The concept of textbook outcomes (TOs) has gained increased attention as a critical metric to assess the quality and success of outcomes following complex surgery. A simple yet effective scoring ...system was developed and validated to predict risk of not achieving textbook outcomes (non-TOs) following hepatectomy for hepatocellular carcinoma (HCC).
Using a multicenter prospectively collected database, risk factors associated with non-TO among patients who underwent hepatectomy for HCC were identified. A predictive scoring system based on factors identified from multivariate regression analysis was used to risk stratify patients relative to non-TO. The score was developed using 70 % of the overall cohort and validated in the remaining 30 %.
Among 3681 patients, 1458 (39.6 %) failied to experience a TO. Based on the derivation cohort, obesity, American Society of Anaesthesiologists score(ASA score), Child-Pugh grade, tumor size, and extent of hepatectomy were identified as independent predictors of non-TO. The scoring system ranged from 0 to 10 points. Patients were categorized into low (0–3 points), intermediate (4–6 points), and high risk (7–10 points) of non-TO. In the validation cohort, the predicted risk of developing non-TOs was 39.0 %, which closely matched the observed risk of 39.9 %. There were no differences among the predicted and observed risks within the different risk categories.
A novel scoring system was able to predict risk of non-TO accurately following hepatectomy for HCC. The score may enable early identification of individuals at risk of adverse outcomes and inform surgical decision-making, and quality improvement initiatives.
In this paper, a second-order consensus problem is investigated for the heterogeneous agents in the cooperation–competition network, with the parameters of the agents’ dynamics being uncertain. By ...introducing an exosystem, a hybrid adaptive and pinning control strategy is firstly proposed to ensure that all the agents follow a desired trajectory which is a function of the exosystem state. Several effective sufficient conditions are obtained by applying algebraic graph theory and the Barbalat lemma. Besides, the switching topologies between the competition agents are also considered. With the help of the Barbalat-like lemma, it is found that second-order consensus problem of the heterogeneous agents can be solved even when the competition sub-network is dynamic. Finally, simulation results are presented to validate the effectiveness of the theoretical analysis.
Lupus nephritis (LN) is a common and severe complication of systemic lupus erythematosus. Without intervention, LN may cause acute kidney injury and end‐stage renal disease. This study aims to ...determine whether microRNA‐485 (miR‐485) affects renal tubular epithelial cells (RTECs) in LN mice via the TGF‐β‐MAPK signaling pathway by targeting RhoA. Renal tissue samples were initially extracted from 15 LN and 15 normal mice. RTECs were cultivated in vitro and grouped after transfection of different mimics, inhibitors, or siRNA‐
RhoA. The target gene of miR‐485 was confirmed by dual‐luciferase reporter assay. Flow cytometry and MTT assay were applied to detect cell viability and apoptosis. It was determined that RhoA was a target gene of miR‐485. We found that urine protein, creatinine, RhoA, interleukin 6 (IL‐6), transforming growth factor‐β1 (TGF‐β1), and p38 mitogen‐activated protein kinases (p38MAPK) were highly expressed in renal tissues of LN mice, while poor levels of miR‐485 were recorded. The overexpression of miR‐485 or siRNA‐
RhoA or the combination of miR‐485 and siRNA‐
RhoA was demonstrated to lead to a reduction of levels of RhoA, IL‐6, TGF‐β, and p38MAPK, as well as a promotion of RTECs proliferation and inhibition of RTECs apoptosis. Taken together, these findings indicated that overexpressed miR‐485 downregulates RhoA which could promote cell viability and inhibit apoptosis of RTECs by regulating the RhoA‐mediated TGF‐β‐MAPK signaling pathway in LN mice.
These findings indicate that overexpressed miR‐485 induces downregulated RhoA which could promote viability and inhibit apoptosis of RTECs by regulating TGF‐β‐MAPK signaling pathway in LN mice. LN mice show abnormal morphology of the renal tissues, higher apoptosis index (AI), and increased positive level of RhoA protein, detected by HE staining, TUNEL staining, and immunohistochemistry. (A) Images of renal tissues in normal mice and LN mice using HE staining (×400); renal tissues in LN mice show obvious pathological changes. (B) TUNEL staining shows that the apoptosis index of LN mice is significantly higher than that in normal mice (×200). (C) Western blot assay shows that the relative protein expression of RhoA in the LN group is significantly higher than the normal group. (D) High positive expression rate of RhoA protein is observed in renal tissues of LN mice, determined by immunohistochemistry (×400). *P < .05 vs the normal group. AI, apoptosis index; GAPDH, glyceraldehyde 3‐phosphate dehydrogenase; HE, hematoxylin eosin; LN, lupus nephritis; TUNEL, terminal deoxynucleotidyl transferase (TdT)‐mediated dUTP nick end labeling.
The key factors governing the single-phase or multi-phase structural change behaviors during the intercalation/deintercalation of guest ions have not been well studied and understood yet. Through ...systematic studies of orthorhombic Fe2(MoO4)3 electrode, two distinct guest ion occupation paths, namely discrete one for Li and pseudo-continuous one for Na, as well as their relationship with single-phase and two-phase modes for Na(+) and Li(+), respectively during the intercalation/deintercalation process have been demonstrated. For the first time, the direct atomic-scale observation of biphasic domains (discrete occupation) in partially lithiated Fe2(MoO4)3 and the one by one Na occupation (pseudo-continuous occupation) at 8d sites in partially sodiated Fe2(MoO4)3 are obtained during the discharge processes of Li/Fe2(MoO4)3 and Na/Fe2(MoO4)3 cells respectively. Our combined experimental and theoretical studies bring the new insights for the research and development of intercalation compounds as electrode materials for secondary batteries.
Abstract Lupus nephritis (LN) is a common and severe complication of systemic lupus erythematosus. Without intervention, LN may cause acute kidney injury and end‐stage renal disease. This study aims ...to determine whether microRNA‐485 (miR‐485) affects renal tubular epithelial cells (RTECs) in LN mice via the TGF‐β‐MAPK signaling pathway by targeting RhoA . Renal tissue samples were initially extracted from 15 LN and 15 normal mice. RTECs were cultivated in vitro and grouped after transfection of different mimics, inhibitors, or siRNA‐ RhoA . The target gene of miR‐485 was confirmed by dual‐luciferase reporter assay. Flow cytometry and MTT assay were applied to detect cell viability and apoptosis. It was determined that RhoA was a target gene of miR‐485. We found that urine protein, creatinine, RhoA, interleukin 6 (IL‐6), transforming growth factor‐β1 (TGF‐β1), and p38 mitogen‐activated protein kinases (p38MAPK) were highly expressed in renal tissues of LN mice, while poor levels of miR‐485 were recorded. The overexpression of miR‐485 or siRNA‐ RhoA or the combination of miR‐485 and siRNA‐ RhoA was demonstrated to lead to a reduction of levels of RhoA, IL‐6, TGF‐β, and p38MAPK, as well as a promotion of RTECs proliferation and inhibition of RTECs apoptosis. Taken together, these findings indicated that overexpressed miR‐485 downregulates RhoA which could promote cell viability and inhibit apoptosis of RTECs by regulating the RhoA‐mediated TGF‐β‐MAPK signaling pathway in LN mice.
Background:
Preparation of del-Nido cardioplegia and its delivery technique can cause significant hemodilution. The resultant effects from hemodilution are largely proportionate to the use of a dual ...circuit. We opted for a custom-disposable single cardioplegia circuit instead of a dual circuit.
Methods:
We describe an alternative technique of del-Nido cardioplegia delivery and initial clinical experience with it at National University Hospital, Singapore. This is a retrospective analysis of data from January 2017 to April 2019, comprising of 177 patients of heart surgery and reflecting a single center database survey under the National Health Care Group.
Results:
Of the 177 patients who underwent surgery with del-Nido cardioplegia, 76 (42.9%) were valve-only procedures and 5 (2.8%) were coronary artery bypass graft–only procedures. Ultrafiltration was utilized in 132 (62.6%) patients, whereas filtrate volume was 2200 150-9500 mL. The alternative technique of del-Nido cardioplegia delivery adopted by National University Hospital advocates for a single pump, single circuit system. The retrospective institutional data highlighted safe delivery of del-Nido cardioplegia using this technique in a range of procedures.
Conclusion:
Besides the safe delivery of del-Nido cardioplegia, the National University Hospital Technique reduces hemodilution and provides other technical benefits including a steeper temperature gradient, modification of circuit configuration to deliver another cardioplegia while on bypass, as well as re-configuration of clamps to spike the base solution.
Berberrubine （BRB） is the primary metabolite of berberine （BBR） that has shown a stronger glucose-lowering effect than BBR in vivo. On the other hand, BRB is quickly and extensively metabolized into ...berberrubine-9-O-β-D-glucuronide （BRBG） in rats after oral administration. In this study we compared the pharmacokinetic properties of BRB and BRBG in rats, and explored the mechanisms underlying their glucose-lowering activities. C57BL/6 mice with HFD-induced hyperglycemia were administered BRB （50 mg·kg^-1·d^-1, ig） for 6 weeks, which caused greater reduction in the plasma glucose levels than those caused by BBR （120 mg·kg^-1·d^-1） or BRB （25 mg·kg^-1·d^-1）. In addition, BRB dose-dependently decreased the activity of α-glucosidase in gut of the mice. After oral administration of BRB in rats, the exposures of BRBG in plasma at 3 different dosages （10, 40, 80 mg/kg） and in urine at different time intervals （0-4, 4-10, 10-24 h） were dramatically greater than those of BRB. In order to determine the effectiveness of BRBG in reducing glucose levels, we prepared BRBG from the urine pool of rats, and identified and confirmed it through LC-MS-IT-TOF and NMR spectra. In human normal liver cell line 1_-02 in vitro, treatment with BRB or BRBG （5, 20, 50 pmol/L） increased glucose consumption, enhanced glycogenesis, stimulated the uptake of the glucose analog 2-NBDG, and modulated the mRNA levels of glucose-6-phosphatase and hexokinase. However, both BBR and BRB improved 2-NBDG uptake in insulin-resistant L-02 cells, while BRBG has no effect. In conclusion, BRB exerts a stronger glucose-lowering effect than BBR in HFD-induced hyperglycemia mice. Although BRB significantly stimulated the insulin sensitivity and glycolysis in vitro, BRBG may have a greater contribution to the glucose-lowering effect because it has much greater system exposure than BRB after oral administration of BRB. The results suggest that BRBG is a potential agent for reducing glucose levels.
Although the increased prevalence of Parkinson’s disease (PD) with aging suggests that aging processes predispose dopamine neurons to degeneration, the mechanism involved remains unknown. Dopamine ...neurons contain significant amounts of neuromelanin, and the amount of neuromelanin increases with aging. In the present study, age-related changes in the number of nigral neurons expressing neuromelanin (NM), α-synuclein, and tyrosine hydroxylase (TH) were stereologically analyzed in the postmortem brains of 28 healthy humans with an age range of 17–84 years. Stereological counting of NM content, α-synuclein content, and TH immunoreactivity revealed significant accumulation of NM and α-synuclein in neurons during the aging process. In cells containing a large amount of NM, α-synuclein-immunoreactive cells in aged individuals outnumbered those of younger individuals. In non-NM cells, the α-synuclein expression profile was similar across age groups. Furthermore, TH-immunoreactive neurons decreased significantly with aging, which was associated with accumulation of NM and α-synuclein. Our results suggest that age related accumulation of NM might induce α-synuclein over-expression and thereby make dopamine neurons more vulnerable to injuries.
Modern Open Source Software (OSS) projects depend on the globally-distributed and synchronized software development. The online collaboration promotes more and more developers to join in OSS ...projects, while on the other hand, integrating new developers with teams is challenging and pivotal to the success of a project. In this paper, we propose a novel expert recommendation method, based on knowledge embedding, that realizes real-time recommendation for working developers. To capture structural information of source files in call graph, we use node2vec algorithm to convert file entities within projects into knowledge mappings within low-dimensional space, based on which we further propose four features to capture the work status and social relationship of developers. We then design a recommender system using random forest method to recommend appropriate experts for the developers. Experiments on 20 Apache OSS projects show that, compared with the baseline methods, our approach behaves significantly better in terms of a series of performance metrics.
Although the increased prevalence of Parkinson's disease (PD) with aging suggests that aging processes predispose dopamine neurons to degeneration, the mechanism involved remains unknown. Dopamine ...neurons contain significant amounts of neuromelanin, and the amount of neuromelanin increases with aging. In the present study, age-related changes in the number of nigral neurons expressing neuromelanin (NM), α-synuclein, and tyrosine hydroxylase (TH) were stereologically analyzed in the postmortem brains of 28 healthy humans with an age range of 17-84 years. Stereological counting of NM content, α-synuclein content, and TH immunoreactivity revealed significant accumulation of NM and α-synuclein in neurons during the aging process. In cells containing a large amount of NM, α-synuclein-immunoreactive cells in aged individuals outnumbered those of younger individuals. In non-NM cells, the α-synuclein expression profile was similar across age groups. Furthermore, TH-immunoreactive neurons decreased significantly with aging, which was associated with accumulation of NM and α-synuclein. Our results suggest that age related accumulation of NM might induce α-synuclein over-expression and thereby make dopamine neurons more vulnerable to injuries.PUBLICATION ABSTRACT
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