Objective
This study aimed to determine the risk of severe postoperative complications (SPCs) in patients with gastric cancer and to construct a nomogram based on independently related factors to ...identify high-risk patients.
Methods
We conducted a prospective study of 636 consecutive patients with gastric cancer who underwent radical gastrectomy. Degrees of sarcopenia and obesity were calculated before surgery. Factors contributing to SPCs were determined using univariate and multivariate analysis. A nomogram consisting of the independent risk factors was constructed to quantify the individual risk of SPCs.
Results
Logistic analysis revealed that sarcopenic obesity, age, open surgery, and combined resection were independent prognostic factors for SPCs. Sarcopenic obese patients have the highest risk in all patients (sarcopenic obesity vs normal, OR = 6.575
p
= 0.001; sarcopenic obesity vs obesity, OR = 5.833
p
= 0.001; sarcopenic obesity vs sarcopenia, OR = 2.571
p
= 0.032), while obese patients share the similar rate of SPCs with normal people (obesity vs normal, OR = 1.056
p
= 0.723). The nomogram we constructed was able to quantify the risk of SPCs reliably (c-index, 0.737).
Conclusions
Sarcopenic obesity, together with age, open surgery, and combined resection are independent predictors of SPCs. Obesity will significantly increase the risk of SPCs in sarcopenic patient with gastric cancer, but it will not bring higher risk to normal patients. Our nomogram is a simple and practical instrument to identify patients at high risk of surgical complications.
Rapid and accurate prediction of crop yield is particularly important for ensuring national and regional food security and guiding the formulation of agricultural and rural development plans. Due to ...unmanned aerial vehicles’ ultra-high spatial resolution, low cost, and flexibility, they are widely used in field-scale crop yield prediction. Most current studies used the spectral features of crops, especially vegetation or color indices, to predict crop yield. Agronomic trait parameters have gradually attracted the attention of researchers for use in the yield prediction in recent years. In this study, the advantages of multispectral and RGB images were comprehensively used and combined with crop spectral features and agronomic trait parameters (i.e., canopy height, coverage, and volume) to predict the crop yield, and the effects of agronomic trait parameters on yield prediction were investigated. The results showed that compared with the yield prediction using spectral features, the addition of agronomic trait parameters effectively improved the yield prediction accuracy. The best feature combination was the canopy height (CH), fractional vegetation cover (FVC), normalized difference red-edge index (NDVI_RE), and enhanced vegetation index (EVI). The yield prediction error was 8.34%, with an R
2
of 0.95. The prediction accuracies were notably greater in the stages of jointing, booting, heading, and early grain-filling compared to later stages of growth, with the heading stage displaying the highest accuracy in yield prediction. The prediction results based on the features of multiple growth stages were better than those based on a single stage. The yield prediction across different cultivars was weaker than that of the same cultivar. Nevertheless, the combination of agronomic trait parameters and spectral indices improved the prediction among cultivars to some extent.
Prognostic nutritional index (PNI) is an indicator to evaluate the nutritional immune status of patients. This study aimed to assess whether preoperative PNI could predict the occurrence of ...postoperative POD in aged patients undergoing non-neurosurgery and non-cardiac surgery.
The aged patients undergoing non-neurosurgery and non-cardiac surgery between January 2014 and August 2019 were included in the retrospective cohort study. The correlation between POD and PNI was investigated by univariate and multivariable logistic regression analysis, propensity score matching (PSM), inverse probability of treatment weighting (IPTW), and subgroup analysis.
In the cohort (n = 29,814), the cutoff value of PNI was 46.01 determined by the receiver operating characteristic (ROC) curve. In univariate and three multivariable regression analysis, the ORs of PNI ≤ 46.01 was 2.573(95% CI:2.261–2.929, P < 0.001),1.802 (95% CI:1.567-2.071, P < 0.001),1.463(95% CI:1.246–1.718, P < 0.001),1.370(95% CI:1.165–1.611, P < 0.001). In the PSM model and IPTW model, the ORs of PNI ≤ 46.01 were 1.424(95% CI:1.172–1.734, P < 0.001) and 1.356(95% CI:1.223–1.505, P < 0.001).
The PNI was found to have a predictive value for POD in patients undergoing non-neurosurgery and non-cardiac surgery. Improving preoperative nutritional status may be beneficial in preventing POD for aged patients.
Baicalein is a biologically important flavonoid in extracted from the Scutellaria baicalensis Georgi, which can effectively inhibit the influenza virus. This study aimed to analyze the safety and ...pharmacokinetic (PK) characteristics of baicalein tablets in healthy Chinese subjects and provide more information for phase II clinical trials. In this multiple‐ascending‐dose placebo‐controlled trial, 36 healthy subjects were randomized to receive 200, 400, and 600 mg of baicalein tablet or placebo once daily on day 1 and day 10, 3 times daily on days 4–9. All groups were intended to produce safety and tolerability outcomes (lowest dose first). Blood and urine samples were collected from subjects in the 600 mg group for baicalein PK analysis. Our study had shown that Baicalein tablet was generally safe and well‐tolerated. All adverse events were mild and resolved without any intervention except one case of fever reported in the 600 mg group, which was considered as moderate but not related with baicalein as judged by the investigator. Oral baicalein tablets were rapidly absorbed with peak plasma levels being reached within 2 h after multiple administration. The highest urinary excretion of baicalein and its metabolites peaked in 2 h, followed by 12 h, with a double peak trend.
Background Ventricular arrhythmia after myocardial infarction is the most important risk factor for sudden cardiac death, which poses a serious threat to human health. As the correlation between ...autonomic nervous systemic dysfunction and heart rhythm abnormality has been gradually revealed, remedies targeting autonomic nervous system dysfunction, especially the sympathetic nerve, have emerged. Among them, renal denervation is noted for its powerful effect on the inhibition of sympathetic nerve activity. We aim to investigate whether renal denervation can reduce ventricular arrhythmia after myocardial infarction and thus decrease the risk of sudden cardiac death. In addition, we explore the potential mechanism with respect to nerve activity and remodeling. Methods and Results Twenty-four beagles were randomized into the control (n=4), renal denervation (n=10), and sham (n=10) groups. Permanent left anterior descending artery ligation was performed to establish myocardial infarction in the latter 2 groups. Animals in the renal denervation group underwent both surgical and chemical renal denervation. Compared with dogs in the sham group, dogs in the renal denervation group demonstrated attenuated effective refractory period shortening and inhomogeneity, flattened restitution curve, increased ventricular threshold, and decreased ventricular arrhythmia. Heart rate variability assessment, catecholamine measurement, and nerve discharge recordings all indicated that renal denervation could reduce whole-body and local tissue sympathetic tone. Tissue analysis revealed a significant decrease in neural remodeling in both the heart and stellate ganglion. Conclusions Surgical and chemical renal denervation decreased whole-body and local tissue sympathetic activity and reversed neural remodeling in the heart and stellate ganglion. Consequently, renal denervation led to beneficial remodeling of the electrophysiological characteristics in the infarction border zone, translating to a decrease in ventricular arrhythmia after myocardial infarction.
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•The release rate of Ag+ from inner silver layer can be controlled by the covering of SrTiO3 nanoparticle coating.•The SrTiO3 nanoparticle coating did not impede the antibacterial ...activity of Ag-modified samples.•The AH-Ti/Ag/Sr substrate possessed the dual functions of osteogenesis and antibacterial activity.•The controlled Ag+ release and the suitable Sr2+ release had a synergistic effect on osteointegration.
Promoting implant osseointegration while preventing infection is one of the major challenges in the development of dental implants. In this study, nano-needle-like structures were prepared on titanium by hot alkali treatment and then coated with uniform silver (Ag) and strontium titanate (SrTiO3) through magnetron sputtering. The results of ion release showed that the SrTiO3 outer coating reduced the release of Ag ions by 30% and 15% respectively on the 4th and 7th days, thus effectively improving the bioactivity of the Ag-modified substrates. In vitro experiments demonstrated that the Ag/SrTiO3-coated specimens (AH-Ti/Ag/Sr) had an excellent effect on the osteogenic differentiation of MC3T3-E1 cells and exhibited antibacterial function against Staphylococcus aureus and Escherichia coli (percentage of dead/total bacteria: ∼93% and ∼88%). Moreover, the in vivo results further confirmed that the Ag/SrTiO3 bilayer coating significantly promoted osteogenesis around the AH-Ti/Ag/Sr implant (the new bone volume and the number of trabeculae: 1.5 and 1.4 fold of the control group) and enhanced the bonding strength between implant and surrounding bone (about 1.9 fold of the control group). All these findings indicate that AH-Ti/Ag/Sr can substantially improve osteogenesis in complex oral microenvironment, and thus has potential applications in oral implantology.
Scutellaria baicalensis (Huang-Qin in Chinese) is a dry root of the perennial herb Scutellaria baicalensis Georgi, which has been used extensively in current prescriptions. Scutellaria baicalensis is ...an herb high in flavonoids, and baicalein is the one flavonoid found in the highest amount in Scutellaria baicalensis.
Influenza virus could cause mild respiratory tract illness to severe pneumonia and even death. Baicalein has been proved to be one of the effective components against the influenza virus. However, there have been few reports on human trials of baicalein. The purpose of this study was to evaluate the safety of baicalein in vivo and analyze its pharmacokinetic characteristics.
Three randomized studies were conducted to evaluate the pharmacokinetics (PK), safety, tolerability, and food effects of baicalein tablets. In the 7-month single-dose safety study, 60 subjects were enrolled and randomized to receive 100–800 mg baicalein tablets or placebo. In the single-dose PK study, 40 subjects were enrolled and randomized to receive 200 mg, 400 mg, 600 mg, 800 mg baicalein tablets. In the study of food effect on PK of baicalein, an additional 10 subjects were enrolled in the 400 mg group, this part of the trial lasted for 7 months. Blood and urine samples for PK analysis were collected at a pre-specified time. PK properties in both fasted and fed states were evaluated, as well as safety and tolerability.
Among the 80 subjects who were evaluable for the single-dose safety and tolerability, 56 adverse events (AEs) were observed in 32/80 subjects, of which 49 events were from 28/68 subjects in baicalein group and 7 events were from 4/12 subjects in placebo group. All AEs were mild and resolved without any medical intervention. The most common AEs were elevated high-sensitivity C-reactive protein (hs-CRP) level and high triglycerides. After a single administration of baicalein tablets (200 mg, 400 mg, 600 mg, or 800 mg), Cmax were 280.44, 628.80, 845.20, 489.55 ng/mL; AUC0-∞ were 2035.57, 2939.31, 4494.88, and 3754.43 h*ng/mL, respectively. And t1/2z ranged from 7.80 to 14.91 h. The exposure of baicalein and its metabolites increased in a less than dose-proportional manner.
Baicalein tablets within the studied dose range were safe and well-tolerated in healthy Chinese subjects with no serious or severe adverse effects. Further investigation will be needed to assess the safety and efficacy in the target patients.
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•Baicalein tablets within the studied dose range were safe and well-tolerated in healthy Chinese subjects.•The most common adverse events were elevated high-sensitivity C-reactive protein level and high triglycerides.•Food had little effect on the exposure of baicalein and its metabolites.•The exposure of baicalein and its metabolites increased in a less than dose-proportional manner.
Immune checkpoint blockade (ICB) has revolutionized cancer therapy. However, the response of patients to ICB is difficult to predict. Here, we examined 81 patients with lung cancer under ICB ...treatment and found that patients with
amplification were resistant to ICB and had a poor progression-free survival. Tumors with
amplifications had significantly decreased STING levels and antitumor T-cell infiltration. Furthermore, we performed deep single-cell RNA sequencing on more than 20,000 single immune cells and identified an immunosuppressive signature with increased subsets of XIST- and CD96-positive exhausted natural killer (NK) cells and decreased CD8
T-cell and NK-cell populations in patients with
amplification. Mechanistically, we found that oncogenic MET signaling induces phosphorylation of UPF1 and downregulates tumor cell STING expression via modulation of the 3'-UTR length of STING by UPF1. Decreased efficiency of ICB by
amplification can be overcome by inhibiting MET. SIGNIFICANCE: We suggest that the combination of MET inhibitor together with ICB will overcome ICB resistance induced by
amplification. Our report reveals much-needed information that will benefit the treatment of patients with primary
amplification or EGFR-tyrosine kinase inhibitor resistant-related
amplification.
.
Platelets corrugated horn is a promising technology for its scalability to a large corrugated horn array. In this communication, we present the design, fabrication, measurement, and uncertainty ...analysis of a wideband 170-320 GHz platelet corrugated horn that features with low sidelobe across the band (<−30 dB). We also propose an accurate and universal method to analyze the axial misalignment of the platelets for the first time. It is based on the mode matching (MM) method with a closed-form solution to off-axis circular waveguide discontinuities obtained by using Graf addition theorem for the Bessel functions. The uncertainties introduced in the fabrication have been quantitatively analyzed using the Monte Carlo method. The analysis shows that the cross-polarization of the corrugated horn degrades significantly with the axial misalignment. It well explains the discrepancy between the designed and the measured cross-polarization of platelets corrugated horn fabricated in the THz band. The method can be used to determine the fabrication tolerance needed for other THz corrugated horns and evaluate the impact of the corrugated horn for astronomical observations.
Identifying the risk factors associated with perioperative mortality is crucial, particularly in older patients. Predicting 6-month mortality risk in older patients based on large datasets can assist ...patients and surgeons in perioperative clinical decision-making. This study aimed to develop a risk prediction model of mortality within 6 months after noncardiac surgery using the clinical data from 11 894 older patients in China.
A multicentre, retrospective cohort study was conducted in 20 tertiary hospitals. The authors retrospectively included 11 894 patients (aged ≥65 years) who underwent noncardiac surgery between April 2020 and April 2022. The least absolute shrinkage and selection operator model based on linear regression was used to analyse and select risk factors, and various machine learning methods were used to build predictive models of 6-month mortality.
The authors predicted 12 preoperative risk factors associated with 6-month mortality in older patients after noncardiac surgery. Including laboratory-associated risk factors such as mononuclear cell ratio and total blood cholesterol level, etc. Also including medical history associated risk factors such as stroke, history of chronic diseases, etc. By using a random forest model, the authors constructed a predictive model with a satisfactory accuracy (area under the receiver operating characteristic curve=0.97).
The authors identified 12 preoperative risk factors associated with 6-month mortality in noncardiac surgery older patients. These preoperative risk factors may provide evidence for a comprehensive preoperative anaesthesia assessment as well as necessary information for clinical decision-making by anaesthesiologists.
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