The study compared machine-learning models with traditional logistic regression to predicting liver outcomes after aortic arch surgery.
Retrospective review from January 2013 to May 2017.
Fuwai ...Hospital.
The study comprised 672 consecutive patients who had undergone aortic arch surgery.
Three machine-learning methods were compared with logistic regression with regard to the prediction of postoperative liver dysfunction (PLD) after aortic arch surgery. The perioperative characteristics, including the patients’ baseline medical condition and intraoperative data, were analyzed. The performance of the models was assessed using the area under the receiver operating characteristic curve. Naïve Bayes had the best discriminative ability for the prediction of PLD (area under the receiver operating characteristic curve = 0.77) compared with random forest (0.76), support vector machine (0.73), and logistic regression (0.72). The primary endpoint of PLD was observed in 185 patients (27.5%). The cardiopulmonary bypass time, long surgery time, long aortic clamp time, high preoperative bilirubin value, and low rectal temperature were strongly associated with the development of PLD after aortic arch surgery.
The machine-learning method of naïve Bayes predicts PLD after aortic arch surgery significantly better than traditional logistic regression.
A variety of metal-doped sulfide catalysts with a wide pH application range have a good prospect for activated persulfate removal of pollutants in water. In this article, a microwave-assisted ...vulcanization method has been utilized to prepare nanoparticles with magnetic properties of FeCoS. It improves the material preparation efficiency and greatly reduces the experimental energy consumption. FeCoS/PMS system has good degradation performance for ciprofloxacin hydrochloride (CIP in the wide pH range of 3–11). The synergistic action of iron and cobalt ions is the main activation mechanism. Compared with single metal-doped sulfide, the recombination of two metals increases the number of electron transfers for enhanced the possibility of breakage of O–O bond in PMS. It makes the catalyst many times more effective in removing pollutants. Stability and recovery experiments show that the FeCoS composite maintains a high catalytic effect under multiple cycles and that the magnetic material can be quickly separated and recovered. And the degradation rate of other typical pollutants can reach more than 90%, showing high degradation performance in the actual waste sample.
This study offers a new strategy for the simple development of magnetic and easily recyclable multi-performance catalytic materials and demonstrates their potential application in the degradation of organic pollutants.
•The nitrogen and sulfur co-doped bimetallic nanoclusters have excellent activation ability.•The addition of S enhances the electron transfer capacity and greatly accelerates the reaction rate.•The simple microwave preparation and efficient recyclability increase the environmental utility of wastewater treatment.•The activation of PMS is highly resistant and has a wide range of pH applications.
We investigate two passivation methods for long-wavelength infrared type-II InAs/GaSb superlattice (T2SL) photodiodes with the PπBN structure containing an InAs/AlSb hole barrier layer. In order to ...eliminate the surface defects of T2SL better to further reduce the surface dark current, anodic vulcanization and SiO2 composite passivation method is adopted to optimize the original SiO2 passivation method. At 77 K, the I–V curve of the devices under the two passivation methods are obtained. Compared with passivation-only SiO2, the dark current density of the anode sulfide and SiO2 composite passivation detector is reduced by one order of magnitude, and the surface resistivity is effectively improved by an order of magnitude. Additionally, the composite passivation method not only improves the uniformity of the device, but also prevents the peeling of the S layer to improve the quality of passivation. This work offers a stable and high-quality passivation method, and it could be popularized passivation in the field of optics, electronics, optoelectronics, and switching devices.
Abstract
Background
In the previous randomized controlled trial by our research group, we evaluated the effect of remote ischemic preconditioning (RIPC) in 130 patients (65 per arm) on acute kidney ...injury (AKI) within 7 days of open total aortic arch replacement. Significantly fewer RIPC-treated patients than sham-treated patients developed postoperative AKI, and, epically, RIPC significantly reduced serious AKI (stage II–III). However, the long-term effect of RIPC in patients undergoing open total aortic arch replacement is unclear.
Methods
This study was a post-hoc analysis. We aimed to assess the roles of RIPC in major adverse kidney events (MAKE), defined as consisting persistent renal dysfunction, renal replacement therapy and mortality, within 90 days after surgery in patients receiving open total aortic arch replacement.
Results
In this 90-day follow-up study, data were available for all study participants. We found that RIPC failed to improve the presence of MAKE within 90 days after surgery (RIPC: 7 of 6510.8%) vs sham: 15 of 6523.1%;
P
= 0.061). In those patients who developed AKI after surgery, we found that the rate of MAKE within 90 days after surgery differed between the RIPC group and the sham group (RIPC: 4 of 3611.2%; sham: 14 of 4829.2%;
P
= 0.046).
Conclusions
At 90 days after open total aortic arch replacement, we failed to find a difference between the renoprotective effects of RIPC and sham treatment. The effectiveness or ineffectiveness of RIPC should be further investigated in a large randomized sham-controlled trial.
Trial registration
This study was approved by the Ethics Committee of Fuwai Hospital (No. 2016–835) and our previous study was registered at clinicaltrials.gov before patient enrollment (
NCT03141385
; principal investigator: G.W.; date of registration: March 5, 2017).
This paper studies superlattice materials with M barrier (InAs/GaSb/AlSb/GaSb superlattice) and B barrier (InAs/AlSb superlattice) structures. Firstly, it introduces the diffusion current, ...generation-recombination current, tunneling current and surface leakage current in devices, and analyzes the factors affecting different dark current mechanisms. Secondly, it theoretically analyzes the influence of the two barrier structures on device performance. Finally, devices were fabricated using these two structures, and the device performance was characterized. At a bias voltage of −50 mV and operating temperature of 77K. The PπMN type long-wave infrared (LWIR) detector has an RA of 91.4 Ω cm2 and a LW dark current density of 3.51 × 10−4 A cm−2. The PπBN type LWIR detector has an RA of 439 Ω cm2 and a LW dark current density of 2.81 × 10−4 A cm−2. Meanwhile, by fitting the data at different temperatures, the activation energy Ea of the PπMN type LWIR detector is 119.8 meV, with dark current mainly determined by diffusion current and generation-recombination current. The activation energy Ea of the PπBN type LWIR detector is 126.2 meV, with dark current mainly determined by diffusion current. This experimentally verifies the dominant dark current mechanisms for the two barrier structures of LWIR detectors, providing strong support for the design of superlattice detector structures.
Background:
Prolonged mechanical ventilation (PMV) is common after cardiothoracic surgery, whereas the mechanical ventilation strategy after pulmonary endarterectomy (PEA) has not yet been reported. ...We aim to identify the incidence and risk factors for PMV and the relationship between PMV and short-term outcomes.
Methods:
We studied a retrospective cohort of 171 who undergoing PEA surgery from 2014 to 2020. Cox regression with restricted cubic splines was performed to identify the cutoff value for PMV. The Least absolute shrinkage and selection operator regression and logistic regressions were applied to identify risk factors for PMV. The impacts of PMV on the short-term outcomes were evaluated.
Results:
PMV was defined as the duration of mechanical ventilation exceeding 48 h. Independent risk factors for PMV included female sex (OR 2.911; 95% CI 1.303–6.501;
P
= 0.009), prolonged deep hypothermic circulatory arrest (DHCA) time (OR 1.027; 95% CI 1.002–1.053;
P
= 0.036), increased postoperative blood product use (OR 3.542; 95% CI 1.203–10.423;
P
= 0.022), elevated postoperative total bilirubin levels (OR 1.021; 95% CI 1.007–1.034;
P
= 0.002), increased preoperative pulmonary artery pressure (PAP) (OR 1.031; 95% CI 1.014–1.048;
P
< 0.001) and elongated postoperative right ventricular anteroposterior dimension (RVAD) (OR 1.119; 95% CI 1.026–1.221;
P
= 0.011). Patients with PMV had longer intensive care unit stays, higher incidences of postoperative complications, and higher in-hospital medical expenses.
Conclusions:
Female sex, prolonged DHCA time, increased postoperative blood product use, elevated postoperative total bilirubin levels, increased preoperative PAP, and elongated postoperative RVAD were independent risk factors for PMV. Identification of risk factors associated with PMV in patients undergoing PEA may facilitate timely diagnosis and re-intervention for some of these modifiable factors to decrease ventilation time and improve patient outcomes.
•Serum and fecal CXCL13 levels were significantly enhanced in patients with CDI.•Serum CXCL13 was significantly correlated with clinical parameters.•CXCL13 mRNA and protein were increased in ...Clostridium difficile infection mouse model.•CXCL13 may be a potential new diagnostic and prognostic biomarker for CDI.
Clostridium difficile infection (CDI) is the leading cause of antibiotic- and healthcare-associated diarrhea. CXCL13 is a well-known CXC chemokine involved in inflammation, but its role in CDI remains unknown. In this study, serum and fecal samplings were collected from 51 CDI patients, 50 diarrhea patients without CDI and 50 healthy control subjects to determine the CXCL13 levels by enzyme-linked immunosorbent assay (ELISA). Besides, a mouse model of C. difficile infection was established, and murine serum and colon tissues were collected for detection of CXCL13 expression using quantitative real-time RT-PCR, ELISA, Western blot, or immunohistochemistry. We found that CXCL13 concentration in serum and fecal samples from CDI patients was significantly higher compared with that from diarrhea patients without CDI and that from healthy controls. Elevated serum CXCL13 positively and significantly correlated with blood markers of inflammation and yielded an increased area under the ROC curve of 0.929. In murine C. difficile infection, CXCL13 were also dramatically increased in serum and infected colon tissues at the transcriptional and protein levels. The elevated CXCL13 levels positively and significantly correlated with inflammatory scores. Therefore, CDI is associated with enhanced release of CXCL13. This study indicated that CXCL13 may be pathogenically involved in CDI and served as a potential new biomarker for diagnosis and prognosis in CDI.
Candida albicans is the leading cause of healthcare associated bloodstream infections. Chemokine CXCL13 is well-known involved in inflammation, but its role in candidemia has not been assessed. Our ...study firstly demonstrated that serum CXCL13 levels were significantly elevated in candidemic patients compared with bacteremic patients and control subjects by ELISA, and CXCL13 concentrations were positively and significantly correlated with clinical Sequential Organ Failure Assessment (SOFA) scores and several laboratory parameters in patients. Moreover, ROC curve analysis showed the diagnostic efficiency of CXCL13 was superior to CRP and PCT. To further study the role of CXCL13, a mouse model was established. Importantly, the data showed the dramatically elevated levels of CXCL13 in mice serum and infected kidney, were significantly correlated with renal fungal burden and pathology scores. In conclusion, our results indicated that CXCL13 had strong potential as a novel biomarker of diagnosis and prognosis for candidemia.
•Serum CXCL13 expression were significantly elevated in patients with systemic candidiasis.•CXCL13 levels were significantly correlated with clinical SOFA score and laboratory parameters in candidemia patients.•CXCL13 concentrations in serum and infected kidney were significantly increased in the mouse model of systemic candidiasis.•CXCL13 may be as a novel biomarker of diagnosis and prognosis for candidemia.
A sensitive and accurate ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) method was developed and validated for the determination of EVT201 and its two ...metabolites, Ro46-1927 and Ro18-5528, in human urine. Different sample preparation methods were compared, and solid-phase extraction (SPE) was finally employed. Separation conditions and mass spectrometry parameters were optimized to achieve complete separation and enough sensitivity. Finally, the three analytes were separated on an Acquity BEH C18 column (2.1 mm × 50 mm, 1.7 μm) with a gradient mobile phase. The gradient elution consisted of acetonitrile (containing 0.1% formic acid) and 10 mM ammonium formate (containing 1% acetonitrile and 0.1% formic acid) at a flow rate of 0.50 mL/min. Detection was performed on an electrospray ionization (ESI) source in positive mode with multiple reaction monitoring (MRM). The method was fully validated in accordance with the bioanalysis guidance in Chinese Pharmacopoeia. It showed satisfying linearity, accuracy, and precision in the range of 0.2–200 ng/mL for all the three analytes. The mean extraction recoveries were 85.2%, 65.6%, 87.9%, and 86.4% for EVT201, Ro46-1927, Ro18-5528, and the IS, respectively. The method was successfully applied to the bioanalysis of 833 urine samples to determine the concentration of EVT201 and its two metabolites simultaneously.
The goal was to investigate the prevalence of acute kidney injury (AKI) after total arch replacement with frozen elephant trunk procedure, which was achieved by antegrade cerebral perfusion and ...moderate hypothermic circulatory arrest (MHCA) or deep hypothermic circulatory arrest (DHCA) among patients with type A aortic dissection.
Overall, 627 adult type A aortic dissection patients who underwent total arch replacement with frozen elephant trunk from January 2013 until December 2016 at Fuwai Hospital were divided into the DHCA (14.1-20.0°C) and MHCA (20.1-28.0°C) groups. Postoperative AKI as the primary outcome was compared using propensity-matched scoring.
Overall, 340 (54.2%) and 287 (45.8%) patients underwent DHCA and MHCA, respectively. The overall incidence of AKI was 75.4%. Age odds ratio (OR) 1.02, 95% confidence interval (CI) 1.00-1.04; P = 0.022, body mass index (OR 1.06, 95% CI 1.01-1.12; P = 0.016), cardiopulmonary bypass duration (OR 1.01, 95% CI 1.00-1.01; P = 0.003) and hypertension history (OR 1.76, 95% CI 1.14-2.70; P = 0.010) were identified as independent risk factors for AKI onset with multivariable analysis. Postoperative AKI was not significantly different between the DHCA and MHCA groups regardless of the overall or propensity-matched cohort (overall data: P = 0.17; propensity score data: P = 0.88). Patients with MHCA experienced higher rates of postoperative stroke after propensity score analysis (DHCA 0.9% vs MHCA 3.7%; P = 0.034).
MHCA was not superior to DHCA in decreasing postoperative AKI. Thus, MHCA should not definitively replace DHCA.
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