu and 9-OHFlu). Serum E2 and T levels were negatively correlated with most OH-PAHs. In addition, we found that serum anti-Müllerian hormone (AMH) level was positively correlated with AGD, and serum E2 level was negatively correlated with neonatal head circumference. PAH exposure in pregnant women may adversely affect the birth outcomes of newborns, especially AGD; and AMH may be involved in the process. Establishing a baseline for the relationship between PAH exposure and health is important to protect the health of mothers and children living in electronic waste (e-waste) recycling areas. Unlabelled Image • Higher maternal PAH exposure is associated with lower cord serum E2 and T levels. • Maternal PAH exposure is positively correlated with birth weight and negatively correlated with head circumference. • Maternal PAH exposure may adversely affect the AGD of newborns by affecting AMH. [ABSTRACT FROM AUTHOR]

• Rice grain length, width, and whiteness notably increased with chalkiness. • Pasting and thermal properties of chalky rice were affected by protein content. • Protein content affected GuichaoII's thermal and Jiazao311′s pasting properties. This study investigated two rice varieties, GuichaoII and Jiazao311, with distinct protein content to determine the variation in appearance, components, pasting, and thermal properties of rice with different chalkiness degrees. Grain length, width, head rice weight, and whiteness of both varieties markedly increased as chalkiness increased from 0% to 50%. However, the variation in components, pasting, and thermal characteristics of chalky grain substantially differed between the rice varieties. The protein content of GuichaoII (low protein content) significantly increased with the chalkiness degree, along with a significant increase in onset, peak, and conclusion temperatures and gelatinization enthalpy. In Jiazao311 (high protein content), the chalkiness degree increased with the protein content but decreased with the starch content, along with increased trough, final, setback, and consistency viscosities. Compared to amylose content, protein content had a greater influence on the thermal properties and pasting characteristics of chalky grains of GuichaoII and Jiazao311, respectively. [ABSTRACT FROM AUTHOR]

Background MicroRNAs (miRNAs) are integral for maintaining immune homeostasis and self-tolerance. The influence of miRNAs on T-cell differentiation and plasticity are critical in the development of chronic rejection of transplanted hearts. In this study, we sought to determine whether the knockout of miR-155 affects the development of cardiac allograft vasculopathy (CAV) in a murine model. Methods miRNA microarray and quantitative polymerase chain reaction (qPCR) analyses were performed for allograft neointimal lesion samples in chronic rejection. A model of heterotopic murine heart transplantation (bm12 to miR-155 +/+ or miR-155 –/– mice) was then used to analyze allograft survival, histology, mRNA expression and T-cell sub-populations in spleens. The accelerated experiments were performed by intraperitoneal injection of either recombinant interleukin-17A or phosphate-buffered saline (PBS) after heart transplantation. For the competitive transfer experiments, CD4 + splenocytes from wild-type (WT) or miR-155 –/– mice were mixed and injected into Rag1 –/– mice, and cardiac transplantation was performed after 24 hours. The differentiation of T-helper subsets (Th1/Th17/iTreg) was investigated in vitro. Results miR-155 –/– mice showed resistance to cardiac rejection along with weakened T-cell–mediated inflammation, especially for Th17 cells. Recombinant IL-17A could restore this relieved injury. The competitive experiments implied that miR-155 plays a vital role in the stability of the Th17 phenotype. In vitro, we also demonstrated that miR-155 –/– mice exhibit a defect in Th17 differentiation. Conclusions miR-155 regulates Th1/Th17-related inflammation in chronic cardiac rejection and may be a potential therapeutic target to attenuate cardiac allograft rejection. Despite advancements in immunosuppressive therapy, the immunologic mechanisms responsible for allograft rejection remain an important issue for both clinicians and researchers. Allograft rejection is a T-cell–dependent phenomenon and is critically dependent on inflammation mediated by CD4 + Th subsets, including Th1, Th2, Th17, Th9 and regulatory T (Treg) cells. [ABSTRACT FROM AUTHOR]

With an ever-increasing penetration of renewable energy sources into the power grid, the development and commercialization of large-scale energy storage systems (ESSs) have been enforced. It is imperative to evaluate the environmental sustainability of ESSs in grid applications to achieve sustainable development goals. In the present work, a cradle-to-grave life cycle analysis model, which incorporates the manufacturing, usage, and recycling processes, was developed for prominent electrochemical energy storage technologies, including lithium iron phosphate batteries (LIPBs), nickel cobalt manganese oxide batteries (NCMBs), and vanadium redox flow batteries (VRFBs). A case study was conducted based on per MWh of energy stored. The greenhouse gas (GHG) emissions of LIPBs, NCMBs, and VRFBs under the Chinese electrical grid peak-shaving scenario were determined to be 323, 263, and 425 kg CO 2 -eq/MWh, respectively. The key components contributing to the GHG emissions were identified. The GHG emissions of different batteries in renewable energy sources (photovoltaic and wind) were evaluated. Moreover, the GHG emissions under the future electricity mixes were predicted according to the carbon peaking and carbon neutrality goals. The GHG emissions of LIPBs, NCMBs, and VRFBs under the Announced Pledges Scenario could be reduced by approximately 23–27% in 2030 and 66–75% in 2050. Moreover, sensitivity analysis was performed, indicating that the GHG emissions were directly linked with the round-trip efficiency. The results could promote the environment, policy, and business model optimization efforts for large-scale energy storage in low-carbon power systems. • A cradle-to-grave LCA model was established for electrochemical energy storage. • The greenhouse gas emissions footprints were analyzed and quantified. • The integration with renewable energy helped significantly reduce greenhouse gas emissions. • The round-trip efficiency were sensitive indicators in all cases. [ABSTRACT FROM AUTHOR]

Thoracic aortic aneurysm and dissection (TAAD) is caused by the apoptosis and phenotypic transformation of vascular smooth muscle cells (VSMCs). The dysfunction of VSMCs affects their secretion of chemokines such as monocyte chemoattractant protein-1 (MCP-1) to recruit the infiltration of macrophages which release proinflammatory cytokines and matrix metalloproteinases (MMPs) to accelerate the process of TAAD formation. We analyzed the expression levels of nuclear factor erythroid 2-related factor 2 (Nrf2) in aortic tissues of TAAD patients and the β-aminopropionitrile fumarate (BAPN)-induced mouse model, and the levels of Nrf2 were elevated in both aortic lesions. Treatment with the Nrf2 activator oltipraz protects against the formation of BAPN-induced aneurysm and dissection, as demonstrated by a higher survival rate, postponing the time of aortic rupture, and inhibiting aortic luminal dilation. In addition, the thoracic aortas of BAPN-treated mice inhibited the apoptosis and phenotypic transformation of VSMCs. When treated with oltipraz, they had reduced macrophage infiltration proinflammatory cytokines and MMPs. Furthermore, oltipraz treatment promoted the translocation of Nrf2 and downregulated the NLRP3 pathway. Nrf2 plays a crucial role in protecting against TAAD development, and persistent activation of Nrf2 is a promising therapeutic strategy against the progression of TAAD. [ABSTRACT FROM AUTHOR]

Under shading stress, increasing canopy light utilization is the primary means of increasing photosynthesis, and in turn, rice (Oryza sativa L.) productivity. Here, an artificial-shading field experiment was conducted to study the influence of planting and light conditions on canopy structure, light utilization by rice plants, and rice grain yield and quality at Wenjiang and Hanyuan, China. The results showed that both grain yield and quality were significantly reduced by shading stress, primarily because of a reduction in the photosynthetic capacity of rice plants. There was no significant difference in grain yield between the methods of increasing the number of seedlings per hill with a reduced number of hills (optimized planting pattern) and traditional high-density planting owing to the decrease in panicle/m2, but there was an increase in spikelet filling rate or grain weight under the optimized planting pattern. Using the optimized planting pattern increased the canopy width and leaf area per hill, and decreased the leaf inclination angle, resulting in a more open rice canopy than that under the traditional high-density planting. Furthermore, the optimized planting pattern enhanced light incidence into the mid and bottom layers of the canopy under shading stress. As a result, the net photosynthetic rates of flag and second leaves were significantly increased by the optimized planting pattern under shading stress. This, in turn, increased the head rice rate at Wenjiang and taste value at both sites, and decreased chalky grain rate and chalkiness degree under shading stress at both sites. Therefore, the optimized planting pattern is a viable planting pattern for the maintenance of rice grain yield while improving grain quality through the optimization of canopy structure and light distribution and utilization, under shading stress. • Rice grain quality was significantly reduced by shading stress. • Optimized planting pattern increased canopy width and leaf area per hill. • Optimized planting pattern increased light incidence into lower canopies. • Optimized planting pattern improved net photosynthetic rate of leaves under shading. • Optimized planting pattern increased grain quality without yield loss under shading. [ABSTRACT FROM AUTHOR]

Background: Transforming growth factor-beta (TGF-β) plays a significant role in the pathogenesis of the intimal hyperplasia of transplant arteriosclerosis (TA). The aim of this study was to evaluate the efficacy of an oral inhibitor of TGF-β receptor I kinase (SD-208) on the development of TA. Methods: BALB/c (H-2 d ) donor aortas were transplanted into C57BL/6 (H-2 b ) recipients, and the mice then received different doses (40 or 60 mg/kg) of SD-208 or control vehicle by daily gavage for 8 weeks. The grafts were analyzed by histology and morphometry at 1, 2, 4, 6 and 8 weeks after transplantation. The effects of TGF-β and SD-208 on neointimal smooth muscle-like cell (SMLC) and vascular smooth muscle cell (VSMC) proliferation and migration were evaluated, and the expression levels of Smad3, P-Smad3, connective tissue growth factor (CTGF) and collagen I were determined by in vitro experiments. Results: The intimal hyperplasia of the SD-208–treated group was significantly reduced compared with the vehicle-treated control group (32% and 48% reduction for 40 mg/kg and 60 mg/kg SD-208 compared with the controls, respectively [n = 5], p < 0.05). SD-208 reduced SMLC proliferation and the production of intimal collagen by 21% and 75%, respectively, in the grafts. SD-208 also abolished the promoting effect of TGF-β on SMLC proliferation and migration but did not affect TGF-β inhibition of VSMCs in vitro. CTGF, a protein downstream of TGF-β, was downregulated with the inhibition of Smad3 phosphorylation by SD-208, both in vitro and in vivo. Moreover, we found that the endogenous Smad3 in SMLCs was upregulated from 2 weeks after transplantation and was 64% higher than in VSMCs at 8 weeks. Conclusion: These results demonstrate that SD-208 can effectively reduce the formation of intimal hyperplasia of TA in the murine aortic allograft model. [Copyright &y& Elsevier]

Sepsis occurs when an infection triggers deranged inflammatory responses. There exists no efficacious treatment for this condition. The transcriptional repressor B-cell Lymphoma 6 (BCL6) is known to act as an inhibitor of macrophage-mediated inflammatory responses. FX1, a novel specific BCL6 BTB inhibitor, is able to attenuate activity of B cell-like diffuse large B cell lymphoma (ABC-DLBCL). Nevertheless, the effect of FX1 in inflammatory responses and sepsis remains unknown. Here, we explored the effect and potential mechanisms of FX1 on the regulation of LPS-induced inflammatory responses in murine sepsis. Mice models of LPS-induced sepsis were monitored for survival rate following FX1 administration. ELISA was used to assess how FX1 administration affected pro-inflammatory cytokines present in macrophages exposed to LPS and in the serum of mice sepsis models. Flow cytometric analysis, Western blot and qRT-PCR were performed to evaluate differences in macrophages immune responses after FX1 pre-treatment. Finally, the affinity of BCL6 binding to downstream target genes was checked by ChIP. The survival rate of mice models of LPS-induced sepsis was improved in following FX1 administration. FX1 decreased the production of inflammatory cytokines, attenuated macrophage infiltration activities and reduced monocytes chemotaxis activities, all of which suggest that FX1 exert anti-inflammatory effects. Mechanistically, FX1 may enhance the affinity of BCL6 binding to downstream target pro-inflammatory genes. These findings illustrated the anti-inflammatory properties and potential mechanisms of FX1 in sepsis caused by LPS. FX1 could potentially become a new immunosuppressive and anti-inflammatory drug candidate in sepsis therapy. • The BCL6 inhibitor FX1 represses pro-inflammatory cytokine induction in LPS-treated macrophages and mice. • FX1 attenuates infiltration and chemotaxis of macrophages in LPS-challenged mice. • FX1 attenuates LPS-activated MAPK and NF-κB signaling pathways. • FX1 enhances the affinity of BCL6 binding to downstream target genes promoters. [ABSTRACT FROM AUTHOR]